Publications by authors named "Drew A Anderson"

67 Publications

Consequences of Repeated Critical Versus Neutral Body Checking in Women With High Shape or Weight Concern.

Behav Ther 2021 07 24;52(4):830-846. Epub 2020 Oct 24.

University at Albany, State University of New York.

Body checking is a repeated behavior conducted in an attempt to gain information about one's shape, weight, size, or body composition. Body checking is associated with negative behavioral, emotional, and cognitive outcomes and may maintain body dissatisfaction and eating disorders. The precise function and consequences of body checking remain less well understood. Specifically, immediate and delayed impacts of repeated critical body checking (CBC) have not been determined. The current study randomly assigned 142 young women with high shape/weight concern to daily 10-min CBC, neutral body checking (NBC), or a non-body critical checking (NBCC) comparison condition, examining their immediate and delayed (one-week follow-up) effects on body satisfaction, self-esteem, and negative affect. Multilevel modeling and follow-up planned comparisons found that compared to NBCC, CBC participants' body satisfaction and self-esteem immediately decreased, but negative affect improved from baseline to follow-up. Compared to CBC, NBC participants' self-esteem and negative affect improved immediately, and their self-esteem improved over time compared to NBCC. Over time, all participants' state body satisfaction improved, regardless of condition. Our findings suggest a 10-min CBC session may function differently than typical (harmful) in vivo body checking. However, reasons for this difference are unclear. Additional research is needed to distinguish (harmful) in vivo body checking from CBC procedures such as this and other mirror exposure interventions. Research is needed to examine the effects of varying CBC duration and instructions during body exposure to further clarify mechanisms of change during body exposures.
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http://dx.doi.org/10.1016/j.beth.2020.10.005DOI Listing
July 2021

The role of rumination and positive beliefs about rumination in eating pathology.

Eat Weight Disord 2021 Jun 7. Epub 2021 Jun 7.

Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA.

Purpose: General and eating disorder (ED)-specific ruminations have been identified as key factors that may contribute to eating pathology. Positive beliefs about rumination (e.g., "Ruminating helps me to prevent future mistakes") may impact this association. However, the effect of positive beliefs about rumination on the links between rumination and ED symptom severity has not been investigated. This study sought to clarify relations between rumination and ED symptom severity and to evaluate the potential moderating effect of positive beliefs about rumination on these associations.

Methods: During a laboratory visit, undergraduate participants (N = 473, M = 18.90 ± 2.27, M = 23.45 kg/m ± 4.31, 54.8% female) completed an online battery of questionnaires assessing general and ED-specific ruminative processes (e.g., brooding, reflection), positive beliefs about rumination, and global ED symptoms. Hierarchical multiple regression analyses assessed the unique contributions of specific ruminative processes, and the moderating effect of positive beliefs on associations between ruminative processes and ED symptom severity.

Results: Hierarchical multiple regression results suggest that, after controlling for gender and BMI, ED-specific brooding, b = 1.32, SE = 0.13, β = 0.46, p < 0.0001, and reflection, b = 1.44, SE = 0.33, β = 0.19, p < 0.0001, accounted for unique variance in ED symptom severity. Moderation model results indicate that, at low levels of general reflection, b = - 0.06, SE = 0.02, β = - 0.51, p = 0.003, and ED-specific reflection, b = - 0.15, SE = 0.03, β = - 0.59, p < 0.0001, increased positive beliefs about rumination were associated with greater ED symptom severity.

Conclusion: Findings suggest ED-specific rumination accounts for ED symptom severity above and beyond general rumination, and that rumination-related expectancies influence the association between reflection and ED symptom severity.

Level Of Evidence: Level III, evidence obtained from a well-designed cohort study.
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http://dx.doi.org/10.1007/s40519-021-01209-1DOI Listing
June 2021

Does the tripartite influence model of body image and eating pathology function similarly across racial/ethnic groups of White, Black, Latina, and Asian women?

Eat Behav 2021 08 8;42:101519. Epub 2021 May 8.

Department of Psychology, University of South Florida, 4202 E Fowler Ave, Tampa, FL 33620, USA.

The tripartite influence model suggests that appearance pressures from family, peers, and the media contribute to thin-ideal internalization, which leads to increased body dissatisfaction and subsequent eating disorder pathology. The tripartite influence model was initially developed and tested among primarily White samples, and emerging research suggests racial/ethnic differences in mean levels of particular model constructs. Consequently, the model's appropriateness for understanding eating disorder risk in racial/ethnic minorities warrants investigation to determine its usefulness in explicating eating disorder risk in diverse populations. Participants in the current study were White (n = 1167), Black (n = 212), Latina (n = 203), and Asian (n = 176) women from five geographically disparate college campuses in the United States. Participants completed the Sociocultural Attitudes Towards Appearance Questionnaire-4, the Multidimensional Body-Self Relations Questionnaire - Appearance Evaluation Subscale, and the Eating Disorder Examination-Questionnaire. Analysis of variance was used to compare mean levels of each construct across racial/ethnic groups. Multigroup structural equation modeling was used to assess the appropriateness of the tripartite influence model for each racial/ethnic group, and to examine differences in the strength of the model pathways across groups. There were significant mean level differences across groups for most model constructs. However, results indicated similar model fit across racial/ethnic groups, with few differences in the strength of model pathways. Findings suggest that although some groups report lower levels of proposed risk factors, the sociocultural risk processes for eating pathology identified through the tripartite influence model are similar across racial/ethnic groups of young adult women. Such information can be used to inform culturally-sensitive interventions.
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http://dx.doi.org/10.1016/j.eatbeh.2021.101519DOI Listing
August 2021

Eating disorder pathology and compulsive exercise during the COVID-19 public health emergency: Examining risk associated with COVID-19 anxiety and intolerance of uncertainty.

Int J Eat Disord 2020 12 24;53(12):2049-2054. Epub 2020 Oct 24.

Department of Psychology, University at Albany, State University of New York, Albany, New York, USA.

Objective: COVID-19 has led to disruptions in daily living and increased uncertainty about physical, financial, social, and psychological consequences, which may contribute to anxiety, eating disorder (ED) pathology, and compulsive exercise. Individual factors, such as intolerance of uncertainty, may impact risk for ED pathology and CE in response to COVID-19 anxiety. The current study examined associations between COVID-19 anxiety, trait intolerance of uncertainty, and COVID-19 intolerance of uncertainty and ED pathology and compulsive exercise.

Method: Undergraduate participants (N = 295) completed a series of online questionnaires between March and April of 2020.

Results: COVID-19 anxiety and intolerance of uncertainty were associated with ED pathology, but not compulsive exercise. Additionally, both trait and COVID-19 intolerance of uncertainty moderated associations between COVID-19 anxiety and compulsive exercise and ED pathology. COVID-19 anxiety was more strongly related to compulsive exercise and ED pathology for individuals with lower intolerance of uncertainty.

Discussion: COVID-19 anxiety may increase risk for ED pathology and may be specifically important in determining risk for ED pathology and compulsive exercise among individuals with lower intolerance of uncertainty. These results contribute to a growing body of research aimed at understanding the mental health consequences of the COVID-19 and suggest that individual factors (e.g., anxiety and intolerance of uncertainty) are important in determining risk for ED pathology and compulsive exercise in the context of the pandemic.
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http://dx.doi.org/10.1002/eat.23395DOI Listing
December 2020

Factor structure of the Eating Disorder Examination - Questionnaire among heterosexual and sexual minority males.

Eat Behav 2020 08 29;38:101403. Epub 2020 May 29.

University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY 12222, United States of America.

Eating disorder (ED) pathology is increasingly recognized among males; however, presentations within males differ from traditional descriptions of ED pathology in females. Additionally, experiences of ED pathology differ between sexual minority (SM) and heterosexual males. These differences suggest that existing ED assessments, which are primarily based on female samples, do not adequately capture ED pathology in SM and heterosexual males. The Eating Disorder Examination-Questionnaire (EDE-Q) is a commonly used assessment of ED pathology; however, at present the factor structure of this instrument in SM and heterosexual males is unclear. This study aimed to determine the most appropriate factor structure of the EDE-Q by evaluating proposed factor structures in a large, non-clinical sample consisting of heterosexual and SM men. Additionally, this study examined differences in the factor structures and severities of ED pathology between SM and heterosexual males. Confirmatory Factor Analyses examining existing factor structures of the EDE-Q indicated that the brief three-factor model was the best fitting model for both heterosexual and SM males. Subsequent comparisons of factor scores between groups indicated that SM males in our sample experienced higher levels of dietary restraint, overvaluation of shape and weight, and body dissatisfaction than heterosexual males. Results provide preliminary support for the use of the brief three-factor model of the EDE-Q when assessing ED pathology among SM and heterosexual males in non-clinical research settings.
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http://dx.doi.org/10.1016/j.eatbeh.2020.101403DOI Listing
August 2020

Rapid response is predictive of treatment outcomes in a transdiagnostic intensive outpatient eating disorder sample: a replication of prior research in a real-world setting.

Eat Weight Disord 2021 Jun 7;26(5):1345-1356. Epub 2020 Jun 7.

Department of Psychology, University at Albany, State University of New York, Albany, NY, USA.

Objective: There is a growing call to identify specific outcome predictors in real-world eating disorder (ED) treatment settings. Studies have implicated several ED treatment outcome predictors [rapid response (RR), weight suppression, illness duration, ED diagnosis, and psychiatric comorbidity] in inpatient settings or randomized controlled trials of individual outpatient therapy. However, research has not yet examined outcome predictors in intensive outpatient programs (IOP). The current study aimed to replicate findings from randomized controlled research trials and inpatient samples, identifying treatment outcome predictors in a transdiagnostic ED IOP sample.

Method: The current sample comprised 210 consecutive unique IOP patient admissions who received evidence-based ED treatment, M(SD) = 15.82 (13.38) weeks. Weekly patient measures of ED symptoms and global functioning were obtained from patients' medical charts.

Results: In relative weight analysis, RR was the only significant predictor of ED symptoms post treatment, uniquely accounting for 45.6% of the predicted variance in ED symptoms. In contrast, baseline ED pathology was the strongest unique predictor of end-of-treatment global functioning, accounting for 15.89% of predicted variance. Baseline factors did not differentiate patients who made RR from those who did not.

Conclusions: Consistent with findings in more controlled treatment settings, RR remains a robust predictor of outcome for patients receiving IOP-level treatment for EDs. Future work should evaluate factors that mediate and moderate RR, incorporating these findings into ED treatment design and implementation.

Level Of Evidence: Level IV, uncontrolled intervention.
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http://dx.doi.org/10.1007/s40519-020-00939-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903880PMC
June 2021

Expectancies about the Effects of Cannabis Use on Eating Disorder Symptoms.

Subst Use Misuse 2020 23;55(11):1825-1833. Epub 2020 May 23.

Psychology, Social Sciences, University at Albany, the State University of New York, Albany, New York, USA.

Substance use, specifically cannabis use, is common among individuals with eating disorder (ED) symptoms; however, few studies have specifically explored the relation between EDs and cannabis use. The present study examined expectancies about the impact of cannabis on cognitive, affective and behavioral ED symptoms. Additionally, this study explored associations between cannabis-related expectancies, cannabis use and cannabis-related problems. Cannabis users with ED symptoms ( = 137) reported on frequency of cannabis use, cannabis-related problems and expectancies about the impact of cannabis on ED symptoms, Participants expected cannabis to decrease restrictive eating, compensatory behaviors, and preoccupation with body shape and weight and fear of eating and weight gain. In contrast, cannabis was expected to increase binge-eating behaviors. Expectancies about the impact of cannabis use on ED symptoms were not associated with more frequent cannabis use nor were they associated with cannabis-related problems. These findings suggest that individuals believe cannabis will improve some ED symptoms; however, these expected improvements are not associated with increased cannabis use and problems. Future research should examine cannabis expectancies in clinical populations and should further explore the association between cannabis expectancies, use, and ED symptoms longitudinally.
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http://dx.doi.org/10.1080/10826084.2020.1766503DOI Listing
June 2021

Vegetarians and omnivores with diagnosed eating disorders exhibit no difference in symptomology: a retrospective clinical chart review.

Eat Weight Disord 2021 Apr 7;26(3):1007-1012. Epub 2020 May 7.

Department of Psychology, Social Sciences 399, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA.

Purpose: Past work suggests that vegetarianism is common in patients diagnosed with eating disorders (EDs), but the exact nature of this association is unclear, with reports conflicting as to whether vegetarianism is a risk factor for EDs, complicates ED treatment, or is wholly innocuous. Since vegetarianism has been on the rise, the need for current data on possible links with EDs is substantial.

Methods: We collected data on demographics, vegetarian status, ED diagnosis, current body mass index (BMI), highest and lowest BMI, Eating Attitudes Test, and Multifactorial Assessment of Eating Disorders Symptoms scores at intake in 124 patients (84.7% women, 90.3% white, M = 23.92 ± 9.16 years) admitted to an intensive outpatient ED program.

Results: We first compared omnivores (n = 72, 58.1%), meat-reducers (n = 27, 21.8%), vegetarians (n = 20, 16.1%), and vegans (n = 5, 4.0%) and found no significant differences in any demographic or outcome variable, with the exception that vegetarians reported significantly lower highest-ever BMI compared to meat-reducers (p = 0.03). To mirror past chart reviews, we then compared the combined groups of meat avoiders (n = 52, 41.9%) to the omnivores (n = 72, 58.1%) and found no significant differences in demographics or ED symptoms (all ps > 0.05).

Conclusion: Overall, data support that meat restriction does not imply greater ED severity.

Level Of Evidence: Level V, descriptive study, retrospective chart review.
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http://dx.doi.org/10.1007/s40519-020-00903-wDOI Listing
April 2021

Testing the Tripartite Influence Model among heterosexual, bisexual, and lesbian women.

Body Image 2019 Sep 16;30:145-149. Epub 2019 Jul 16.

Department of Psychology, University of South Florida, United States.

This cross-sectional study explored similarities and differences between heterosexual, bisexual, and lesbian women in levels of, and relationships between, the following constructs using a Tripartite Influence Model framework: family, peer, and media appearance pressures, thin- and muscular-ideal internalization, and eating disorder (ED) pathology. Self-identified heterosexual (n = 1,528), bisexual (n = 89), and lesbian (n = 278) undergraduate women completed the Sociocultural Attitudes Towards Appearance Questionnaire-4 and the Eating Disorder Examination-Questionnaire. Sexual orientation differences in appearance pressures, appearance-ideal internalization, and ED pathology were examined via analysis of variance tests. Relationships between these variables were examined with multi-group path analyses, controlling for age, race/ethnicity, and body mass index. Compared with lesbian women, heterosexual and bisexual women reported higher levels of peer appearance pressures. Paths from peer appearance pressures and thin-ideal internalization to shape/weight overvaluation and body dissatisfaction were strongest for bisexual women. Overall, results indicate notable similarities between heterosexual, bisexual, and lesbian women. However, preliminary evidence for potential differences highlights the importance of examining variation in ED risk between sexual minority subgroups.
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http://dx.doi.org/10.1016/j.bodyim.2019.07.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6703947PMC
September 2019

Gender-based differential item functioning in measures of eating pathology.

Int J Eat Disord 2019 09 24;52(9):1047-1051. Epub 2019 Jun 24.

Department of Psychology, University of South Florida, Tampa, Florida.

Objective: Eating disorder (ED) symptoms are common and impairing in males, despite their perception as "female" disorders. As existing self-report symptom measures were developed and primarily validated in women, there is a need to establish the utility of these measures in men. The present study used differential item functioning (DIF) analyses to explore whether item endorsement differed by gender for three commonly used ED symptom measures.

Method: Participants were undergraduate men (n = 1,083) and women (n = 2,424) from three universities in the United States. Global scores on the Eating Attitudes Test-26 (EAT-26), Eating Disorder Examination Questionnaire (EDEQ), and Eating Disorder Diagnostic Scale for DSM-IV (EDDS) were examined. Tests of DIF were conducted by regressing each item against its composite scale score, and then comparing fit and variance explained (R ) to a model with the interaction of item*gender. The clinical significance threshold for DIF is ΔR ≥ 0.13.

Results: There was no evidence of clinically significant DIF within the EAT-26, EDEQ, or EDDS.

Discussion: Findings suggest that the examined measures perform similarly for undergraduate men and women, supporting their use in nonclinical male samples. However, development and testing of items reflecting ED symptoms that more commonly occur in males (e.g., muscularity-oriented behaviors) is encouraged.
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http://dx.doi.org/10.1002/eat.23126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815513PMC
September 2019

Female Athlete Body Project Intervention with Professional Dancers: A Pilot Trial.

Eat Disord 2021 Jan-Feb;29(1):56-73. Epub 2019 Jun 24.

Department of Psychology, University at Albany, State University of New York , Albany, NY, USA.

As aesthetic athletes, professional dancers have increased vulnerability for eating disorders (EDs), with three times higher risk than non-dancers. Among ballet dancers, generalized risk for EDs associated with internalization of western cultural female beauty ideals is compounded by idealization of a ballet-specific body ideal, a combination that confers unique vulnerability for eating pathology. Empirical support has been established for an athlete-specific intervention promoting body acceptance and reduced eating pathology among general populations of young-adult women and female collegiate athletes; the current study adapted this intervention for pilot implementation among professional ballet dancers. Participants from two elite ballet companies ( = 19) were randomized to a control and intervention condition. All participants self-reported eating pathology and related variables pre- and post-intervention, and at six-week follow-up. Post-intervention, participants receiving the intervention demonstrated reductions in body dissatisfaction, = .005, = -.63, dietary restraint, = .008, = -.59, and eating pathology, = .007, = -.60, as compared to control group counterparts; significant differences were retained at follow-up. Results provide preliminary evidence that this intervention has the potential to provide a feasible and acceptable means of ED prevention in female professional ballet dancers. Barriers to feasibility are identified and discussed.
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http://dx.doi.org/10.1080/10640266.2019.1632592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928448PMC
September 2021

A preliminary naturalistic clinical case series study of the feasibility and impact of interoceptive exposure for eating disorders.

Behav Res Ther 2019 06 15;117:54-64. Epub 2019 Feb 15.

Department of Psychology, University at Albany, State University of New York, USA.

Recent literature suggests that individuals with eating disorders demonstrate altered interoceptive processing, which may relate to the maintenance of symptoms and thus represent a salient treatment target. Adopting treatment techniques effective for other conditions characterized by disturbed interoceptive processes (e.g., anxiety disorders) could aid in improving the outcomes of psychological interventions for eating disorders. The current investigation was a naturalistic case series (N = 4) that examined adjunctive interoceptive exposure (IE) for eating disorders, with an emphasis on evaluating the feasibility, acceptability, and impact of this intervention on anxiety sensitivity, interoceptive deficits, and eating disorder symptoms. Results suggested that all individuals who received 4 consecutive sessions of traditional and eating-disorder-specific IE exercises demonstrated decreases in interoceptive deficits and subjective distress. Results for anxiety sensitivity and eating disorder symptoms were encouraging yet more mixed. Findings also generally suggested that the intervention was feasible and acceptable, yet between-session practice compliance varied considerably among participants. Overall, we describe how IE may be used to target interoceptive deficits in eating disorders and provide preliminary evidence of how this may be accomplished within naturalistic intensive outpatient settings.
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http://dx.doi.org/10.1016/j.brat.2019.02.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815515PMC
June 2019

Identifying a male clinical cutoff on the Eating Disorder Examination-Questionnaire (EDE-Q).

Int J Eat Disord 2018 12 27;51(12):1357-1360. Epub 2018 Nov 27.

Department of Psychology, University of South Florida, Tampa, Florida.

Objective: Evidence suggests that eating disorders (EDs) may be under-detected in males. Commonly used measures of EDs such as the Eating Disorder Examination-Questionnaire (EDE-Q) were initially developed within female samples, raising concern regarding the extent to which these instruments may be appropriate for detecting EDs in males. The current study used receiver operating characteristic curve analysis to (a) examine the accuracy of the EDE-Q global score in correctly classifying males with and without clinically significant ED pathology, and (b) establish the optimal EDE-Q global clinical cutoff for males.

Method: Participants were a clinical sample of 245 male ED patients and a control sample of 205 male undergraduates.

Results: Eating Disorder Examination-Questionnaire global scores demonstrated moderate-high accuracy in predicting ED status (area under the curve = 0.85, 95% CI: 0.82-0.89). The optimal cutoff of 1.68 yielded a sensitivity of 0.77 and specificity of 0.77.

Discussion: Overall, results provide preliminary support for the discriminant validity of EDE-Q scores among males. However, concerns remain regarding the measure's ability to comprehensively assess domains of disordered eating most relevant to males. Therefore, careful attention to the possibility for measurement bias and continued evaluation of the scale in males is encouraged.
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http://dx.doi.org/10.1002/eat.22972DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310481PMC
December 2018

Evaluating Associations Between Perfectionism, Emotion Regulation, and Eating Disorder Symptoms in a Mixed-Gender Sample.

J Nerv Ment Dis 2018 11;206(11):900-904

Department of Psychology, University at Albany, State University of New York, Albany, New York.

Prior research supports maladaptive perfectionism as a risk factor for eating disorders; however, not all individuals with elevated levels of perfectionism endorse eating pathology, suggesting additional variables may interact with perfectionism to account for this association. The current study examined the influence of difficulties in emotion regulation on the relation between perfectionism and eating disorders. Undergraduate students (N = 309, 50.7% male) from a large university completed measures of perfectionism, emotion dysregulation, and eating pathology. The results indicated that high levels of perfectionism only accounted for significant variance in eating disorder symptoms among individuals with limited access to adaptive strategies to regulate emotions, but not among those with greater access to adaptive strategies. Findings demonstrate that clinicians and researchers should consider the role of emotion regulation among individuals with elevated levels of perfectionism and eating pathology. Future research should prospectively evaluate these associations and examine mechanisms that may further elucidate these relations.
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http://dx.doi.org/10.1097/NMD.0000000000000895DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6209118PMC
November 2018

Gender differences in relations between alcohol-related compensatory behavior and eating pathology.

Eat Weight Disord 2019 Aug 8;24(4):715-721. Epub 2018 Sep 8.

University at Albany, State University of New York, 1400 Washington Avenue, Social Sciences 399, Albany, NY, 12222, USA.

Purpose: Concerns about caloric intake associated with alcohol use (e.g., fear of weight gain) are positively associated with compensatory eating behaviors (e.g., caloric restriction, self-induced vomiting), a phenomenon that has been identified across gender. Specific motivations for compensatory behaviors differ; some relate to eating disorder (ED) pathology (e.g., shape and weight concerns), and others to alcohol (e.g., enhancing effects). Research examining motivations for alcohol-related compensatory behaviors in men is limited to date. The current study sought to assess how specific types of alcohol-related compensatory behaviors and their association with ED pathology present differently by gender.

Methods: Undergraduates (N = 530, 48% female) completed the Compensatory Eating Behaviors in Response to Alcohol Consumption Scale (CEBRACS), Eating Disorders Diagnostic Scale (EDDS), and reported height, weight, and frequency and quantity of alcohol consumption. Data were examined using linear regression, and relations between CEBRACS behaviors and eating pathology were compared across gender.

Results: Factors that were positively associated with EDDS scores for both men and women included alcohol-related dietary restraint, and exercise. For women, but not men, alcohol-related bulimic behavior also contributed to elevations in EDDS scores.

Conclusions: Findings indicate that specific types of alcohol-related compensatory eating behaviors (i.e., dietary restraint and exercise) are positively related to ED pathology for both male and female participants. In contrast, bulimic behaviors' association with ED pathology is gender specific. Understanding gender differences in alcohol-related compensatory behaviors and ED risk may inform gender-specific intervention targets.

Level Of Evidence: Cross-sectional descriptive study, Level V.
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http://dx.doi.org/10.1007/s40519-018-0545-7DOI Listing
August 2019

Comparing internalization of appearance ideals and appearance-related pressures among women from the United States, Italy, England, and Australia.

Eat Weight Disord 2019 Oct 17;24(5):947-951. Epub 2018 Jul 17.

School of Psychology and Public Health, La Trobe University, Melbourne, Australia.

Researchers have observed variation in levels of body image disturbance and eating pathology among women from different Western countries. Examination of cross-cultural differences in the established risk factors (i.e., thin-ideal internalization, muscular-ideal internalization, and appearance pressures from family, peers, and media) for negative outcomes may help to elucidate the prominence of specific risk factors within a given Western society and guide associated interventions. Women from the United States (US), Italy, England, and Australia completed the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4). Analysis of covariance controlling for age and BMI indicated significant cross-country differences for all SATAQ-4 subscales. Results typically indicated higher levels of appearance-ideal internalization and appearance pressures in the US and lower levels in Italy; however, associated effect sizes were generally small. A medium effect of country was observed for peer-appearance pressures, which were highest in the US compared with all other countries. Repeated-measures analysis of variance and paired samples t tests conducted within each country identified thin-ideal internalization and media appearance pressures as the predominant risk factors for all four countries. Overall, findings suggest more cross-country similarities than differences, and highlight the importance of delivering interventions to address thin-ideal internalization and media appearance pressures among women from Western backgrounds.Level of evidence Descriptive study, Level V.
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http://dx.doi.org/10.1007/s40519-018-0544-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815512PMC
October 2019

Evaluation of the contribution of values clarification to a brief mindfulness meditation intervention for anxiety.

J Clin Psychol 2018 09 15;74(9):1387-1402. Epub 2018 Mar 15.

Department of Psychology, University at Albany, State University of New York.

Objective: Evaluate the incremental effects of a computerized values clarification (VC) activity on anxiety symptomology and quality of life over and above establishment of a mindfulness meditation (MM) practice.

Method: Anxious participants (N = 120, Female = 86; M  = 22.26) were randomly assigned to a 2-week, 10-min daily MM practice + control task or a 2-week, 10-min daily MM practice + VC task. Pre-assessments and post-assessments included well-established and ideographic self-report measures.

Results: Overall decreases in past week and past 24-h anxiety symptom frequency, as well as increased quality of life during the previous 24-h cycle only. VC did not have a demonstrable impact on outcomes.

Conclusions: Though findings are preliminary, brief VC exercises may not enhance outcomes that follow from mindfulness practice. Additional research is needed to isolate specific and shared impacts of mindfulness-based and values-based treatment strategies on anxiety symptoms and quality of life.
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http://dx.doi.org/10.1002/jclp.22610DOI Listing
September 2018

Associations among fear, disgust, and eating pathology in undergraduate men and women.

Appetite 2018 06 23;125:445-453. Epub 2018 Feb 23.

Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA.

Fear and disgust are distinct emotions that have been independently linked with EDs and may motivate avoidance behaviors that may be relevant targets for ED interventions (e.g., food rejection). Despite similar motivational function, it is possible that one emotion is more strongly associated with ED symptoms, relative to the other. Given that emerging evidence suggests that disgust-based behavior may be more difficult to change than fear-based behaviors, research is needed to evaluate whether each emotion differentially relates to ED symptoms. Therefore, the current study tested the relative importance of fear and disgust in accounting for variance in ED symptoms. Participants included undergraduate men (n = 127) and women (n = 263) from a university in the northeast US. Participants completed self-report measures assessing demographics, disordered eating attitudes and behaviors, and visual analog scales assessing fear and disgust responses to high-calorie food images, low-calorie food images, and non-food fear and disgust images. Bivariate correlations revealed significant positive associations among fear, disgust, and EDE-Q global symptom scores. Relative weights analysis results yielded relative importance weights that suggested disgust responding to high calorie food images accounts for the greatest total variance in EDE-Q global symptom scores in men, and fear responding to high calorie food images accounts for the greatest total variance in EDE-Q scores in women. Findings provide initial evidence that investigative and clinical efforts should consider fear and disgust as unique facets of negative affect with different patterns of relative importance to ED symptoms in undergraduate men and women.
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http://dx.doi.org/10.1016/j.appet.2018.02.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878746PMC
June 2018

Evaluating the role of repetitive negative thinking in the maintenance of social appearance anxiety: An experimental manipulation.

Behav Res Ther 2018 03 5;102:36-41. Epub 2018 Jan 5.

University at Albany, State University of New York, 399 Social Sciences, 1400 Washington Avenue, Albany, NY 12222, USA.

Social appearance anxiety (SAA), or fear of having one's appearance negatively evaluated by others, is a risk factor for eating pathology and social anxiety, but maintenance processes for SAA remain unclear. The current study evaluated repetitive negative thinking (RNT) as a process through which SAA is maintained over time. Undergraduates (N = 126) completed self-report measurements, made an impromptu speech task to induce SAA, and were randomized to either engage in RNT or distraction following the speech task. Participants then attended a second appointment one day later and were asked to make a second speech. Results indicated positive associations between self-reported trait SAA and RNT. Individuals asked to engage in RNT following the appointment 1 speech task reported significantly higher state SAA than those who engaged in distraction. Findings indicated no significant effect of group on appointment 2 SAA, but post-hoc analyses suggested that naturally-occurring RNT may have accounted for increases in SAA across appointments. Overall, results provide support for the importance of RNT in maintaining various internalizing symptoms.
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http://dx.doi.org/10.1016/j.brat.2018.01.001DOI Listing
March 2018

Expanding exposure-based interventions for eating disorders.

Int J Eat Disord 2017 10 16;50(10):1137-1141. Epub 2017 Aug 16.

University at Albany, State University of New York, Albany, New York.

Initial trials evaluating exposure-based interventions for eating disorders (EDs) in the 1980s demonstrated mixed results. Since that time, innovations in exposure therapy for anxiety disorders have yielded insights that can be used to refine and expand the approach to effectively target ED behaviors. This article provides a brief summary of relevant advances in exposure therapy for anxiety and outlines how these advances may be adapted and evaluated for use with ED samples. More specifically, we propose shifting to an inhibitory learning framework, considering treatment targets other than fear, and increasing variability in exposure techniques represent three important areas for future study. Overall, this article aims to provide professionals in the field with a framework for how to incorporate cutting-edge advances in exposure therapy into rigorous intervention research for EDs.
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http://dx.doi.org/10.1002/eat.22761DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5814124PMC
October 2017

An Interactive, Graphical Tool for Retrospectively Assessing Symptom Frequency and Severity: An Illustration With Eating Disorder Behaviors, Body Weight, and Stress.

Assessment 2017 Oct 16;24(7):835-852. Epub 2016 Sep 16.

3 University at Albany, Albany, NY, USA.

There are few assessments that gather valid, highly detailed data on short-term (i.e., weekly) symptom frequency/severity retrospectively. In particular, methodologies that provide valid data for research investigating symptom changes are typically prospective, expensive, and burdensome. The purpose of this study was to evaluate a new interactive and graphical assessment tool for gathering detailed information about eating-related symptom frequency/severity retrospectively over a 3-month period. A mixed eating disorder sample ( N = 113) recruited from the community provided symptom data once weekly for 12 weeks and completed the Interactive, Graphical Assessment Tool (IGAT) assessing eating disorder symptoms on three occasions to determine the test-retest and concurrent validity of the IGAT. The IGAT performed marginally better than other measures for retrospective symptom frequency assessment in the eating disorders and did so at a greater level of detail than other available tools. Future research should evaluate the IGAT with other behaviors of interest.
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http://dx.doi.org/10.1177/1073191116668629DOI Listing
October 2017

Running to win or to be thin? An evaluation of body dissatisfaction and eating disorder symptoms among adult runners.

Body Image 2016 Jun 4;17:43-7. Epub 2016 Mar 4.

University at Albany, State University of New York, 1400 Washington Avenue, Social Sciences 399, Albany, NY 12222, USA.

The current study evaluated associations between sport-performance-related body dissatisfaction (BD), general-appearance-related BD, and their relation to EAT-26 scores among a sample of adult runners who participated in middle- and long-distance races in the northeastern United States (N=400, 46.5% male). Women reported elevated BD and eating disorder symptoms, as compared to men. Ridge regression was used to analyze correlations between appearance- and performance-related BD with EAT-26 scores. Results demonstrated that appearance- and performance-related BD positively correlated with EAT-26 scores in women (βs=0.18 and 0.13, respectively). Race length was a significant covariate for women, such that those who ran middle-distance race events were more likely to report higher EAT-26 scores (β=-3.12). These associations were not demonstrated in men. Results suggest that it is beneficial to address sport-specific body image concerns, in addition to more general appearance-related body image concerns in female runners.
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http://dx.doi.org/10.1016/j.bodyim.2016.02.003DOI Listing
June 2016

Considering alternative calculations of weight suppression.

Eat Behav 2016 Jan 12;20:57-63. Epub 2015 Nov 12.

University at Albany, SUNY, Department of Psychology, 399 Social Sciences, 1400 Washington Avenue, Albany, NY 12222, USA. Electronic address:

Weight suppression (WS)--the difference between an individual's highest adult weight and current weight-relates to eating pathology and weight gain; however, there are several methodological issues associated with its calculation. The current study presents four alternative methods of calculating WS and tests whether these methods differentially relate to maladaptive outcomes. Alternative methods of calculation included: (1) change in BMI units; (2) BMI category change; (3) percent change in weight; and (4) two different uses of regression residuals. A sample of undergraduate students (N=631) completed self-report measures of eating pathology, current and past weight, and teasing. Measures included the Eating Disorder Examination-Questionnaire and the Perceptions of Teasing Scale. Results indicated that components of WS, current weight and highest weight, were strongly related in the present sample. The traditional method of calculating WS was related to eating pathology, binge eating and teasing for both males and females. However, WS indices orthogonal to the highest weight did not correlate with eating pathology and teasing in both males and females; for females, WS indices orthogonal to current weight were also unrelated to eating pathology. Findings suggest that the link between WS and eating pathology is mitigated after accounting for an individual's highest weight. Future research should continue to assess the reliability and clinical utility of this construct and consider using alternative WS calculations.
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http://dx.doi.org/10.1016/j.eatbeh.2015.11.003DOI Listing
January 2016

Does short-term fasting promote pathological eating patterns?

Eat Behav 2015 Dec 24;19:168-72. Epub 2015 Sep 24.

University of Albany, State University of New York, 399 Social Sciences Building, 1400 Washington Avenue, Albany, NY 12222, United States. Electronic address:

Fasting, or going a significant amount of time without eating, has been identified as a risk factor for the development of pathological eating patterns. Findings from several studies examining the impact of fasting on subsequent eating behaviors have been mixed. The current study recruited college students to record food intake, episodes of binge eating, and use of compensatory behaviors before, throughout, and following a 24-hour fast. Participants attended an initial appointment in which they completed measures of dietary restraint and disinhibition and received instructions on self-monitoring and fasting. Participants (N=122) self-monitored their eating behaviors for 96 h, including a 24-hour fasting period. Participants did not demonstrate significant increases in disordered eating behaviors following the fast (e.g., objective binge episodes, self-defined excessive eating or compensatory behavior use). Baseline disinhibition predicted excessive eating as well as objective binge episodes both before and after fasting. Altogether, findings have implications for research seeking to further understand how fasting may contribute to the development of pathological eating patterns; specifically, it seems that the ED risk associated with fasting is derived from the behavior's interaction with other individual difference variables.
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http://dx.doi.org/10.1016/j.eatbeh.2015.09.005DOI Listing
December 2015

Contributions of mindful eating, intuitive eating, and restraint to BMI, disordered eating, and meal consumption in college students.

Eat Weight Disord 2016 Mar 5;21(1):83-90. Epub 2015 Aug 5.

Department of Psychology, University at Albany, State University of New York, 1400 Washington Ave., Albany, NY, 12222, USA.

Purpose: Mindful eating and intuitive eating are promoted as means to circumvent potentially maladaptive dietary restraint while maintaining a healthy weight. Although theoretically related, no studies have examined the correlations between intuitive eating, mindful eating, and restraint in the same sample. This study sought to examine these constructs and their correlations with body mass index (BMI), eating-disordered behaviors, and meal consumption in a college sample.

Methods: Participants (N = 125) completed a laboratory taste-test meal and measures of each eating-related construct using the EDDS, IES, MEQ, and TFEQ-Restraint Subscale.

Results: Mindful eating, intuitive eating, and restraint were not strongly correlated. Hierarchical multiple regression analyses indicated that restraint and intuitive eating accounted for significant variance in disordered eating and BMI. Elevated restraint was associated with increased BMI and disordered eating; elevated intuitive eating was associated with decreased BMI and disordered eating. Mindful eating did not correlate with any outcome variables. Follow-up analyses suggested that specific intuitive eating subscales accounted for unique variance in the relation between intuitive eating and disordered eating. Intuitive eating was the only construct that was significantly associated with meal consumption.

Conclusions: Intuitive eating and restraint appear to be only weakly correlated, and each is differentially associated with meal consumption. Mindful eating does not appear to relate to outcome variables.
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http://dx.doi.org/10.1007/s40519-015-0210-3DOI Listing
March 2016

Is level of intuitive eating associated with plate size effects?

Eat Behav 2015 Aug 19;18:125-30. Epub 2015 May 19.

University at Albany-State University of New York, Department of Psychology, 1400 Washington Avenue, Social Sciences 399, Albany, NY 12222, United States. Electronic address:

Objective: Intuitive eating is an eating approach that emphasizes increased focus on internal hunger and fullness cues to regulate eating behavior; thus, successful intuitive eating should curb the influence of environmental factors such as plate and portion size on consumption. The current study examined whether self-reported levels of intuitive eating moderated the influence of portion size on college students' food consumption during an afternoon meal of pasta and tomato sauce.

Method: Participants (N=137, 63.5% female) were randomly assigned to either a large plate (12-inch) or small plate (8-inch) external cue condition. All participants fasted for four daytime hours, completed the Intuitive Eating Scale, and then were asked to rate a meal of pasta and tomato sauce on different dimensions of taste. Participants were told that they could eat as much pasta as they would like.

Results: Higher levels of intuitive eating were associated with greater food consumption. At the mean level of intuitive eating, participants ate more pasta in the large plate condition. Furthermore, the influence of plate size on food consumption increased as levels of intuitive eating increased.

Discussion: Individuals who report high levels of intuitive eating may be more likely to eat an objectively larger amount of food in a permissive food environment, and may have implications for eating approaches that promote eating in response to internal hunger and fullness cues.
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http://dx.doi.org/10.1016/j.eatbeh.2015.05.005DOI Listing
August 2015

A pilot study of maudsley family therapy with group dialectical behavior therapy skills training in an intensive outpatient program for adolescent eating disorders.

J Clin Psychol 2015 Jun 13;71(6):527-43. Epub 2015 Apr 13.

State University of New York at Albany.

Objective: The goal of this study was to provide pilot clinical data on the effectiveness of an intensive outpatient treatment model for adolescent eating disorders that combines Maudsley-based family therapy and group dialectical behavior therapy skills training.

Method: Measures of physical and psychological status were gathered upon admission, discharge, and at 3 follow-up intervals.

Results: Adolescents who completed the program gained a significant amount of weight and experienced a significant decrease in eating disorder psychopathology. At the 1-year follow-up, 64% of adolescents were weight restored and menstruating normally. Measures of eating disorder psychopathology continued to improve up to a year after treatment.

Conclusions: This pilot, multimodal program warrants further investigation and may be an effective intermediate level of care treatment option for adolescent eating disorders.
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http://dx.doi.org/10.1002/jclp.22176DOI Listing
June 2015

Development and validation of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4).

Psychol Assess 2015 Mar 6;27(1):54-67. Epub 2014 Oct 6.

Department of Psychology, University of Westminster.

The Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) and its earlier versions are measures designed to assess societal and interpersonal aspects of appearance ideals. Correlational, structural equation modeling, and prospective studies of the SATAQ-3 have shown consistent and significant associations with measures of body image disturbance and eating pathology. In the current investigation, the SATAQ-3 was revised to improve upon some conceptual limitations and was evaluated in 4 U.S. and 3 international female samples, as well as a U.S. male sample. In Study 1, exploratory and confirmatory factor analyses for a sample of women from the Southeastern United States (N = 859) indicated a 22-item scale with 5 factors: Internalization: Thin/Low Body Fat, Internalization: Muscular/Athletic, Pressures: Family, Pressures: Media, Pressures: Peers. This scale structure was confirmed in 3 independent and geographically diverse samples of women from the United States (East Coast N = 440, West Coast N = 304, and North/Midwest N = 349). SATAQ-4 scale scores demonstrated excellent reliability and good convergent validity with measures of body image, eating disturbance, and self-esteem. Study 2 replicated the factorial validity, reliability, and convergent validity of the SATAQ-4 in an international sample of women drawn from Italy, England, and Australia (N = 362). Study 3 examined a sample of college males from the United States (N = 271); the 5-factor solution was largely replicated, yet there was some evidence of an underlying structure unique to men. Future research avenues include additional item testing and modification of the scale for men, as well as adaptation of the measure for children and adolescents.
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http://dx.doi.org/10.1037/a0037917DOI Listing
March 2015

Gender-based differential item functioning in common measures of body dissatisfaction.

Body Image 2014 Jun 28;11(3):206-9. Epub 2014 Mar 28.

Department of Psychology, University at Albany, State University of New York, Albany, NY, United States. Electronic address:

Many widely used measures of body image were developed using all-female samples and thus may not adequately capture the male experience of body dissatisfaction. The current study examined differential item functioning (DIF) in three commonly-used measures of body image: The Body Shape Questionnaire (N=590, 39.7% male), the Body Dissatisfaction subscale of the Eating Disorders Inventory (N=529, 44.6% male), and the Shape and Weight Concern subscales of the Eating Disorders Examination Questionnaire (N=1116, 43.5% male). Participants completed a series of measures evaluating body image and eating pathology. Results evidenced statistically significant DIF in several of the items; one item met criteria for clinically significant DIF. While most items did not evidence clinically elevated levels of DIF, additional evaluation is necessary in order to determine overall quality of the measures in terms of capturing the experience of male body image concerns.
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http://dx.doi.org/10.1016/j.bodyim.2014.02.001DOI Listing
June 2014

Patterns of compensatory behaviors and disordered eating in college students.

J Am Coll Health 2014 ;62(8):526-33

a Department of Psychology, University at Albany, State University of New York , Albany , New York.

Unlabelled: Abstract.

Objective: The current study investigated rates of endorsement of eating-related compensatory behaviors within a college sample.

Participants: This sample included male and female students (N = 1,158).

Methods: PARTICIPANTS completed the Eating Disorder Examination Questionnaire (EDE-Q). The study defined 3 groups of students: those who did not endorse purging behaviors, those who endorsed only exercise, and those who endorsed laxative use or vomiting. Rates of related eating disorder risk variables were compared across the 3 groups.

Results: Almost half of college students reported utilizing exercise as a compensatory strategy over the past 28 days. Those reporting compensatory exercise did not differ from other community and college samples on EDE-Q subscales.

Conclusions: Findings suggest that college students report significant rates of compensatory exercise, and those who report exercise as their only compensatory behavior also report relatively low levels of eating disorder risk.
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http://dx.doi.org/10.1080/07448481.2014.930468DOI Listing
March 2016
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