Psychometric properties of the Cystic Fibrosis Eating Attitudes and Behaviours scale (CFEAB) in an adult population.

OBJECTIVES: Individuals with Cystic Fibrosis (CF) may be at an increased risk of developing a range of eating difficulties. Scales designed to measure disordered eating in the general population do not cover CF-specific behaviours resulting in a knowledge gap. The CFEAB was developed as a CF-specific measure assessing eating behaviours and attitudes however little evidence exists regarding its psychometric quality. The aim of this cross-sectional study was to provide a robust assessment of its internal consistency, structural validity, and criterion validity. METHODS: One-hundred and thirty-two people with CF completed self-report scales pertaining to mental health, eating disorders, and the Cystic Fibrosis Eating Attitudes and Behaviours (CFEAB). RESULTS: Results of exploratory structural equation modelling indicated that a three-factor structure produced good fit with the 24-item CFEAB but a purified 12-item CFEAB displayed superior fit and internal consistency. Also, the 12-item scale predicted significant amounts of variance for anxiety, depression, and eating disorders showing enhanced relevance for clinical use. Conclusions These findings add emphasis to the importance of the validation and development of CF-specific measures and the possible inclusion at clinics to help improve CF patient care.

Investigating the nature of depressive experiences in adults who self-medicate low mood with alcohol.

OBJECTIVE: This study sought to explore whether individuals who self-medicate with alcohol experience higher levels of depression, and whether symptom level experiences are affected by the behavior of self-medication. DESIGN: Data were from the Wave I (2001-2002) National Epidemiologic Survey on Alcohol and Related Conditions - NESARC. Only participants who answered affirmatively to either one or both of the two stem questions that highlight the key symptoms of depression were included (n = 13,753). RESULTS: A one-factor model of depression was supported. Experiences of suicidality were more likely to be endorsed by people who self-medicated, compared to those with low mood who do not use alcohol in this way. Typically, more common experiences of depression in the form of appetite difficulties were less likely to be reported by those who self-medicated, compared to those who do not. CONCLUSIONS: The findings aid understanding of the drinking patterns and other mental health correlates of those who engage in the behavior of self-medication. Findings indicate that those who self-medicate are at a higher risk for suicidality, given the same level of depression. These findings highlight the importance of identifying these potentially problematic health behaviors as early as possible, due to these risks.

Examining the alcohol-related consequences of adult drinkers who self-report medicating low mood with alcohol: An analysis of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions survey data.

The aim of this paper is to examine the alcohol-related consequences experienced by adults who reported a 2-week period of low mood and identified as a 'self-medicator' compared to those who do not. Our focus is on assessing whether the conceptualization of alcohol use disorder severity differs across adult drinkers who self-medicate with alcohol during a period of low mood, compared to those who do not. This study used secondary data from the NESARC survey. The analytic sample consisted of 5945 participants who answered questions from the alcohol abuse/dependence (alcohol experiences) section, in the last 12 months. The sample was split into four groups by whether they self-medicated with alcohol or not, drank alcohol in the last year, and their drinking class. The findings indicated that a one-factor model was the best fit, and all items were a strong indicator of alcohol use disorder. The two-parameter model had the best fit, indicating that the diagnostic criteria were placed as a good fit along a continuum of severity. It was revealed that the hazardous drinking group who self-medicated, experienced more consequences even at low levels of severity. As the self-medicating hazardous drinking group also showed the highest estimates for alcohol use disorder severity, this may indicate that this group is composed of high-functioning self-medicators who are trying to regulate their drinking, and may not be as clinically high risk as expected, due to their drinking patterns.

Self-medicating low mood with alcohol use: Examining the role of frequency of alcohol use, quantity consumed and context of drinking.

OBJECTIVE: The concept of self-medication refers to the use of substances to help cope with periods of psychological distress. This study sought to examine the typical drinking patterns of adults who self-report using alcohol to self-medicate low mood using data from a large, nationally representative US household survey. MATERIALS AND METHODS: Data was from the Wave I (2001-2002) National Epidemiological Survey on Alcohol and Related Conditions (NESARC). The sample consisted of individuals who met the depression criteria, who indicated that they had drank alcohol to improve their mood when they felt down for at least two weeks, and consumed alcohol in the last 12 months (n = 5900). Alcohol use related to the last 12 months (frequency, quantity, and drinking context). RESULTS: A multiple group Latent Class Analysis was conducted to identified clinically relevant homogeneous groups of drinkers who self-report use of alcohol to self-medicate compared to those who do not. Two latent classes emerged for each of the two self-medicating groups, which were named based on their probabilities, as 'seldom drinkers' and 'hazardous drinkers' in the self-medication group, and as 'normal drinkers' and 'very seldom drinkers' in the non-self-medication group. CONCLUSIONS: The findings of this paper indicate that the behaviour of self-medication may be a factor in why people may be more hazardous drinkers, and that these individuals are drinking to relieve their mood, more likely than someone who does not use alcohol for this purpose. The findings also provide clinical insight, as the behaviour of self-medication could be used as a target for intervention.

Coping styles in adults with cystic fibrosis: implications for emotional and social quality of life.

As life expectancy increases, interest has grown surrounding the factors that may influence quality of life (QOL) for people with cystic fibrosis (CF). The aim of the current study was to examine which specific coping styles were positively or negatively associated with social and emotional QOL in a CF sample. One hundred and twenty-two respondents aged 18 and over were recruited through an online support group. Respondents completed the 'CF Questionnaire-Revised (CFQ-R)' and the 'Brief COPE'. The CFQ-R is a disease-specific instrument designed to measure the impact of CF on nine QOL domains and the Brief COPE is a 28 item questionnaire which assesses 14 coping scales. A multivariate regression model revealed that higher substance abuse and disengagement was associated with lower emotional QOL whereas greater use of religion, instrumental coping and acceptance was positively associated with emotional QOL. Active coping was linked to better social QOL and a negative association was reported between distraction coping with both emotional and social domains. Given the burden of CF, ascertaining which factors enhance or diminish emotion and social well-being is now an integral component of QOL research. The current findings may therefore have value in informing clinical interventions which aim to cater for the psychological needs of individuals with CF.