Development and validation of the Eating Disorders Screen for Athletes (EDSA): A brief screening tool for male and female athletes

ObjectivesTo develop and validate the Eating Disorders Screen for Athletes (EDSA), a brief eating disorders screening tool for use in both male and female athletes. Methods: Data from Division I athletes at a Midwestern university (N = 434) were used to conduct exploratory factor analysis (EFA) by gender. Data from athletes competing at various levels at universities across the United States (N = 862) were then used to conduct confirmatory factor analysis (CFA) and receiver operator characteristic (ROC) curve analysis by gender. Athletes from a range of lean and non-lean sports were included. Gender-specific empirically derived cut-offs on the Eating Disorder Examination-Questionnaire were used to classify high eating disorder risk for ROC curve analysis. Measurement invariance by gender, level of competition, and sport type was also examined. Results: A six-item, one-factor structure for the EDSA was supported by EFA and CFA in both genders, and internal consistency was good for both male (α = 0.80) and female athletes (α = 0.86). ROC curve analyses indicated that the EDSA was highly accurate in predicting eating disorder risk status and identified a score of 3.33 as the optimal cut-off for both male (sensitivity = 0.96, specificity = .80) and female athletes (sensitivity = 0.96, specificity = .64). Results also supported strong measurement invariance for the EDSA by gender, level of competition (Division I versus club), and sport type (lean versus non-lean). Conclusions: The EDSA shows promise as a brief screening tool to identify male and female athletes at risk for eating disorders.     

A Randomized Comparison of Two Psychosocial Interventions on Family Functioning in Adolescents with Bipolar Disorder

Impairments in family functioning are associated with more severe depressive and manic symptoms, earlier recurrences, and more suicidal behaviors in early-onset bipolar disorder. This study examined whether family-focused treatment for adolescents (FFT-A) with BD I or II disorder led to greater increases in family cohesion and adaptability and decreases in conflict over 2 years compared to a briefer psychoeducational treatment (enhanced care, EC). Participants were 144 adolescents (mean age: 15.6 ± 1.4 years) with BD I or II with a mood episode in the previous 3 months. Adolescents and parents were randomized to either FFT-A (21 sessions) or EC (three sessions). Patients received guideline-based pharmacotherapy throughout the 2-year study. Trajectories of adolescent- and parent-rated family cohesion, adaptability, and conflict were analyzed over 2 years. FFT-A had greater effects on adolescent-rated family cohesion compared to EC over 2 years. Participants in FFT-A and EC reported similar improvements in family conflict across the 2 years. In the FFT-A group, low-conflict families had greater adolescent-rated family cohesion throughout the study compared to high-conflict families. High-conflict families in both treatment groups tended to show larger reductions in conflict over 2 years than low-conflict families. Family psychoeducation and skills training may improve family cohesion in the early stages of BD. Measuring levels of family conflict at the start of treatment may inform treatment responsiveness among those receiving FFT-A.     

脊柱疾患临床诊断的辩证思维

脊柱外科是骨科学的一个亚专科,也是外科学领域中发展最为迅速的一个分支学科。脊柱外科疾患的正确诊断有赖于诊断过程中的正确辩证思维。在临床诊断思维中,从疾病学角度和症状学角度,需要正确处理几个辨证关系,同时要避免临床思维常见误区,才能提高诊断正确性。     

Unconscious odour conditioning 25 years later: Revisiting and extending ‘Kirk-Smith, Van Toller and Dodd’

The pioneering work by Kirk-Smith, Van Toller, and Dodd [Kirk-Smith, M. D., Van Toller, C., & Dodd, G. H. (1983). Unconscious odour conditioning in human subjects. Biological Psychology, 17, 221–231], established that an unnoticed odorant paired with an emotionally meaningful task can influence mood and attitudes when the odorant alone is re-encountered subsequently. This study was particularly important in highlighting unconscious odour learning processes as they may happen in everyday life. However, it was severely criticized by Black and Smith [Black, S. L., & Smith, D. G. (1994). Has odor conditioning been demonstrated? A critique of “Unconscious odour conditioning in human subjects”. Biological Psychology, 37, 265–267] on methodological grounds. In the present paper, we replicated and extended Kirk-Smith et al.’s investigation taking into account Black and Smith’s criticisms and carrying out additional controls to improve the validity of the study. The results confirm the initial findings of Kirk-Smith and colleagues by demonstrating the effectiveness of olfactory stimuli in inducing conditioned hedonic reactions even when presented below the level of awareness.     

A disgust mood state causes a negative interpretation bias, but not in the specific domain of body-related concerns

The present study was designed to examine the effects of a disgust mood state on negative interpretation bias, in particular in the domain of body and weight concerns. Participants (N = 120) were randomly assigned to one of four mood induction groups (i.e., disgust, anxiety, happy, and neutral) and were afterwards asked to respond to various types of ambiguous scenarios to index general threat interpretations, negative body-related interpretations, and neutral/positive interpretations. Results demonstrated that both the anxiety and disgust mood induction groups displayed higher levels of negative interpretations of the ambiguous threat scenarios than the neutral and happy groups. However, no evidence was obtained for a negative interpretation bias in the body-related domain for these negative mood groups, and this conclusion was also true for participants scoring high on a scale of eating disorder symptoms. Altogether, these findings suggest that disgust does not play a role in eating pathology by inducing a negative interpretation bias in the specific domain of body and weight concerns.     

How do psychological treatments work? Investigating mediators of change

Little is known about how psychological treatments work. Research on treatment-induced mediators of change may be of help in identifying potential causal mechanisms through which they operate. Outcome-focused randomised controlled trials provide an excellent opportunity for such work. However, certain conceptual and practical difficulties arise when studying psychological treatments, most especially deciding how best to conceptualise the treatment concerned and how to accommodate the fact that most psychological treatments are implemented flexibly. In this paper, these difficulties are discussed, and strategies and procedures for overcoming them are described.     

Mediators in the dissonance eating disorder prevention program

Previous research has supported thin-ideal internalization as a partial mediator of the effects of the dissonance eating disorder prevention program. The current study replicated previous findings and examined an additional mediator, body dissatisfaction, hypothesized to account for partial intervention effects. As a secondary goal, we developed a more rigorous and accurate test of mediation that accounted for the temporal, causal interplay between mediator and outcome, and controlled for “reverse mediation”. Results from a sample of 71 high-risk females (M age = 19.8, SD = 1.3) who participated in a four-week dissonance intervention supported thin-ideal internalization as a partial mediator of the effects of the dissonance intervention on bulimic symptoms, even after controlling for body dissatisfaction as a second mediator. Furthermore, results supported body dissatisfaction as a partial mediator for bulimic symptoms after controlling for thin-ideal internalization. Significant “reverse mediation” effects suggested the reciprocal influence of some risk factors for bulimia nervosa and bulimic symptoms. These results contribute to our understanding of the mediators in the dissonance intervention, which can help refine eating disorder prevention programs.     

Brain activation on pre-reading tasks reveals at-risk status for dyslexia in 6-year-old children

In this fMRI-study, 6-year-old children considered at risk for dyslexia were compared with an age-/gender-matched control group for differences in brain activation when presented with visual stimuli differing in demands for literacy processing. Stimuli were nameable pictures, brand logos familiar to children, and written words - these were either regularly spelled using early-acquired rules ("alphabetic") or more complex ("orthographic"). Brain responses distinguished between the presentation conditions, as a function of group, within many cortical areas. Activation in the alphabetic and orthographic conditions in the left angular gyrus correlated with individual at-risk index scores, and activation in inferior occipito-temporal regions further indicated differential activation for the two groups related to orthographic processing, especially. Since similar patterns are reported in adult dyslexics when processing written words, it appears that sensitivity to the cortical differentiation of reading networks is established prior to formal literacy training.     

Ethnic differences in BMI, weight concerns, and eating behaviors: comparison of Native American, White, and Hispanic adolescents

Evidence suggests that substantial proportions of adolescents, regardless of ethnicity or gender, are engaged in excessive weight control behaviors. Crago and Shisslak (2003), however, have noted that small samples and poorly validated instruments have limited the value of previous ethnic difference studies. Using the McKnight Risk Factor Survey, we compared Native American, White, and Hispanic adolescents. Native students were divided into groups with one (NA-mixed) or two (NA) Native American biological parents. Surveys were completed by 5th through 10th grade students. BMI z-scores were significantly higher for boys and girls in the NA group, and boys in this group were significantly more engaged in weight control behaviors, including purging. A higher percentage of Native and Hispanic girls preferred a larger body size. BMI was positively correlated with weight and shape concerns and with weight control behaviors, regardless of ethnicity or gender. Overweight among Native adolescents may put them at greater risk for eating problems than their White peers.     

Developmental Instability and Individual Variation in Brain Development: Implications for the Origin of Neurodevelopmental Disorders

ABSTRACT— Research on the origin of neurodevelopmental disorders has traditionally been pursued within a constrained, disorder-specific perspective. The developmental instability (DI) model described here offers a broader approach based on the evolutionary genetics of normal variation, reflecting our understanding that the processes generating genetic diversity are not unique to any specific disorder. The DI model helps account for shared features, including atypical functional and anatomic asymmetries, reduced general intellectual functioning, and complex patterns of heritability, across different types of neural variation. The model suggests research strategies that may help illuminate the specific and unique causal factors characterizing different types of neural variation.