Weight Status and DSM-5 Diagnoses of Eating Disorders in Adolescents From the Community.

OBJECTIVE: To estimate jointly the point prevalence of weight and eating disorders in a community sample of adolescents; to investigate psychosocial correlates of thinness, overweight, and obesity, and of full- and subthreshold eating disorders (EDs); and to examine the relationships between weight status and prevalence of EDs. METHOD: A total of 3,043 Canadian adolescents (1,254 males and 1,789 females; mean age = 14.19 years, SD = 1.61 years) completed self-report questionnaires, including the Eating Disorder Diagnostic Scale, and measures of psychosocial functioning. Objective weight and height were collected, and weight status was defined according to the International Obesity Task Force body mass index growth curve centiles. RESULTS: In all, 29.5% (95% CI = 26.7, 32.5) of males and 22.8% (95% CI = 20.5, 25.2) of females were overweight or obese. A total of 2.2% (95% CI = 1.5, 3.2) of males and 4.5% (95% CI = 4.4, 4.5) of females met DSM-5 criteria for an ED; in addition, 1.1% (95% CI = 0.7, 1.9) of males and 5.1% (95% CI = 4.0, 6.5) of females were identified with a subthreshold ED. Both full- and subthreshold EDs were significantly associated with markedly impaired psychosocial functioning. There was a significant relationship between prevalence of EDs and weight status, with an increased risk for a bulimic disorder in obese relative to normal-weight males (odds ratio [OR] = 7.86) and females (OR = 3.27). CONCLUSION: This study provides estimates for the prevalence of DSM-5 EDs in adolescents, further support for their impact on mental health, and new evidence for an association between bulimic disorders and obesity. Results call for an integrated approach in research and prevention regarding the whole spectrum of eating- and weight-related disorders.

Developmental trajectories of romantic stages and associations with problem behaviours during adolescence.

Normative romantic development is theorized to progress through a series of stages: affiliative activities, group-based dating, and romantic relationships. The objectives of this research were threefold: empirically examine this progression of romantic stages during adolescence, determine normative and atypical trajectories, and examine links with internalizing and externalizing symptoms. An eight-wave longitudinal study was conducted with 698 adolescents (53.6% female; M(age) = 11.8 years at start of study). A group-based trajectory approach was employed to identify prototypical trajectories of romantic development and a model with three distinct romantic trajectories (i.e., On-time, Early Starters and Late Bloomers) was identified. Both timing and sequencing of romantic activity differed among trajectory groups. Analysis of Variance (ANOVAs) identified associations between Early Starters and externalizing behaviours in early, middle and later adolescence. The findings support progression through theorized stages of romantic activity and highlight the problems that are linked to early-starting and non-sequenced romantic development.

Partial hospitalization for youth with psychiatric disorders: treatment outcomes and 3-month follow-up.

A partial hospitalization program was developed for youth with moderate to severe psychiatric disorders. The objectives of this study were to prospectively assess changes from admission to discharge in the participants' clinical symptoms and psychosocial functioning, as well as the maintenance of any treatment gains at 3-month follow-up. In this naturalistic treatment study, 55 youth completed both the youth partial hospitalization program and the study. Diagnosis at admission was established by a psychiatrist based on a clinical assessment and a structured diagnostic interview. Clinician-rated and self-report measures of symptoms and psychosocial functioning were administered at admission, discharge, and follow-up to track changes over time. Clinically and statistically significant improvements were found in both symptoms and psychosocial functioning from admission to discharge on all study measures. Furthermore, these gains were maintained at 3-month follow-up. The results suggest that partial hospitalization programs can be an effective modality in treating youth with moderate to severe psychiatric disorders.

Extraocular connective tissue architecture.

Extraocular muscle pulleys, now well known to be kinematically significant extraocular structures, have been noted in passing and described in fragments several times over the past two centuries. They were late to be fully appreciated because biomechanical modeling of the orbit was not available to derive their kinematic consequences, and because pulleys are distributed condensations of collagen, elastin and smooth muscle (SM) that are not sharply delineated. Might other mechanically significant distributed extraocular structures still be awaiting description?An imaging approach is useful for describing distributed structures, but does not seem suitable for assessing mechanical properties. However, an image that distinguished types and densities of constituent tissues could give strong hints about mechanical properties. Thus, we have developed methods for producing three dimensional (3D) images of extraocular tissues based on thin histochemically processed slices, which distinguish collagen, elastin, striated muscle and SM. Overall tissue distortions caused by embedding for sectioning, and individual-slice distortions caused by thin sectioning and subsequent histologic processing were corrected by ordered image warping with intrinsic fiducials. We describe an extraocular structure, partly included in Lockwood's ligament, which contains dense elastin and SM bands, and which might refine horizontal eye alignment as a function of vertical gaze, and torsion in down-gaze. This active structure might therefore be a factor in strabismus and a target of therapeutic intervention.