Examining Teacher Concerns and Anxiety on the Implementation of a Universal Body Image Program.

In the past 30 years, there have been numerous positive body image and eating disorder prevention programs targeting youth developed for school-based settings. Frequently, teachers are used as interventionists to increase dissemination, decrease costs relative to researchers, and increase scalability. However, little is known about teacher concerns and barriers that may hinder successful uptake and implementation. The current study recruited a total of 269 teachers who consented to implement a universal body image and appearance-related bullying and teasing prevention program in their classrooms as part of a randomized controlled trial. Teachers expressed some worry that they may say the wrong thing, and concern about feeling uncomfortable teaching the program due to their own body dissatisfaction. Teacher's ethnicity, gender, years teaching, dieting behaviors and other weight control behaviors, and self-efficacy were not associated with concerns related to teaching the curriculum. Teachers with lower body esteem reported higher concerns and anxiety related to teaching a body image curriculum. In free response items, teachers worried about handling student comments that were beyond the scope of the curriculum. Teacher self-efficacy was the only variable associated with the number of program sessions implemented. Findings suggest avenues to increase implementation.

The Impact of COVID-19 Pandemic on Psychiatric Rehabilitation in Residential Facilities: Perspectives of Staff and Residents.

The coronavirus pandemic imposed significant changes in the care of patients in psychiatric residential facilities, especially during lockdown periods. The aim of this study was to assess the impact of the pandemic on patients and staff of psychiatric residential facilities (RFs). This cross-sectional survey was conducted between 30 June and 30 July 2021 and involved 31 RFs located in the province of Verona (Italy). In total, 170 staff members and 272 residents participated in this study. Staff showing clinically significant symptoms of anxiety, depression and burnout were, respectively, 7.7%, 14.2% and 6%. Staff were concerned about the risk that COVID-19 infection might spread among residents (67.6%) and that residents could not receive an acceptable service due to service reconfiguration because of the pandemic (50.3%). Residents found it very unpleasant not to be permitted to attend family members (85.3%), and not to be allowed to engage in outdoor activities due to the restrictions (84%). Both staff and residents agree that the main problematic areas for the residents was the interdiction to meet family members or friends and the interdiction to outdoor activities, whereas problems related to the COVID-19 infection were considered by the staff members as more frequently problematic than reported by residents. The COVID-19 pandemic had a significant impact on the rehabilitation care and recovery journeys of the residents of psychiatric RFs. Therefore, sustained, and careful attention is needed to ensure that the rehabilitation needs of people with severe mental disorders are not neglected in time of pandemics. Supplementary Information: The online version contains supplementary material available at 10.1007/s40737-023-00343-6.

Eating disorder pathology in a sample of midlife and older adults experiencing food insecurity.

Researchers have recently identified food insecurity (FI) as a risk factor for eating disorder pathology (EDP). Yet, associations between FI and EDP remain understudied in midlife and older adults. The current study is a descriptive and exploratory re-analysis of Becker et al. (2017, 2019), investigating prevalence rates of EDP and differences in EDP between midlife and older adult food bank clients. Additionally, we examined the relations between FI severity and EDP in each age group. Participants included 292 midlife (51-65 years) and 267 older adults (66+) who were clients of a local foodbank. All participants completed a self-report questionnaire inquiring about FI, EDP, and demographic information. Overall, 8.9 % of respondents had a probable eating disorder (10.5 % of midlife adults, 5.6 % of older adults). Binge eating was the most endorsed EDP. Significantly more midlife adults reported night eating and skipping ≥two meals in a row versus older adults. Additionally, FI severity level was associated with higher risk of night eating, BE, skipping ≥two meals in a row, and laxative use in midlife adults. These same associations were significant for older adults, with the addition of vomiting and exception of laxative use. Evidently, the relations between FI and EDP seen in younger populations extends into mid and late-life, with minimal differences between midlife and older adults living with FI. It is imperative that we intentionally include midlife and older adults in FI and EDP research, investigating how best to address disordered eating across the lifespan within the context of experiencing FI.

Posttraumatic stress disorder and other mental health correlates in a predominantly Latino/Hispanic sample living with food insecurity.

OBJECTIVE: Food insecurity (FI) is a global public health concern that is associated with psychopathology, including depression and anxiety. Individuals living with social disadvantages, such as experiencing low SES or being part of minoritized populations, are at higher risk of developing lifetime posttraumatic stress disorder (PTSD) following trauma exposure. Yet relatively little is known about PTSD prevalence rates and the potential mental health burden in populations with FI. The primary aim of this study was to investigate the prevalence rates and characteristics of PTSD and associated mental health burdens in a low SES, predominantly Latino/Hispanic sample with FI in the United States. METHOD: The study utilized self-report surveys in a cross-sectional design. Participants included 891 clients of a local urban food bank. RESULTS: In this sample, 45.8% reported experiencing one or more traumatic events and 17.4% met the clinical cutoff for PTSD. These results indicate that, while rates of traumatic event exposure are comparable to the general population, those experiencing FI report higher rates of PTSD. Of those with PTSD, 72.3% met the clinical cutoff for generalized anxiety disorder, 69% for depression, and 25.8% for an eating disorder (ED). Furthermore, PTSD symptom severity accounted for 43.6%, 29.6%, and 18.7% of the variance in linear regression models for depressive symptoms, anxiety symptoms, and ED pathology, respectively. CONCLUSIONS: The compounding mental health consequences of experiencing FI, PTSD, and other psychopathology needs further investigation. Moreover, affordable and accessible treatment models are imperative to address the needs of this low-SES population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Validity and reliability of the Body-Esteem Scale among a diverse sample of preadolescent youth.

Researchers have called for more psychometric research on body image assessment measures in children. The Body-Esteem Scale (BES) is a commonly used 24-item measure of self-evaluation of body image in youth, yet only one study has evaluated the psychometric properties of this measure in preadolescent children. The goal of the present study was to replicate and extend the original psychometric work on the BES by examining the factor structure, reliability, and convergent validity in a diverse sample of children ages 9-11 years old. Teachers who taught 4th- and 5th-grade students in the United States were invited to participate. A total of 556 students completed an online survey in their classrooms. Findings indicate a one-factor model best fits the data after eliminating three BES items. The BES had strong scale score consistency. Supporting the convergent validity of the BES, body-esteem scores were positively correlated with general self-esteem and body satisfaction scores, while negatively correlated with body dissatisfaction, engagement in appearance conversations, and social comparison scores. There were no significant group differences on mean BES scores between gender and grade level. Overall, the BES is suitable to assess the body esteem of preadolescent children. Future research needs to replicate these findings and examine the BES's ability to detect a change in body-esteem scores across time in youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Motivation for dietary restraint, and disordered eating among adults experiencing food insecurity in the United States.

OBJECTIVE: Does engaging in dietary restraint due to weight/shape concerns versus economic hardship differentially relate to disordered eating? METHOD: The sample consisted of 582 adults experiencing food insecurity (FI) who completed online measures assessing severity of FI, disordered eating, loss of control over eating, and dietary restraint. Participants reported their motivation for dietary restraint with options consisting of weight/shape concerns, economic hardship (i.e., insufficient funds and prioritizing others' needs), mixed reasons, and other/I do not know. RESULTS: In the sample, 18% reported engaging in dietary restraint primarily due to weight/shape concerns, 33% due to economic hardship, 18% other/do not know, and 30% due to a mix of reasons. There were positive correlations between FI, economic hardship, dietary restraint, disordered eating, and loss of control over eating. Regression analyses revealed the association between dietary restraint and disordered eating does not differ across individuals who endorse economic hardship as a motivator for dietary restraint. Findings replicated with loss of control. However, the association between dietary restraint and disordered eating grew stronger as more dietary restraint due to weight/shape concerns was endorsed. No significant association emerged with loss of control. DISCUSSION: Research is needed to replicate findings and examine how patterns of food scarcity impacts disordered eating in food insecure populations with and without weight/shape concerns. Findings suggest that motivation for dietary restraint may influence associations with dietary restraint and the cognitive components of disordered eating, but not the behavioral components of disordered eating. PUBLIC SIGNIFICANCE STATEMENT: Disordered eating due to dietary restraint is most commonly associated with weight and shape concerns; however, even when dietary restraint is due to economic reasons, it can still be associated with disordered eating.

Non-specific lipid-transfer proteins: Allergen structure and function, cross-reactivity, sensitization, and epidemiology.

BACKGROUND: Discovered and described 40 years ago, non-specific lipid transfer proteins (nsLTP) are present in many plant species and play an important role protecting plants from stressors such as heat or drought. In the last 20 years, sensitization to nsLTP and consequent reactions to plant foods has become an increasing concern. AIM: The aim of this paper is to review the evidence for the structure and function of nsLTP allergens, and cross-reactivity, sensitization, and epidemiology of nsLTP allergy. MATERIALS AND METHODS: A Task Force, supported by the European Academy of Allergy & Clinical Immunology (EAACI), reviewed current evidence and provide a signpost for future research. The search terms for this paper were "Non-specific Lipid Transfer Proteins", "LTP syndrome", "Pru p 3", "plant food allergy", "pollen-food syndrome". RESULTS: Most nsLTP allergens have a highly conserved structure stabilised by 4-disulphide bridges. Studies on the peach nsLTP, Pru p 3, demonstrate that nsLTPs are very cross-reactive, with the four major IgE epitopes of Pru p 3 being shared by nsLTP from other botanically related fruits. These nsLTP allergens are to varying degrees resistant to heat and digestion, and sensitization may occur through the oral, inhaled or cutaneous routes. In some populations, Pru p 3 is the primary and sole sensitizing allergen, but many are poly-sensitised both to botanically un-related nsLTP in foods, and non-food sources of nsLTP such as Cannabis sativa, Platanus acerifolia, (plane tree), Ambrosia artemisiifolia (ragweed) and Artemisia vulgaris (mugwort). Initially, nsLTP sensitization appeared to be limited to Mediterranean countries, however more recent studies suggest clinically relevant sensitization occurs in North Atlantic regions and also countries in Northern Europe, with nsLTP sensitisation profiles being broadly similar. DISCUSSION: These robust allergens have the potential to sensitize and provoke symptoms to a large number of plant foods, including those which are raw, cooked or processed. It is unknown why some sensitized individuals develop clinical symptoms to foods whereas others do not, or indeed what other allergens besides Pru p 3 may be primary sensitising allergens. It is clear that these allergens are also relevant in non-Mediterranean populations and there needs to be more recognition of this. CONCLUSION: Non-specific LTP allergens, present in a wide variety of plant foods and pollens, are structurally robust and so may be present in both raw and cooked foods. More studies are needed to understand routes of sensitization and the world-wide prevalence of clinical symptoms associated with sensitization to these complex allergens.

An exploratory examination of internalized weight stigma in a sample living with food insecurity.

Internalized weight stigma (IWS) is associated with various health concerns, regardless of body size. One weakness of existing IWS research is that it largely lacks diverse study populations. One recent exception, however, found increasing IWS was associated with higher levels of food insecurity (FI) in a low-income, majority Latinx sample. Using the same sample (N = 530), the present study further explored levels of IWS as compared to documented (mostly White/European) samples; we also investigated IWS in relation to three dichotomous eating disorder (ED) outcomes (e.g., any/no vomiting). Finally, based on previous qualitative findings regarding dietary restraint in the most severe level of FI, we explored the independent contribution of dietary restraint and IWS to cross-sectional risk of ED pathology. Results indicated that individuals living with FI experience IWS at concerning levels. Additionally, IWS played a small yet significant role in cross-sectional risk for ED pathology regardless of FI severity, while dietary restraint contributed to independent risk only in those with the most severe FI. Findings suggest that IWS is prevalent in this marginalized population, associated with ED pathology, and that the effect of dietary restraint on risk for ED pathology appears to uniquely impact those living with severe FI.

Sexual trauma uniquely associated with eating disorders: A replication study.

Objective: Extensive research supports the contention that trauma exposure is a nonspecific risk factor for the development of eating disorders (EDs). Limited research has investigated the relative association of diverse types of traumatic events with EDs in the same statistical model. In a recent exception, Breland et al. (2018) found that only sexual trauma predicted ED pathology among female veterans when both sexual trauma and combat exposure were examined simultaneously, even though combat exposure alone had been previously identified as an ED risk factor. Given the current replication crisis in psychology, it is important to investigate if this finding replicates in different populations. This study investigated whether results from Breland et al. (2018) would (a) replicate in a distinct population (i.e., participants living with food insecurity) and (b) hold when 3 additional traumatic events were included in the statistical model. Method: We hypothesized that self-reported sexual trauma would be uniquely associated with ED pathology as compared to combat exposure, wreck/crash/accident, serious body-related accident, and life-threatening illness or injury. Results: Using a cross-sectional logistic regression model, sexual trauma was the only independent predictor of EDs in the model, thus replicating the findings of Breland et al. (2018) in a different population. Conclusion: Findings highlight the importance of (a) investigating multiple traumatic events in the same statistical models and (b) careful screening of traumatic events in patients presenting with EDs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Food insecurity & dietary restraint in a diverse urban population.

The primary aim of this study was to investigate self-reported reasons for engaging in dietary restraint (DR) in a food insecure urban population. It also tested whether DR was associated with increased eating disorder (ED) pathology when DR was broadly assessed. The initial sample (N = 503) consisted of adult clients visiting food pantries who completed the Eating Disorder Diagnostic Scale for DSM 5, the Radimer Cornell Food Insecurity Measure, and three items from the DR subscale of Eating Disorder Examination Questionnaire (EDE-Q); EDE-Q items were modified to allow participants to explain why they restricted. Analyses included participants (N = 259) who responded to one of the modified EDE-Q questions. Results indicated that participants engaged in DR for several reasons, including minimizing the effect of hunger for other family members (i.e., children), "stretching" food to make it last longer, and prioritizing medical expenses. Intentional efforts to limit food intake in this sample were correlated with increased ED pathology. Although it is not surprising that adults experiencing food insecurity engage in intentional DR, this study adds important information about why food insecure adults engage in DR and highlights the importance of assessing DR for reasons other than weight and shape concerns.

Traumatic event exposure associated with increased food insecurity and eating disorder pathology.

OBJECTIVE: The primary aim was to investigate the association between food insecurity (FI) and eating disorders, which are nutrition-based public health problems, with traumatic event exposure in a low-income marginalized population. The study also investigated the association between traumatic event exposure, anxiety and weight stigma. DESIGN: The study used self-report surveys in a cross-sectional design. SETTING: Food pantries affiliated with the local food bank in a major US city. SUBJECTS: Participants (n 503) consisted of clients presenting to food pantries. Participants were predominantly female (76·5 %), Latino/Hispanic (64·6 %) and low-income (59 % reported earning under $US 10 000 per year). RESULTS: Results indicated that 55·7 % of participants had directly experienced a traumatic event; this increased to 61·6 % when witnessing was included. Higher levels of FI were associated with greater traumatic event exposure. Increased exposure to traumatic events correlated with worsened overall eating disorder pathology (r=-0·239), weight stigma (r=-0·151) and anxiety (r=-0·210). CONCLUSIONS: The present study is the first to investigate the association of FI, eating disorders and trauma in a low-income marginalized population. Results indicate that exposure to traumatic events is common in this civilian population and that traumatic event exposure is associated with higher levels of FI and eating disorder pathology. Results indicate that further research is warranted given that traumatic event exposure, eating disorder pathology, weight stigma and anxiety may complicate effective delivery of public health interventions in those living with FI.

Food insecurity and eating disorder pathology.

OBJECTIVE: The primary aim of this study was to investigate eating disorder (ED) pathology in those living with food insecurity. A secondary aim was to investigate whether any-reason dietary restraint, weight self-stigma, and worry increased as level of food insecurity increased. METHOD: Participants (N = 503) seeking food from food pantries completed questionnaires assessing level of food insecurity, demographics, ED pathology, dietary restraint, weight self-stigma, and worry. RESULTS: Consistent with hypotheses, participants with the highest level of food insecurity (i.e., adults who reported having hungry children in their household) also endorsed significantly higher levels of binge eating, overall ED pathology, any-reason dietary restraint, weight self-stigma, and worry compared to participants with lower levels of food insecurity. Contrary to hypotheses, compensatory behaviors also increased as level of food insecurity worsened. Overall, 17% of those in the child hunger food insecurity group reported clinically significant ED pathology. DISCUSSION: This is the first study to assess the full spectrum of ED pathology in a low-income, marginalized population with food insecurity. Given that food insecurity is a global concern, results from this study suggest that greater attention to the association between ED pathology and food insecurity is warranted by researchers around the world.