Reliability and validity of a parent-reported screening tool for disordered eating in children and young people with type 1 diabetes.

BACKGROUND: There is a high prevalence and complex overlap between type 1 diabetes (T1D) and disordered eating. However, screening for disordered eating in children and young people (CYP) with T1D is not routinely conducted, with reluctance reported by both professionals and parents. This study aimed to validate a parent-reported version of a validated disordered eating screening tool for CYP with T1D (the Diabetes Eating Problems Survey-Revised; DEPS-R). METHODS: The existing DEPS-R was adapted for parental use. Eighty-nine parents of CYP with T1D aged 11-14 years completed the parent-reported DEPS-R and other questionnaires related to demographics, child eating behaviours and parental well-being. CYP of parents were invited to participate, with 51 CYP completing the validated CYP-reported DEPS-R for comparison. RESULTS: The parent-reported DEPS-R demonstrated good internal consistency (Cronbach's α = 0.89). Moderate to good inter-rater reliability was found between the parent-reported DEPS-R and CYP-reported DEPS-R (ICC 0.746, 95% CI = 0.554-0.855, p < 0.001), indicating good convergent validity. Construct validity with hypothesised variables, including specific eating behaviours, diabetes-related distress, well-being, CYP BMI, gender and parental worry about CYP disordered eating, suggested validity of the measure. However, some hypothesised variables did not significantly correlate with the parent-reported DEPS-R as expected. CONCLUSIONS: The parent-reported DEPS-R has demonstrated good reliability and validity, and it may provide clinical benefit by increasing screening and early detection of disordered eating in CYP with T1D. Whilst novel and providing stepped increase in our knowledge, these findings would benefit from further validation (e.g. in a larger sample and responsiveness).

PRIORITY Trial: Results from a feasibility randomised controlled trial of a psychoeducational intervention for parents to prevent disordered eating in children and young people with type 1 diabetes.

AIMS: Children and young people (CYP) with type 1 diabetes (T1D) are at increased risk of disordered eating. This study aimed to determine the feasibility and acceptability of a novel, theoretically informed, two-session psychoeducational intervention for parents to prevent disordered eating in CYP with T1D. METHODS: Parents of CYP aged 11-14 years with T1D were randomly allocated to the intervention or wait-list control group. Self-reported measures including the Diabetes Eating Problem Survey-Revised (DEPS-R), Problem Areas in Diabetes Parent Revised (PAID-PR), Child Eating Behaviour Questionnaire subscales (CEBQ), Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), clinical outcomes (e.g. HbA1c, BMI, medication and healthcare utilisation) and process variables, were collected at baseline, 1-and 3-month assessments. Acceptability data were collected from intervention participants via questionnaire. RESULTS: Eighty-nine parents were recruited, which exceeded recruitment targets, with high intervention engagement and acceptability (<80% across domains). A signal of efficacy was observed across outcome measures with moderate improvements in the CEBQ subscale satiety responsiveness (d = 0.55, 95% CI 0.01, 1.08) and child's BMI (d = -0.56, 95% CI -1.09, 0.00) at 3 months compared with controls. Trends in the anticipated direction were also observed with reductions in disordered eating (DEPS-R) and diabetes distress (PAID-PR) and improvements in wellbeing (WEMWBS). CONCLUSIONS: This is the first study to have co-designed and evaluated a novel parenting intervention to prevent disordered eating in CYP with T1D. The intervention proved feasible and acceptable with encouraging effects. Preparatory work is required prior to definitive trial to ensure the most relevant primary outcome measure and ensure strategies for optimum outcome completion.

Feasibility and efficacy of an online compassion-focused imagery intervention for veterinarian self-reassurance, self-criticism and perfectionism.

BACKGROUND: Veterinarians report high levels of psychological distress and self-criticism. However, there is minimal research investigating psychological interventions for veterinarians. Evidence suggests that compassion-focused therapy is effective at reducing distress in those with high self-criticism. This study aimed to investigate the feasibility and preliminary effectiveness of a 2-week online compassionate imagery intervention for veterinarians. METHODS: A one-group repeated measures design was used with 128 veterinarians. Participants completed measures of perfectionism, self-criticism, self-reassurance and fears of compassion four times, at 2-week intervals (at baseline, pre-intervention, post-intervention and 2-week follow-up). Participants answered written questions about their intervention experience post-intervention. RESULTS: Content analysis of the qualitative data found the intervention to be acceptable and beneficial to participants. Overall, study attrition was 50.8%, which is reasonable for a low-cost intervention. Minimal differences were found between participants who dropped out compared to those who completed the intervention. Perfectionism, work-related rumination and self-criticism were significantly reduced post-intervention, and these effects were maintained at follow-up. Resilience and self-reassurance remained unchanged. Fears of compassion reduced over the baseline period and pre-post intervention, questioning the validity of the measure. CONCLUSION: Overall, in the context COVID-19, the intervention showed impressive feasibility and preliminary effectiveness. Randomised control trials are recommended as the next step for research to establish the intervention's effectiveness.

Effectiveness of self-compassion-related interventions for reducing self-criticism: A systematic review and meta-analysis.

Self-criticism is the process of negative self-evaluation. High levels are associated with psychopathology and poorer therapeutic outcomes. Self-compassion interventions were developed to explicitly target self-criticism. The aim of this review was to estimate the overall effect of self-compassion-related interventions on self-criticism outcomes and investigate potential moderating variables. A systematic search of the literature identified 20 randomized controlled trials (RCTs) that met the inclusion criteria. Nineteen papers, involving 1350 participants, had sufficient data to be included in the meta-analysis. Pre- and post-data points were extracted for the compassion and control groups. Study quality was assessed using an adapted version of the Cochrane Collaboration's risk of bias tool, which concluded that studies were of moderate quality. Meta-analysis findings indicated that self-compassion-related interventions produce a significant, medium reduction in self-criticism in comparison with control groups (Hedges' g = 0.51, 95% CI [0.33-0.69]). Moderator analysis found greater reductions in self-criticism when self-compassion-related interventions were longer and compared with passive controls rather than active. The remaining moderators of forms of self-criticism, sample type, intervention delivery, intervention setting and risk of bias ratings were insignificant. Overall, the review provides promising evidence of the effectiveness of self-compassion-related interventions for reducing self-criticism. However, results are limited by moderate quality studies with high heterogeneity. Directions for future research indicate that more RCTs with active controls, follow-ups, consistent use and reporting of measures and diverse samples are needed.