Informing the development of Australia's national eating disorders research and translation strategy : a rapid review methodology

Background Eating disorders (EDs) are highly complex mental illnesses associated with significant medical complications. There are currently knowledge gaps in research relating to the epidemiology, aetiology, treatment, burden, and outcomes of eating disorders. To clearly identify and begin addressing the major deficits in the scientific, medical, and clinical understanding of these mental illnesses, the Australian Government Department of Health in 2019 funded the InsideOut Institute (IOI) to develop the Australian Eating Disorder Research and Translation Strategy, the primary aim of which was to identify priorities and targets for building research capacity and outputs. A series of rapid reviews (RR) were conducted to map the current state of knowledge, identify evidence gaps, and inform development of the national research strategy. Published peer-reviewed literature on DSM-5 listed EDs, across eight knowledge domains was reviewed: (1) population, prevalence, disease burden, Quality of Life in Western developed countries; (2) risk factors; (3) co-occurring conditions and medical complications; (4) screening and diagnosis; (5) prevention and early intervention; (6) psychotherapies and relapse prevention; (7) models of care; (8) pharmacotherapies, alternative and adjunctive therapies; and (9) outcomes (including mortality). While RRs are systematic in nature, they are distinct from systematic reviews in their aim to gather evidence in a timely manner to support decision-making on urgent or high-priority health concerns at the national level. Results Three medical science databases were searched as the primary source of literature for the RRs: Science Direct, PubMed and OVID (Medline). The search was completed on 31st May 2021 (spanning January 2009-May 2021). At writing, a total of 1,320 articles met eligibility criteria and were included in the final review. Conclusions For each RR, the evidence has been organised to review the knowledge area and identify gaps for further research and investment. The series of RRs (published separately within the current series) are designed to support the development of research and translation practice in the field of EDs. They highlight areas for investment and investigation, and provide researchers, service planners and providers, and research funders rapid access to quality current evidence, which has been synthesised and organised to assist decision-making

Development and validation of the Online Histrionic Personality Scale (OHPS) using the DSM-5 criteria for Histrionic Personality Disorder

The present study evaluated personality presentation in online environments in terms of histrionic personality. The aim of the study was to develop the Online Histrionic Personality Scale (OHPS). The OHPS was developed using the diagnostic criteria for histrionic personality disorder (HPD) in the DSM-5 and assesses histrionic behavior in online environments. The present study comprised 381 university students (219 females and 162 males) from four different samples. The validity of the OHPS was investigated utilizing exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and criterion validity. As a result of the EFA, a single-factor structure with an eigenvalue of 3.850 was found and accounted for 48.12% of the total variance. This one-dimensional structure was tested with CFA in two different samples. CFA results show that OHPS had an acceptable fit. The criterion validity of the OHPS was examined with the Desire for Being Liked Scale (DBLS) and the Histrionic Personality Belief subscale of the Personality Belief Questionnaire-Short Form (PBQ-STF). Analysis showed that the OHPS was significantly associated with desire for being liked (r = .65, p < .01) and histrionic personality beliefs (r = .70, p < .01). The reliability of the OHPS was evaluated with Cronbach’s α internal consistency reliability coefficient and corrected item total correlation coefficient in three different samples. The Cronbach α internal consistency coefficients of the OHPS were .84 (EFA sample), .88 (CFA sample), and .88 (criterion validity sample). Corrected item total correlation coefficients of OHPS ranged from .53 to .62 in the EFA sample, .47 to .78 in the CFA sample, and .52 to .76 in the criterion validity sample. The distribution of data was examined with floor and ceiling effects in three different samples. Finally, the standard error of measurement (SEM) was calculated in three different samples. There were no floor and ceiling effects in the data, and the SEM values were within acceptable limits. When validity and reliability analyses of the OHPS are considered as a whole, it is concluded that the OHPS is a valid and reliable scale that assesses online histrionic personality among university students

Changes in weight bias following weight loss : the impact of weight-loss method

BACKGROUND: Many obese individuals lose weight to reduce weight stigma; however, little is known about whether other people's attitudes actually improve towards obese individuals after they have lost weight, and whether changes in attitudes depend on the method of weight loss. This study examined changes in people's perceptions of an obese target who had lost weight through diet and exercise or through surgery. METHOD: Participants (N=73) initially viewed an image of an obese woman or a thin woman (control condition), and were asked to indicate their perceptions of the target with respect to the target's behaviors (for example, how often she exercises), as well as some personality characteristics (for example, lazy, sloppy and competent). Participants then viewed a more recent image of the target in which she had lost weight, and were informed that the target had lost weight through diet and exercise or through surgery, or were not provided with any explanation for the weight loss. Participants once again indicated their impression of the target on the same measures. RESULTS: Regardless of the method of weight loss, all targets were rated as eating more healthily, exercising more, and being more competent and less sloppy after having lost weight. Participants also rated the target as less lazy when they learned that she had lost weight through diet and exercise, or when no information was provided about the method of weight loss; the target who lost weight through surgery, however, was not seen as being any less lazy after losing weight. CONCLUSION: These findings indicate that perceptions of obese individuals can in fact improve after they have lost weight, but that this might depend on the method of weight loss.6 page(s

Digital social evaluation : relationships between receiving likes, comments, and follows on social media and adolescents' body image concerns

A defining feature of social media is its social interactivity, but limited research has investigated how various aspects of digital social evaluation (i.e., likes, follows, comments) may be related with users’ body image concerns. This study investigated the relationships between aspects of digital social evaluation and body image concerns in adolescents. Australian adolescents (N = 245, 58.4 % male, Mage = 13.79, SD = 1.11) completed online surveys measuring digital social evaluation frequency (likes, follows, positive and negative comments about appearance and non-appearance), perceived importance (likes, number of followers), body dissatisfaction, restrictive eating attitudes, and drive for muscularity. Adolescents reported frequently receiving digital social evaluation, with females receiving more positive, but not negative, comments than males. All aspects of digital social evaluation were positively correlated with at least one aspect of body image concern. Controlling for other factors, all three aspects of body image were associated with receiving more frequent positive appearance-based comments, greater restrictive eating attitudes and body dissatisfaction were also associated with greater importance of likes, whilst greater drive for muscularity was associated with less frequent likes and comments. Digital social evaluation should be considered in future longitudinal or experimental research, and media literacy interventions

Protect me from my selfie: Examining the association between photo-based social media behaviors and self-reported eating disorders in adolescence

Objective: This study examined whether social media behaviors were associated withhigher odds of meeting criteria for an eating disorder and whether gender moderatedthese relationships.Method: Australian adolescents (N = 4,209; 53.15% girls) completed the self-reportphoto investment and manipulation scales. Additional self-report items assessedavoidance of posting selfies and investment in others' selfies. Eating disorders wereidentified by the Eating Disorder Examination Questionnaire and other self-reportmeasures aligned with diagnostic and statistical manual for mental disorders-5criteria.Results: A multinomial logistic regression examining the effect of avoidance of posting selfies, photo investment, photo manipulation, and investment in others' selfieson the likelihood of meeting criteria for an eating disorder, compared to no disorder,was significant (χ2[42] = 1,128.93, p p = .025, OR = 1.74), whereby boys were morelikely to meet criteria for clinical/subclinical anorexia nervosa in the context ofgreater avoidance of posting selfies.Discussion: Appearance-related social media behaviors may be indicative of eatingdisorder risk. Implications for clinicians and advancements for social media screeningtools are discussed

Prevalence and correlates of body dysmorphic disorder in health club users in the presence vs absence of eating disorder symptomology

Purpose: Body dysmorphic disorder (BDD) has been consistently linked with eating disorders, however studies that stratify associations between BDD in subjects with and without eating disorder symptomology are sparse. It was, therefore, the aim of this study to assess correlates of BDD (including social media use, motivations for exercise, exercise addiction, and sexuality) stratified by eating disorder symptomology. Methods: Cross-sectional study of 1665 health club users recruited online completed a battery of surveys. BDD prevalence rates were calculated and logistic regression models were created in two sub-samples: indicated or no-indicated eating disorder symptomology. Results: The key findings showed the prevalence of BDD in participants with indicated-eating disorder symptomology was significantly higher than in participants without indicated-eating disorder symptomology, yielding an odds ratio of 12.23. Furthermore, several correlates were associated with BDD only participants with an absence of eating disorder symptomology (gender, BMI, exercise addiction, exercising for mood improvement, attractiveness and tone), with others being significantly associated with BDD in participants in the presence of indicated eating disorders symptomology (exercising for health and enjoyment, relationship status, and ethnicity). Conclusions: This study provides more evidence of the complex relationship that exists between BDD and eating disorders. Furthermore, it is recommended that practitioners working with BDD subjects should screen for eating disorders due to the high morbidity associated with eating disorders. Level of evidence: Level III: case-control analytic study