BackgroundThe Eating Disorder Examination-Questionnaire (EDE-Q), a widely used self-report instrument, is often used for measuring change in eating disorder symptoms over the course of treatment. However, limited data exist about test-retest reliability, particularly for men. The current study evaluated EDE-Q 7-day test-retest reliability in male (n = 47) and female (n = 44) undergraduate students together and separately by gender.ResultsInternal consistency was consistently higher for women and at Time 2, but remained acceptable for both men and women at both time points. Cronbach’s α ranged from .75 (Restraint at Time 1) to .93 (Shape Concern at Time 2) for women and from .73 (Eating Concern at Time 2) to .89 (Shape Concern at Time 2) for men. With the exception of some of the eating disorder behaviors, test re-test reliability was fairly strong for both men and women. Shape Concern and the global EDE-Q score were highest for both men and women (Spearman’s rho > 0.89 with the exception of Shape Concern for women for which Spearman’s rho = .86). Test re-test reliability was lower for the eating disorder behavior measures, particularly for men, for whom Kendall’s tau-b for frequency and phi for occurrence was less than 0.70 for all but objective bulimic episodes.ConclusionsResults were consistent with past research for women, indicating strong test re-test reliability in attitudinal features of eating disorders, but lower test re-test reliability in behavioral features. Internal consistency and test re-test reliability was good for the attitudinal features of eating disorder in men, but tended to be lower for men compared to women. The EDE-Q appears to be a reliable instrument for assessing eating disorder attitudes in both male and female undergraduate students, but is less reliable for assessing ED behaviors, particularly in men.
Objective As part of a larger implementation trial for Cognitive Processing Therapy (CPT) for posttraumatic stress disorder (PTSD) in a community health center, we used formative evaluation to assess relations between iterative cultural adaption (for Spanish-speaking clients) and implementation outcomes (appropriateness & acceptability) for CPT. Method Qualitative data for the current study were gathered through multiple sources (providers: N=6; clients: N=22), including CPT therapy sessions, provider field notes, weekly consultation team meetings, and researcher field notes. Findings from conventional and directed content analysis of the data informed refinements to the CPT manual. Results Data-driven refinements included adaptations related to cultural context (i.e., language, regional variation in wording), urban context (e.g., crime/violence), and literacy level. Qualitative findings suggest improved appropriateness and acceptability of CPT for Spanish-speaking clients. Conclusion Our study reinforces the need for dual application of cultural adaptation and implementation science to address the PTSD treatment needs of Spanish-speaking clients.
Objective Bulimia nervosa (BN) and binge eating disorder (BED) are associated with significant health impairment. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) comprise both psychological (disturbances in mood and affect) and physiological (bloating and changes in appetite) symptoms that may trigger binge eating and/or purging. Method Female participants were drawn from the Collaborative Psychiatric Epidemiological Surveys, conducted from 2001–2003. Weighted multivariable logistic regression modeled the association between lifetime PMS and PMDD and lifetime odds of BN or BED. Results Among 8,694 participants, 133 (1.0%) had BN and 185 (1.8%) BED. Additionally, 366 (4.2%) had PMDD and 3,489 (42.4%) had PMS. Prevalence of PMDD and PMS were 17.4% and 55.4% among those with BN, 10.7% and 48.9% among those with BED and 3.4% and 59.1% among those with subthreshold BED. After adjustment for age, race/ethnicity, income, education, body mass index, age at menarche, birth control use and comorbid mental health conditions, PMDD was associated with 7-times the odds of BN (OR 7.2, 95% CI 2.3, 22.4) and PMS with 2-times the odds of BN (OR 2.5, 95% CI 1.1, 5.7). Neither PMDD nor PMS were significantly associated with BED. Discussion Women with PMS and PMDD have a higher odds of BN, independent of comorbid mental health conditions. PMS and PMDD may be important comorbidities to BN to consider in clinical settings, and future research should investigate whether PMS and PMDD affect the onset and duration of bulimic symptoms as well as the potential for shared risk factors across disorders.
Our study extends the literature on associations between posttraumatic stress disorder (PTSD) and chronic medical conditions by assessing differences in the magnitude of these relations by ethnicity. We examined group differences in the magnitude of the relation between PTSD and chronic medical conditions (cardiovascular disease [CVD], hypertension, obesity, diabetes). We obtained data from Latino (n = 3,224) and non-Latino white (n = 4,180) respondents from the Collaborative Psychiatric Epidemiology Surveys. Logistic regression models were constructed to test for the modification of the effect of PTSD on chronic medical conditions by ethnicity, and then by nativity. Unadjusted models revealed significant interactions between Latino ethnicity and PTSD for odds of diabetes (OR = 2.18 [Latino] v. 0.81 [non-Latino white]), CVD (OR = 3.23 [Latino] v. 1.28 [non-Latino white]), and hypertension (OR = 1.61 [Latino] v. 0.98 [non-Latino white]). Among U.S.-born Latinos, we found a significant interaction between ethnicity and PTSD for odds of CVD (OR = 4.18 [Latino] v. 1.28 [non-Latino white]) and diabetes (OR = 2.27 [Latino] v. 0.81 [non-Latino white]). These findings attenuated in adjusted models with the exception of differences in PTSD and odds of diabetes among Latinos (including aggregated group & U.S.-born) compared to non-Latino whites. Our findings support the need for further research on the complex relations between PTSD and chronic conditions, including the investigation of conditional risk by Latino sub-groups.
Blum, A. (1999). Jail time by the book: Black youths more likely to get tough sentences than whites, study shows.
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