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Stice E, Wisting L, Desjardins CD, Hood KK, Hanes S, Rubino L, Shaw H. Evaluation of a novel eating disorder prevention program for young women with type 1 diabetes: A preliminary randomized trial. Diabetes Res Clin Pract 2023; 206:110997. [PMID: 37951479 DOI: 10.1016/j.diabres.2023.110997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/23/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE Evaluate whether the Body Project prevention program adapted for young women with type 1 diabetes (Diabetes Body Project) reduces eating disorder (ED) risk factors and symptoms. METHODS Young women (aged 15-30) at high-risk for EDs due to having type 1 diabetes and body image concerns (N = 55) were randomized to virtually delivered Diabetes Body Project groups or an educational control condition, completing measures at pretest, posttest, and 3-month follow-up. RESULTS Diabetes Body Project versus the control participants showed significantly greater reductions in thin-ideal internalization, body dissatisfaction, diabetes distress, diabetes eating pathology, and ED symptoms by posttest, and greater reductions in diabetes eating pathology and ED symptoms, and greater improvements in quality of life by 3-month follow-up, which were medium to large effects (d's ranged from -0.43 to -0.90). Although control participants showed a worsening of glycemic control (time in range) verses Diabetes Body Project participants, this difference was non-significant (d = 0.26). CONCLUSIONS Virtually delivered Diabetes Body Project decreased ED risk factors and symptoms in young women with type 1 diabetes. A well powered randomized controlled trial is warranted to evaluate this intervention over longer follow-up.
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Yamamiya Y, Desjardins CD, Stice E. Sequencing of symptom emergence in anorexia nervosa, bulimia nervosa, binge eating disorder, and purging disorder in adolescent girls and relations of prodromal symptoms to future onset of these eating disorders. Psychol Med 2023; 53:4657-4665. [PMID: 37698515 DOI: 10.1017/s0033291722001568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND To advance knowledge regarding the etiology of eating disorders, we characterized the sequencing of eating disorder symptom emergence for adolescent girls who subsequently developed anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) for community-recruited adolescents and tested whether prodromal symptoms increased risk for future onset of each eating disorder. METHODS Data collected from adolescent girls (N = 496; M age = 13.02, s.d.= 0.73) who completed a diagnostic interview annually over an 8-year period were used to address these aims. RESULTS For all four eating disorders, compensatory weight-control behaviors were the first behavioral symptom to emerge and weight/shape overvaluation was the first cognitive symptom to emerge. Moreover, lower-than-expected BMI predicted future AN onset, binge eating and all cognitive symptoms predicted future BN onset, weight/shape overvaluation predicted future BED onset, and compensatory behavior and all cognitive symptoms predicted future PD onset. These predictive effects were small-to-large in magnitude. Collectively, prodromal symptoms predicted an eating disorder onset with 83-87% accuracy. CONCLUSIONS Results suggest that compensatory weight-control behaviors and weight/shape overvaluation typically emerge before other prodromal symptoms in all eating disorders during adolescence. Moreover, different prodromal symptoms seem to predict future onset of different eating disorders. Screening adolescent girls for these prodromal symptoms and implementing indicated prevention programs designed to reduce these symptoms may prove effective in preventing future onset of eating disorders.
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Affiliation(s)
| | | | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, US
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Stice E, Bohon C, Shaw H, Desjardins CD. Efficacy of virtual delivery of a dissonance-based eating disorder prevention program and evaluation of a donation model to support sustained implementation. J Consult Clin Psychol 2023; 91:139-149. [PMID: 36745074 DOI: 10.1037/ccp0000796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Evaluate whether the Body Project prevention program reduces eating disorder risk factors and symptoms when implemented via synchronous video telepsychiatry, which could markedly increase the reach of this intervention and test whether a pay-it-forward donation model could support sustained implementation of this intervention. METHOD Young women at high risk for eating disorders because of body image concerns (N = 75; age range 16-27) were randomized to Body Project groups delivered virtually by peer educators or a waitlist control condition; participants who completed the Body Project for free because of past donations were encouraged to donate money so that this intervention could be provided for free to others. RESULTS Participants randomized to virtually delivered Body Project groups showed significantly or marginally greater pretest-to-posttest reductions in pursuit of the thin ideal, body dissatisfaction, dieting, negative affect, and eating disorder symptoms than controls. The average effect was large (d = .79), which was 49% larger than the average effect observed previously for in-person peer-educator-delivered Body Project groups (d = .53; [.76-.53 = .23/.53 = 49%]). However, only 3.6% of participants donated money to support future implementation of this intervention. CONCLUSIONS The evidence that the Body Project produced large reductions in eating disorder risk factors and symptoms when implemented virtually and that the effects were larger than for in-person Body Project groups suggests it would be useful to implement this prevention program virtually, which could expand the reach of this intervention. Future studies should evaluate alternative methods for supporting sustained implementation of this prevention program. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Stice E, Desjardins CD, Rohde P. Young women who develop anorexia nervosa exhibit a persistently low premorbid body weight on average: A longitudinal investigation of an important etiologic clue. J Psychopathol Clin Sci 2022; 131:479-492. [PMID: 35653756 PMCID: PMC9511824 DOI: 10.1037/abn0000762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE test whether (1) young women who subsequently show onset of anorexia nervosa (AN) exhibit persistently lower average premorbid BMI than those who subsequently show onset of bulimia nervosa (BN), binge eating disorder (BED), purging disorder (PD), or no eating disorder; (2) a proximal spike in other risk factors occurs immediately before AN emergence; and (3) psychological and behavioral factors differentiate youth who show persistently low BMI from those who do not. METHOD Data from a sample (N = 1952) of young women at high-risk for eating disorders followed for 3 years and a socioethno-racially representative sample (N = 496) of adolescent girls followed for 8 years were used to address these aims. RESULTS Participants who developed AN exhibited significantly lower average measured premorbid BMI over repeated assessments than those who showed onset of other or no eating disorders. Dietary restraint, negative affect, and eating affect regulation expectancies significantly increased immediately before AN onset. Youth who showed persistently low BMI reported lower pressure for thinness, body dissatisfaction, and dieting at baseline, implying that elevations in these factors did not drive the low BMI. CONCLUSIONS The evidence that young women who subsequently show AN onset exhibit a low premorbid BMI on average is novel and suggests that etiologic models should incorporate this finding and selective prevention programs should target low-BMI adolescent girls. The finding that dieting, negative affect, affect-regulation eating expectances spiked immediately before emergence of AN is also novel and suggests that it might be useful for selective prevention programs to target these factors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Eric Stice
- Department of Psychiatry and Behavioral Sciences
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Stice E, Desjardins CD, Rohde P, Shaw H. Sequencing of symptom emergence in anorexia nervosa, bulimia nervosa, binge eating disorder, and purging disorder and relations of prodromal symptoms to future onset of these disorders. J Abnorm Psychol 2021; 130:377-387. [PMID: 34180702 PMCID: PMC8244173 DOI: 10.1037/abn0000666] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The objective of this study was to characterize the temporal sequencing of symptom emergence for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD), as well as to test whether prodromal symptoms increase risk for future onset of each type of eating disorder and compare the predictive effects to those of established risk factors. Data from four prevention trials that targeted high-risk young women with body image concerns (N = 1,952; Mage = 19.7, SD = 5.7) and collected annual diagnostic interview data over 3-year follow-up were combined to address these aims. Regarding behavioral symptoms, compensatory weight control behaviors typically emerged first for AN, BN, and PD, whereas binge eating typically emerged first for BED. Regarding cognitive symptoms, for AN, weight/shape overvaluation typically emerged first, whereas for BN, BED, and PD, overvaluation typically emerged simultaneously with feeling fat and fear of weight gain. Binge eating, compensatory behaviors, weight/shape overvaluation, fear of weight gain, and feeling fat predicted BN, BED, and PD onset, whereas weight/shape overvaluation, fear of weight gain, and lower than expected body mass index predicted AN onset. Predictive effects of prodromal symptoms were similar in magnitude to those of established risk factors: Collectively, prodromal symptoms and risk factors predicted onset of specific eating disorders with 67-83% accuracy. Results suggest that compensatory weight control behaviors and cognitive symptoms are likely to emerge before binge eating in the various eating disorders and that offering indicated prevention programs to youth with prodromal symptoms may be an effective way to prevent eating disorders. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University
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Distefano R, Schubert EC, Finsaas MC, Desjardins CD, Helseth CK, Lister M, Carlson SM, Zelazo PD, Masten AS. Ready? Set. Go! A school readiness programme designed to boost executive function skills in preschoolers experiencing homelessness and high mobility. European Journal of Developmental Psychology 2020. [DOI: 10.1080/17405629.2020.1813103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Rebecca Distefano
- Institute of Child Development, University of Minnesota, Twin Cities, Minneapolis, MN, USA
| | | | - Megan C. Finsaas
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | | | | | - Marie Lister
- Institute of Child Development, University of Minnesota, Twin Cities, Minneapolis, MN, USA
| | - Stephanie M. Carlson
- Institute of Child Development, University of Minnesota, Twin Cities, Minneapolis, MN, USA
| | - Philip David Zelazo
- Institute of Child Development, University of Minnesota, Twin Cities, Minneapolis, MN, USA
| | - Ann S. Masten
- Institute of Child Development, University of Minnesota, Twin Cities, Minneapolis, MN, USA
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Shaw H, Rohde P, Desjardins CD, Stice E. Sexual orientation correlates with baseline characteristics but shows no moderating effects of dissonance-based eating disorder prevention programs for women. Body Image 2020; 32:94-102. [PMID: 31841780 PMCID: PMC8765481 DOI: 10.1016/j.bodyim.2019.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 11/17/2022]
Abstract
This study provided the first test of whether sexual orientation (categorized as heterosexual vs. sexual minority) is associated with baseline eating disorder risk factors and symptoms, moderated the intervention effects of variants of the dissonance-based Body Project, or moderated the relation of baseline risk factors to future change in eating disorder symptoms. A total of 680 women with body image concerns were randomized to clinician-or peer-led Body Project groups, the eBody Project, or educational video control and completed assessment of eating disorder risk factors and symptoms at pretest, posttest, and at six-, 12-, 24-, and 36-month follow-up. Results indicated that sexual minority women had significantly higher negative affect and impaired psychosocial functioning at baseline, but did not differ on other eating disorder risk factors or symptoms. We found no evidence that sexual orientation moderates the effects of the Body Project on risk factor or symptom change over follow-up or the relation of baseline risk factors to future change in eating disorder symptoms. Overall, sexual minority and heterosexual women differ on two, less specific eating disorder-related risk factors at baseline, but did not differ in response to different versions of the Body Project or the relations of risk factors to future symptom change.
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Affiliation(s)
| | - Paul Rohde
- Oregon Research Institute, United States
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Christ TJ, Desjardins CD. Curriculum-Based Measurement of Reading: An Evaluation of Frequentist and Bayesian Methods to Model Progress Monitoring Data. Journal of Psychoeducational Assessment 2017. [DOI: 10.1177/0734282917712174] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Curriculum-Based Measurement of Oral Reading (CBM-R) is often used to monitor student progress and guide educational decisions. Ordinary least squares regression (OLSR) is the most widely used method to estimate the slope, or rate of improvement (ROI), even though published research demonstrates OLSR’s lack of validity and reliability, and imprecision of ROI estimates, especially after brief duration of monitoring (6-10 weeks). This study illustrates and examines the use of Bayesian methods to estimate ROI. Conditions included four progress monitoring durations (6, 8, 10, and 30 weeks), two schedules of data collection (weekly, biweekly), and two ROI growth distributions that broadly corresponded with ROIs for general and special education populations. A Bayesian approach with alternate prior distributions for the ROIs is presented and explored. Results demonstrate that Bayesian estimates of ROI were more precise than OLSR with comparable reliabilities, and Bayesian estimates were consistently within the plausible range of ROIs in contrast to OLSR, which often provided unrealistic estimates. Results also showcase the influence the priors had estimated ROIs and the potential dangers of prior distribution misspecification.
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Cutuli JJ, Desjardins CD, Herbers JE, Long JD, Heistad D, Chan CK, Hinz E, Masten AS. Academic achievement trajectories of homeless and highly mobile students: resilience in the context of chronic and acute risk. Child Dev 2012; 84:841-57. [PMID: 23110492 DOI: 10.1111/cdev.12013] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Analyses examined academic achievement data across third through eighth grades (N = 26,474), comparing students identified as homeless or highly mobile (HHM) with other students in the federal free meal program (FM), reduced price meals (RM), or neither (General). Achievement was lower as a function of rising risk status (General > RM > FM > HHM). Achievement gaps appeared stable or widened between HHM students and lower risk groups. Math and reading achievement were lower, and growth in math was slower in years of HHM identification, suggesting acute consequences of residential instability. Nonetheless, 45% of HHM students scored within or above the average range, suggesting academic resilience. Results underscore the need for research on risk and resilience processes among HHM students to address achievement disparities.
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Affiliation(s)
- J J Cutuli
- University of Pennsylvania, Philadelphia, PA, USA.
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