Factor structure and measurement invariance of the Body Appreciation Scale - 2 among Brazilian gender-expansive individuals and transgender men.

Among gender-expansive individuals and transgender men, body appreciation can play a protective role against minority stressors and is associated with gender euphoria. The Body Appreciation Scale (BAS-2; Tylka & Wood-Barcalow, 2015) is a leading measure of body appreciation that has been mainly validated in cisgender and mixed-gender samples; however, it has not been validated among Brazilian gender-expansive individuals and transgender men. Therefore, we evaluated the psychometric properties of the BAS-2 among adult Brazilian gender-expansive individuals and transgender men. Participants (158 gender-expansive individuals and 138 transgender men) were recruited through social media in Brazil. Confirmatory Factor Analysis (CFA) supported the original 10-item, unidimensional solution. Multigroup CFA showed configural, metric, and scalar invariance of the BAS-2 between gender-expansive individuals and transgender men. Moreover, the BAS-2 demonstrated significant negative associations, ranging from small to large, with self-objectification, drive for muscularity, and appearance-ideal internalization. We also found good internal consistency and test-retest reliability of the measure. Taken together, our results support the psychometric properties of the BAS-2 among Brazilian gender-expansive individuals and transgender men. The present work offers a valuable contribution towards better understanding facets of positive body image across gender-expansive and transgender populations.

The association of alcohol use and positive and negative urgency to same day objective binge eating in emerging adults.

Introduction: Objective binge eating and problematic alcohol use often co-occur and are common behaviors in emerging adults. Both behaviors are thought to be driven by affect regulation processes. Objective binge eating often occurs in the context of increasing or acute negative affect, and often occurs in solitude. Alcohol use in emerging adults can also be associated with negative affect regulation. However, in contrast to objective binge eating, a large body of research indicates that there are positively valenced pathways to alcohol use in this age group. Emerging adults often drink socially, to enhance enjoyment, and in the context of positive mood. We propose that one pathway to objective binge eating in this developmental period is through alcohol use itself, such that emerging adults who consume alcohol and who are more likely to act impulsively in the context of positive emotion (i.e., have high levels of positive urgency) may be more likely to binge eat following drinking. Methods: We collected data using ecological momentary assessment in 106 undergraduates on positive and negative affect, motives for drinking and eating, and alcohol use and objective binge eating, in addition to baseline questionnaires of impulsivity. Results: There were no significant changes in affect prior to drinking in this sample. Alcohol use at one time point significantly increased odds of objective binge eating at a later time point in the same day. Individual differences in positive urgency, the tendency to act rashly while experiencing positive affect, were also associated with increased odds of objective binge eating that occurred after alcohol use. Individual differences in negative urgency, the tendency to act rashly after experiencing negative affect, did not have a main effect on objective binge episodes, but did interact with alcohol use to increase the odds of objective binge eating following drinking. The vast majority of drinking episodes prior to objective binge eating were social drinking episodes, and participants most commonly endorsed "to have fun" as a reason for drinking. Discussion: Results suggest that alcohol consumption may increase risk for objective binge eating in emerging adults.

Prevalence of Comorbid Depression and Insomnia Among Veterans Hospitalized for Heart Failure with Alzheimer Disease and Related Disorders.

OBJECTIVE: To examine prevalence of Alzheimer Disease and related dementias (ADRD) and patient characteristics as a function of comorbid insomnia and/or depression among heart failure (HF) patients discharged from hospitals. DESIGN: Retrospective cohort descriptive epidemiology study. SETTING: VA Hospitals. PARTICIPANTS: N = 373,897 Veterans hospitalized with heart failure from October 1, 2011 until September 30, 2020. MEASUREMENTS: We examined VA and Center for Medicare & Medicaid Services (CMS) coding in the year prior to admission using published ICD-9/10 codes for dementia, insomnia, and depression. The primary outcome was the prevalence of ADRD and the secondary outcomes were 30-day and 365-day mortality. RESULTS: The cohort were predominantly older adults (mean age = 72 years, SD = 11), male (97%), and White (73%). Dementia prevalence in participants without insomnia or depression was 12%. In those with both insomnia and depression, dementia prevalence was 34%. For insomnia alone and depression alone, dementia prevalence was 21% and 24%, respectively. Mortality followed a similar pattern with highest 30-day and 365-day mortality higher in those with both insomnia and depression. CONCLUSIONS: These results suggest that persons with both insomnia and depression are at an increased risk of ADRD and mortality compared to persons with one or neither condition. Screening for both insomnia and depression, especially in patients with other ADRD risk factors, could lead to earlier identification of ADRD. Understanding comorbid conditions which may represent earlier signs of ADRD may be critical in the identification of ADRD risk.

Internet-delivered eating disorders prevention program for adolescent girls with type 1 diabetes: Acceptable and feasible.

BACKGROUND: Adolescents with type 1 diabetes are at significantly increased risk for eating disorders and few interventions exist. OBJECTIVE: This study examined the feasibility, acceptability, and preliminary effects of an internet-based eating disorders prevention program adapted specifically for adolescent girls with type 1 diabetes. PARTICIPANTS AND METHODS: Thirty-five girls (16.2 ± 1.1 years) participated Body Project (T1D Style), a 4-week program consisting of four adolescent sessions focused on promoting illness acceptance, challenging sociocultural body image pressures, increasing social support, and teaching assertive communication. Caregivers participated in one session focused on fostering body image positivity and a healthy relationship with food. Pre-intervention, post-intervention, and 3-month follow-up surveys assessed disordered eating, body dissatisfaction, thin-ideal internalization, diabetes acceptance, diabetes distress, and quality of life. Cohen's d effect sizes were calculated at post-intervention and follow-up. Program acceptability was assessed at post-intervention. Manual fidelity and homework completion were monitored. RESULTS: High manual fidelity, retention, and homework completion were achieved. Quantitative and qualitative feedback from teens and caregivers suggested high acceptability. Large effects (d = 1.35-0.83) were observed for dieting, body dissatisfaction, diabetes distress, diabetes acceptance, and diabetes-related quality of life at post-intervention, with large-medium effects (d = 1.16-0.58) at follow-up. Medium-small effects (d = 0.49-0.78) at post-intervention were observed for diabetes-specific disordered eating and thin-ideal internalization, with effects maintained at follow-up. CONCLUSIONS: Results support the acceptability and feasibility of this targeted eating disorders prevention program for adolescent girls with type 1 diabetes. Future clinical trials are warranted to determine its effectiveness compared to a control condition.