The role of attribution in weight anxiety and eating disorders in women

This thesis examines weight anxiety and eating disorders amongst women from an attributional perspective. The studies comprise two distinct but interrelated components: investigations of the role of attribution in the development and maintenance of weight anxiety and eating disorders; and analyses of two screening instruments for eating disorders. The study presented in Chapter 2 examines whether, amongst women without an eating disorder, attributions can be extracted in a factor-analytic manner to form relevant stereotypes associated with 'fat' or 'thin' women. The results confirm that clear weight-related factors can be extracted, and these resemble common stereotypes of fatness and thinness. In Chapters 3 and 4 the attributions of both eating disordered and non-eating disordered women were examined. Four groups have been examined: the Anorexic group; the Bulimic group; the Over-Eater group; and the Non-Eating Disordered group. It is proposed that the attributions of eating disordered women and non-eating disordered women will differ; that the various eating disordered groups will also differ in their attributions; and that attributions will differentially contribute to the development and maintenance of different weight anxieties and eating disorders. The results confirm these propositions: this thesis shows that there are attributionaI differences between the women with and without eating disorders; that there are differences in the attributions of the Bulimic, Anorexic and Over-Eater groups; and that there is evidence to suggest that attributions contribute differentially to the development and maintenance of weight anxiety and eating disorders. The internal validity of the subscale structure of the Eating Disorder Inventory (EDI) (Garner, Olmsted and Polivy, 1983) is examined in Chapters 5 and 6, and Chapter 6 analyses the structure of another assessment instrument, the SCANS (Slade and Dewey, 1986). The results confirm the doubts raised about the validity of the subscale structure of the EDI: no clear support for the subscale structure put forward by Garner et al. has been found, and the factor analyses indicate that no single factor structure can be replicated. The factor analysis of the SCANS, presented in Chapter 6, suggests that the subscale structure of this measure is also not well replicated. It is argued that the subscales of both instruments should be used only with caution. Chapter 5 also examines weight anxiety in older women. This study has shown that older women also are anxious about their weight and that their weight anxiety takes a similar form to those of younger women; for this group of women lifestyle might be an influential factor in their weight anxiety. Chapter 7 discusses all the issues raised in the earlier chapters in relationship to the literature. Finally, the findings of this thesis are discussed, models of the role of attributions are outlined and directions for future research are discussed

The role of attribution in weight anxiety and eating disorders in women

This thesis examines weight anxiety and eating disorders amongst women from an attributional perspective. The studies comprise two distinct but interrelated components: investigations of the role of attribution in the development and maintenance of weight anxiety and eating disorders; and analyses of two screening instruments for eating disorders. The study presented in Chapter 2 examines whether, amongst women without an eating disorder, attributions can be extracted in a factor-analytic manner to form relevant stereotypes associated with 'fat' or 'thin' women. The results confirm that clear weight-related factors can be extracted, and these resemble common stereotypes of fatness and thinness. In Chapters 3 and 4 the attributions of both eating disordered and non-eating disordered women were examined. Four groups have been examined: the Anorexic group; the Bulimic group; the Over-Eater group; and the Non-Eating Disordered group. It is proposed that the attributions of eating disordered women and non-eating disordered women will differ; that the various eating disordered groups will also differ in their attributions; and that attributions will differentially contribute to the development and maintenance of different weight anxieties and eating disorders. The results confirm these propositions: this thesis shows that there are attributionaI differences between the women with and without eating disorders; that there are differences in the attributions of the Bulimic, Anorexic and Over-Eater groups; and that there is evidence to suggest that attributions contribute differentially to the development and maintenance of weight anxiety and eating disorders. The internal validity of the subscale structure of the Eating Disorder Inventory (EDI) (Garner, Olmsted and Polivy, 1983) is examined in Chapters 5 and 6, and Chapter 6 analyses the structure of another assessment instrument, the SCANS (Slade and Dewey, 1986). The results confirm the doubts raised about the validity of the subscale structure of the EDI: no clear support for the subscale structure put forward by Garner et al. has been found, and the factor analyses indicate that no single factor structure can be replicated. The factor analysis of the SCANS, presented in Chapter 6, suggests that the subscale structure of this measure is also not well replicated. It is argued that the subscales of both instruments should be used only with caution. Chapter 5 also examines weight anxiety in older women. This study has shown that older women also are anxious about their weight and that their weight anxiety takes a similar form to those of younger women; for this group of women lifestyle might be an influential factor in their weight anxiety. Chapter 7 discusses all the issues raised in the earlier chapters in relationship to the literature. Finally, the findings of this thesis are discussed, models of the role of attributions are outlined and directions for future research are discussed

Wellbeing in Bereavement and Widowhood

This article will examine how beveavement and widowhood affect wellbeing drawing on psychological, gerontological, and sociological research. The article will begin with an outline of what is meant by bereavement and widowhood. It will then present an overview of the effects that bereavement and widowhood has on wellbeing. In the next section, a brief history of approaches to bereavement will be presented. Next, more recent approaches will be discussed including the Dual Process Model of Bereavement (Stroebe &amp; Schut, 1999), and a discussion of the debate concerning continuing and relinquishing bonds. The focus will then turn to factors which influence wellbeing with a focus both on pre- and post-bereavement experiences, and on such factors as age and gender. Finally, there will be a discussion of factors which may enhance wellbeing, such as resilience, identity reconstruction, and coping strategies. </jats:p

Exploring resilience in adult daughter and spousal carers of people living with dementia in North West England: an ecological approach

Purpose Research has shown that informal carers of people living with dementia (PLWD) can be resilient in the face of caregiving challenges. However, little is known about resilience across different kinship ties. This study aims to update and build on our previous work, using an ecological resilience framework to identify and explore the factors that facilitate or hinder resilience across spousal and adult daughter carers of PLWD. Design/methodology/approach This study conducted in-depth qualitative interviews with a purposive sample of 13 carers from North West England and analysed the data using a constructivist grounded theory approach (Charmaz, 2003). Findings Adult daughters were motivated to care out of reciprocity, whereas spouses were motivated to care out of marital duty. Spouses had a more positive and accepting attitude towards caregiving and were better able to maintain continuity, which facilitated their resilience. Research limitations/implications Resilience emerged on multiple levels and depended on the type of kinship tie, which supports an ecological approach to resilience. The implications of these findings are discussed. Originality/value This paper makes a novel contribution to the literature as it uses an in-depth qualitative methodology to compare resilience across spousal and adult daughter carers of PLWD. This study adopts an ecological approach to identify not just individual-level resilience resources but also interactive community- and societal-level resources. </jats:sec

Inconsistent Adoption of World Health Organization V (2010) Semen Analysis Reference Ranges in the United States Six Years After Publication

Objective To determine the percentage of laboratories in the United States that have adopted the World Health Organization 2010 (WHO 5) semen analysis (SA) reference values six years after their publication. Methods Laboratories were identified via three approaches: using the Clinical Laboratory Improvement Amendments (CLIA) website, the CDC's 2015 Assisted Reproductive Technology Fertility Clinical Success Rate Report, and automated web searches. Laboratories were contacted by phone or email to obtain de-identified SA reports and reference ranges. Results We contacted 617 laboratories in 46 states, of which 208 (26.7%) laboratories in 45 states were included in our analysis. 132 (63.5%) laboratories used WHO 5 criteria, 57 (27.4%) used WHO 4 criteria, and 19 (9.1%) used other criteria. WHO 5 criteria adoption rates varied by geographic region, ranging from 87.5% (35/40) in the Midwest to 50.0% (33/66) in the West. There was a greater adoption rate of WHO 5 reference values in academic affiliated (23/26, 88.5%) compared to non-academic affiliated laboratories (110/182, 60.4%) (P=0.028). Conclusion While the majority of laboratories have adopted WHO 5 criteria following its release six years ago, a large percentage (36.5%) use what is now considered outdated criteria. This variability could result in the characterization of a male's semen values as being “within reference range” at one center and “outside of reference range” at another. This inconsistency in classification may result in confusion for the both patient and physician and potentially shift the burden of infertility evaluation and treatment to the female partner

The Postpartum Specific Anxiety Scale: development and preliminary validation

Perinatal symptoms of anxiety are increasingly recognised due to their high prevalence and impact. Studies using pregnancy-specific anxiety measures have found that they may predict perinatal outcomes more effectively than general measures. However, no such measure exists to assess anxieties specific to the postpartum. This study aimed to develop and validate a measure (Postpartum Specific Anxiety Scale; PSAS) that accurately represents the specific anxieties faced by postpartum women, using a four-stage methodology: (1) 51 items were generated from interviews conducted with a group of 19 postpartum women at two time points, (2) the scale was reviewed and refined by a diverse expert panel, (3) an online pilot study (n = 146) was conducted to assess comprehensibility and acceptability and (4) an online sample of 1282 mothers of infants up to 6 months old completed the PSAS against a battery of convergent measures. A subsample (n = 262) repeated the PSAS 2 weeks later. The PSAS possessed good face and content validity and was comprehensible and acceptable to postpartum women. PSAS scores were significantly correlated with other measures indicating good convergent validity. Principal component analyses (PCA) revealed a simple four-factor structure. Reliability of the overall scale and individual PSAS factors proved to be good to excellent. A preliminary receiver operating characteristic (ROC) analysis also suggested that the PSAS may be a useful screening tool. The psychometric evidence suggests that the PSAS is an acceptable, valid, and reliable research tool to assess anxieties, which are specific to the postpartum period. Next steps in the iterative validation process are considered for both research and screening purposes

Sub-Saharan Africa's Mothers, Newborns, and Children: Where and Why Do They Die?

In the first article in a series on maternal, newborn, and child health in sub-Saharan Africa, Joy Lawn and colleagues outline where and why deaths among mothers and children occur and what known interventions can be employed to prevent these deaths

Postpartum-specific anxiety as a predictor of infant-feeding outcomes and perceptions of infant-feeding behaviours: new evidence for childbearing specific measures of mood

Studies of pregnancy-specific anxiety suggest that it is a distinct construct which predicts perinatal outcomes more effectively than other general measures of anxiety. In response, a novel measure of postpartum-specific anxiety (PSAS) has been developed and validated, but it is not yet clear whether it possesses the same predictive power as its pregnancy-specific counterparts. The aim of this short-term prospective study was to (a) test the predictive validity of the PSAS in the context of one specific perinatal outcome, infant-feeding, and (b) examine whether the PSAS may be more efficacious at predicting infant-feeding outcomes and behaviours than the more commonly used general measures. Eight hundred mothers of infants aged between 0 and 6 months completed the PSAS alongside general measures of anxiety and depression at baseline. A subsample (n = 261) returned to complete a follow-up questionnaire examining infant-feeding outcomes and behaviours two weeks later. Hierarchical regression models revealed that the PSAS was associated with lower odds of breastfeeding exclusively, and breastfeeding in any quantity in the first 6 months postpartum. PSAS scores were also significantly associated with infant-feeding behaviours including a lower perceived enjoyment of food, and greater perceived food responsiveness and satiety responsiveness in the infant. As hypothesised, the PSAS was a stronger predictor of infant-feeding outcomes and behaviours than general anxiety and depression. The findings provide evidence for the predictive validity of the PSAS and call for the use of childbearing specific measures of mood when attempting to predict perinatal outcomes. Replication of these findings across other indices of maternal and infant health is now necessary