Lindsay M. Howard

The denial, concealment, or omission of disordered eating behaviors has received limited attention in the eating disorder literature, partly due to the lack of reliable and valid measures. This study re-examined the factor structure of the Denial of Disordered Eating Behaviors Scale (DDEBS-12) and tested measurement invariance across gender identity, racial identity, and levels of disordered eating in a non-clinical undergraduate sample (N = 3285). Confirmatory factor analyses did not support the original unidimensional structure. Instead, a seven-item model assessing denial of dietary restriction demonstrated the best fit and was renamed the DDEBS-restriction. The revised scale showed good internal consistency and demonstrated expected associations with measures of concealment, disclosure, and dietary restriction, supporting convergent and criterion validity. Measurement invariance analyses supported configural and metric invariance across men and women, Black and White participants, and individuals with non-clinical versus elevated levels of disordered eating; scalar invariance was not supported across disordered eating severity groups. These findings suggest that the DDEBS-restriction demonstrates promising psychometric properties within an undergraduate sample, though additional research is needed to establish its generalizability across broader and more diverse populations.

To explore the receipt of mental health education, assessment, and referrals, and mental health service use among individuals with vestibular disorders. Patients with vestibular disorders living in the US, Australia, Canada, and the UK were surveyed through social media forums. Questionnaires assessed demographics, anxiety (Generalized Anxiety Disorder-7), depression (Center for Epidemiological Studies Depression-10), dizziness (Dizziness Handicap Inventory), and type of professional providing mental health education, assessment, referral, and treatment. The 226 participants were largely White (90%), educated (67% holding an associate’s degree or higher) women (88%) with an average age of 45 who self-identified as having chronic vestibular symptoms (78%), as opposed to episodic ones (22%). Fifty-two percent reported never receiving verbal education, written education (69%), mental health assessment (54%), or referral (72%). Participants were more likely to receive mental health treatment in the past if they had received verbal resources and/or referrals from clinicians. The majority of patients with vestibular disorders report that medical professionals have not provided education, mental health assessment, or a mental health referral.

The acquired preparedness (AP) model of eating disorder (ED) risk suggests transaction between impulsive traits and eating expectancies, though there remains a lack of research investigating distinct facets of impulsivity within this framework. This study examined how different facets of impulsivity moderate associations between eating expectancies and binge-eating severity in daily life. Women with binge-eating symptoms (N = 40) completed surveys followed by 10 days of ecological momentary assessment (EMA). Generalized estimating equations examined the independent and interactive effects of impulsivity facets and eating expectancies on EMA-measured binge-eating severity. Significant interactions were found between eating expectancies and emotional and behavioral impulsivity, but not a cognitive facet. Results suggest that among women high in emotional impulsivity, those with greater eating expectancies report higher binge-eating severity. Conversely, among those with lower behavioral impulsivity, those with lower eating expectancies report lower binge-eating severity. Future prospective work is needed with non-clinical samples.

The purpose of this study was to develop the Underreporting of Disordered Eating Behaviors Scale (UDEBS) to detect attempts by respondents to underreport eating patterns that reflect symptoms of an eating disorder. In “Study 1”, the scale and validity measures were administered via an online survey to 692 undergraduates. In “Study 2”, these measures were administered to 810 undergraduates using a simulation design where participants were randomized to four conditions: (1) answering as truthfully as possible, or as if they are trying to hide (2) Binge Eating Disorder (BED), (3) Anorexia Nervosa (AN), or (4) Bulimia Nervosa (BN). “Study 1” results suggested that men and women have divergent UDEBS distributions and item endorsement rates; therefore, separate analyses were performed by gender. Individuals who scored above one standard deviation (SD) on the UDEBS reported less body dissatisfaction and disordered eating (ps < 0.05) than those who scored one SD below. In “Study 2” women who were instructed to hide an eating disorder reported significantly higher UDEBS scores than women instructed to answer truthfully. There were no significant differences between conditions for men. The final 15-item scale indicated that women who complied with instructions to underreport produced scores 1.45 (BN) to 1.72 (AN) times greater than the truthful responding condition. This novel scale can potentially assist in detecting women who underreport in relation to disordered eating, which may be useful in research and clinical contexts where underreporting is a concern. Future research is needed with men and clinical samples. Level I Evidence obtained from an experimental study.

Objective: The present meta‐analysis evaluated changes in individuals' risk of engaging in distinct disordered eating behaviors (DEBs) in the long‐term.Method: Longitudinal studies assessing changes in DEBs via ≥2 assessments with a time lag of ≥10 years were included. Risk ratios were calculated for baseline to 10–14.9‐year (M = 11.04) follow‐up and baseline to ≥15‐year (M = 18.62) follow‐up changes in the use of binge eating, multiple purging, self‐induced vomiting, laxatives, diuretics, diet pills, compensatory exercising, fasting/dieting, and multiple DEBs; Cohen's d was used for continuous binge‐eating plus purging variable changes. Subgroup and meta‐regression analyses tested whether eating disorder (ED) clinical sample versus nonclinical sample status, female versus male sex/gender, higher versus lower study bias, and baseline mean age and body mass index influenced overall effect magnitude for analyses with sufficient data.Results: Seventeen studies (26 [sub]samples) were included. Overall, individuals' risk of engaging in various restrictive eating and other compensatory behaviors decreased over time and the magnitudes of risk reductions for the use of certain compensatory DEBs were larger over longer follow‐up durations. Specifically, for significant DEB change models, risk reductions spanned from 20.0–39.8% for 10‐year follow‐up and 24.7–74.8% for ≥15‐year follow‐up. However, nuances were found in the nature of these DEB changes as a function of DEB type, follow‐up length, ED versus nonclinical sample composition, and baseline mean age.Conclusions: These findings provide important information that can help identify treatment priorities and suggest that targeted and tailored preventative ED treatments warrant consistent implementation at the community‐level, particularly for youth.