Publications by authors named "Sara R Gould"

7 Publications

  • Page 1 of 1

Measurement invariance of the Eating Pathology Symptoms Inventory (EPSI) in adolescents and adults.

Eat Behav 2021 08 2;42:101538. Epub 2021 Jul 2.

Recovery Record, Inc., San Francisco, CA, USA.

Adolescence is a common period for eating disorder (ED) onset. The availability of psychometrically sound measures of ED psychopathology enables clinicians to accurately assess symptoms and monitor treatment outcomes continuously from adolescence and adulthood. The purpose of this study was to assess if the Eating Pathology Symptoms Inventory (EPSI) is invariant across adolescents and adults. Participants (N = 29,821) were adolescent (n = 5250) and adult (n = 24,571) users of the Recovery Record (RR) mobile phone application who provided EPSI responses through the application. Measurement invariance testing was conducted to assess invariance of the EPSI Body Dissatisfaction, Restricting, Excessive Exercise, Purging, Cognitive Restraint, and Binge Eating scales across adolescents (age 13 through 17) and adults (age 18 and older). Findings indicated that all EPSI factors administered in the RR app replicated in both adolescent and adult users. The EPSI factor structure was largely equivalent in adolescents and adults, demonstrating evidence for configural and metric invariance, as well as some evidence for scalar invariance. Our results indicated that EPSI scales measured the same constructs across development. Clinicians and researchers may benefit from utilizing the EPSI to measure ED psychopathology in adolescents and for continued progress monitoring into adulthood.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.eatbeh.2021.101538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518978PMC
August 2021

HiTOP Assessment of the Somatoform Spectrum and Eating Disorders.

Assessment 2021 Jun 9:10731911211020825. Epub 2021 Jun 9.

University of Mainz, Mainz, Germany.

We report on Phase 1 efforts of the Hierarchical Taxonomy of Psychopathology (HiTOP) measurement subgroup tasked with developing provisional scales for the somatoform spectrum and eating disorders. In Study 1, items were written to assess five somatoform spectrum constructs (bodily distress symptoms, conversion symptoms, health anxiety, disease conviction, and somatic preoccupation). Scale development analyses were conducted on 550 university students. The conversion symptom items were too infrequently endorsed and were set aside for Phase 2. Analyses of the other items yielded four scales corresponding closely to their hypothesized structure. In Study 2, we delineated 15 specific feeding and eating disorder constructs. A sample of 400 university students were administered candidate items and several eating disorder questionnaires for criterion validity. Analyses yielded six scales capturing previously described constructs, tapping content related to body image and weight concerns, restricting and purging, cognitive restraint, binging, excessive exercise, and muscle building. Two scales representing additional constructs deemed to be of high clinical import-negative attitude towards obesity and avoidant/restrictive food intake disorder-were retained for Phase 2, for a total of eight scales. Overall, we concluded that Phase 1 had been successful at generating a comprehensive set of provisional scales for inclusion in Phase 2.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/10731911211020825DOI Listing
June 2021

Do differences between individuals who are healthy weight or overweight on self-report measures of disinhibited eating and restrained eating reflect reality or item "bias"?

Psychol Assess 2020 Jun 19;32(6):553-567. Epub 2020 Mar 19.

Department of Internal Medicine.

In light of increasing rates of overweight and obesity worldwide, there is a critical need for accurate self-report measures of disinhibited and restrained eating behaviors across the weight spectrum. Item response theory was used to determine whether differences in disinhibited and restrained eating between healthy weight and overweight or obese individuals were due to item bias (i.e., differential item functioning). Study 1 participants were healthy weight ( = 510) or overweight or obese ( = 304) adults recruited from the community. Study 2 participants were healthy weight ( = 778) or overweight or obese ( = 320) college students. Study 1 participants completed the Eating Disorder Examination-Questionnaire (EDE-Q), Eating Disorder Inventory-3, Dutch Eating Behaviors Questionnaire, Restraint Scale, and Three-Factor Eating Questionnaire. Study 2 participants completed the Eating Pathology Symptoms Inventory (EPSI). Items on the Restraint Scale demonstrated the most evidence for bias (60% of items), whereas the majority of other scales demonstrated low to moderate levels of item bias (17-38% of items). However, EDE-Q Restraint and EPSI Binge Eating, Cognitive Restraint, Excessive Exercise, Muscle Building, and Negative Attitudes Toward Obesity scales did not show any evidence of differential item functioning among weight groups. Participants with the same level of disordered eating responded differently to certain eating disorder self-report items due to weight-bias, rather than true between-groups differences. Nevertheless, EDE-Q Restraint, EPSI Cognitive Restraint, and EPSI Binge Eating did not exhibit any evidence of bias and are ideal for assessing restrained and disinhibited eating across the weight spectrum in both research and clinical settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1037/pas0000810DOI Listing
June 2020

A new approach to eating-disorder classification: Using empirical methods to delineate diagnostic dimensions and inform care.

Int J Eat Disord 2018 07 21;51(7):710-721. Epub 2018 Aug 21.

Department of Psychology, University of Minnesota, Minneapolis, Minnesota.

Objective: Despite changes to the diagnostic criteria for eating disorders (EDs) in the DSM-5, the current diagnostic system for EDs has limited ability to inform treatment planning and predict outcomes. Our objective was to test the clinical utility of a novel dimensional approach to understanding the structure of ED psychopathology.

Method: Participants (N = 243; 82.2% women) were community-recruited adults with a DSM-5 ED assessed at baseline, 6-month, and 1-year follow-up. Hierarchical factor analysis was used to identify a joint hierarchical-dimensional structure of eating, mood, and anxiety symptoms. Exploratory structural equation modeling was used to test the ability of the dimensional model to predict outcomes.

Results: At the top of the hierarchy, we identified a broad Internalizing factor that reflected diffuse symptoms of eating, mood, and anxiety disorders. Internalizing branched into three subfactors: distress, fear-avoidance (fears of certain stimuli and behaviors to neutralize fears, including ED behaviors designed to reduce fear of weight gain), and body dissatisfaction, which was nested within distress. The lowest level of the hierarchy was characterized by 15 factors. The hierarchical model predicted 60.1% of the variance in outcomes at 6-month follow-up, whereas all DSM eating, mood, and anxiety disorders combined predicted 35.8% of the variance in outcomes.

Discussion: A dimensional approach to understanding and diagnosing EDs improved the ability to prospectively predict clinical course above-and-beyond the traditional categorical (DSM-based) approach. Our findings have implications for endeavors to improve the prediction of ED prognosis and course, and to develop more effective trans-diagnostic treatments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/eat.22891DOI Listing
July 2018

New Horizons in Measurement: a Review of Novel and Innovative Approaches to Eating-Disorder Assessment.

Curr Psychiatry Rep 2017 Sep 11;19(10):76. Epub 2017 Sep 11.

Department of Psychology, University of Kansas, Fraser Hall, 1415 Jayhawk Boulevard, Lawrence, KS, 66045, USA.

Purpose Of Review: Eating disorders are serious mental-health concerns that will affect over 30 million individuals in the USA at some point in their lives. Eating disorders occur across the lifespan, in a variety of ethnicities and races, in both men and women, and across the socioeconomic spectrum. Given the prevalence and severity of eating disorders, it is important that clinicians and researchers have access to appropriate assessment tools to aid in the early identification and treatment referral, differential diagnosis, treatment planning, and progress monitoring, and to ensure valid research findings. In this review, we describe novel and innovative assessment tools that were developed within the past 5 years for utilization in research and/or clinical practice with individuals with eating disorders.

Recent Findings: We identified six multidimensional assessments for eating disorders, all of which can be administered online (with some also offering paper-and-pencil versions). Strengths of the measures included good internal consistency, test-retest reliability, and convergent validity. However, in part, due to problematic scale construction methods, certain scales had poor discriminant validity and most were developed and validated in mostly female samples. There are promising new eating disorder measures from which to choose; however, many measures continue to be limited by poor discriminant validity and need additional validation prior to incorporation into routine research and clinical practice.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11920-017-0826-2DOI Listing
September 2017

Understanding eating disorders within internalizing psychopathology: A novel transdiagnostic, hierarchical-dimensional model.

Compr Psychiatry 2017 11 28;79:40-52. Epub 2017 Jun 28.

Children's Mercy Kansas City, United States.

Background: Several problems with the classification and diagnosis of eating disorders (EDs) have been identified, including proliferation of 'other specified' diagnoses, within-disorder heterogeneity, and frequent diagnostic migration over time. Beyond problems within EDs, past research suggested that EDs fit better in a spectrum of internalizing psychopathology (characterized by mood and anxiety disorders) than in a separate diagnostic class.

Purpose: To develop a transdiagnostic, hierarchical-dimensional model relevant to ED psychopathology that: 1) reduces diagnostic heterogeneity, 2) includes important dimensions of internalizing psychopathology that are often excluded from ED diagnostic models, and 3) predicts clinical impairment.

Procedures: Goldberg's (2006) method and exploratory structural equation modeling were used to identify a hierarchical model of internalizing in community-recruited adults with EDs (N=207).

Findings: The lowest level of the hierarchy was characterized by 15 factors that defined specific aspects of eating, mood, and anxiety disorders. At the two-factor level, Internalizing bifurcated into Distress (low well-being, body dissatisfaction, suicidality, dysphoria, ill temper, traumatic intrusions) and Fear-Avoidance (claustrophobia, social avoidance, panic symptoms, dietary restricting, excessive exercise, and compulsions). Results showed that the lowest level of the hierarchy predicted 67.7% of the variance in clinical impairment. In contrast, DSM eating, mood, and anxiety disorders combined predicted 10.6% of the variance in impairment secondary to an ED.

Conclusions: The current classification model represents an improvement over traditional nosologies for predicting clinically relevant outcomes for EDs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.comppsych.2017.06.009DOI Listing
November 2017

Do state mental health plans address the New Freedom Commission's goals for children's mental health?

Clin Child Fam Psychol Rev 2009 Dec;12(4):295-309

Clinical Child Psychology Program, 2009 Dole Human Development Center, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045-7561, USA.

The latest initiative to address mental health needs of the nation, including those of children and youth, is the President's New Freedom Commission on Mental Health (NFC). The NFC formulated a benchmark of six goals and related recommendations toward which the U.S. should strive, including the recommendation that each state develop a comprehensive mental health plan. It is not clear, however, whether the states' developed plans address the goals established by the NFC and to what degree. This project provides a summary of 50 state mental health plans regarding children and youth in the U.S. by examining components that address each of the six NFC goals and is a test of federal leadership on a state issue. Results indicate that state mental health plans addressed the NFC goals to differing degrees with specific attention to children and youth mental health services. Overall, the NFC goal of eliminating disparities in mental health services was addressed most completely, while the NFC goal of understanding that mental health and physical health are associated was addressed least often. The information provided by this analysis represents a first step in gaining a comprehensive picture about public policies for the mental health of children, adolescents, and their families.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10567-009-0054-3DOI Listing
December 2009
-->