Inhibitory control and sensitivity to reward are relevant to the food choices individuals make frequently. An imbalance of these systems can lead to deficits in decision-making that are relevant to food ingestion. This study evaluated the relationship between dietary behaviors – binge eating and consumption of sweetened beverages and snacks - and behavioral control processes, among 198 ethnically diverse adolescents, ranging in age from 14 to 17, in Southern California. Neurocognitive control processes were assessed with the Iowa Gambling Task, a generic Go/No-Go task, and a food-specific Go/No-Go task. The food-specific Go/No-Go task directly ties the task to food cues that trigger responses, addressing an integral link between cue-habit processes. Dietary measures were assessed with self-administered food frequency and binge eating questionnaires. Results of latent variable models revealed marked gender differences. Inhibitory problems on the food-specific and generic Go/No-Go tasks were significantly correlated with binge eating only in females, whereas inhibitory problems measured with these tasks were the strongest correlates of sweet snack consumption in males. Higher BMI percentile and sedentary behavior also predicted binge eating in females and sweet snack consumption in males. Inhibitory problems on the generic Go/No-Go, poorer affective decision-making, assessed with the Iowa Gambling Task, and sedentary behavior were associated with sweetened beverage consumption in males, but not females. The food-specific Go/No-Go was not predictive in models evaluating sweetened beverage consumption, providing some initial discriminant validity for the task, which consisted of sweet/fatty snacks as no-go signals and no sugar-sweetened beverage signals. This research extends other study findings, revealing gender differences in inhibitory function relevant to behavioral control. Further, the findings contribute to research implicating the relevance of cues in habitual behaviors and their relationship to snack food consumption in an understudied population of diverse adolescents not receiving treatment for obesity or eating disorders.

Background A cancer diagnosis may provide a ‘teachable moment’ in cancer recovery. To better understand factors influencing lifestyle choices following diagnosis, we examined associations between time since diagnosis and symptom burden with recommended dietary (e.g., 5+ fruit/vegetable servings/day), physical activity (e.g., >150 active minutes, 3–5 times/week) and smoking behaviors (i.e., eliminate tobacco use) in cancer survivors. Methods We analyzed cross-sectional survey data collected from breast (n=528), colorectal (n=106) and prostate (n=419) cancer survivors following active treatment at The University of Texas MD Anderson Cancer Center. Four regression models were tested for behaviors of interest. Additionally, we assessed symptom burden as a potential moderator and/or mediator between time since diagnosis and behaviors. Results Respondents were mostly female (55%) and non-Hispanic white (68%) with a mean age of 62.8 ± 11.4 years and mean time since diagnosis of 4.6 ± 3.1 years. In regression models, greater time since diagnosis predicted lower fruit and vegetable consumption (B=−0.05, p=0.02) and more cigarette smoking (B=0.06, p=0.105). Greater symptom burden was a significant negative predictor for physical activity (B=−0.08, p<.001). We did not find evidence that symptom burden moderated or mediated the association between time since diagnosis and health behaviors. Conclusion We assessed the prevalence of recommended behaviors in the context of other challenges that survivors face, including time since diagnosis and symptom burden. Our results provide indirect evidence that proximity to a cancer diagnosis may provide a teachable moment to improve dietary and smoking behaviors and that symptom burden may impede physical activity following diagnosis.

The commentary discusses several topics in Dr. Iacobucci's article on mediation analysis with categorical variables including the lack of equivalency of mediated effect measures, ab, and c–c′, that are algebraically equivalent in ordinary least squares regression models. The commentary raises the issue of correlated mediation coefficients and presents formulas to include the correlation in the test of significance. References to new developments in causal mediation analysis for categorical variables are given and the importance of programs of research to establish a mediation theory is emphasized.

Our findings provide preliminary evidence that pain intensity and body image are important factors in understanding depressive symptoms in patients with lymphedema. Clinical implications include screening for pain and body image concerns in this population to identify patients who are in distress. Counseling interventions targeting body image dissatisfaction can also be potentially helpful for patients with lymphedema.

Background Causal inference continues to be a critical aspect of evaluation research. Recent research in causal inference for statistical mediation has focused on addressing the sequential ignorability assumption; specifically, that there is no confounding between the mediator and the outcome variable. Objectives This article compares and contrasts three different methods for assessing sensitivity to confounding and describes the graphical depiction of these methods. Design Two types of data were used to fully examine the plots for sensitivity analysis. The first type was generated data from a single mediator model with a confounder influencing both the mediator and the outcome variable. The second was data from an actual intervention study. With both types of data, situations are examined where confounding has a large effect and a small effect. Subjects The nonsimulated data were from a large intervention study to decrease intentions to use steroids among high school football players. We demonstrate one situation where confounding is likely and another situation where confounding is unlikely. Conclusions We discuss how these methods could be implemented in future mediation studies as well as the limitations and future directions for these methods.