Do the SCOFF items function differently by food-security status in U.S. college students?: Statistically, but not practically, significant differences

Despite food insecurity (FI) being associated with eating disorders (EDs), little research has examined if ED screening measures perform differently in individuals with FI. This study tested whether items on the SCOFF performed differently as a function of FI. As many people with FI hold multiple marginalized identities, this study also tested if the SCOFF performs differently as a function of food-security status in individuals with different gender identities and different perceived weight statuses. Data were from the 2020/2021 Healthy Minds Study (N = 122,269). Past-year FI was established using the two-item Hunger Vital Sign. Differential item functioning (DIF) assessed whether SCOFF items performed differently (i.e., had different probabilities of endorsement) in groups of individuals with FI versus those without. Both uniform DIF (constant between-group difference in item-endorsement probability across ED pathology) and non-uniform DIF (variable between-group difference in item-endorsement probability across ED pathology) were examined. Several SCOFF items demonstrated both statistically significant uniform and non-uniform DIF (ps < .001), but no instances of DIF reached practical significance (as indicated by effect sizes pseudo ΔR2 ≥ 0.035; all pseudo ΔR2's ≤ 0.006). When stratifying by gender identity and weight status, although most items demonstrated statistically significant DIF, only the SCOFF item measuring body-size perception showed practically significant non-uniform DIF for perceived weight status. Findings suggest the SCOFF is an appropriate screening measure for ED pathology among college students with FI and provide preliminary support for using the SCOFF in individuals with FI and certain marginalized identities

Disparities in eating disorder risk and diagnosis among sexual minority college students: Findings from the national Healthy Minds Study

ObjectiveTo examine differences in eating disorder (ED) risk and diagnosis by sexual orientation in a national sample of college students.MethodData from 178 U.S. colleges and universities participating in the Healthy Minds Study between 2016 and 2019 were analyzed (36,691 cisgender men, 81,730 cisgender women; 15.7% self‐identifying as sexual minorities). Outcomes were ED risk (≥2 on the SCOFF) and self‐reported lifetime ED diagnosis. Prevalence estimates adjusted for demographics and weight status were computed via logistic regression.ResultsHigher proportions of questioning (29.1%), bisexual (26.3%), and gay men (30.9%) exhibited elevated risk than heterosexual men (14.3%), and a higher proportion of gay men exhibited elevated risk than bisexual men. Higher proportions of questioning (34.5%) and bisexual women (34.6%) exhibited elevated risk than heterosexual women (27.6%); proportions of lesbian (28.1%) and heterosexual women were similar. Among those with elevated risk, higher proportions of bisexual (5.0%) and gay men (7.1%) and of questioning (14.7%), bisexual (18.1%), and lesbian women (19.6%) had been diagnosed relative to heterosexual men (2.0%) and heterosexual women (10.3%), respectively.DiscussionQuestioning and bisexual individuals appear to be particularly vulnerable; they may experience elevated ED risk relative to their heterosexual peers yet underdiagnosis relative to their gay or lesbian peers.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162796/2/eat23304_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162796/1/eat23304.pd

Testing the Tripartite Influence Model Among Heterosexual, Bisexual, and Lesbian Women

This cross-sectional study explored similarities and differences between heterosexual, bisexual, and lesbian women in levels of, and relationships between, the following constructs using a Tripartite Influence Model framework: family, peer, and media appearance pressures, thin- and muscular-ideal internalization, and eating disorder (ED) pathology. Self-identified heterosexual (n = 1,528), bisexual (n = 89), and lesbian (n = 278) undergraduate women completed the Sociocultural Attitudes Towards Appearance Questionnaire-4 and the Eating Disorder Examination-Questionnaire. Sexual orientation differences in appearance pressures, appearance-ideal internalization, and ED pathology were examined via analysis of variance tests. Relationships between these variables were examined with multi-group path analyses, controlling for age, race/ethnicity, and body mass index. Compared with lesbian women, heterosexual and bisexual women reported higher levels of peer appearance pressures. Paths from peer appearance pressures and thin-ideal internalization to shape/weight overvaluation and body dissatisfaction were strongest for bisexual women. Overall, results indicate notable similarities between heterosexual, bisexual, and lesbian women. However, preliminary evidence for potential differences highlights the importance of examining variation in ED risk between sexual minority subgroups

Is intuitive eating a privileged approach? Cross-sectional and longitudinal associations between food insecurity and intuitive eating

Abstract Objective: To examine: (1) cross-sectional and longitudinal associations between measures of food insecurity (FI; household status and youth-reported) and intuitive eating (IE) from adolescence to emerging adulthood; and (2) the association between FI persistence and IE in emerging adulthood. Design: Longitudinal population-based study. Young people reported IE and FI (two items from the US Household Food Security Module) in adolescence and emerging adulthood. Parents provided data on household FI via the six-item US Household Food Security Module in adolescence. Setting: Adolescents (M age = 14·3 ± 2 years) and their parents, recruited from Minneapolis/St. Paul public schools in 2009–2010 and again in 2017–2018 as emerging adults (M age = 22·1 ± 2 years). Participants: The analytic sample (n 1372; 53·1 % female, 46·9 % male) was diverse across race/ethnicity (19·8 % Asian, 28·5 % Black, 16·6 % Latinx, 14·7 % Multiracial/Other and 19·9 % White) and socio-economic status (58·6 % low/lower middle, 16·8 % middle and 21·0 % upper middle/high). Results: In cross-sectional analyses, youth-reported FI was associated with lower IE during adolescence (P = 0·02) and emerging adulthood (P < 0·001). Longitudinally, household FI, but not adolescent experience of FI, was associated with lower IE in emerging adulthood (P = 0·01). Those who remained food-insecure (P = 0·05) or became food-insecure (P = 0·02) had lower IE in emerging adulthood than those remaining food-secure. All effect sizes were small. Conclusions: Results suggest FI may exert immediate and potentially lasting impacts on IE. As evidence suggests IE is an adaptive approach conferring benefits beyond eating, it would be valuable for interventions to address social and structural barriers that could impede IE

Do the SCOFF items function differently by food-security status in U.S. college students?: Statistically, but not practically, significant differences

Despite food insecurity (FI) being associated with eating disorders (EDs), little research has examined if ED screening measures perform differently in individuals with FI. This study tested whether items on the SCOFF performed differently as a function of FI. As many people with FI hold multiple marginalized identities, this study also tested if the SCOFF performs differently as a function of food-security status in individuals with different gender identities and different perceived weight statuses. Data were from the 2020/2021 Healthy Minds Study (N&nbsp;=&nbsp;122,269). Past-year FI was established using the two-item Hunger Vital Sign. Differential item functioning (DIF) assessed whether SCOFF items performed differently (i.e., had different probabilities of endorsement) in groups of individuals with FI versus those without. Both uniform DIF (constant between-group difference in item-endorsement probability across ED pathology) and non-uniform DIF (variable between-group difference in item-endorsement probability across ED pathology) were examined. Several SCOFF items demonstrated both statistically significant uniform and non-uniform DIF (ps&nbsp;&lt;&nbsp;.001), but no instances of DIF reached practical significance (as indicated by effect sizes pseudo ΔR2&nbsp;≥&nbsp;0.035; all pseudo ΔR2's&nbsp;≤&nbsp;0.006). When stratifying by gender identity and weight status, although most items demonstrated statistically significant DIF, only the SCOFF item measuring body-size perception showed practically significant non-uniform DIF for perceived weight status. Findings suggest the SCOFF is an appropriate screening measure for ED pathology among college students with FI and provide preliminary support for using the SCOFF in individuals with FI and certain marginalized identities

Disordered Eating Among Collegiate Athletes

Athletes face a unique set of eating disorder (ED) risk factors related to sport participation. However, existing ED risk measures for this population are limited in their use as screening tools by their length and focus on a single gender. Therefore, the purpose of this study was to develop and validate the Eating Disorders Screen for Athletes (EDSA), a brief screening tool for 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 college athletes competing at various levels across the United States (N=482) were 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 identify ED cases and non-cases for the ROC curve analysis. Results: A 5- item, 1-factor structure for the EDSA was supported by EFA and CFA in both males and females. ROC curve analyses indicated that the EDSA was highly accurate in distinguishing between cases and non- cases and identified a score of 3.6 as the optimal cut-off for both males (sensitivity=.96, specificity=.86) and females (sensitivity=.91, specificity=.67). Conclusions: The EDSA shows promise as a brief screening tool to identify male and female athletes at risk for EDs.https://deepblue.lib.umich.edu/bitstream/2027.42/149479/1/Hazzard.doc

Weight gain attempts and diet modification efforts among adults in five countries: a cross-sectional study

BackgroundRecent research has emphasized a growing trend of weight gain attempts, particularly among adolescents and boys and young men. Little research has investigated these efforts among adults, as well as the specific diet modifications individuals who are trying to gain weight engage in. Therefore, the aims of this study were to characterize the diet modification efforts used by adults across five countries who reported engaging in weight gain attempts and to determine the associations between weight gain attempts and concerted diet modification efforts.MethodsCross-sectional data from the 2018 and 2019 International Food Policy Study, including participants from Australia, Canada, Mexico, the United Kingdom, and the United States (N = 42,108), were analyzed. In reference to the past 12&nbsp;months, participants reported on weight gain attempts and diet modification efforts related to increased consumption of calories, protein, fiber, fruits and vegetables, whole grains, dairy products, all meats, red meat only, fats, sugar/added sugar, salt/sodium, and processed foods. Unadjusted (chi-square tests) and adjusted (modified Poisson regressions) analyses were conducted to examine associations between weight gain attempts and diet modification efforts.ResultsWeight gain attempts were significantly associated with higher likelihood of each of the 12 forms of diet modification efforts among male participants, and 10 of the diet modification efforts among female participants. Notably, this included higher likelihood of efforts to consume more calories (males: adjusted prevalence ratio [aPR] 3.25, 95% confidence interval [CI] 2.94-3.59; females: aPR 4.05, 95% CI 3.50-4.70) and fats (males: aPR 2.71, 95% CI 2.42-3.03; females: aPR 3.03, 95% CI 2.58-3.55).ConclusionsOverall, the patterns of association between weight gain attempts and diet modification efforts may be indicative of the phenomenon of muscularity-oriented eating behaviors. Findings further highlight the types of foods and nutrients adults from five countries may try to consume in attempts to gain weight

Examining prospective mediational relationships between momentary rumination, negative affect, and binge eating using ecological momentary assessment

Background: Rumination is linked to negative affect (NA), and there is accumulating support for an association between rumination and eating disorder (ED) behaviors. However, no research has examined the dynamic interrelationships between negative affect, rumination, and binge eating in naturalistic settings. Methods: The present study used ecological momentary assessment (EMA) to assess the hypotheses that momentary rumination would mediate relationships between NA and binge eating, and momentary NA would mediate relationships between rumination and binge eating. Given that rumination may be focused on weight, shape, and food in ED samples, models were examined separately for general and ED-specific rumination. Forty women completed a 10-day EMA protocol that included measures of NA, general and ED-specific rumination, and binge eating. Results: Multilevel mediation models indicated significant within-subjects indirect effects, such that momentary general rumination mediated the association between NA and binge eating, and NA also mediated the association between general but not ED-specific rumination and binge eating. Between-subjects effects indicated women with higher overall NA reported greater ED-specific rumination, which was associated with greater binge eating. Limitations: The study was limited by a modest sample size, and the design precludes causal inferences. Conclusions: Results highlight the momentary interplay between rumination and NA as a mechanism underlying binge eating, as well as the specificity of ruminative thought content in relationship to binge eating. Future work is needed to address the construct of rumination in the context of eating disorder interventions