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Biomedical subjects

R D Crosby

Publications and source records attributed to R D Crosby.

At least 19 recordsLinked to original sources

Sexual violence and weight control techniques among adolescent girls.

OBJECTIVE: Research has linked childhood sexual abuse and eating disturbances among adult females. Less is known about whether sexual abuse in the form of dating violence has implications for deviant weight control techniques among adolescent girls. This study assesses the association between sexual violence and weight control practices among girls. We also attempt to untangle the effects of family environment from this association and to determine if weak impulse control mediates the association. METHOD: Survey data were gathered from 2,629 girls in Grades 9-12 to assess health risks. Girls responded to questions regarding dating violence, unwanted sexual contact, purging, and diet pill consumption. Logistic regression was used to assess the unique contribution of sexual violence on weight control techniques. RESULTS: Dating violence and unwanted sexual contact elevated the probability that girls would report practicing weight control techniques by 6-13%. Controls for family environment did not eliminate these associations. Weak impulse control did not significantly mediate these associations. DISCUSSION: These findings suggest that sexual violence has immediate implications as a risk factor for weight control techniques in adolescence.

Adolescent↗

Eating disturbance and sexual trauma in childhood and adulthood.

OBJECTIVE: This study examined the relationship between sexual trauma and eating disorder behavior, taking into account the effects of developmental stage of the victim and the effects of multiple sexual assaults. METHOD: Four groups of adult women took part in this study. Subjects were either victims of childhood sexual abuse, victims of rape in adulthood, victims of both childhood sexual abuse and rape, and controls who were not traumatized sexually. All subjects were assessed with semistructured interviews and self-report inventories that assessed eating disorder behavior, general psychopathology, and impulsivity. RESULTS: Victims of childhood sexual abuse differed from controls on measures of eating disorder behavior and individuals who had experienced both childhood sexual abuse and rape in adulthood were most likely to display eating disorder-related psychopathology. Victims of childhood sexual abuse also distinguished themselves with high levels of eating disorder behavior plus multiple forms of impulsive self-destructive behavior. DISCUSSION: This study provides additional support for the association between childhood sexual abuse and eating disorder behavior. Childhood sexual abuse may be particularly linked to the presence of binge eating behavior and several other forms of impulsive self-destructive behavior.

Adult↗

Food presentation and energy intake in a feeding laboratory study of subjects with binge eating disorder.

OBJECTIVE: The purpose of this study was to examine the influence of the number of foods presented and the amount of food presented on overeating or binge eating behavior in obese subjects with and without binge eating disorder (BED). METHOD: Ten subjects (5 BED, 5 non-BED), male and female, aged 18-65, participated. Their body weight was > or =130% of their ideal body weight (IBW). They were evaluated in a feeding laboratory setting on four occasions when they were presented with (a) either one or two binge foods presented in (b) either two or four times the amount of their self-reported usual intake during a binge/overeating episode. Measurement included energy intake and self-recorded measures of hunger, fullness, anxiety, and depression. RESULTS: The results indicated that the number and amount of food presented influenced significantly the amount of food consumed. Although subjects with BED tended to eat more than the non-BED obese, the differences did not reach statistical significance. DISCUSSION: The results have implications for the interpretation of results obtained in feeding laboratory settings, suggesting that attention needs to be given to both the number and amount of foods presented because both variables have an impact on the amount of food eaten during overeating or binge eating episodes.

Adolescent↗

Sexual victimization and adolescent weight regulation practices: a test across three community based samples.

OBJECTIVE: This study had four objectives: 1) to examine the association between sexual victimization and weight regulation across three samples of adolescent girls, 2) to assess whether sexual victimization is associated with more extreme forms of weight regulation in girls, 3) to discern whether sexual victimization has implications for the use of multiple forms of weight regulation, and 4) to address the role of physical victimization in explaining these relationships. METHOD: Data from three separate samples of 9th-12th graders were used to test these hypotheses. Girls from the upper Midwest responded to survey questions related to victimization and weight regulation in a largely urban sample (N = 2,086), a rural sample (N = 2,629), and a statewide sample (N = 966). RESULTS: Logistic regression revealed that sexual victimization was consistently associated with weight regulation in adolescent girls, independent of the effects of physical victimization. In the urban sample, being sexually victimized was associated with an increase in the probability of purging by 18% relative to not being sexually victimized. Sexual victimization was associated more strongly with extreme forms of weight regulation and significantly discriminated whether girls would choose multiple weight regulation forms. CONCLUSIONS: Sexual victimization contributes unique variance to the probability that girls will practice weight regulation techniques. Data from three independent samples confirms that being violated sexually places girls at risk for various health compromising eating behaviors.

Adolescent↗

An assessment of the recidivism rates of substantiated and unsubstantiated maltreatment cases.

OBJECTIVE: This study assembles information about the large number of maltreatment reports that are determined by social services to be unsubstantiated. Specifically, we assess whether the status of a maltreatment case (substantiated vs. unsubstantiated) has implications for recidivism. Recidivism rates for substantiated and unsubstantiated maltreated juveniles were also compared to juvenile offenders. METHOD: Juvenile court records for 15,812 juveniles were assessed over a 3 year period. The data included 2558 maltreatment cases. Fifty-four percent of these cases were unsubstantiated. Logistic regression analysis was employed to assess the probability of recidivism based on time one referral status. RESULTS: Youth whose maltreatment allegations were unsubstantiated had significantly lower odds of recidivating than abused youth. Having a case recorded as unsubstantiated lowered a youth's odds of subsequent offending by 55% relative to being abused. The probability of recidivating was highest for juvenile offenders, followed in order by maltreated youth and youth whose reports were unsubstantiated. DISCUSSION: This is one of the first studies to examine the court histories of substantiated and unsubstantiated maltreatment cases. If the subsequent outcomes following maltreatment investigations are used as an indicator of seriousness, our results suggest that assessment caseworkers are successfully sorting out the serious from the less serious cases.

Child↗

Development of a brief measure to assess quality of life in obesity.

OBJECTIVE: Obesity researchers have a growing interest in measuring the impact of weight and weight reduction on quality of life. The Impact of Weight on Quality of Life questionnaire (IWQOL) was the first self-report instrument specifically developed to assess the effect of obesity on quality of life. Although the IWQOL has demonstrated excellent psychometric properties, its length (74 items) makes it somewhat cumbersome as an outcome measure in clinical research. This report describes the development of a 31-item version of the IWQOL (IWQOL-Lite). RESEARCH METHODS AND PROCEDURES: IWQOLs from 996 obese patients and controls were used to develop the IWQOL-Lite. Psychometric properties of the IWQOL-Lite were examined in a separate cross-validation sample of 991 patients and controls. RESULTS: Confirmatory factor analysis provided strong support for the adequacy of the scale structure. The five identified scales of the IWQOL-Lite (Physical Function, Self-Esteem, Sexual Life, Public Distress, and Work) and the total IWQOL-Lite score demonstrated excellent psychometric properties. The reliability of the IWQOL-Lite scales ranged from 0.90 to 0.94 and was 0.96 for the total score. Correlations between the IWQOL-Lite and collateral measures supported the construct validity of the IWQOL-Lite. Changes in IWQOL-Lite scales over time correlated significantly with changes in weight, supporting its sensitivity to change. Significant differences in IWQOL-Lite scale and total scores were found among groups differing in body mass index, supporting the utility of the IWQOL-Lite across the body mass index spectrum. DISCUSSION: The IWQOL-Lite appears to be a psychometrically sound and clinically sensitive brief measure of quality of life in obese persons.

Adult↗

The relationship between health-related quality of life and weight loss.

OBJECTIVE: This is a report of health-related quality of life (HRQOL) changes in obese patients completing at least 1 year of outpatient treatment in a weight reduction program combining phentermine-fenfluramine and dietary counseling. RESEARCH METHODS AND PROCEDURES: Participants were 141 women (87.6%) and 20 men (12.4%) who had an average body mass index at intake of 41.1 kg/m(2) (SD = 7.0, range = 29.5 to 67.0 kg/m(2)) and an average age of 44.9 years (SD = 9.3, range = 23 to 65 years). HRQOL was assessed at intake and at 1-year follow-up using the Impact of Weight on Quality of Life (IWQOL)-Lite questionnaire. The relationship between HRQOL changes and weight loss was examined using Pearson correlations. Clinically meaningful change in HRQOL was defined as a 1.96 SEM reduction in IWQOL-Lite total score. RESULTS: On average, participants lost 20.2 kg or 17.6% of their weight over the 1-year period. Of the participants, 15.5% lost <10% of their weight, 24.2% lost 10% to 14.9%, 23.6% lost 15% to 19.9%, and 36.6% lost 20% or more. All five IWQOL-Lite scales and total score showed statistically significant improvement over the 1-year period. Changes in IWQOL-Lite scores from intake to 1 year showed statistically significant correlations with percentage of weight loss for all subscales and total score. Subscale correlations with weight loss ranged from 0.166 (Public Distress) to 0.396 (Physical Function) and was 0.370 for the total score. Forty-four percent of participants losing <10% met the criterion of clinically meaningful change, compared with 51.3% losing 10% to 14.9%, 55.3% losing 15% to 19.95%, and 76.3% losing >20%. For total score and for three of the five IWQOL-Lite scales (Physical Function, Self-Esteem, and Sexual Life), the relationship between weight loss and clinically meaningful change was linear and was significant at p < 0.05. Physical Function and Self-Esteem were most strongly affected by weight loss. DISCUSSION: HRQOL changes, as measured by an obesity-specific instrument (IWQOL-Lite), are strongly related to weight reduction.

Adult↗

Long-term follow-up of patients' status after gastric bypass.

BACKGROUND: We report a long-term (13-15 year) follow-up of a cohort of 100 patients who underwent gastric bypass for morbid obesity. METHODS: Sources of information include baseline data collected before surgery and information obtained at follow-up interview including data on weight history, psychosocial functioning, and medical complications. RESULTS: Mean age at follow-up was 56.8 years. The mean weight loss at long-term follow-up was 29.5 kg (range -13.6 to 93.6 kg). Three subjects weighed more at long-term follow-up than before the operation. Overall, 74% of those interviewed indicated that the gastric bypass had benefited them in terms of their physical health. However, 68.8% reported continued problems with vomiting and 42.7% with "plugging". Eight had died. CONCLUSION: The findings in this study suggest that at long-term follow-up the majority of individuals who have undergone gastric bypass feel that the procedure benefited them, although some complications including difficulties with "plugging" and vomiting were present at long-term follow-up.

Adaptation, Psychological↗

Sexual trauma and personality: developmental vulnerability and additive effects.

Two types of sexual trauma, sexual abuse in childhood and rape in adulthood, were investigated in terms of possible effects on personality. Four groups of participants were studied: women who had experienced sexual abuse in childhood, women who had experienced rape as adults, women who had experienced both of these sexual traumas, and a control group of women who had experienced no sexual trauma. Personality functioning was assessed using the Dimensional Assessment of Personality Pathology. Groups who had experienced childhood sexual abuse displayed the highest degree of personality disturbance; however, the additive effects of repeated sexual trauma were limited. These findings may reflect the outcome of specific adversity in childhood on the psychobiological constructs underlying personality.

Adult↗

Utilization of empirically supported psychotherapy treatments for individuals with eating disorders: A survey of psychologists.

OBJECTIVE: The purpose of this study was to assess the primary methods used by psychotherapists in treating individuals with eating disorders and to determine the extent to which certain empirically supported psychotherapies (i.e., cognitive behavioral therapy [CBT] and interpersonal psychotherapy [IPT]) are used in clinical settings. METHOD: Surveys developed for this study were sent to 500 psychologists randomly selected from a list of all licensed doctoral-level psychologists in an upper midwestern state. RESULTS: Despite the findings that CBT techniques were reported to be frequently used, most respondents identified something other than CBT or IPT as their primary theoretical approach. In addition, the majority of respondents indicated not having received training in the use of manual-based, empirically supported treatment approaches for working with individuals with eating disorders, although most reported a desire to obtain such training. CONCLUSIONS: Although commonly referred to as the "treatments of choice" in research literature, manual-based, empirically supported approaches to working with individuals with eating disorders has not received adequate dissemination.

Adolescent↗

Relationship of temperament and perceptions of nonshared environment in bulimia nervosa.

OBJECTIVE: Examine the relationship between temperament variables and perceptions of nonshared environment as they relate to bulimia nervosa. METHOD: Fifty-seven adult women completed the Tridimensional Personality Questionnaire and the Sibling Inventory of Differential Experience. These measures provided assessments of frequently studied temperament traits as well as nonshared environmental factors believed to be associated with psychopathology and temperament. RESULTS: Bulimic subjects showed higher levels of harm avoidance than did control subjects. Also, bulimic subjects perceived their fathers as less affectionate and more controlling than control subjects. Among bulimics, high levels of harm avoidance were associated with high levels of maternal affection and low levels of maternal control. Similarly, among bulimics, high levels of novelty seeking were more likely to be associated with decreased paternal control than was true for control subjects. DISCUSSION: These findings highlight the possible relationship between particular temperamental variables and associated family responses in bulimia nervosa.

Adolescent↗

Eating disorders in patients with cystic fibrosis.

This study was designed to examine rates of eating disorders and psychopathology in patients with cystic fibrosis (CF). Fifty-eight CF patients and 43 healthy control participants were evaluated using structured psychiatric interviews and rating scales. Two control participants and no CF patients were diagnosed with an eating disorder. Additionally, 11 CF patients were diagnosed with one or more psychiatric disorders. Group means on the rating scales did not show clinically meaningful elevations in either group. These data indicate no evidence for elevated rates of eating disorders in CF patients. Similarly, rates of other psychiatric disorders in the CF group were not greater than the prevalence reported in the general population.

Adolescent↗

Development and validation of the Validity Indicator Profile.

The Validity Indicator Profile (VIP; Frederick, 1997) is a two-alternative forced choice (2AFC) procedure intended to identify when the results of cognitive and neuropsychological testing may be invalid because of malingering or other problematic response styles. The test consists of 100 problems that assess nonverbal abstraction capacity and 78 word-definition problems. The VIP attempts to establish whether an individual's performance in an assessment battery should be considered representative of his or her true overall capacities (valid or invalid). Performances classified as valid are classified as "compliant" and reflect a high effort to respond correctly. Performances classified as invalid are subclassified as "careless" (low effort to respond correctly), "irrelevant" (low effort to respond incorrectly), or "malingering" (high effort to respond incorrectly). The VIP development sample included 944 nonclinical participants and 104 adults undergoing neuropsychological evaluation. The cross-validation sample consisted of 152 nonclinical participants, 61 brain-injured adults, 49 individuals considered to be at risk for malingering, and 100 randomly generated VIP protocols. The nonverbal subtest of the VIP demonstrated an overall classification rate of 79.8%, with 73.5% sensitivity and 85.7% specificity. The verbal subtest of the VIP demonstrated an overall classification rate of 75.5%, with 67.3% sensitivity and 83.1% specificity.

Adolescent↗

Commitment to treatment goals in prediction of group cognitive-behavioral therapy treatment outcome for women with bulimia nervosa.

The purpose of this study was to investigate potential client variables that predict favorable response to group cognitive-behavioral therapy in a sample of women (N = 143) seeking treatment for bulimia nervosa. Similar to findings of previous studies, bulimic symptom remission at end of treatment was predicted by baseline degree of bulimic symptom severity but not by depressive symptomatology or perfectionism. After these variables were controlled for, both pretreatment ratings of desire to discontinue bulimic behaviors and expected success significantly added to prediction of treatment outcome. The primary variable found to predict longer term outcome was symptom remission at the end of treatment and at the 1-month follow-up.

Adult↗

Imipramine plus cognitive-behavioral therapy in the treatment of school refusal.

OBJECTIVE: To investigate the efficacy of 8 weeks of imipramine versus placebo in combination with cognitive-behavioral therapy (CBT) for the treatment of school-refusing adolescents with comorbid anxiety and major depressive disorders. METHOD: This was a randomized, double-blind trial with 63 subjects entering the study and 47 completing. Outcome measures were weekly school attendance rates based on percentage of hours attended and anxiety and depression rating scales. RESULTS: Over the course of treatment, school attendance improved significantly for the imipramine group (z = 4.36, p < .001) but not for the placebo group (z = 1.26, not significant). School attendance of the imipramine group improved at a significantly faster rate than did that of the placebo group (z = 2.39, p = .017). Over the 8 weeks of treatment, there was a significant difference between groups on attendance after controlling for baseline attendance; mean attendance rate in the final week was 70.1% +/- 30.6% for the imipramine group and 27.6% +/- 36.1% for the placebo group (p < .001). Defining remission as 75% school attendance, 54.2% of the imipramine group met this criterion after treatment compared with only 16.7% from the placebo group (p = .007). Anxiety and depression rating scales decreased significantly across treatment for both groups, with depression on the Children's Depression Rating Scale-Revised decreasing at a significantly faster rate in the imipramine group compared with the placebo group (z = 2.08, p = .037). CONCLUSIONS: Imipramine plus CBT is significantly more efficacious than placebo plus CBT in improving school attendance and decreasing symptoms of depression in school-refusing adolescents with comorbid anxiety and depression.

Adolescent↗

Relationship of childhood sexual abuse and eating disturbance in children.

OBJECTIVE: To test the hypothesis that childhood sexual abuse increases the risk of eating disturbance in children. METHOD: Data obtained from 20 sexually abused children were compared with data obtained from 20 nonabused control children. All subjects were female and between the ages of 10 and 15 years. Subjects completed a battery of tests assessing eating disorder behaviors, body image concern, and childhood trauma history. RESULTS: Comparison of the 2 groups revealed that the abused children had higher levels of weight dissatisfaction and purging and dieting behavior. Furthermore, abused children reported eating less than control children when they felt emotionally upset. Abused children were less likely than control children to exhibit perfectionistic tendencies, but more likely to desire thinner body types. CONCLUSIONS: This is the first controlled study to examine the relationship between childhood sexual abuse and eating disturbance which relied on children as subjects. The results support previous findings with adult subjects which indicate that a history of childhood sexual abuse is associated with weight and body dissatisfaction, along with purging and dietary restriction.

Adolescent↗

Hedonics of binge eating in women with bulimia nervosa and binge eating disorder.

OBJECTIVE: Potential differences in the hedonics of binge eating between female subjects with bulimia nervosa (BN) and female subjects with binge eating disorder (BED) were examined. METHOD: Women seeking treatment for BN (N = 29) and BED (N = 49) completed the Eating Hedonics Questionnaire. RESULTS: Subjects in both groups reported similar precipitants and levels of distress associated with binge eating. Of interest, BED subjects were more likely to report that they enjoyed the food, the taste of the food, the smell and the texture of the food while binge eating. In addition, the BED group reported more relaxation and less physical discomfort and anxiety as a consequence of binge eating compared to the BN group. DISCUSSION: There are interesting and potentially important differences between individuals with BN and BED in the cognitions and behaviors associated with binge eating.

Adult↗

Eating disorders and psychiatric disorders in the first-degree relatives of obese probands with binge eating disorder and obese non-binge eating disorder controls.

OBJECTIVE: The purposes of the present study were to examine the possibility of a familial tendency for binge eating disorder (BED) among the obese, to clarify the relationship between BED and other eating disorders, and to test the relationship between BED and other psychiatric disorders. METHOD: We studied 32 female BED outpatients and 23 obese females without BED. A possible history of eating disorders was assessed using the Structured Clinical Interview for DSM-III-R-Eating Disorders section administered by telephone interview. Family history information for other psychiatric disorders was collected using the Family History Research Diagnostic Criteria RESULTS: The frequency of all eating disorders and the risk for other psychiatric disorders were not significantly different between the relatives of the two groups. These results were consistent across generation and gender. DISCUSSION: This study failed to show a familial tendency for BED, or any significant familial relationship between BED and other eating disorders, and did not support the hypothesis of coaggregation of other psychiatric disorders with BED.

Adult↗