Public health has a productive history of improving global health due to its focus on reaching large populations using effective and scalable interventions. Yet, the marriage between evidence-based science and the implementation of community/public health interventions within mental illness remains underdeveloped. Research suggests that major depression is the most commonly cited comorbidity for eating disorders (EDs). Thus, identification of public health strategies that jointly impact depression and EDs, including shared risk factors, has the potential to significantly impact mental health suffering. The primary aim of this paper is to examine and discuss such public health approaches as well as explore cues taken from public health efforts to inform future directions in research and clinical practice. As a comprehensive review of all public health initiatives that address EDs and depression is beyond the scope of this paper, this paper reviews a series of programs/approaches that either are of large scale and/or have received empirical support. In particular, public health related interventions that aim to reduce variable risk factors associated with EDs and depression, as well as interventions that aim to reduce continuous measures of ED and depression symptoms are reviewed. To date, despite significant progress in modifying risk factors for EDs and depression, the field still lacks a public health study that has been appropriately designed and/or adequately powered to assess true ED/depression prevention effects. Further, although several programs show promise, many widely disseminated approaches lack empirical support, raising concerns about the potential for waste of limited resources. In summary, although the combination of prevention and public health based approaches appear to have merit when trying to move the needle on risk factors and symptoms associated with EDs and/or depression, further research is needed to investigate the reach and effectiveness of large scale dissemination efforts of such endeavors.
Although research has shown links between family-of-origin violence (FOV), intimate partner violence (IPV), and hostility, research has not examined whether hostility mediates the relationship between FOV and IPV. The current study examined whether hostility mediates FOV and IPV perpetration in 302 men arrested for domestic violence. Results demonstrated that hostility fully mediated the relationship between father-to-participant FOV and physical and psychological IPV and the relationship between mother-to-participant FOV and physical IPV. Results indicated that hostility fully mediated the relationship between experiencing and witnessing FOV and physical IPV (composite FOV), and partially mediated the relationship between composite FOV and psychological aggression.
Objective The primary aim of this paper was to investigate moderators and predictors of response to two programs designed to reduce eating disorder risk factors in collegiate female athletes. This study served as an ancillary study to a parent trial that investigated the feasibility of an athlete modified cognitive dissonance-based program (AM-DBP) and an athlete modified healthy weight intervention program (AM-HWI). Design 157 female collegiate athletes were randomized to either the AM-DBP or the AM-HWI program. Participants completed surveys at baseline, post-intervention, 6 weeks, and 1 year. Methods After classifying sports as either lean or non-lean, we investigated if sport type acted as a moderator of program response to AM-DBP and AM-HWI using ANOVAs. Next, we examined whether baseline thin-ideal internalization, weight concern, shape concern, bulimic pathology, dietary restraint, and negative affect acted as predictors of changes in bulimic pathology using linear regression models. Results Athletes in non-lean sports who received AM-DBP showed more improvement in negative affect versus non-lean sport athletes in AM-HWI. Higher baseline scores of bulimic pathology predicted greater response in bulimic pathology to both programs at 6-weeks. In contrast, athletes with higher dietary restraint and negative affect baseline scores showed decreased response to both interventions at 6-weeks. Finally, athletes with higher baseline shape concern showed a decreased response to the AM-HWI intervention at the post intervention time point. Conclusion Results from the present study indicate that lean/non-lean sport may not play a strong role in determining response to efficacious programs. Further, factors such as pre-existing bulimic pathology, dietary restraint, negative affect, and shape concern may affect general response to intervention versus specific responses to specific interventions.
Objective The current case report details the treatment of a 16‐year‐old adolescent with anorexia nervosa utilizing a novel adjunct, acceptance‐based interoceptive exposure, prior to family‐based treatment (FBT) for eating disorders. Method The exposure‐based module focused particularly on the tolerance of disgust. For six sessions, the clinician taught the client skills that could be used to tolerate distress to visceral sensations associated with disgust. These skills were to be used during in‐ and between‐session exposures. Each session included exposure to physical sensations that occurred while drinking a milkshake. Results Across six sessions, the client reported improvement in symptoms in addition to gaining weight. Additionally, she consumed more calories of a test meal following the intervention. Within broader FBT, the client reached an established weight goal, was able to return to physical activity, and reported an increased ability to manage distress. Discussion Given the client's improvement on the Eating Disorders Examination‐Questionnaire (EDE‐Q) within six sessions, we believe IE may be a useful adjunct to FBT. Interoceptive exposure may augment the efficacy of FBT for anorexia nervosa as it provides clients with skills to utilize during the refeeding phase of treatment.
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