Momentary physiological indices related to eating disorders: A systematic and methodological review.

Eating disorders (ED) are serious psychiatric illnesses, with no everyday support to intervene on the high rates of relapse. Understanding physiological indices that can be measured by wearable sensor technologies may provide new momentary interventions for individuals with ED. This systematic review, searching large databases, synthesises studies investigating peripheral physiological (PP) indices commonly included in wearable wristbands (heart rate [HR], heart rate variability [HRV], electrodermal activity [EDA], peripheral skin temperature [PST], and acceleration) in ED. Inclusion criteria included: (a) full peer-reviewed empirical articles in English; (b) human participants with active ED; and (c) containing one of five wearable physiological measures. Kmet risk of bias was assessed. Ninety-four studies were included (Anorexia nervosa [AN; N = 4418], bulimia nervosa [BN; N = 916], binge eating disorder [BED; N = 1604], other specified feeding and eating disorders [OSFED; N = 424], and transdiagnostic [N = 47]). Participants with AN displayed lower HR and EDA and higher HRV compared to healthy individuals. Those with BN showed higher HRV, and lower EDA and PST compared to healthy individuals. Other ED and Transdiagnostic samples showed mixed results. PP differences are indicated through various assessments in ED, which may suggest diagnostic associations, although more studies are needed to validate observed patterns. Results suggest important therapeutic potential for PP in ED, and larger studies including diverse participants and diagnostic groups are needed to fully uncover their role in ED.

Comparisons between atypical anorexia nervosa and anorexia nervosa: Psychological and comorbidity patterns.

OBJECTIVE: Literature comparing "atypical" anorexia nervosa (atypical AN) and anorexia nervosa (AN) suggests these diagnoses share significant similarities in eating disorder (ED) pathology and psychiatric comorbidities. This study evaluated potential differences in ED pathology, psychiatric comorbidity, associated mechanisms (i.e., ED fears and perfectionism), and demographic factors (i.e., ethnicity and age) between individuals with atypical AN and AN. METHOD: Data from seven protocols were combined for a total 464 individuals diagnosed with atypical AN (n = 215) or AN (n = 249). Between-group differences in ED severity and behaviors, psychiatric comorbidities, ED fears, perfectionism, and demographic factors were assessed using t-tests, Wilcoxon rank-sum tests, and Fisher's exact test. RESULTS: Participants with atypical AN reported higher levels of overvaluation of weight and shape than those with AN. Participants with AN scored higher on food-related fears (anxiety about eating, food avoidance behaviors, and feared concerns) and fears of social eating, as well as obsessive-compulsive symptoms. Participants with AN were more likely to identify as Asian or Pacific Islander. No other statistically significant differences were found between groups for overall ED severity, ED behaviors, psychiatric comorbidities, general ED fears, perfectionism, or demographic factors. DISCUSSION: Overall, results support previous literature indicating limited differences between individuals with atypical AN and AN, though individuals with atypical AN reported more overvaluation of weight and shape and those with AN reported higher food and social eating fears and obsessive-compulsive symptoms. Relatively few overall differences between atypical AN and AN highlight the importance of exploring dimensional conceptualizations of AN as an alternative to the current categorical conceptualization. PUBLIC SIGNIFICANCE: This study assessed differences among individuals with atypical anorexia nervosa and anorexia nervosa in eating disorder severity and behaviors, comorbid psychiatric diagnoses, associated mechanisms, and demographic factors. Few differences emerged, though participants with atypical anorexia nervosa reported more overvaluation of weight and shape, while those with anorexia nervosa reported more food and social eating fears and higher obsessive-compulsive symptoms. Results support exploration of these diagnoses as a spectrum disorder.

Evidence-Based Assessments for Transdiagnostic Eating Disorder Symptoms: Guidelines for Current Use and Future Directions.

Eating disorders are severe and often chronic mental illnesses that are associated with high impairment and mortality rates. Recent estimates suggest that eating disorder prevalence rates are on the rise, indicating an increased need for accurate assessment and detection. The current review provides an overview of transdiagnostic eating disorder assessments, including interview, self-report, health and primary care screeners, and technology-based and objective assessments. We focused on assessments that are transdiagnostic in nature and exhibit high impact in the field. We provide recommendations for how these assessments should be used in research and clinical settings. We also discuss considerations that are crucial for assessment, including the use of a categorical versus dimensional diagnostic framework, assessment of eating disorders in related fields (i.e., anxiety and depression), and measurement-based care for eating disorders. Finally, we provide suggestions for future research, including the need for more research on short transdiagnostic screeners for use in health care settings, standardized assessments for ecological momentary assessment, development of state-based assessment of eating disorder symptoms, and consideration of assessment across multiple timescales.

An Approach to Assessing the Influence of Environmental and Occupational Cancer Hazard Identification on Policy Decision-Making.

BACKGROUND: Cancer hazard identification is critical to informing decisions on preventive actions. However, the influence of cancer hazard assessments on the creation of health-protective regulations is poorly understood. Although prior studies have measured the health and economic benefits of regulatory actions in general, we are not aware of efforts to explicitly study the influence of cancer hazard identification on policy decisions in the United States. OBJECTIVES: In this commentary, we present an approach to examine whether formal identification of a substance as a human carcinogen may prompt a regulatory action to reduce exposure to carcinogens and enhance public health. Further, we discuss the broader implications of cancer hazard identification on policy decision-making, including identifying gaps and providing recommendations. METHODS: Using the Report on Carcinogens (RoC) as a test case, we systematically searched U.S. federal and state databases for notices of regulations mentioning the RoC from 1995 to 2023. For each regulation, we extracted information on the carcinogen(s) regulated, the regulatory agency, the regulatory purpose, the economic sector exposure sources, and the analyzed public health benefits and costs. We created a publicly available, web-based interactive tool to visualize the data. DISCUSSION: U.S. regulatory agencies have been using cancer hazard evaluations, such as the RoC, for decades to inform public health policy actions to prevent or mitigate cancer risks. Specifically, nonregulatory cancer hazard assessments have been used to prioritize chemical evaluations, support regulatory-based assessments, and trigger regulatory action. Our approach showed that assessing the influence of cancer hazard identification on science-based public health policies is feasible, informative, and needed, and our study is a first step in this direction. We recommend expanding this approach to other cancer and noncancer hazard assessments to ultimately inform our understanding of the influence of hazard classifications on policymaking. https://doi.org/10.1289/EHP12681.

Exploring Sociocultural Influences Affecting Body Image in Survivors of Childhood Sexual Assault.

This phenomenological study explored the lived experiences of survivors of childhood sexual assault, their meaning making process of the assault, and how messages from their sociocultural environment affected their relationship with, and perception of, their bodies. Utilizing a social constructivist framework, the research team interviewed eleven (n = 11) participants from a variety of backgrounds who were gender assigned female at birth and had survived childhood sexual assault (CSA). Four major themes emerged from the narratives collected. These include sociocultural impacts which included four subthemes: family relationships, peer relationships, societal and environmental influences, and cultural and ethnic influences; meaning making of the critical event, i.e., childhood sexual assault; self-perception of their bodies; internal processes that have shaped their perceptions and meaning making, i.e., thoughts, feelings, and behaviors. Findings indicate major influence of sociocultural factors in shaping participant's internal processes as survivors of CSA, meaning making, and subsequently self-perceptions of, and relationship with, their bodies. We discuss CSA and body image keeping the intersectionality of the individual, their experiences, and the impact of sociocultural contexts on that intersectionality.

Competing for perfection: A scoping review evaluating relationships between competitiveness and eating disorders or disordered eating behaviours.

OBJECTIVE: Eating disorders (EDs) impact multiple domains in a person's life including interpersonal interactions. Although a considerable amount of literature has evaluated social comparison and ED pathology, less has focussed on the influence of competitiveness on eating behaviours within ED and community samples. To address this, a systematic scoping review was conducted to evaluate current knowledge on this topic. METHOD: PRISMA guidelines for scoping reviews were utilised to identify relevant articles in three databases without limits to date or publication type. RESULTS: A total of 2952 articles were identified. After removing duplicates and books, 1782 articles were evaluated against inclusion criteria, and 91 articles were included. Results were synthesised under six differing conceptualisations of competitiveness: competition in pro-eating disorder communities (n = 28), general personality competitiveness (n = 20), sexual competition hypothesis (n = 18), interpersonal competitiveness with peers (n = 17), familial competitiveness (n = 8) and competitiveness to avoid inferiority (n = 5). CONCLUSION: Varying conceptualisations of competitiveness were identified within the ED literature, and preliminary evidence suggests competitiveness may be associated with ED pathology in ED and community samples, although results were not uniform. Future research is needed to clarify these relationships and to identify possible clinical implications.

Workshop Report: Catalyzing Knowledge-Driven Discovery in Environmental Health Sciences through a Harmonized Language.

Harmonized language is essential to finding, sharing, and reusing large-scale, complex data. Gaps and barriers prevent the adoption of harmonized language approaches in environmental health sciences (EHS). To address this, the National Institute of Environmental Health Sciences and partners created the Environmental Health Language Collaborative (EHLC). The purpose of EHLC is to facilitate a community-driven effort to advance the development and adoption of harmonized language approaches in EHS. EHLC is a forum to pinpoint language harmonization gaps, to facilitate the development of, raise awareness of, and encourage the use of harmonization approaches and tools, and to develop new standards and recommendations. To ensure that EHLC's focus and structure would be sustainable long-term and meet the needs of the field, EHLC launched an inaugural workshop in September 2021 focused on "Developing Sustainable Language Solutions" and "Building a Sustainable Community". When the attendees were surveyed, 91% said harmonized language solutions would be of high value/benefit, and 60% agreed to continue contributing to EHLC efforts. Based on workshop discussions, future activities will focus on targeted collaborative use-case working groups in addition to offering education and training on ontologies, metadata, and standards, and developing an EHS language resource portal.

Catalyzing Knowledge-Driven Discovery in Environmental Health Sciences through a Community-Driven Harmonized Language.

Harmonized language is critical for helping researchers to find data, collecting scientific data to facilitate comparison, and performing pooled and meta-analyses. Using standard terms to link data to knowledge systems facilitates knowledge-driven analysis, allows for the use of biomedical knowledge bases for scientific interpretation and hypothesis generation, and increasingly supports artificial intelligence (AI) and machine learning. Due to the breadth of environmental health sciences (EHS) research and the continuous evolution in scientific methods, the gaps in standard terminologies, vocabularies, ontologies, and related tools hamper the capabilities to address large-scale, complex EHS research questions that require the integration of disparate data and knowledge sources. The results of prior workshops to advance a harmonized environmental health language demonstrate that future efforts should be sustained and grounded in scientific need. We describe a community initiative whose mission was to advance integrative environmental health sciences research via the development and adoption of a harmonized language. The products, outcomes, and recommendations developed and endorsed by this community are expected to enhance data collection and management efforts for NIEHS and the EHS community, making data more findable and interoperable. This initiative will provide a community of practice space to exchange information and expertise, be a coordination hub for identifying and prioritizing activities, and a collaboration platform for the development and adoption of semantic solutions. We encourage anyone interested in advancing this mission to engage in this community.

Making sense of human biomonitoring data: findings and recommendations of a workshop.

The ability to measure chemicals in humans (often termed biomonitoring) is far outpacing the ability to interpret reliably these data for public health purposes, creating a major knowledge gap. Until this gap is filled, the great promise of routinely using biomonitoring data to support decisions to protect public health cannot be realized. Research is needed to link biomonitoring data quantitatively to the potential for adverse health risks, either through association with health outcomes or using information on the concentration and duration of exposure, which can then be linked to health guidelines. Developing such linkages in the risk assessment paradigm is one of the primary goals of the International Council of Chemical Associations' (ICCA) Long-Range Research Initiative (LRI) program in the area of biomonitoring. Therefore, ICCA sponsored a workshop to facilitate development of a coordinated agenda for research to enable an improved interpretation of human biomonitoring data. Discussions addressed three main topics: (1) exploration of the link between exposure, dose, and human biomonitoring data, (2) the use of computational tools to interpret biomonitoring data, and (3) the relevance of human biomonitoring data to the design of toxicological studies. Several overarching themes emerged from the workshop: (a) Interpretation and use of biomonitoring data should involve collaboration across all sectors (i.e., industry, government, and academia) and countries. (b) Biomonitoring is not a stand-alone tool, and it should be linked to exposure and toxicological dose information. (c) Effective communication is critical, because when uncertainty about the actual risks is high, the perceived risks grow in the absence of communication. (d) The scope of future biomonitoring activities encompasses a variety of research approaches - from advancing the science to fill data gaps to advancing the accessibility of the current knowledge to enable better information sharing.

Use of genomics in toxicology and epidemiology: findings and recommendations of a workshop.

The sequencing of the human genome has revolutionized biology and led to an astounding variety of technologies and bioinformatics tools, enabling researchers to study expression of genes, the function of proteins, metabolism, and genetic differences within populations and between individuals. These scientific advances are making an impact in the medical research community and hold great promise for prevention, diagnosis, and treatment of diseases. This developing field also holds great promise for improving the scientific basis for understanding the potential impacts of chemicals on health and the environment. A workshop sponsored by the International Council of Chemical Associations was held to review the state of the science in the application of genomics technologies in toxicology and epidemiology. Further, consideration was given to the ethical, legal, and regulatory issues and their influence on the direction and application of genomics technologies to environmental health research. Four overarching themes emerged from the workshop: Genomics technologies should be used within a framework of toxicology and epidemiology principles and applied in a context that can be used in risk assessment; effective application of these technologies to epidemiology will require suitable biologic samples from large and diverse population groups at the relevant period of exposure; ethical, legal, and social perspectives require involvement of all stakeholder communities; and a unified research agenda for genomics technologies as applied to toxicology, epidemiology, and risk assessment is urgently needed for the regulatory and scientific communities to realize the potential power and benefits of these new technologies.