Sleep reactivity is associated with social anxiety and disordered-eating behaviors in college students.

Objective: Investigate whether sleep reactivity was associated with social anxiety and disordered-eating behaviors in a college population. Participants: One hundred ninety-eight college-age men and women. Methods: Participants completed self-report measures of social anxiety, disordered-eating behaviors and sleep reactivity. Results: Sleep reactivity was associated with greater dietary restriction and purging, controlling for social anxiety but it was not associated with binge eating. Sleep reactivity was associated with elevated symptoms of social anxiety, controlling for disordered-eating behaviors. Conclusions: The results suggest that sleep reactivity represents a shared correlate of disordered-eating behaviors and social anxiety that may partially explain their co-occurrence. Interventions to help college students high in sleep reactivity effectively manage stress and regulate their sleep may aid in the prevention and treatment of social anxiety and disordered-eating behaviors.

Gender differences in the relation between interpersonal stress and momentary shape and weight concerns in youth with overweight/obesity.

The purpose of this study was to examine relations between interpersonal stress and momentary shape and weight concerns among pre-adolescent and early adolescent boys and girls with overweight/obesity, using ecological momentary assessment (EMA). We also aimed to determine whether interpersonal stress was differentially related to shape/weight concerns in boys versus girls. Forty youth, ages 8-14 years (53% female), with overweight or obesity reported their state-level shape/weight concerns and negative affect and their recent interpersonal stress (i.e., stress experienced since the last EMA assessment) multiple times a day, for two weeks. Results indicated that interpersonal stress predicted shape/weight concerns in girls but was not related to shape/weight concerns in boys. At the between-person level, higher overall feelings of loneliness and social rejection and a higher overall desire for more friends predicted higher average levels of shape/weight concerns. At the within-person level, higher momentary ratings of loneliness, social rejection, and desire for more friends predicted lower shape/weight concerns. These data suggest that the tendency to experience interpersonal stress may be more detrimental to body satisfaction for girls with overweight/obesity than for boys with overweight/obesity. Interventions that focus on reducing interpersonal stress may be effective in ameliorating shape/weight concerns in girls with overweight/obesity.

Emotion regulation flexibility and disordered eating.

Research suggests that individuals with eating disorders use more putatively maladaptive emotion regulation strategies and fewer putatively adaptive strategies. However, there is growing theoretical and empirical support for the notion that the efficacy of emotion regulation strategies varies across situations. Thus, successful emotion regulation is characterized by the ability to flexibly choose between emotion regulation strategies in order to fit one's situational needs. Despite growing support for this conceptualization of successful emotion regulation, no research has investigated it in relation to disordered eating. Using the emotion regulation choice paradigm, this study investigated the association between emotion regulation flexibility and disordered eating. Women (N = 50) completed self-report questionnaires and a laboratory-based emotion regulation choice task to assess emotion regulation flexibility. Results indicated that lower emotion regulation flexibility was associated with more frequent purging and excessive exercise. Emotion regulation flexibility was not significantly associated with binge eating or overall eating disorder psychopathology. These findings suggest that individuals who engage in unhealthy compensatory behaviors exhibit reduced emotion regulation flexibility. If replicated in clinical samples, treatment for eating disorders characterized by compensatory behaviors may benefit from incorporating additional strategies to help people utilize emotion regulation strategies in a flexible, situationally appropriate manner.

Threat appraisal partially mediates the relation between neuroticism and bulimic symptoms.

Several studies support an association between neuroticism and bulimic symptoms; however, few studies have focused on how neuroticism exerts its influence. The purpose of this study was to extend the literature by investigating threat appraisal as a potential mediator of the relation between neuroticism and bulimic symptoms. One hundred and twenty women completed self-report measures of trait neuroticism, threat appraisal, and bulimic symptoms. Approximately half of the sample reported moderate or high levels of bulimic symptoms. Bootstrapping analyses revealed that neuroticism and threat appraisal were both positive predictors of bulimic symptoms. Further, threat appraisal partially mediated the association between neuroticism and bulimic symptoms. The findings suggest that women high in neuroticism may be vulnerable to experiencing bulimic symptoms, particularly during periods of heightened stress. These women may perceive bulimic behavior to be more effective in alleviating negative stressful emotions compared to more adaptive coping strategies. Based on the findings, women diagnosed with bulimia nervosa with high levels of neuroticism may benefit from interventions that specifically target threat appraisals to facilitate their ability to effectively adapt to stress.

Illicit Drug Use, Cigarette Smoking, and Eating Disorder Symptoms: Associations in an Adolescent Twin Sample.

OBJECTIVE: Twin studies have shown that genetic factors in part explain the established relation between alcohol use (i.e., problematic use or abuse/dependence) and eating disorder symptoms in adolescent and adult females. However, studies have yet to elucidate if there are similar shared genetic factors between other aspects of substance involvement, such as illicit drug use and repeated cigarette smoking. METHOD: For those sex-specific phenotypic correlations above our threshold of .20, we used a behavioral genetic design to examine potential shared genetic overlap between self-reported lifetime illicit drug use and repeated cigarette smoking and the eating disorder symptoms of drive for thinness (DT), bulimia (BU), and body dissatisfaction (BD), as assessed with the Eating Disorder Inventory-II, in 16- to 17-year-old female and male twin pairs. RESULTS: Only phenotypic correlations with illicit drug use met our threshold for twin modeling. Small to moderate genetic correlations were observed between illicit drug use and BU in both girls and boys and between illicit drug use and DT in girls. CONCLUSIONS: Similar etiological factors are at play in the overlap between illicit drug use and certain eating disorder symptoms in girls and boys during adolescence, such that genetic factors are important for covariance. Specifically, illicit drug use was associated with bulimia nervosa symptoms in girls and boys, which parallels previous substance use research finding a genetic overlap between alcohol use and bulimia nervosa symptoms. Future research should prospectively examine developmental trajectories to further understand the etiological overlap between substance involvement and eating disorder symptoms.

Risk factors, prevention, and treatment of corticosteroid-induced osteoporosis in adults.

An orthopedist can play a critical role in corticosteroid induced osteoporosis management by identifying at-risk patients and selecting appropriate prophylactic measures. This article is part two in a two-part series on osteoporosis. Part one appeared in the July 2008 issue of ORTHOPEDICS.

Understanding risk factors, screening, and treatment of postmenopausal osteoporosis.

Between 30% and 50% of American women will endure a clinical fracture during their lifetime due to the loss of bone mineral density that occurs with menopausal estrogen loss. This article is part one in a two-part series on osteoporosis. Part two will appear in the August 2008 issue of ORTHOPEDICS.