Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns: implications for eating disorder prevention

Third-wave behavioural interventions are increasingly popular for treating and preventing mental health conditions. Recently, researchers have begun testing whether these interventions can effectively targeting eating disorder risk factors (disordered eating, body image concerns). This meta-analysis examined whether third-wave behavioural interventions (acceptance and commitment therapy; dialectical behaviour therapy; mindfulness-based interventions; compassion-focused therapy) show potential for being effective eating disorder prevention programs, by testing their effects on eating disorder risk factors in samples without an eating disorder. Twenty-four studies (13 randomized trials) were included. Most studies delivered selective prevention programs (i.e. participants who reported elevated risk factor). Third-wave interventions led to significant pre–post (g = 0.59; 95% CI = 0.43, 0.75) and follow-up (g = 0.83; 95% CI = 0.38, 1.28) improvements in disordered eating, and significant pre–post improvements in body image (g = 0.35; 95% CI = 0.13, 0.56). DBT-based interventions were associated with the largest effects. Third-wave interventions were also significantly more efficacious than wait-lists (g = 0.39; 95% CI = 0.09, 0.69) in reducing disordered eating, but did not differ to other interventions (g = 0.25; 95% CI = –0.06, 0.57). Preliminary evidence suggests that third-wave interventions may have a beneficial effect in ameliorating eating disorder risk.     

In Search of Meaning: A Preliminary Typology of Gay Male Spiritual Identity Development

Reconciliation of the conflict between religious identity and sexual orientation has been related to a number of psychological challenges (Lease, Horne, & Noffsinger‐Frazier, 2005; Schuck & Liddle, 2001), and little is known about the convergence of spiritual identity, distinctly defined as separate from religious identity, and sexual orientation identity. This qualitative inquiry investigated the process by which 7 Caucasian gay men from a variety of religious backgrounds constructed spiritual identities outside the realm of institutionalized religion. From the findings, the authors hypothesize a typology of spiritual development influenced by religions of origin. Limitations of the study, implications, and future directions in research are also addressed.     

Maternal and child contributions to cortisol response to emotional arousal in young children from low-income, rural communities

Relations of maternal and child characteristics to child cortisol reactivity to and recovery from emotional arousal were examined prospectively at approximately 7 months of age (infancy) and then again at approximately 15 months of age (toddlerhood). The sample was diverse and population based (N = 1,292 mother-infant dyads) and included families from predominantly low-income, rural communities. Maternal behavior, family income-to-need ratio and social advantage, and child temperament, attention, and mental development were assessed, and children's saliva was sampled before and after standardized procedures designed to elicit emotional arousal. Maternal engagement in infancy was associated with greater cortisol reactivity at the infancy assessment and with reduced overall cortisol level at the toddler assessment. Also at the toddler assessment, child attention, mental development, and temperamental distress to novelty were associated with increased cortisol reactivity and regulation, whereas temperamental distress to limitations and African American ethnicity were associated with reduced cortisol reactivity. Findings are consistent with prior work linking early caregiving to the development of the hypothalamic-pituitary-adrenal axis stress response system and with a conceptual model in which developing temperament is characterized by the interplay of emotional reactivity and the emergence of the ability to effortfully regulate this reactivity using attention.     

Comparative decline of professional school graduates' performance on the Examination for Professional Practice in Psychology

The discrepancy between traditional (Boulder Model) and professional school (Vail Model) clinical psychology graduate programs on the Examination for Professional Practice in Psychology (EPPP) was greater using 1997-2005 data than in an earlier study using 1988-1995 data. The relative decline of the performance of professional school graduates on the EPPP was attributed in part to the increase of 31.1% in number of listed professional schools over the last decade, in particular, because those schools have lower academic standards. It is recommended that professional programs accept fewer students and have more rigorous quality control mechanisms for the students who have been accepted. It is further recommended that no new professional schools be started and that marginal programs be phased out.     

Clinical Interview for high‐risk Parents of premature infants (CLIP) as a predictor of early disruptions in the mother–infant relationship at the nursery

The relations between mothers' narrative regarding the infant and the premature birth and the quality of mother–infant interaction were examined in mothers of 47 very low birth weight (<1650 g) premature singletons prior to discharge. Maternal representations were assessed with the Clinical Interview for high‐risk Parents of premature babies (CLIP), a semistructured interview that explores mothers' experiences of the pregnancy, delivery, hospitalization period, thoughts and feelings about the infant, and impending discharge. Ten minutes of mother–infant interaction were videotaped, and global and microanalytic codes were used to define three interactive variables: maternal adaptation, maternal touch, and infant withdrawal. Factor analysis of the CLIP items identified two factors with eigen values of 2.00 and above, termed Readiness for Motherhood and Maternal Rejection. Regression analyses were used to predict the three interactive variables by the infant's medical condition, maternal anxiety and depression, and the CLIP factors. Maternal adaptation to the infant's signal and maternal positive touch were each uniquely predicted by the mother's readiness for the maternal role, and were each negatively related to maternal depression. The infant's interactive withdrawal was independently predicted by maternal rejection. The clinical implications of the findings and the potential use of the CLIP for routine detection of early disruptions in the mother–infant relationship are discussed. ©2003 Michigan Association for Infant Mental Health.     

Initial Reliability and Validity of the Life Satisfaction Scale for Problem Youth in a Sample of Drug Abusing and Conduct Disordered Youth

Responses to Life Satisfaction Scale for Problem Youth (LSSPY) items were examined in a sample of 193 substance abusing and conduct disordered adolescents. In responding to the LSSPY, youth endorse their percentage of happiness (0 to 100%) in twelve domains (i.e., friendships, family, school, employment/work, fun activities, appearance, sex life/dating, use of drugs, use of alcohol, money/material possessions, transportation, control of one's life). Results indicated that the LSSPY yielded three factor structures (i.e., Social Satisfaction, External Obligations Satisfaction, Substance Use Satisfaction), demonstrated good initial psychometric properties, and appears to be a useful instrument in the evaluation of treatment outcome in problem youth. Males were more satisfied in the Social and External Obligations domains than females, although no gender differences were indicated in Substance Use Satisfaction. Caucasian, African-American, and Hispanic youths responded to LSSPY items similarly. Future directions are discussed in light of these results.     

The development of an attentional bias for angry faces following Pavlovian fear conditioning

Although it is well documented that fear responses develop following aversive Pavlovian conditioning, it is unclear whether fear learning also manifests in the form of attentional biases for fear-related stimuli. Boschen, Parker, and Neumann (Boschen, M. J., Parker, I., & Neumann, D. L. (2007). Changes in implicit associations do not occur simultaneously to Pavlovian conditioning of physiological anxiety responses. Journal of Anxiety Disorders, 21, 788-803.) showed that despite the acquisition of differential skin conductance conditioned responses to angry faces paired (CS+) and unpaired (CS−) with an aversive shock, development of implicit associations was not subsequently observed on the Implicit Association Test. In the present study, participants (N = 76) were assigned either to a Shock or NoShock group and completed a similar aversive Pavlovian conditioning procedure with angry face CS+ and CS− stimuli. Participants next completed a visual probe task in which the angry face CS+ and CS− stimuli were paired with angry face control stimuli and neutral faces. Results confirmed that differential fear conditioning was observed in the Shock group but not in the NoShock group, and that the Shock group subsequently showed a selective attentional bias for the angry face CS+ compared with the CS− and control stimuli during the visual probe task. The findings confirm the interplay between learning-based mechanisms and cognitive processes, such as attentional biases, in models of fear acquisition and have implications for treatment of the anxiety disorders.     

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.     

Revisiting the effect of quality of graphics on distance judgments in virtual environments: A comparison of verbal reports and blind walking

In immersive virtual environments, judgments of perceived egocentric distance are significantly underestimated, as compared with accurate performance in the real world. Two experiments assessed the influence of graphics quality on two distinct estimates of distance, a visually directed walking task and verbal reports. Experiment 1 demonstrated a similar underestimation of distances walked to previously viewed targets in both low- and high-quality virtual classrooms. In Experiment 2, participants’ verbal judgments underestimated target distances in both graphics quality environments but were more accurate in the high-quality environment, consistent with the subjective impression that high-quality environments seem larger. Contrary to previous results, we suggest that quality of graphics does influence judgments of distance, but only for verbal reports. This behavioral dissociation has implications beyond the context of virtual environments and may reflect a differential use of cues and context for verbal reports and visually directed walking.     

Under Reporting of Suicide Ideation in US Army Population Screening: An Ongoing Challenge

Previous research in US Army Soldiers shows rates of mental health concerns as two to four times higher on anonymous surveys than on postdeployment health assessments. In this study, Soldiers presenting for health reassessment completed two questionnaires on suicide risk factors: one linked to the health assessment and one anonymous. About 5.1% of respondents reported suicide ideation on the anonymous questionnaire, 3.0% on the linked questionnaire, and 0.9% on the health reassessment. About 56.4% who reported suicide ideation anonymously told nobody of their thoughts. Current screening procedures identify only one in seven Soldiers experiencing suicide ideation and highlight the need for alternative risk‐detection strategies.