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This study investigated vocational students' mental health by identifying the prevalence of depression, stress, anxiety, eating disorders and associated risk and protective factors among 16- to 18-year-old students attending a vocational college in Malta. Health Related Quality of Life (HRQOL) was also investigated. A sample of 422 students completed standardised self-report mental health tools and a demographic and personal variables' questionnaire. A total of 64.4% of students were found to be struggling with at least one of the mental health conditions assessed while 36.7% reported a suspected eating disorder. The prevalence rates of depression, anxiety and stress (moderate, severe or extremely severe) were 43.3%, 48.8% and 29.3% respectively. Students had a lower HRQOL than the reference population as indicated by European norm data. Only 13.5% of participants sought help from mental health services. Risk factors include female gender, poverty, being LGBTQ, not living with both parents, past negative school experiences, poor relationships and presence of suspected or diagnosed conditions or disabilities, amongst others. Having supportive relationships with family, peers and school personnel emerged as protective factors.

Occupational therapists play a vital role in the care of individuals with feeding, eating, and swallowing (FES) disorders across the lifespan. Although there are certain standards created by the Accreditation Council of Occupational Therapy (ACOTE) for understanding of assessment and management practices specific to FES, there are inconsistencies in how occupational therapy programs in the United States address FES disorders within their curriculum. This cross-sectional exploratory survey study received responses from 54 Master of Occupational Therapy (MSOT) programs and 63 entry-level Occupational Therapy Doctoral (OTD) programs. Survey questions included quantitative and qualitative information on general information regarding FES content taught within the program. Survey results indicated only 4.8% of programs had a course dedicated to FES disorders and an average of 6.37 hours were dedicated to FES across the lifespan. Chi-squared tests for independence demonstrated a significant difference between pediatric educational hours over adult occupational therapy educational hours in FES (p<0.001). There was no significant difference however between the number of hours dedicated to FES between MSOT and OTD programs (p=0.146). The results question the adequacy of educational hours dedicated to FES management across the lifespan. In order for occupational therapy practitioners to bring their inherent value in contributing holistically to assessment and management of FES disorders, therapists must have knowledge and confidence in their skills. Ensuring that entry-level occupational therapists are adequately prepared to evaluate and treat individuals with FES disorders is imperative for the profession to remain liable and competent in the field of FES. While occupational therapy education programs are meeting the ACOTE dysphagia standard, the question remains if the number of hours programs are dedicating is enough to ensure entry level competency, as well as enough to compete with speech and language pathologists.

The objective of this study was to explore the role that Autistic identity, sensory processing and camouflaging behaviours have on eating disorder symptomology in Autistic adults. Previous research has focused on cognitive and sensory factors to explain the association between autism and eating disorders, but the roles of social identity and camouflaging are yet to be explored. Autistic participants (N = 180) were recruited from NHS settings and community groups. The participants completed online questionnaires measuring autistic identity, camouflaging behaviours, sensory processing, autistic traits and eating disorder symptoms. Multiple regression revealed that camouflaging significantly predicted eating disorder symptoms. Although sensory processing was related, it did not significantly predict eating disorder symptom severity. In addition, there was no significant relationship between autistic identity and eating disorder symptom severity. This study highlights the impact that camouflaging behaviours and sensory processing can have on eating disorder symptomatology in autism and may indicate important considerations for the treatment of eating disorders in Autistic people.

Inappropriate mealtime behavior (IMB) is a type of feeding challenge within the broader class of food refusal. The purpose of this study was to critically analyze the efficacy of interventions for the treatment of IMB through a meta-analysis of research using single-case experimental designs. We examined the extent to which different interventions resulted in decreases in IMB while also producing increases in food acceptance. This meta-analysis was also used to examine the efficiency of different interventions in achieving clinical significance. We identified 38 studies involving 266 cases in which IMB was treated with a behavioral intervention. The results indicated interventions that combined escape extinction and non-escape extinction had greater effect sizes for both reducing IMB and increasing food acceptance than either escape extinction alone or non-escape extinction alone. However, interventions that included escape extinction were slightly less efficient at decreasing IMB than were interventions that did not include escape extinction. We discuss the implications of these findings and provide recommendations for future research.

Timely diagnosis of dysphagia is important for people with an intellectual disability. Periodic screening of each individual by speech-language therapists is barely feasible with respect to limited resources. Therefore, preselection of individuals with an increased dysphagia risk through screening by caregivers is crucial. This study aimed to develop the novel "Screening instrument for Dysphagia for people with an Intellectual Disability" (SD-ID).The SD-ID was developed, validated and optimised in two rounds. Version 3, consisting of nine risk factors and 20 items concerning eating/drinking behaviour, was thoroughly studied for feasibility, concurrent validity and reliability, and then optimised. The SD-ID (version 3) was filled out in an average of four minutes (feasibility). A strong positive association was found between scores on SD-ID and Dysphagia Disorder Survey (concurrent validity). Test-retest and interrater reliability were very good. Two additional risk factors were added and two items removed to yield the final version 4. The most optimal cut-off score appeared to be either 4 or 5.The SD-ID is a reliable instrument to screen for an increased risk of dysphagia in people with an intellectual disability. Ideally it is part of a cyclic work process: Screening with SD-ID (step 1), diagnostic work-up if necessary (step 2), recommendations (step 3), and evaluation (step 4).

Pediatric feeding disorders are common and are often associated with chronic medical conditions and developmental disorders. A multidisciplinary treatment approach may be offered through outpatient or intensive programs. Benefit has been demonstrated with intensive programs, but there is little data regarding outpatient approaches. We described outcomes from a well-established outpatient feeding assessment program related to the referral base and program outcomes. Study packets collecting demographics and self-reported feeding skills were distributed to the referral population and redistributed three months later. Standardized surveys implemented included Montreal Children's Hospital Feeding Scale (MCH-FS) and parenting stress index (PSI-SF). One hundred and ninety-eight subjects completed the initial packet. MCH-FS was elevated in all subjects indicating a broad range of feeding concerns. PSI elevation was present in a broad range of comorbidities compared to group without comorbidities. At 3 months (n = 55), MCH-FS and feeding skills improved without change in PSI-SF. The quality of therapy overall was deemed excellent to above average by most subjects. A multidisciplinary outpatient program has a role in managing infants and children with feeding disorders regardless of comorbidity. Severely affected individuals may benefit from more intensive programs and/or may require long-term care to effect significant change.

Background: Dysphagia affects over half of adults after stroke. Dysphagia rehabilitation aims to improve swallowing and reduce negative outcomes for these adults. However, significant variability exists in dysphagia rehabilitation. Research is needed to explore the underlying clinician-specific and workplace factors that contribute to variability in dysphagia rehabilitation after stroke. Aim: To explore factors influencing speech pathology practice in dysphagia rehabilitation after stroke. Methods & Procedures: We used a phenomenological approach with an interpretivist perspective. Twenty speech pathologists working in dysphagia rehabilitation participated from different workplace settings around Australia. Five semi-structured focus groups were conducted online. Data were inductively analysed using thematic analysis with a coding reliability method. Outcomes & Results: Four themes were discussed within focus groups: (1) relationship between experienced and less experienced clinicians: 'Following what other people have done', (2) need for collaborative learning: 'A safe space to share and train', (3) variation between settings impacts on continuity of care: 'There's a difference between community and acute', and (4) working effectively with multidisciplinary teams (MDT): 'An MDT which can listen to the voice of speech pathology'. Conclusions & Implications: Relationships between senior and junior speech pathologists, within speech pathology and MDT, and across inpatient and community settings influenced speech pathology practice. Flattened hierarchies in speech pathology, collaborative learning in workplaces, mutual respect within teams and connection across inpatient and community settings could improve the quality and consistency of dysphagia rehabilitation after stroke.

Introduction: Dysphagia affects up to 70% of care home residents, increasing morbidity and hospital admissions. Speech and language therapists make recommendations to support safe nutrition but have limited capacity to offer ongoing guidance. This study aimed to understand if recommendations made to support safe and effective care are implemented and how these relate to the actual care delivered. Methods: Eleven mealtimes with residents with dysphagia were observed during 2020 using a tool capturing 12 elements of expected practice. Staff actions during mealtimes were compared with adherence to residents' care plans and speech and language therapist recommendations. Results: Written recommendations predominantly focused on food and fluid modification. Observations (n = 66) revealed food texture, posture, and alertness were adhered to on 90% of occasions, but alternating food and drink, prompting and ensuring swallow completed adherence was less than 60%. Thickened fluids frequently did not align with required International Dysphagia Diet Standardisation Initiative levels. Nutrition care provided in the dining room was less safe due to a lack of designated supervision. Conclusion: Care homes need to be supported to establish a safe swallowing culture to improve residents' safety and care experience.

Background: People with intellectual disability frequently have eating, drinking and swallowing difficulties (dysphagia) and are at greater risk of premature mortality, particularly from aspiration and respiratory infections. The insertion of a percutaneous endoscopic gastrostomy (PEG), as part of a multidisciplinary management plan, may help to maintain and improve nutrition. This study included people with intellectual disability who had ever had a PEG inserted and who presented to the specialist Speech and Language Therapy team in one Greater Manchester borough between 2000 and 2022 and assessed the risk of death and sociodemographic and clinical factors associated with this. Methods: This was a cohort study using secondary data. Kaplan--Meier estimates were used to construct the probability of mortality curves. Cox proportional hazards were used to compare death rates in the different sociodemographic and clinical characteristic groups and were presented as hazard ratios and 95% confidence intervals. Findings: Of 42 people included in the study, 18 (43%) died from the point of PEG insertion to the end of the study (December 2022). The median (interquartile range) time to death from PEG insertion was 5 (2-10) years, with four people (10%) dying in the first year. Aspiration pneumonia and unspecified pneumonia were responsible for seven (39%) deaths. No significant associations were found between sociodemographic and clinical factors and risk of death. Conclusion: In persons with intellectual disability and a PEG who were followed up between 2000 and 2022, the mortality was around 40% with deaths occurring in the first year and respiratory conditions being an important cause. The lack of association with sociodemographic and clinical characteristics may have been due to a limited sample size. Further research is needed with larger samples and more variables, including quality of life data, to help understand and improve clinical practice in this area.

Eating disorders are serious mental health conditions that impact many school-age youth. School psychologists are likely to encounter students with eating disorders. However, with limited training in this area, practitioners may feel intimidated about responding appropriately while practicing within the boundaries of their competence. Students and families deserve evidence-based care from highly trained specialists coupled with collaboration from school-based mental health care teams, especially because of the heightened mortality risk of eating disorders (Fichter & Quadflieg, 2016). This often means that the school-based mental health professional will not be the primary provider. Rather, schools can collaborate with comprehensive eating disorder centers or individual specialists to support care. This article presents lessons the authors learned from clinical experience as practitioners and provides recommendations for supporting students and families affected by disordered eating.

Background: Person-centred services are inherently related to patients/caregivers' needs. However, the extent to which dysphagia services within Singapore meet consumer needs is largely unknown. Involving patients/caregivers in service evaluation/redesign deepens the understanding of consumer needs. This process also increases the success of implementing service enhancements through relevant and meaningful change. Aim: This study aimed to identify aspects of dysphagia services, within acute and subacute settings in Singapore, perceived as highly important and easy to change by patients/caregivers. Methods & Procedures: Using concept mapping methodology, 5 patients and 11 caregivers reflected on their experiences of receiving dysphagia care and proposed 59 unique suggestions to improve dysphagia services within Singapore. Then, each individual sorted the suggestions into groups based on similarity and rated each statement for its perceived importance and changeability for service enhancement. Data were analysed using multidimensional scaling, hierarchical cluster analysis, and bivariate analysis to generate clusters of conceptually similar suggestions and a prioritised list of suggestions for service enhancement. Results: Twelve clusters were identified, with most rated as more important than changeable for service improvement. Participants prioritised 23 (39%) of the suggestions as highly important and easy to change, and these focused on ensuring effective communication among consumers and healthcare team, enhancing patients and carers' access to support at home, increasing patients and carers' access to educational resources, and improving service quality and access through technology. Conclusion: These findings provide future directions on how to develop and implement dysphagia services in Singapore to better meet the needs of patients/caregivers.

Implementation support for prevention interventions is receiving increased attention, as many organizations receive training in evidence-based practices but do not deliver the interventions optimally. The "Body Project," a four-session program, significantly reduces eating disorder symptoms and future disorder onset among group participants when delivered by peer educators at colleges/universities. Costs and cost-effectiveness of the program were examined using data from a randomized trial that compared three levels of implementation support at 63 colleges: (1) a train-the-trainer (TTT) workshop alone; (2) TTT plus a technical assistance (TA) workshop; or (3) TTT plus TA plus monthly quality assurance (QA) consultations. Effectiveness was measured by the production of reliable change in eating disorder symptoms from pretest to posttest. Costs and cost-effectiveness of two levels of implementation support are reported, comparing TTT-only with TTT + TA + QA (effectiveness of the TTT + TA condition did not differ from TTT-only) and using results from an earlier study as a proxy for a no-treatment control. Two perspectives are considered: a sponsoring organization providing the training at multiple sites and a college delivering the intervention to its eligible students. From the perspective of a sponsoring organization, adding both the TA training and QA support improves the cost-effectiveness per eligible student receiving the intervention. From the perspective of costs for a college to deliver the intervention, receiving TA training and QA support is also more cost-effective than the training workshop alone, whether the peer educators are paid or unpaid and whether costs of group supervision are included or excluded. Results converge with previous research showing that more intensive implementation support can be more cost-effective.

Feeding disorders can be quite complex, with medical concerns, anatomical abnormalities, skill deficits, and behavioral or environmental components contributing to the development and maintenance of significant feeding concerns. Because of this, an interdisciplinary approach to assessment and treatment is oftentimes warranted. Within the current study, a 4-year-old boy with autism spectrum disorder and oral phase dysphagia, who also met criteria for pediatric feeding disorder, presented with severe food selectivity and baby bottle dependence. Behavioral concerns as well as oral motor deficits were identified as contributing to his lack of food acceptance. While there are various behavioral treatments to increase food acceptance and decrease problem behaviors during mealtimes in children with feeding disorders (e.g., nonremoval of the spoon, alternative methods of food deposit), these treatments may not be effective for children with co-morbid oral motor deficits, or the use of such behavioral treatments may perpetuate oral motor deficits. Therefore, herein we evaluate the effectiveness of a lip closure prompt, in combination with a behavioral treatment package, at increasing food acceptance in a child with a feeding disorder who did not demonstrate lip closure on a spoon. Following this combined treatment approach, the child began accepting bites from a spoon and the lip closure prompt was faded out. The effectiveness of this combined treatment approach, as well as implications for future research and treatment in pediatric feeding disorders, is discussed.

Since the international declaration of the COVID-19 pandemic in 2020, the life of the world population has had significant repercussions in all areas, mainly in health. Also, there have been a large number of changes in people's lives, which have modified routines, relationships, habits, family economy, work environments and in the population of children, adolescents and young adults their school environment. The educational system was forced, thanks to confinement, to move from school classrooms to family homes using the devices available according to the economic level of each one. This resulted in the modification of study habits in students, affecting routines, moods and personal relationships, among others. This article presents a study on the psychosocial conditions that the students of the Universidad Tecnológica de Torreón have presented before, during the confinement and the new normality of the pandemic, in which significant changes (p < 0.05) were found. The results obtained are a tool that elucidates the aspects to care and keep track of our student population to avoid reaching a stronger problem. In addition to creating and/or strengthening learning strategies that help the student to have a comprehensive life within the university

Objective: College men may be at risk for binge eating (BE) but are underrepresented in research. This study aimed to examine if body weight/shape concerns, perceived stress, and psychological distress significantly contributed to the likelihood of BE over the past 28 days. Participants: A racially/ethnically diverse sample (N = 873) of college men. Method: An anonymous online survey was administered. Logistic regression analysis was conducted to examine the hypothesized associations for the entire sample, and exploratory analyses were conducted within each racial/ethnic group. Results: The model explained approximately 25% of the variance in BE, with body weight/shape concerns as the only significant predictor in the overall sample and for the White, Black, and Asian subsamples; none of the variables were significant among Latino men. Conclusions: Body weight/shape concerns predict BE among diverse college men. The findings have implications for future research, as well as for prevention and intervention for college men.

Objective: To examine whether sexual assault prospectively predicts unhealthy weight management behaviors in college women. Method: Participants were female college students (N = 483) with monthly assessments across the first year, including the frequency and severity of sexual assault and unhealthy weight management behaviors. Results: Frequency of sexual assault prior to college predicted dieting, purging, and diet pill use, over the first year. Severity of those experiences predicted dieting and diet pill use. Frequency of sexual assault during the first semester predicted purging and diet pill use during the second semester. Severity predicted all three unhealthy weight management behaviors. Findings held consistently when controlling for socioeconomic status (SES), race/ethnicity, body mass index (BMI), and pre-college mood, anxiety, and eating disorders, as well as unhealthy weight management behaviors during the first semester in longitudinal analyses. Reverse models were non-significant. Conclusions: This research documents the detrimental effects of sexual assault on unhealthy weight management behaviors in college women, and highlights the importance of prevention and intervention.

Objective: To compare the prevalence and trajectories of risky health behaviors in sexual minority (SM; lesbian/gay/bisexual/questioning/asexual) versus heterosexual undergraduates across their first year of post-secondary. Participants: First-year undergraduates (N = 704, M[subscript age] = 17.97 years, 24% SM) from a midsized Canadian university. Methods: Students completed monthly (September-April) online questionnaires assessing substance use (binge drinking, tobacco, cannabis, illicit drug use) and disordered eating (binge eating, fasting, purging). Results: At the outset of the academic year, SM students endorsed more frequent cannabis use, illicit drug use, fasting, and binge eating, but less frequent tobacco use, versus heterosexual students. Over the year, SM students' binge drinking frequency declined less than that of heterosexual students, but their illicit drug use decreased while that of their heterosexual peers increased, and all students reported declining disordered eating frequency. Conclusions: Campus wellness initiatives for SM students should offer prevention and harm-reduction strategies prior to or shortly after their arrival on campus.

Research has shown that Physical Education (PE) is a white, male, and able body-dominated profession, particularly in Spain. When some female pre-service PE teachers, who had a difficult relationship with their bodies and sports abilities, enrol in such a degree, some of these problematic relations come to light. Participants for this study were four female pre-service teachers who self-identified as lesbian, anorexic, visually impaired, and big respectively. Data were collected through participant-produced texts, graphical representations, and interviews. The authors then reconstructed the participants' stories which are presented in the form of narratives. The conceptual tool of embodying norm-criticality helped us to highlight the importance of critical reflection about own beliefs, past experiences and understandings, and their influence on pedagogical practices in PE. This study contributes to the push towards a change of the stereotypical beliefs of what a PE teacher should be or look like, and in this way, emphasises the vast benefits of diversifying PE teachers' beliefs and understandings.

Objective: College students with disordered eating (DE) are at increased risk of body focused repetitive behaviors (BFRBs). Both DE and BFRBs are described as impulsive and compulsive. However, the associations of impulsive DE with impulsive BFRBs and compulsive DE with compulsive BFRBs have not been examined. Methods: 191 college-aged students completed a survey of BFRBs and DE. Results: Participants who reported hair pulling were twice as likely to report clinically significant DE than those who denied hair pulling (p = 0.022). Participants who endorsed distressing hair pulling (p = 0.026), skin picking (p =0.052), and nail biting (p = 0.094) were twice as likely to report clinically significant DE than those who were not distressed by these behaviors. Evidence did not support the association of BFRBs and DE along an impulsive/compulsive continuum. Conclusions: Results suggest that BFRBs and DE often co-occur, and the role of impulsivity and compulsivity in these behaviors is complex.

This study aimed to evaluate the frequency of sleep and eating problems in children with autism spectrum disorder (ASD), the factors associated with these problems, and the relationship with the risk of developing depression and anxiety in their parents. In the study, 156 children with ASD and their parents were included. The Brief Autism Mealtime Behavior Inventory (BAMBI), the Children's Sleep Habits Questionnaire (CSHQ), the Hospital Anxiety Depression Scale (HADS) were completed by the parents. The Childhood Autism Rating Scale (CARS) was administered by the researchers to evaluate the severity of ASD in children. The mean age of children was 8.08 ± 2.84, and 87.2% of the children were male. The mean score of CARS was 41.25 ± 6.16, the mean score of BAMBI was 45.67 ± 11.87, and the mean score of CSHQ was 51.67 ± 10.17. According to the CSHQ, 83.3% of the children had sleep problems. The response rate above the cut-off point in the HAD-A subscale was 59.6%, whereas it was 67.3% in the HAD-D subscale. There was a positive correlation between CARS and BAMBI, CSHQ, HAD-A, and HAD-D subscales. There was a positive correlation between BAMBI and CHSQ, HAD-A, and HAD-D subscales. There was a positive correlation between the CSHQ, HAD-A, and HAD-D subscales. There was a negative correlation between the age of the child with ASD, food refusal, and resistance to bedtime. As sleeping and eating problems affect a large portion of children diagnosed with ASD and their caregivers, large population-based studies evaluating both these problems must be designed and carried out to understand factors affecting the prevalence, development, and persistence of sleeping and eating problems and to determine interventions to reduce these issues.

Even when raters demonstrate agreement in the use of a measure, limited score variability or violation of often-ignored statistical assumptions can result in lower reliability estimates than intuitively expected. This article uses data drawn from two randomized controlled trials of schema therapy and cognitive behavioral therapy for the treatment of major depression and binge eating disorder or bulimia nervosa (N = 212) to illustrate the limits of the intraclass coefficient. Randomly selected therapy sessions were rated for therapeutic alliance quality by independent observers using the well-validated Vanderbilt Psychotherapy Process Scale and Vanderbilt Therapeutic Alliance Scale. Scores on subscales related to therapist behavior were restricted, indicating consistent alliance-supportive actions. Inter-rater reliability estimates were low despite high agreement between raters, however. The use of Bland-Altman plots to visualize agreement and data spread is suggested as a useful tool for researchers, consistent with the ideal of exploring reliability from a number of perspectives.

Mealtime is an essential occupation that occurs daily in the school setting for all learners. This study explored how school occupational therapy practitioners address mealtime challenges using a one-group, convergent mixed methods design. Participants were school occupational therapy practitioners who service pre-K to 5th-grade students. Data were collected using an electronic survey (n = 195) and semi-structured interviews (n = 11) to gain an in-depth understanding of therapeutic processes and practitioner experiences regarding mealtime challenges. Survey results indicated that 41% of practitioners evaluate mealtime using non-standardized methods like clinical observations (88%) and teacher interviews (78%). The most common mealtime interventions and outcomes reported by practitioners were self-feeding (73%) and independence with mealtime routines (37%). Interview themes revealed the informal processes practitioners use to address mealtime challenges and feelings of apprehension about supporting students with complex mealtime needs. Formal documentation and more frequent coordination between parents, school staff, and community providers are target areas for improvement. The development of clear practice guidelines at the local, state, and national level are critical tasks to empower this change.

The association between restrained eating and alcohol use remains poorly understood among undergraduates. Consistent with tension reduction theory, individuals with disordered eating may be motivated to drink alcohol to cope with negative emotionality. Perhaps what pushes them to drink despite restriction goals is impulsivity. The combined impact of drinking to cope and impulsivity on the theoretically complex link between restrained eating and alcohol outcomes has not been previously examined. The current study tested the moderating effect of drinking to cope and impulsivity on the association between restrained eating and alcohol use and problems. Undergraduates (N = 1,619) self-reported on eating disorder symptoms, alcohol use motives, impulsivity, and alcohol outcomes. A moderation model revealed that restrained eating predicted past 30-day alcohol use, but only for women high in both drinking to cope and impulsivity. These findings help characterize alcohol misuse risk among young adults who restrict their eating, thereby, results may inform interventions.

Background: Food-related advertisements have been identified as influential factors affecting Australian adolescents' food preferences and dietary habits. Objective: This study aimed to investigate adolescents' (athletes and non-athletes) views about healthy eating, the advertising of discretionary foods and beverages, and the effects of food advertising on dietary behaviours. Method: Qualitative study involving the analysis of data from seven focus group discussions with young people aged 12-17 years (N = 27; 10 males and 17 females; 14 elite athletes, 13 non-athletes) from three different socioeconomic status secondary schools. Results: Both athlete and non-athlete participants discussed the importance of how social media is used for food advertisements. Many adolescents exhibited scepticism about the intent of advertising discretionary foods and beverages targeted toward adolescents. Three themes were identified from the data analysis: (1) physical and cognitive benefits of healthy eating; (2) scepticism, mistrust and ethical concerns about food and beverage advertisements targeted toward adolescents; and (3) portrayal of thin and fit ideals in social media. Conclusion: Health educators and policymakers addressing adolescent healthy eating behaviours should focus more fully on the influence of social media food advertising. Greater promotion of the importance of good nutrition during adolescence may optimise training performance and improve young people's nutritional knowledge and healthy eating habits.

Though a relationship between sexual assault and suicidal thinking is established, fewer studies explore complex coping mechanisms for these college student treatment issues. We hypothesized that the relationship between sexual assault and suicide ideation was mediated by binge eating concerns and that treatment for recent sexual assault would also result in greater change in eating concerns and suicidal thoughts. An eating concerns subscale and an item assessing suicidal thoughts from the Collegiate Center for Mental Health (CCMH) 2018-2019 data set were completed during treatment (n = 53,016). Results supported the hypotheses, revealing eating concerns as a significant partial mediator. Moreover, recent sexual assault survivors, particularly men, experienced greater changes during treatment than clients with other presenting concerns. Findings suggest problematic coping strategies that may increase the likelihood of suicidal thinking following sexual assault. Practitioners should monitor students' eating concerns and emphasize emotional regulation strategies to reduce suicidality. Limitations of correlational methodology and small effect sizes are also discussed.

Introduction: Individuals with intellectual disabilities (ID) are at heightened risk of behavioral problems. Methods: This study investigated differences in the severity of challenging behaviors (CBs) among individuals with IDs at varying life stages. Data were collected from parents' retrospective interviews. Surveys were completed by 47 parents whose child with IDs was 19 years or older and had made use of welfare services for individuals who exhibit CBs. Results: The final study sample consisted of 28 parents. Findings showed that: (a) parents gave the lowest total scores for severity of CBs for their adult children when at the pre-school stage compared to other stages (elementary school, junior high school, high school, and post-high school), (b) differences between life stages appear to depend on the type of CB, and (c) the most common CB recorded for children between 0 and 2 years old was extreme hyperactivity, followed by severe sleep disturbances. Conclusions: The results of the study show that domain ratings for stereotypic/restricted behaviors, sleep disturbance problems, feeding problems, and problems with elimination often remain stable throughout the life stages. Moreover, parents frequently reported that CBs often occurred in children aged 0-2 years.

Background: Eating patterns such as breakfast consumption and fruit and vegetable intake have been associated with academic achievement and cognitive function. Method: The purpose of this study was to learn more about psychological (emotion-driven eating) and behavioral (over-eating) eating patterns and motives, and the roles of body image, academic achievement (reading and math), and social supports (peer acceptance and school attachment), among 378 fourth-grade students (55% boys) from 14 classrooms across 6 schools within a large Midwestern urban area. Results: Results were analyzed through a 2-group (male and female) path analysis. Boys' overeating (R[superscript 2] = 9%) was not significantly predicted. Their emotional eating (R[superscript 2] = 22.2%) was negatively, significantly predicted by peer acceptance and interaction of peer acceptance and school attachment. Girls' overeating (R[superscript 2] = 13.6%) was negatively, significantly predicted by positive body image. Girls' emotional eating (R[superscript 2] = 24.1%) was negatively significantly predicted by positive body image, math scores, and peer acceptance. Conclusions: Boys' and girls' eating patterns are differentially affected by their school experiences.

Objective: Disordered eating and problematic alcohol use may negatively impact women's health, and the two issues frequently occur together. We assessed the interaction between negative urgency and disordered eating variables on binge drinking frequency. We also examined impulsivity facets in relation to binge eating, purging, and restrictive eating using multiple linear regression. Methods: Undergraduate women (M age 19.02; SD 1.51; n 262) from a mid-sized southeastern university, reported quantity and frequency of alcohol use over the past 90 days, disordered eating measured by the Multifactorial Assessment of Eating Disorder Symptoms (MAEDS), and impulsivity on the UPPS-P. Results: Negative urgency was the best impulsivity predictor of binge eating and restrictive eating. Negative urgency was a significant predictor of binge drinking frequency (negative binomial regression, p values < 0.01), but no interaction was found. Conclusions: To reduce these behaviors, college students may benefit from campus programs offering adaptive strategies to cope with negative affect.

Objective: To investigate the impact of generalized joint hypermobility (GJH) on eating behavior. Participants: Physical therapy and rehabilitation students. Methods: The Beighton evaluation (a cutoff of 5/9) for defining GJH. The Eating Attitudes Test (EAT-40) was used for eating disorders. Smoking habits and alcohol use were also questioned. Results: Compared with 51 non-GJH students (mean age 20.5 years, 73% female), 46 students with asymptomatic GJH (20.6 years, 89% female) were more likely to have greater median EAT-40 scores (9 vs. 6, p = 0.002). There was no statistically significant difference between the groups in terms of the susceptibility to eating behavior disorders (6.5% vs. 2.0%), smoking habits (6.5% vs. 9.8%), and alcohol use (15.2% vs. 11.8%) (p > 0.05). Positive correlation (r = 0.221, p = 0.029) and positive effect (R = 0.221, R[superscript 2] = 0.049; p < 0.05) between Beighton scores and EAT-40 scores were found. Conclusion: The more joint hypermobility the greater the risk for eating disorders.

Objective: Combined alcohol and disordered eating (drunkorexia) are alcohol fueled weight management behaviors. Mindfulness negatively relates to both disordered eating and alcohol use. Participants: Participants (n = 344, average age 20) were primarily female (85.2%, n = 293), and Caucasian (82.6%, n = 284). Methods: Students reported drunkorexia and mindfulness. Results: Drunkorexia behaviors were negatively correlated with Acting with Awareness (AA; full attention to a present moment; r = -0.21, p < 0.001) and Nonjudgment (NJ; understanding and leniency toward oneself; r = -0.22, p < 0.001). Drunkorexia motivations are significantly correlated with AA (r = -0.13, p = 0.01) and NJ (r = -0.18, p = 0.001). Structural equation modeling revealed higher levels of NJ related to higher levels of drunkorexia. Conclusion: The objective was to determine a potential relationship between drunkorexia behaviors and motivations, and trait mindfulness. Findings suggest a nonjudgmental disposition relates to lower levels of drunkorexia.

Objective: Body dissatisfaction elevates the risk for disordered eating behaviors. Excessive exercise is prevalent among college women and associated with harm. Risk theory posits a bidirectional relationship between risk factors for disordered eating behaviors and the behaviors themselves. This study investigated the longitudinal, reciprocal relationship between body dissatisfaction and excessive exercise. Participants and methods: College women (n = 302) assessed in August (baseline) and November (follow-up). Results: Baseline body dissatisfaction significantly predicted increases in excessive exercise endorsement at follow-up, controlling for baseline excessive exercise endorsement and body mass index (BMI). Baseline excessive exercise endorsement predicted increases in body dissatisfaction at follow-up, controlling for baseline body dissatisfaction and BMI. Conclusions: Findings support the presence of a positive feedback loop between body dissatisfaction and excessive exercise; both predict increases in risk for the other, regardless of weight status. Future research should test whether this process is ongoing and predicts further distress.

Families of children with developmental disabilities are faced with many challenges in the course of their child's learning and language development. Feeding difficulty is recognised as an additional challenge in children with developmental disabilities which further affects the child's development and health. The severity can range from picky eating and food selectivity to total food refusal and dependence on special formulas or tube feedings which adds to the family's financial burden and stress. Family members and caregivers struggle with managing the behavioural challenges implicated in feeding difficulties, accessing information, and implementing the recommended intervention by the behavioural analysts to maintain positive results. Therefore, the purpose of this article is to provide a basic description of the procedures implemented by a behavioural analyst during the assessment and intervention phase to further their understanding and assist them in implementing a treatment plan with high fidelity.

Eight percent of adolescent girls were found to be engaged in problematic social media use. Problematic social media use is associated with serious physical and mental consequences. This study aimed to explore the effects of thin-ideal internalization on problematic social media use and the role of selfie-related behaviors and friendship quality. We recruited 903 Chinese adolescent girls with an average age of 13.73 years (ranging from 11 to 16 years) recruited to complete the self-report questionnaire, which contained four measures. Results revealed a moderated mediation model. Girls who had internalized thin-ideal images were more vulnerable to social media's addictive properties, constantly engaged in selfie-related behaviors, and developed subsequent problematic social media use. However, for adolescent girls, high friendship quality buffered against developing problematic social media use, despite selfie-related behaviors. The study provides suggestions to reduce problematic social media use among adolescents to promote their physical and mental health.

Introduction: College students face increased risk for a variety of mental health problems but experience barriers to treatment access. Prevention programs, including those implemented by peer educators, may decrease treatment needs and increase service access. We examined the implementation of an evidence-based eating disorder prevention program, "Body Project," delivered by college peer educators at 63 colleges/universities, comparing three levels of implementation support: (1) Train-the-Trainer (TTT) training; (2) TTT plus a technical assistance workshop (TTT + TA); and (3) TTT + TA with one year of quality assurance calls (TTT + TA + QA). The present study tested the degree to which indicators proposed by the Consolidated Framework for Implementation Research (CFIR) were associated with core implementation outcomes. Method: We tested whether indices of CFIR domains (i.e., perceived intervention characteristics, outer and inner setting factors, provider characteristics, and implementation process) were correlated with three implementation outcomes (program reach, fidelity, effectiveness) during a 1-year implementation period. Results: Greater program reach was associated with implementation process, specifically the completion of more implementation activities ([beta] = 0.46). Greater program fidelity was associated with higher positive ([beta] = 0.44) and lower negative ([beta] = - 0.43) perceptions of the "Body Project" characteristics, and greater reported general support for evidence-based practices ([beta] = 0.41). Greater effectiveness was associated with lower negative perceptions of "Body Project" characteristics (d = 0.49). Conclusions: Several implementation determinants proposed by the CFIR model predicted outcomes, especially intervention fidelity. Across the outcomes of interest, implementation determinants related to peer educator and supervisor perceived characteristics of the specific intervention and general attitudes towards evidence-based practices emerged as robust predictors to inform future work investigating ongoing implementation and sustainability of programs in university settings.

The results of the current study present a nationally-representative examination of which college students with psychological disorders register for accommodations at their institutions of higher education. Results indicate that students with psychological disorders already receiving treatment via medication and/ or therapy were more likely to register for accommodations at their institution. Results also indicated that students with ADHD, bipolar, eating disorder, personality disorder, and other psychological disorders were all significantly less likely to register for accommodations as compared to students without these disorders. Students with neurodevelopmental disorders such as Autism Spectrum Disorder (ASD) were significantly more likely to register for accommodations as compared to students without ASD, which may be the result of less perceived stigma or less concern of individuals with ASD with perceived stigma.

The purpose of this study was to examine the experiences of culturally diverse individuals who have suffered from an eating disorder. Semi-structured interviews revealed four themes: influences; mental health community issues; barriers to treatment; and stereotypes. These themes represent weak areas within the education that is provided to youth related to mental health and eating disorders. Results of this study may prove beneficial to psychologists and counselors who can work to bridge the gap between the mental health community and different cultural groups.

It is common for children with autism spectrum disorder to experience feeding problems that develop at an early age and include picky eating, food refusal, and rapid eating. This can lead to medical complications such as gastrointestinal issues or nutritional deficiencies. Feeding problems in children with autism can result in social-emotional implications. Children with autism may also experience oral sensitivities linked to feeding problems. Parents, doctors, and educators can use early interventions and behaviour therapy to support each child and improve feeding behaviour. More research in this area is required to support future learning in autism feeding problems.

Moved by the lived experience of an honors student, authors describe a three-year Honors and Eating Concerns Research Collaborative (2019-2022), which examines the relationship between perfectionism and eating concerns among honors students. Under faculty advisement, first- and second-year honors psychology majors (n = 5) participated in the collective, carrying out three empirical studies (producing two honors theses) and gathering data from 413 high-achieving students across the curriculum (54 identifying as honors). In survey research, the instruments used were questionnaires and interviews; measures involved four scales--Almost Perfect Scale-Revised (APSR), Perceived Stress Scale (PSS-10), Three-Factor Eating Questionnaire (TFEQ), and Eating Disorder Examination Questionnaire (EDEQ). Key findings suggest that concerns about eating, weight, and body shape are common among high-achieving students, who also experience elevated levels of perceived stress (women highest). Authors posit this faculty/student engagement collaborative as a viable alternative to the traditional expert/mentee model. A review of literature is provided, and implications for future study and broader appropriation are discussed.

The aim of this study was to investigate the effect of body image and Corona disease anxiety on athlete's eating disorders. The method of this research is descriptive and correlational. The statistical population Agri Ibrahim Çeçen University Faculty of Sports Sciences, which is equal to 340 people. To determine the sample size, Cochran's sample size estimation formula was used and the number of samples was equal to 181 people who were selected by simple random sampling method. Corona Disease Anxiety Scale (CDAS) by Alipour et al. (2019), Body Image Questionnaire by Cash et al. (1990) and Eating Disorders Questionnaire by Garner D, and Olmsted (1982) were used to collect data. SPSS software was used to analyze the data and regression coefficient was used to analyze the research hypotheses. The results show that body image has a significant negative effect on eating disorders (p <0.05, Beta = -0.44). Corona anxiety also had a significant positive effect on eating disorders (p <0.05, Beta = 0.56). Therefore, it can be concluded that with more attention to the body image, reflection on physical characteristics, satisfaction with different body parts and attitudes about weight, eating disorders decrease and with increasing Corona disease anxiety, eating disorders increase. Attitudes toward the body should be controlled and ways to get into Coronavirus anxiety should be limited.

Aim of the present study was to evaluate the relationship between sensory sensitivity and autistic eating behaviours or Eating Disorders (EDs) symptomatology, in a group of 75 adults with Autism Spectrum Disorders (ASDs) without intellectual disabilities, through a series of self-report questionnaires. We found that, controlling for demographic and clinical features: (i) hypersensitivity in the vision domain predicted higher levels of both EDs symptoms and autistic eating behaviours; (ii) hyposensitivity in the taste domain predicted higher levels of EDs symptoms. This gives preliminary evidence that not only in children diagnosed with ASDs, but even in adult individuals, the threshold of sensory sensitivity is associated with dysfunctional eating behaviours.

Autistic children commonly experience mealtime difficulties; however, it is unknown what makes an effective transdisciplinary mealtime service for autistic children. This study used a realist evaluation framework to explore caregivers' and therapists' perceptions of the contexts, mechanisms and associated outcomes of a transdisciplinary mealtime management service for autistic children. Semi-structured interviews were conducted with six caregivers of autistic children engaged in a transdisciplinary mealtime service and 10 therapists providing the service, with interview data analysed using a realist evaluation approach. Four-context (child factors, family factors, therapist factors and institutional parameters), three-mechanism (transdisciplinary collaboration, child-centred approach and managing caregiver expectations) and two-outcome (impact on the child and impact on the caregiver) themes were identified. Findings highlighted that transdisciplinary collaboration, a child- and family-centred approach and managing caregiver expectations are key mechanisms providing a foundation for the development of evidence-based mealtime services for autistic children.

Past research suggests that children, particularly those with autism spectrum disorder, with general behavioral inflexibility to objects, persons, and environments may be at risk for feeding problems. However, questions remain about whether feeding problems are better predicted by behavioral inflexibility or sensory sensitivity, and whether general or food-specific measures are stronger predictors. The present study compared two types of behavioral inflexibility (general, food-specific) and two types of sensory sensitivity (food touch, temperature) for their association with children's feeding problems. Participants were 372 children and their parents who completed surveys on their children's demographics, as well as measures of behavioral inflexibility, sensory sensitivity, and feeding problems. The children, all referred to a feeding clinic were 71.8% male and had a mean age of 71.53 months. For this sample, 33. 7% had autism spectrum disorder (ASD), 28.7% had special needs other than ASD, and 37.5% had no special needs. ANCOVAs examined child demographics (age, weight status, medical problems, gender, special needs status) for their associations with each measure of inflexibility and sensitivity, finding that ASD was associated with more general and food-specific inflexibility, and younger age was associated with more food touch sensitivity. Hierarchical multiple regressions, which controlled for demographics, including ASD diagnosis, compared the four measures of inflexibility and sensitivity as predictors for each feeding problem. These analyses found food-specific behavioral inflexibility was the only significant predictor of all three feeding problems. Results suggest reducing the severity of children's feeding problems, clinicians focus on increasing behavioral flexibility as it relates to food.

The study was aimed to define swallowing related problems of toddlers with Down syndrome (DS) by comparing toddlers with typically developing children (TDC). A total of 127 children (96 DS, 31 TDC), and their mothers included in the study. The presence of chewing disorders, food selectivity, drooling, coughing during swallowing was scored as 'absent' or 'present'. The Pediatric version of the Eating Assessment Tool-10 (PEDI EAT-10) was used to determine dysphagia symptom severity, and the Turkish version of the Feeding/Swallowing Impact Survey (T-FS-IS) was used to measure the impact of swallowing disorders on caregivers. Mothers of DS reported higher rates of chewing disorders (n = 39, 40.6%), drooling (n = 30, 31.3%) and coughing during swallowing (n = 50, 41.7%) than mothers of TDC (p < 0.01). The mean PEDI-EAT-10 score of children with DS was higher than TDC (p = 0.006). There were significant differences between groups in terms of T-FS-IS. Moderate to strong correlations were detected between PEDI-EAT-10 and total and subscale scores from T-FS-IS (p < 0.001). This prospective study defines swallowing related problems of toddlers with DS. The study results highlight the importance of early investigation of (i) swallowing concerns in children with DS, and (ii) caregivers' quality of life to define swallowing problems and plan an appropriate swallowing related management program.

This study followed a pre-registered analysis plan with the aim to investigate whether autistic traits and self-compassion are correlated in autistic adults, and to test an indirect effect of autistic traits on anxiety/depression via self-compassion. We present the findings of an online survey of 456 participants (n = 228 autistic adults, n = 228 non-autistic adults) who completed the Autism Spectrum Quotient (AQ), the Self-Compassion Scale (SCS) and the Hospital Anxiety and Depression Scale (HADS). Lower self-compassion was reported by autistic participants compared to non-autistic participants, and a negative correlation was found between autistic traits and self-compassion in both groups. Furthermore, an indirect association between autistic traits and anxiety/depression via self-compassion was observed in both samples. Considering that many autistic people experience co-occurring anxiety and depression, and that self-compassion is a skill that can be cultivated with practice, the findings of this study suggest that self-compassion may be a modifiable factor that could improve the mental health of this population.