Emotional eating and cognitive conflicts as predictors of binge eating disorder in patients with obesity

Background/Objectives: Binge Eating Disorder (BED) is often associated with obesity. In order to identify the variables that allow to better detect the presence of BED, people with overnutrition were compared with and without BED in the presence of cognitive conflicts, eating symptoms and anxious-depressive symptoms. The inclusion of cognitive conflicts had been relevant in bulimia studies but had not been investigated with respect to BED. Method: Two groups with obesity were evaluated, one without BED (OB, n = 54) and the other with BED (OB-BED, n = 48), using a social-demographic questionnaire as well as a semi-structured interview to assess BED, questionnaires (DASS-21, EDE-Q, EEQ) and the Repertory Grid Technique. Results: Overall, the OB-BED group presented more conflicts and more symptoms. The model that best differentiated between the groups included emotional eating and level of cognitive conflicts, correctly classifying 91.4% of the sample. Conclusion: These results highlight the role played by cognitive conflicts and emotional eating as differentiating elements between OB and OB-BED, with a high level of predictive accuracy.     

Naming speed as a predictive diagnostic measure in reading and attentional problems

This study aimed to describe and compare naming speed abilities in children diagnosed with either Reading Learning Difficulties (RLD) or Attention Deficit/Hyperactivity Disorder (ADHD), or comorbidity for both (ADHD+RLD). To examine the explanatory power of naming speed and ADHD symptomatology in predicting group associations (while controlling for gender and age), the “Rapid Automatized Naming and Rapid Alternating Stimulus Tests” (RAN/RAS) were utilized. A sample of 101 children (age range = 5–16 years) was divided into four groups: RLD (n = 14), ADHD (n = 28), comorbid (n = 19), and control (n = 40). There were statistically significant differences in RAN/RAS results among the diagnostic groups. Moreover, discriminant analysis revealed that naming speed tasks significantly predicted reading and attentional problems, especially at earlier ages. These results demonstrate the potential usefulness of RAN/RAS in the diagnosis of reading and attentional problems, particularly if the children are aged from 5 to 9.     

Parenting as a Mechanism of Change in Psychosocial Treatment for Youth with ADHD,Predominantly Inattentive Presentation

We investigated whether parenting and child behavior improve following psychosocial treatment for Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Presentation (ADHD-I) and whether parenting improvements mediate child outcomes. We analyzed data from a randomized clinical trial investigating the efficacy of a multicomponent psychosocial intervention (Child Life and Attention Skills, CLAS, n = 74) in comparison to Parent-Focused Treatment (PFT, n = 74) and treatment as usual (TAU, n = 51) for youth with ADHD-I (average child age = 8.6 years, range 7–11 years, 58 % boys). Child and parent/family functioning were assessed prior to treatment, immediately following treatment, and at follow-up into the subsequent school year using parent and teacher reports of inattention, organization, social skills, academic competency (teachers only), parenting daily hassles, and positive and negative parenting behaviors (parents only). Both treatment groups improved on negative parenting and home impairment, but only CLAS families also improved on positive parenting as well as academic impairment. Improvements in positive and negative parenting mediated treatment effects on child impairment independent of improvements in child inattention, implicating parenting as an important mechanism of change in psychosocial treatment for ADHD-I. Further, whereas parent-focused training produces improvements in negative parenting and impairment at home for children with ADHD-I, a multicomponent approach (incorporating child skills training and teacher consultation) more consistently produces improvements at school and in positive parenting, which may contribute to improvements in social skills into the next school year.     

Elucidating Genetic Counseling Outcomes from the Perspective of Genetic Counselors

Outcomes in the field of genetic counseling have not been well-defined or categorized, despite pressures to provide evidence-based measures in all areas of healthcare. This study describes a process to elucidate and categorize a wide-ranging set of outcomes as characterized by diverse groups of practicing genetic counselors. Semi-structured focus groups were conducted at the National Society of Genetic Counselors 2013 NSGC Annual Education Conference during an educational breakout session. A general inductive qualitative research approach was utilized to code focus group notes, categorize them into themes, and compare them across specialty groups. A total of 107 individuals participated in 14 focus groups, consisting of specialists in cancer (n = 20), general genetics (n = 40), prenatal genetics (n = 11), and “other” (n = 36). Of the twelve genetic counseling outcomes themes identified, the most common across focus groups included: 1) appropriateness of testing and accuracy of results interpretation; 2) psychosocial outcomes; 3) adherence to or receipt of appropriate medical management; and 4) patient and provider knowledge. Data assessed by specialty demonstrated similarities in outcomes themes, suggesting that a common set of genetic counseling outcomes would likely be appropriate to cover the majority of needs for the profession. Results can serve as a platform from which to build a more well-defined and comprehensive set of outcomes.     

Clinical Utility of Expanded Carrier Screening: Reproductive Behaviors of At-Risk Couples

Expanded carrier screening (ECS) analyzes dozens or hundreds of recessive genes to determine reproductive risk. Data on the clinical utility of screening conditions beyond professional guidelines are scarce. Individuals underwent ECS for up to 110 genes. Five-hundred thirty-seven at-risk couples (ARC), those in which both partners carry the same recessive disease, were invited to participate in a retrospective IRB-approved survey of their reproductive decision making after receiving ECS results. Sixty-four eligible ARC completed the survey. Of 45 respondents screened preconceptionally, 62% (n = 28) planned IVF with PGD or prenatal diagnosis (PNDx) in future pregnancies. Twenty-nine percent (n = 13) were not planning to alter reproductive decisions. The remaining 9% (n = 4) of responses were unclear. Of 19 pregnant respondents, 42% (n = 8) elected PNDx, 11% (n = 2) planned amniocentesis but miscarried, and 47% (n = 9) considered the condition insufficiently severe to warrant invasive testing. Of the 8 pregnancies that underwent PNDx, 5 were unaffected and 3 were affected. Two of 3 affected pregnancies were terminated. Disease severity was found to have significant association (p = 0.000145) with changes in decision making, whereas guideline status of diseases, controlled for severity, was not (p = 0.284). Most ARC altered reproductive planning, demonstrating the clinical utility of ECS. Severity of conditions factored into decision making.     

Eight-Year Latent Class Trajectories of Academic and Social Functioning in Children with Attention-Deficit/Hyperactivity Disorder

We examined trajectories of academic and social functioning in children with attention-deficit/hyperactivity disorder (ADHD) to identify those who might be at risk for especially severe levels of academic and social impairment over time. We estimated a series of growth mixture models using data from two subsamples of children participating in the NIMH Collaborative Multisite Multimodal Treatment Study of Children with ADHD (MTA) including those with at least baseline and 96-month data for reading and mathematics achievement (n = 392; 77.3% male; M age = 7.7; SD = 0.8) or social skills ratings from teachers (n = 259; 74.9% male; M age = 7.6; SD = 0.8). We compared latent trajectories for children with ADHD to mean observed trajectories obtained from a local normative (i.e., non-ADHD) comparison group (n = 289; 80.6% male; M age = 9.9; SD = 1.1). Results indicated six latent trajectory classes for reading and mathematics and four classes for teacher social skills ratings. There was not only a relationship between trajectories of inattention symptoms and academic impairment, but also a similarly strong association between trajectory classes of hyperactive-impulsive symptoms and achievement. Trajectory class membership correlated with socio-demographic and diagnostic characteristics, inattention and hyperactive-impulsive symptom trajectories, externalizing behavior in school, and treatment receipt and dosage. Although children with ADHD display substantial heterogeneity in their reading, math, and social skills growth trajectories, those with behavioral and socio-demographic disadvantages are especially likely to display severe levels of academic and social impairment over time. Evidence-based early screening and intervention that directly address academic and social impairments in elementary school-aged children with ADHD are warranted. The ClinicalTrials.gov identifier is NCT00000388.     

Subjective Well-Being in Adolescence: The Role of Self-Control,Social Support,Age, Gender,and Familial Crisis

Focusing on adolescents’ subjective well-being, the present study comprised three parts. The first examined the role of two coping mechanisms, self-control and social support, in predicting subjective well-being. The second related to the role of age and gender in predicting adolescents’ subjective well-being. The third raised the question of whether exposure to familial crisis would predict adolescents’ subjective well-being and whether self-control and social support would moderate the link between crisis and adolescents’ subjective well-being. Participants included 380 adolescents ages 13–17 years (M = 15.32, SD = .98; 194 boys, 176 girls, 10 unspecified), from six integrative junior-high and high schools in central Israel. All schools served a heterogeneous Jewish student population. Based on responses to a questionnaire identifying adolescents who reported experiencing a severe life crisis during the last year (e.g., severe illness in family, parent death or separation/divorce), the sample was divided into two groups: exposure to familial crisis (n = 96) and no exposure to familial crisis (n = 284). Outcomes revealed that both self-control and social support predicted adolescents’ subjective well-being. As expected, older adolescents presented lower levels of subjective well-being than younger ones. In contrast to the hypothesis, gender did not predict subjective well-being. Although exposure to crisis did not predict higher negative affect or lower positive affect, an interaction emerged between self-control and crisis in predicting positive affect. Thus, among adolescents who experienced crisis, better self-control skills predicted higher levels of positive affect.     

The Role of Gratitude in Breast Cancer: Its Relationships with Post-traumatic Growth, Psychological Well-Being and Distress

Despite the increasing number of studies documenting the positive effects of gratitude in coping with traumatic events and facilitating psychological well-being, none is addressed to patients with life-threatening illnesses such as cancer. The aims of this study are to examine the role of gratitude in a breast cancer sample and its correlations with post-traumatic growth, psychological well-being, and distress; and to compare patients reporting higher levels of gratitude (High Gratitude Individuals, HGI) versus those reporting lower levels (Low Gratitude Individuals, LGI). 67 breast cancer patients were assessed with: (1) Gratitude Questionnaire; (2) Post-traumatic Growth Inventory (PTGI); (3) Psychological Well-being Scales (PWBS) (4) Symptom Questionnaires (SQ); and were divided into: (1) High Gratitude Individuals—HGI (n = 27); (2) Low Gratitude Individuals—LGI (n = 40). Bivariate correlations between questionnaires and ANOVA between-group were calculated. Gratitude was significantly and positively correlated to all of PTGI scales, to PWBS positive relations, to SQ relaxation and contentment, and negatively related to anxiety, depression, and hostility-irritability. HGI and LGI reported significant differences on the PTGI and SQ dimensions, but not on PWB scales, with HGI displaying higher levels of PTGI, positive affect and lower symptomatology. Also in breast cancer patients gratitude is strongly associated to post-traumatic growth, reduced distress and increased positive emotions, but surprisingly not to psychological well-being. Since the majority of patients reported low gratitude levels, the results suggest the importance of developing interventions to clinically increase them also in oncology.     

Positive emotion infusions of elevation and gratitude: Increasing help-seeking intentions among people with heightened levels of depressive symptomatology

Three online studies assessed a new approach for increasing help seeking among people with depressive symptomatology (i.e. a positive emotion infusion, PEI). A PEI refers to the induction of positive emotion such that people’s mindsets – including perceptions of help-seeking – are temporarily altered. Study 1 (n = 382) indicated that help-seeking intentions are negatively correlated with depressive symptomatology and positively correlated with elevation and gratitude. Studies 2 and 3 implemented fully randomized experimental designs. In Study 2, two elevation-based (Study 2a, n = 285) and two gratitude-based (Study 2b, n = 338) emotion inductions increased levels of elevation and gratitude, respectively. Results of Study 3a (n = 390) indicate a causal relationship between experiencing the story-based elevation induction and increased help-seeking intentions. The two gratitude-based PEIs (Study 3b, n = 466) were unsuccessful at influencing help-seeking; auxiliary analyses indicate the possibility of iatrogenic effects. Overall, the potential of PEIs was indicated, as was need for caution.     

The Beneficial Role of Spiritual Counseling in Heart Failure Patients

To ascertain the beneficial role of spiritual counseling in patients with chronic heart failure. This is a pilot study evaluating the effects of adjunct spiritual counseling on quality of life (QoL) outcomes in patients with heart failure. Patients were assigned to “religious” or “non-religious” counseling services based strictly on their personal preferences and subsequently administered standardized QoL questionnaires. A member of the chaplaincy or in-house volunteer organization visited the patient either daily or once every 2 days throughout the duration of their hospitalization. All patients completed questionnaires at baseline, at 2 weeks, and at 3 months. Each of the questionnaires was totaled, with higher scores representing positive response, except for one survey measure where lower scores represent improvement (QIDS-SR16). Twenty-three patients (n = 23, age 57 ± 11, 11 (48 %) male, 12 (52 %) female, mean duration of hospital stay 20 ± 15 days) completed the study. Total mean scores were assessed on admission, at 2 weeks and at 3 months. For all patients in the study, the mean QIDS-SR16 scores were 8.5 (n = 23, SD = 3.3) versus 6.3 (n = 18, SD = 3.5) versus 7.3 (n = 7, SD = 2.6). Mean FACIT-Sp-Ex (version 4) scores were 71.1 (n = 23, SD = 15.1) versus 74.7 (n = 18, SD = 20.9) versus 81.4 (n = 7, SD = 8.8). The mean MSAS scores were 2.0 (n = 21, SD = 0.6) versus 1.8 (n = 15, SD = 0.7) versus 2.5 (n = 4, SD = 0.7). Mean QoL Enjoyment and Satisfaction scores were 47.2 % (n = 23, SD = 15.0 %) versus 53.6 % (n = 18, SD = 16.4 %) versus 72.42 % (n = 7, SD = 22 %). The addition of spiritual counseling to standard medical management for patients with chronic heart failure patients appears to have a positive impact on QoL.     

Relationships between identity domains and life satisfaction in minority and majority youth in Albania,Bulgaria, Czech Republic,Kosovo, and Romania

Abstract

The purpose of this study was to examine relationships between identity domains (educational and relational identity) and life satisfaction in a cross-national perspective, by targeting minority (Roma) and majority youth in Albania, Bulgaria, Czech Republic, Kosovo, and Romania. Based on the three-factor identity formation model, we investigated the interplay between three identity processes (i.e., commitment, in-depth exploration, and reconsideration of commitment) and life satisfaction. Participants were 1860 adolescents aged 12–19 years from Albania (n = 350), Bulgaria (n = 398), the Czech Republic (n = 293), Kosovo (n = 542), and Romania (n = 277). They completed self-reports of the Utrecht-Management of Identity Commitments Scale (U-MICS) and the Life Satisfaction Scale (SWLS). We adopted a structural equation modelling approach to test (a) measurement invariance of identity and life satisfaction models across groups and (b) associations between identity domains (educational and relational) and life satisfaction. Findings indicated measurement invariance for identity and life satisfaction measures across cultural groups. In the total sample, life satisfaction was consistently associated with high commitment, high in-depth exploration, and low reconsideration of commitment in the educational identity domain. Sample-specific associations highlighted important cultural differences. Implications of these findings for identity and well-being in minority and mainstream youth across the countries under investigation are discussed.     

VERB™ Summer Scorecard: Findings from a Multi-level Community-based Physical Activity Intervention for Tweens

The benefits of physical activity for adolescents are well established. Multi-level interventions may be especially effective in establishing and sustaining health-enhancing behaviors. This study explored the influences of a multi-level community intervention aimed at increasing physical activity among tweens (youth 9–13). Two Florida school districts far apart served as intervention and comparison sites in a quasi-experimental post-test design. Youth in grades 5 through 8 in the intervention community (n = 1,253) and comparison community (n = 866) completed an anonymous post-intervention survey. An intent-to-treat analysis did not show any statistically significant group differences for the physical activity outcomes examined. However, a subset analysis revealed that students who reported participating in the intervention were more likely to be physically active than youth in the comparison group, as well as youth in the intervention community who reported not participating. Participating in the intervention was significantly related to meeting recommendations for vigorous physical activity (OR = 2.08, P = 0.0259), being physically active on weekends (OR = 1.84, P = 0.0017), and reporting more days of trying a new game or sport (OR = 1.49, P = 0.046) after controlling for grade, gender, race/ethnicity, and SES. These findings support the efficacy of multi-level interventions to create effective health behavior change, especially when linkages among community, media, schools, and the home are present.     

Performing and Declining PGD: Accounts of Jewish Israeli Women Who Carry a <Emphasis Type="Italic">BRCA1/2</Emphasis> Mutation or Partners of Male Mutation Carriers

To describe factors associated with preimplantation genetic diagnosis (PGD) decisions among Jewish Israeli BRCA1/2 carriers or spouses of a male carrier, we contacted all women who initiated PGD consultation for embryonic BRCA1/2 mutation detection at Sheba Medical Center, prior to March 2014. Applying a qualitative approach, we asked women to elaborate on the factors they considered in either opting for PGD or discontinuing the screening procedure. Participants were 18 Jewish Israeli women; 14 were carriers of one of the Ashkenazi founder mutations in BRCA1/2, and four were spouses of male mutation carriers, who underwent at least one cycle of PGD. Prior to seeking PGD, ten of the women had no children. At the time of the interview, all but three had at least one child. Three factors emerged as key motivators for PGD: having witnessed the disease in a close relative (n = 12); prior IVF treatment for infertility (n = 12); and having pre-existing frozen embryos (n = 6). Ten women withdrew from the PGD process due to clinical, logistical, and financial reasons. In conclusion, most women decided to withdraw from PGD instead of continuing until a successful conception was achieved. Those who opted for PGD attributed their discontinuation of further screening to the emotional burden that is greatly intensified by practical difficulties.     

Associations Between Sport Participation,Goal and Sportspersonship Orientations,and Moral Reasoning

This study examined associations between level of sport participation, goal and sportspersonship orientations, and moral reasoning in sport and nonsport situations and orientation by sport participation interactions. Participants were individuals with elite (n = 176), high school (n = 183), and youth sport (n = 78) participation. When judging sport situations, individuals who participated in elite sports demonstrated poorer moral reasoning than those who participated in high school and youth sports. At low levels of sportspersonship, individuals who participated in youth sports demonstrated higher moral reasoning than those who participated in high school and elite sports. When judging nonsport situations, moral reasoning was positively related to positive sportspersonship and negatively related to ego orientation but did not differ by sport participation. Within sport, sport participation and goal and sportspersonship orientations play a critical role in moral reasoning. However, these orientations may be more important than sport participation in moral reasoning beyond the sport context.     

Association of financial and health literacy with cognitive health in old age

We tested the hypothesis that higher financial and health literacy is associated with better cognitive health in 755 older persons who completed a literacy measure (M = 67.9, SD = 14.5) and then had annual clinical evaluations for a mean of 3.4 years. In proportional hazards models, higher literacy was associated with decreased risk of developing incident Alzheimer’s disease (n = 68) and results were similar for financial and health literacy subscales and after adjustment for potential confounders. In mixed-effects models, higher literacy was related to higher baseline level of cognition and reduced cognitive decline in multiple domains. Among the 602 persons without any cognitive impairment at baseline, higher literacy was associated with a reduced rate of cognitive decline and risk of developing incident mild cognitive impairment (n = 142). The results suggest that higher levels of financial and health literacy are associated with maintenance of cognitive health in old age.     

“Leaving it to God” Religion and Spirituality among Filipina Immigrant Breast Cancer Survivors

Many Filipinos have a powerful adherence to Catholicism. However, little is known about spirituality and religious involvement of Filipina Americans who have been diagnosed with breast cancer. Ten (n = 10) in-depth qualitative interviews with Filipina immigrant breast cancer survivors identified prayer to be the most common religious practice, followed by prayers by others and spiritual support from the Catholic Church. These findings can help clinicians and researchers understand the role of spirituality and religion in providing comfort and support for Filipina immigrant breast cancer patient as they face the stress of diagnosis and treatment.     

Addressing the Challenges Faced by Early Adolescents: A Mixed-Method Evaluation of the Benefits of Peer Support

In this article, we describe a mixed-methods study used to examine the effectiveness of a widely-used peer support program designed to facilitate the transition to adolescence and high school by enhancing self-concept and other desirable outcomes. For the quantitative component, a longitudinal design was employed (930 Grade 7 students, 3 schools, 2 years), with control group and baseline (i.e., pre-program) data against which to compare the effects. Using a multilevel approach, the results provide evidence to suggest that the program was largely successful in achieving its aims of enhancing students’ school self-concept, school citizenship, sense of self and possibility, connectedness, and resourcefulness. A sub-sample of students from the experimental group participated in the qualitative component, which included open-ended survey results (n = 408 Grade 7 students, n = 75 peer support leaders) and focus groups (n = 119 Grade 7 students, n = 44 peer support leaders) to identify students’ personal perspectives of the program. The qualitative results confirmed the quantitative findings that the program has important benefits for Grade 7 students and provided rich and valuable insights into students’ views of the intervention. The findings of this research have important implications and suggest that the provision of peer support has the potential to a make significant contribution to schools’ efforts to orchestrate positive outcomes for adolescents.     

Effectiveness of Two Cognitive Interventions Promoting Happiness with Video-Based Online Instructions

A 3-month experimental online study examined the short-term and 1 month follow-up effects of regularly practicing one of two cognitive interventions on subjective well-being. Participants were 435 self-selected adults (366 female, 69 male, aged 18–63) randomly assigned to one of three conditions: writing about best possible selves in the future (n = 135), making gratitude lists (n = 150) or writing to-do-lists as a control condition (n = 150). The study was fully self-administered and exercise instructions were given in online videos. Repeated-measures MANOVA revealed that both interventions significantly increased subjective well-being in comparison to the control condition. Effect sizes for the different components of subjective well-being ranged from r = .09–.13 (η² = .01–.02) for the 2 months intervention period. These effects were maintained until the 1-month follow-up. Enjoyment and interest regarding the exercise as indicators of perceived person-intervention-fit moderated the effect; participants of the happiness interventions who perceived a better fit showed greater increases in subjective well-being. These findings confirm previous research on these interventions and encourage further studies on online interventions, especially regarding possibilities to increase participants’ motivation and reduce dropout attrition.     

Smaller splenium in children with nonverbal learning disability compared to controls,high-functioning autism and ADHD

The current study investigated morphological differences in the corpus callosum in children ages 8 to 18 years old with nonverbal learning disability (NLD; n = 19), high-functioning autism (HFA; n = 23), predominantly inattentive ADHD (ADHD:PI; n = 23), and combined type ADHD (ADHD:C; n = 25), as well as those demonstrating typical development (n = 57). Midsagittal area of the corpus callosum and five midsagittal anterior-to-posterior corpus callosum segments were examined using magnetic resonance imaging. Controlling for midsagittal brain area and age, no group differences were found for total corpus callosum area. This finding indicates that higher functioning children on the autistic spectrum do not have smaller corpus callosi as has been found in previous research with heterogeneous samples. Following segmentation of the corpus callosum, the NLD group was observed to have significantly smaller splenia compared to all other groups. Smaller splenia in the NLD group was associated with lower WASI PIQ scores but not WASI VIQ scores. Children with HFA were observed to have larger midbody areas than children with NLD and neurotypically developing children. Children with HFA and NLD demonstrated behavioral symptoms of inattention and hyperactivity similar to the ADHD groups indicating that corpus callosum differences seen in the NLD and HFA groups are not related to these behaviors.     

Diagnostic Accuracy of Memory Measures in Alzheimer’s Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

With an increasing focus on biomarkers in dementia research, illustrating the role of neuropsychological assessment in detecting mild cognitive impairment (MCI) and Alzheimer’s dementia (AD) is important. This systematic review and meta-analysis, conducted in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) standards, summarizes the sensitivity and specificity of memory measures in individuals with MCI and AD. Both meta-analytic and qualitative examination of AD versus healthy control (HC) studies (n = 47) revealed generally high sensitivity and specificity (≥ 80% for AD comparisons) for measures of immediate (sensitivity = 87%, specificity = 88%) and delayed memory (sensitivity = 89%, specificity = 89%), especially those involving word-list recall. Examination of MCI versus HC studies (n = 38) revealed generally lower diagnostic accuracy for both immediate (sensitivity = 72%, specificity = 81%) and delayed memory (sensitivity = 75%, specificity = 81%). Measures that differentiated AD from other conditions (n = 10 studies) yielded mixed results, with generally high sensitivity in the context of low or variable specificity. Results confirm that memory measures have high diagnostic accuracy for identification of AD, are promising but require further refinement for identification of MCI, and provide support for ongoing investigation of neuropsychological assessment as a cognitive biomarker of preclinical AD. Emphasizing diagnostic test accuracy statistics over null hypothesis testing in future studies will promote the ongoing use of neuropsychological tests as Alzheimer’s disease research and clinical criteria increasingly rely upon cerebrospinal fluid (CSF) and neuroimaging biomarkers.