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Research on the effects of progress feedback and clinician problem-solving tools on patient outcome has been limited to a few clinical problems and settings (Shimowaka, Lambert & Smart, 2010). Only one randomized clinical trial has examined feedback-assisted treatment in an inpatient eating-disordered population. Results from this study suggested that those who received feedback-assisted (Fb) treatment were more likely to meet Jacobson and Truax's (1991) criteria for recovery than participants in the treatment-as-usual (TAU) condition; however, while these interventions appear to have worked well in the inpatient setting, the long-term effects of this treatment have not been investigated. This is especially pertinent in an eating disorder population, where outcomes tend to be poor and course of illness tends to be chronic. In this study, the effect of feedback interventions on long-term outcome was investigated. Fifty-three of the individuals from the aforementioned original study were contacted by mail, email, or telephone three to four years after leaving the inpatient facility to assess their current level of distress (as measured by the OQ-45) and overall psychological functioning. Comparisons were made between the outcomes of patients assigned to the experimental feedback condition and the TAU condition. Results suggested that both treatment conditions were nearly indistinguishable from one another and did not significantly differ at follow-up; however, the study was significantly underpowered. Our effect size suggested that the Fb group slightly deteriorated over time, while the TAU group slightly improved; however, effect sizes were minimal and did not meet criteria for "small" change according to Cohen's d. Patients’ Body Mass Index (BMI) largely remained the same since leaving the hospital, with a small portion deteriorating. The vast majority of women sought out multiple forms of treatment over the follow-up period, regardless of treatment condition. This is consistent with past research that suggests women with more severe pathology, and who thus require inpatient treatment, tend to experience a more chronic pattern of symptoms even after receiving intensive treatment. Overall, the superiority of feedback-assisted treatment that was found post-treatment appeared to diminish over time and was not detected at follow-up. Suggestions for further research are delineated.

Social media use represents an emerging area of interest in relation to body image and disordered eating. Previous research has demonstrated social media use may be related to eating disorder risk, an increase in body image concerns, bulimic symptoms, and restricted eating. Orthorexia Nervosa (ON), a disordered eating pattern focused on the purity/quality of food, needs further investigation within the social media context. The current study examined whether young adult women’s social media use was associated with objectified body consciousness and orthorexia nervosa symptoms. Social media use, both active and passive, was significantly correlated with body consciousness (body surveillance and body shame) but was not significantly correlated with orthorexia nervosa symptoms. However, in the regression model, only objectified body consciousness, not social media use, significantly predicted ON tendencies. Understanding the impact of social media and body consciousness on ON behaviors may have implications for young women’s mental health, as well as eating disorder programs and recovery.

Previous research has demonstrated the influential role of physical appearance-related feedback in the development of body image and eating disturbances. Teasing and negative feedback have been established as strong correlates and predictors of body dissatisfaction, maladaptive eating behaviors, and psychological distress. However, very little is known about ambiguous appearance-related feedback and its impact on others. The current study sought to explore this area with an experimental study to examine the effects of ambiguous appearance-related feedback on body image, mood states, and intentions to use body change strategies. Undergraduate women (N=146) were randomly assigned to an ambiguous appearance-related or ambiguous nonappearance-related feedback condition. Body image, mood states, and intentions to diet, exercise, and use unhealthy weight control methods were assessed before and after feedback was provided by a confederate. Results indicated no significant differences between feedback conditions in body image and mood states. The mean trends for all mood state, with the exception of anger, indicated better mood states after ambiguous appearance-related feedback compared to after ambiguous nonappearance-related feedback. State anger was greater in the ambiguous appearance-related feedback condition suggesting that this particular type of feedback was interpreted in a negative manner. Further, there was a significant difference between feedback conditions for intentions to diet and use bulimic behaviors, with lower levels in the ambiguous appearance-related feedback condition. No significant differences were found for intentions to exercise. State appearance comparison was not shown to mediate the relationship between ambiguous feedback and body image, mood states, or intentions to use body change strategies. Trait appearance satisfaction, appearance comparison, appearance schematicity, and thin ideal internalization were found to moderate the relationship between ambiguous feedback and state depression. Trait appearance comparison moderated the relationship between ambiguous feedback and intentions to use bulimic behaviors. Exploratory analyses conducted with subsamples developed using high versus low levels of trait disturbance showed significant results for the subsample based on trait appearance comparison levels. The findings are discussed in the context of possible reasons for the unexpected responses to the ambiguous appearance-related versus nonappearance-related feedback. The limitations of the study and directions for future research are also noted.

The purpose of this study was to determine if the Female Athlete Screening Tool (FAST) is a valid indicator of the three physical components of Female Athlete Triad (FAT), malnutrition, amenorrhea, and low bone mineral density, and if administration of the FAST can be used as a time- and cost-effective way to identify FAT. Participants completed the FAST, the Menstrual Status Questionnaire, and had a blood sample drawn. Interpretation of the total FAST score placed participants in one of three conditions: normal, subclinical disordered eating, or clinical eating disorder. The presence of the three biomarkers of FAT was determined by participants’ responses on the Menstrual Status Questionnaire and protein analyses of their blood samples, in which plasma Prealbumin and CTx levels were tested. Results indicated that there were not significant differences between total FAST scores of participants in each of the groups for any of the three biomarkers (i.e., low versus normal Prealbumin levels; amenorrhea versus normal menstruation; high versus normal CTx levels). More research is needed before it can be determined if the FAST is an appropriate diagnostic tool for FAT. An overwhelming majority of the sample (79.5%) received total FAST scores that fell in the subclinical disordered eating or clinical eating disorder ranges, which supports previous findings that female athletes are at a high risk of developing disordered eating habits or eating disorders due to their unique characteristics and lifestyles.

The purpose of this study is to examine the relationship between mindful eating and eating pathology. This was accomplished by using two measures, the Eating Disorder Inventory, Third Edition (EDI-3), and the Mindful Eating Questionnaire (MEQ). Participants included in this study were 134 students from a midsized mid-south university who were asked to complete a demographics measure, EDI-3, and MEQ. Only three scales from the EDI-3 were considered; Drive for Thinness, Bulimia, and Body Dissatisfaction. Combined they provide an Eating Disorder Risk Composite (EDRC) score. Results indicated that there was no significant relationship between the MEQ overall score and the EDRC score, which implies that there is no relationship between mindful eating and eating pathology, specifically eating disorder risk. Additional analyses revealed significant negative correlations between the Awareness, Disinhibition, and Emotional Response subscales of the MEQ and the EDRC score. This study contributes to the limited research on the relationship between mindful eating and eating pathology. Results from this study indicate that the specific aforementioned factors have a greater impact on eating pathology when compared to the overall concept of mindfulness.

Over 25 million people in the United States are affected by eating disorders, and understanding children's eating style can help determine maladaptive eating behaviors. This study was an investigation of parents' beliefs about their children's eating behaviors in relation to parental work status. Two theoretical frameworks were used to guide the study. Symbolic interactionism focused on communication between parents and children. Social learning theory focused on adolescents possibly learning their eating behaviors from observing their parents' eating habits. The research questions and hypotheses examined if there was a relationship between the work status of parents and their beliefs about maladaptive eating behaviors in their adolescents. This study used the parent-report measure, Children's Eating Behaviour Questionnaire (CEBQ). A nonexperimental causal-comparative quantitative research method was used. The participants included parents who have children between the ages of 6 and 12, and the sample size for this study was 126. A link between parental beliefs and early precursors of disordered eating in adolescents was not established. If patterns of a relationship between parents' work status and beliefs about children's maladaptive eating behaviors had been found, the patterns may have provided the possibility of serving as a factor of early intervention programs. The social change aspect obtained from this study may be that parents can work outside the home or not, and there may be other variables (such as family time, closeness, communication, stress) that may provide more information on how parents perceive children's eating behaviors.

Eating disorders remain a phenomenon that escapes full comprehension, resulting in frustration for those who suffer from the disorders, their families, and their therapists. It is becoming increasingly necessary to describe the mechanism by which eating disorders develop, in order to effectively treat and prevent these disorders. The aim of this study was to illuminate factors that contributed to the development of eating disorders within the individual contexts of the lives of the participants, as well as how those factors interacted in context to culminate in the development of an eating disorder. This qualitative study was conducted from an interpretive perspective. The findings show how individual contextual factors interact to produce a marked fear of gaining weight, which is driven by fear of negative evaluation, and that the eating disorder behaviour serves specific functions that are related to coping with stress within the lives of the participants. / Psychology / M. Sc. (Psychology with specialisation in Research Consultation)

The current study examined whether elevations on four variables (drive for thinness, depressed mood, maladaptive cognitions, and ineffectiveness) were related to increased risk of developing an eating disorder over a 4-year prospective interval. Subjects (N = 191) were female undergraduates who were assessed with the Anorexia-Bulimia Inventory (ABI), Eating Disorder Inventory (EDI), and a structured clinical interview. Results indicated that individuals with elevated scores on each of the four variables at the initial assessment did not show higher absolute eating disorder incidence rates over the 4-year interval. However, initial scores on the four variables together lll explained approximately 13% of both anorexia and bulimia symptom severity variance at the final assessment. Changes over time in the four variables were more highly related to later symptom severity, explaining 34% of the variance in anorexic severity and 16% in bulimic severity. Thus, the findings suggest that initial scores, and especially changes in scores, on the four variables were related to severity of symptoms 4 years later. However, a large proportion of the variance in eating disorder severity remained unexplained. Examination of the role of each risk variable individually revealed that initial elevations on maladaptive cognitions and drive for thinness subscales were related to higher anorexic symptom severity at the later assessment. Of interest was the absence of significant relationships between early scores on maladaptive cognitions and drive for thinness and subsequent bulimic symptoms, suggesting that anorexia and bulimia may have somewhat different risk pathways. The pretest scores on the depressed mood and ineffectiveness subscales were not significantly correlated with symptom severity at the later assessment, and were not identified by the regression analyses as parsimonious or efficient predictors of eating disorder symptoms. This finding suggests that perhaps early difficulties with depression and low self-esteem are less related to onset of later eating disorders than previously believed. Finally, the overall 4-year incidence rate of .6% found in the current study suggests that as women move through their college years, they are departing the developmental period of high risk for onset of eating disorders, and thus, new cases become increasingly rare.

The present study examined whether there was a relationship between daughters' eating disorder symptomology and maternal food control and health-conscious eating attitudes. Eighty-eight females with a continuum of eating disorder behaviors (DSM-IV eating disorders through nondieters) and 74 of their mothers participated. Participants completed the Anorexia Bulimia Inventory, two subscales from the Eating Disorder Inventory, the Three Factor Eating Questionnaire , the Family Environment Scale, the Maternal Food Control and Meal Preparation Scale, and the Marlowe-Crowne Social Desirability Scale. Results indicated that, in general, daughters' reported eating disorder symptomology and perceived familial control were related. Some of the more specific maternal food control variables perceived by daughters were also related to their reported symptomology. Yet, maternal reports on these same variables tended not to correspond to daughters' reported symptomology. Specifically, regression analyses indicated that a combination of perceived high familial control, perceived low maternal concern with healthy meal preparation and restriction, and perceived high maternal anxiety regarding healthy eating predicted higher levels of reported anorexic symptomology. Similar variables predicted reported bulimic symptomology, but only increased general familial control predicted symptoms characteristic of both disorders. Analyses also revealed that daughters' eating disorder symptomology tended to be inversely related to responding in a socially desirable manner. Perceptual differences were noted and discussed between mothers' and daughters' reports of familial control. Lastly, mothers' report of food control was not correlated with reported familial control. This study was the first to examine the more specific maternal control issues, maternal health-conscious attitudes, and their relationship to daughters' maladaptive eating behaviors. The results of the present study are consistent with the speculation that a combination of daughters' perception of high familial control, high maternal anxieties about children's eating practices, and low maternal concern with healthy meal preparation might contribute to the development or maintenance of anorexic and bulimic symptomology. Finally, limitations were discussed and recommendations were made for future research.