The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 Years

OBJECTIVE: The aim of this study was to examine the relative importance of dissatisfaction, overvaluation, and preoccupation with body weight and shape in predicting increases in disordered eating behaviors and depressive symptoms from adolescence through to early adulthood. METHOD: The study involved 1,830 participants (60% female) who completed the Project EAT survey during adolescence (mean age = 14.90 years, SD = 1.65 years) and again, 15 years later, in early adulthood. Participants provided assessments of dissatisfaction, overvaluation and preoccupation with weight and shape, as well as disordered eating and depressive symptoms at both time points. RESULTS: The three aspects of body image had distinct patterns of association with the outcomes both concurrently and longitudinally. Dissatisfaction predicted depressive symptoms as well as a wide range of disordered eating outcomes, including dieting, unhealthy weight control behaviors (UWCBs), and binge eating, particularly in female participants. Preoccupation was associated with all of these disordered eating behaviors (but not with depressive symptoms) and was notably the strongest predictor of dieting and UWCBs in female participants. Overvaluation was associated with both disordered eating and depressive symptoms, although typically was a less potent predictor of difficulties than the other aspects of body image. DISCUSSION: Dissatisfaction, overvaluation, and preoccupation are related but make distinct contributions to clinically significant outcomes. Models of eating disorders should move beyond focusing exclusively on dissatisfaction or overvaluation toward a broader conceptualisation of body image. Findings from this study particularly suggest the importance of considering preoccupation with weight and shape

Bidirectional associations between body dissatisfaction and depressive symptoms from adolescence through early adulthood

Body dissatisfaction and depressive symptoms are commonly experienced during adolescence and increase the risk of adverse health outcomes, especially eating disorders. However, the dominant temporal associations between these two experiences (i.e., whether one is a risk factor for the other or the two are mutually reinforcing) has yet to be fully explored. We examined the associations between body dissatisfaction and depressive symptoms assessed at baseline and 5- and 10-year follow-up in younger (M age = 12.9 years at baseline, 56% female, n = 577) and older (M age = 15.9 years at baseline, 57% female, n = 1,325) adolescent cohorts assessed as part of Project Eating Among Teens and Young Adults. Associations between body dissatisfaction and depressive symptoms were examined using cross-lagged models. For females, the dominant directionality was for body dissatisfaction predicting later depressive symptoms. For males, the picture was more complex, with developmentally sensitive associations in which depressive symptoms predicted later body dissatisfaction in early adolescence and early adulthood, but the reverse association was dominant during middle adolescence. These findings suggest that interventions should be tailored to dynamic risk profiles that shift over adolescence and early adulthood, and that targeting body dissatisfaction at key periods during development may have downstream impacts on depressive symptoms

Affect in response to stressors and coping strategies: an ecological momentary assessment study of borderline personality disorder

Background: Affect instability is a core symptom of borderline personality disorder (BPD). Ecological momentary assessment allows for an understanding of real-time changes in affect in response to various daily stressors. The purpose of this study was to explore changes in affect in response to specific stressors and coping strategies in subjects with BPD utilizing ecological momentary assessment (EMA) methodology. Methods: Subjects (n = 50) with BPD were asked to complete real-time assessments about stressors experienced, affect felt, and coping strategies employed six times per day for a 1-week period. Mixed effect regression models were used to measure the effect of stressors and coping strategies on affect change. Results: While most stressors led to experiencing more negative affect, only being in a disagreement was independently associated with increased negative affect. Among coping strategies, only doing something good for oneself independently reduced negative affect, controlling for all other coping strategies used. Conclusions: These findings provide valuable insights into affective instability in BPD and can help inform treatment with individuals with the disorder

Cardiovascular Variability, Sociodemographics, and Biomarkers of Disease: The MIDUS Study

Introduction: Like heart rate, blood pressure (BP) is not steady but varies over intervals as long as months to as short as consecutive cardiac cycles. This blood pressure variability (BPV) consists of regularly occurring oscillations as well as less well-organized changes and typically is computed as the standard deviation of multiple clinic visit-to-visit (VVV-BP) measures or from 24-h ambulatory BP recordings (ABPV). BP also varies on a beat-to-beat basis, quantified by methods that parse variation into discrete bins, e.g., low frequency (0.04–0.15 Hz, LF). However, beat-to-beat BPV requires continuous recordings that are not easily acquired. As a result, we know little about the relationship between LF-BPV and basic sociodemographic characteristics such as age, sex, and race and clinical conditions. Methods: We computed LF-BPV during an 11-min resting period in 2,118 participants in the Midlife in the US (MIDUS) study. Results: LF-BPV was negatively associated with age, greater in men than women, and unrelated to race or socioeconomic status. It was greater in participants with hypertension but unrelated to hyperlipidemia, hypertriglyceridemia, diabetes, elevated CRP, or obesity. LF-diastolic BPV (DBPV), but not-systolic BPV (SBPV), was negatively correlated with IL-6 and s-ICAM and positively correlated with urinary epinephrine and cortisol. Finally, LF-DBPV was negatively associated with mortality, an effect was rendered nonsignificant by adjustment by age but not other sociodemographic characteristics. Discussion: These findings, the first from a large, national sample, suggest that LF-BPV differs significantly from VVV-BP and ABPV. Confirming its relationship to sociodemographic risk factors and clinical outcomes requires further study with large and representative samples

Seizures in Fragile X syndrome: Associations and longitudinal analysis of a large clinic-based cohort

Fragile X syndrome (FXS), the most common inherited cause of intellectual disability, learning disability, and autism spectrum disorder, is associated with an increased prevalence of certain medical conditions including seizures. The goal of this study was to better understand seizures in individuals with FXS using the Fragile X Online Registry with Accessible Research Database, a multisite observational study initiated in 2012 involving FXS clinics in the Fragile X Clinic and Research Consortium. Seizure data were available for 1,607 participants, mostly male (77%) and white (74.5%). The overall prevalence of at least one seizure was 12%, with this rate being significantly higher in males than females (13.7 vs. 6.2%

Does sex education before college protect students from sexual assault in college?

Purpose College-bound young people experience sexual assault, both before and after they enter college. This study examines historical risk factors (experiences and exposures that occurred prior to college) for penetrative sexual assault (PSA) victimization since entering college. Methods A cross-sectional study, including an online population-based quantitiative survey with undergraduate students was conducted in spring 2016. Bivariate analyses and multivariable regressions examined risk and protective factors associated with ever experiencing PSA since entering college. Concurrently-collected in-depth ethnographic interviews with 151 students were reviewed for information related to factors identified in the survey. Results In bivariate analyses, multiple historical factors were significantly associated with PSA in college including adverse childhood experiences and having experienced unwanted sexual contact before college (for women) and initiation of alcohol, marijuana, and sexual behaviors before age 18. Significant independent risk factors for college PSA included female gender, experiencing unwanted sexual contact before college, first oral sex before age 18, and “hooking up” (e.g., causual sex or sex outside a committed partnership) in high school. Receipt of school-based sex education promoting refusal skills before age 18 was an independent protective factor; abstinence-only instruction was not. In the ethnographic interviews, students reported variable experiences with sex education before college; many reported it was awkward and poorly delivered. Conclusions Multiple experiences and exposures prior to college influenced the risk of penetrative sexual assault in college. Pre-college comprehensive sexuality education, including skills-based training in refusing unwanted sex, may be an effective strategy for preventing sexual assault in college. Sexual assault prevention needs to begin earlier; successful prevention before college should complement prevention efforts once students enter college

Shared risk factors for mood-, eating-, and weight-related health outcomes.

Objective: Given the overlap among depressive symptoms, disordered eating, and overweight, identifying shared risk factors for these conditions may inform public health interventions. This study aimed to examine cross-sectional and prospective relationships among these 3 conditions, and identify potential shared eating-related and psychosocial variable risk factors (i.e., body dissatisfaction, dieting, teasing experiences). Method: A population-based sample (n = 1,902) self-reported depressive symptoms, disordered eating (binge eating, extreme weight control behaviors), weight status, and several putative risk factors (body satisfaction, dieting frequency, weight-related teasing) at 5-year intervals spanning early/middle adolescence, middle adolescence/early young adulthood, and early/middle young adulthood. Results: There was moderate overlap among depressive symptoms, disordered eating, and overweight at each time point, and moderate stability in each condition over time. Body dissatisfaction and dieting were the most potent shared risk factors for later depressive symptoms, disordered eating, and overweight among males and females (ps \u3c .05). Conclusions: Depressive symptoms, disordered eating, and overweight share several risk factors, including dieting and body dissatisfaction, which may be effective targets for interventions aiming to simultaneously prevent these 3 conditions

Heart rate variability predicts levels of inflammatory markers: Evidence for the vagal anti-inflammatory pathway

Evidence from numerous animal models shows that vagal activity regulates inflammatory responses by decreasing cytokine release. Heart rate variability (HRV) is a reliable index of cardiac vagal regulation and should be inversely related to levels of inflammatory markers. Inflammation is also regulated by sympathetic inputs, but only one previous paper controlled for this. In a larger and more representative sample, we sought to replicate those results and examine potential sex differences in the relationship between HRV and inflammatory markers. Using data from the MIDUS II study, we analyzed the relationship between 6 inflammatory markers and both HF-HRV and LF-HRV. After controlling for sympathetic effects measured by urinary norepinephrine as well as a host of other factors, LF-HRV was found to be inversely associated with fibrinogen, CRP and IL-6, while HF-HRV was inversely associated with fibrinogen and CRP. We did not observe consistent sex differences. These results support the existence of the vagal anti-inflammatory pathway and suggest that it has similar effects in men and women