Aging male symptomatology and eating behavior

Objective: The literature on eating disorders in older males is still very limited. We assessed the relationship between aging male symptomatology and eating behavior in middle-aged and older men.

Method: We distributed anonymous questionnaires to men aged 40–75?years living in or near Innsbruck, Austria, covering demographic items, current eating disorder symptoms (as defined by DSM-5), and associated measures of eating pathology, body image, and sports activity (including exercise addiction). We also administered the Aging Males’ Symptoms scale (AMS), and classified respondents as “high-AMS” (AMS score ≥37; N?=?82) or “low-AMS” (AMS score <37; N?=?386).

Results: High-AMS men reported a significantly higher mean current BMI, a greater prevalence of eating disorder symptoms, higher scores on the Eating Disorder Examination Questionnaire, greater risk of exercise addiction, and more negative body image than low-AMS men.

Discussion: We found a marked association between aging-male symptomatology and eating-disorder symptomatology in aging men. Our findings suggest that clinicians should carefully inquire about eating disorder symptoms in men aged 40 and above reporting aging-male symptomatology. Importantly, several men in the study reported “purging” via excessive exercise (as opposed to the more common methods of vomiting or use of laxatives or diuretics), and therefore this should be a subject of inquiry in clinical evaluations. To pursue these findings, subsequent studies of eating disorders in older men should consider assessing endocrinological measures, particularly testosterone levels, and should use longitudinal designs.     

Attention-deficit/hyperactivity disorder–specific stimulant misuse,mood, anxiety,and stress in college-age women at high risk for or with eating disorders

ABSTRACT

Objective: To examine the misuse of attention-deficit/hyperactivity disorder (ADHD)-specific stimulants in a college population at high risk for or with clinical or subclinical eating disorders. Participants: Four hundred forty-eight college-age women aged 18–25 at high risk for or with a clinical or subclinical eating disorder. Methods: Participants completed assessments of stimulant misuse and psychopathology from September 2009 to June 2010. Results: Greater eating disorder pathology, objective binge eating, purging, eating disorder–related clinical impairment, depressive symptoms, perceived stress, and trait anxiety were associated with an increased likelihood of stimulant misuse. Subjective binge eating, excessive exercise, and dietary restraint were not associated with stimulant misuse. Conclusions: ADHD-specific stimulant misuse is associated with eating disorder and comorbid pathology among individuals at high risk for or with clinical or subclinical eating disorders. Screening for stimulant misuse and eating disorder pathology may improve identification of college-age women who may be engaging in maladaptive behaviors and inform prevention efforts.     

Anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD): Cross-informant,sex, and subtype differences

Objective: This study examined symptoms of anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD). Participants: Data were collected between March 2011 and March 2016 from 150 college students with ADHD and 150 college students without ADHD. Method: Participants with ADHD were compared to a sex- and ethnicity-matched control group. For the ADHD group, parent and self-report of anxiety and depression were also compared. Results: College students with ADHD self-reported significantly higher anxiety and depressive symptoms than did students without ADHD. Scores on parent-report measures of anxiety and depressive symptoms were significantly higher than scores on self-report measures. Significant sex differences were found for participants with ADHD, with females showing higher depressive and anxiety symptoms than males. Parent-reported anxiety symptoms were higher for those with inattentive type ADHD compared to combined type ADHD. Conclusion: The current study highlights the importance of multi-informant assessment in ADHD evaluations for college-aged adults.     

ADHD,depression, and substance abuse risk among beginning college students

Abstract

Objective: This study examined differences in substance use, depression, and academic functioning among ADHD and non-ADHD college students. Participants: Included 1,748 students (ages 18–25; women 68.4%; Caucasian 71.3%) with and without history of ADHD. Methods: We assessed the relationship of ADHD to substance use variables, controlling for depressive symptoms and examined relationships with GPA. Results: ADHD students were more likely to have engaged in frequent alcohol use, binge drinking, regular marijuana use and to have used other drugs in the last year. They reported higher depression symptoms than non-ADHD students, although substance abuse risk remained high even when controlling for depressive symptoms. ADHD students had lower overall GPA than those without ADHD. However, this difference was no longer significant when controlling for depression and marijuana use. Conclusions: College campuses should consider programing aimed at identifying ADHD students at risk for developing substance abuse problems and emotional difficulties.     

Associations among sleep problems,executive dysfunctions,and attention-deficit/hyperactivity disorder symptom domains in college students

Objective: The present study examined whether executive functions (EFs) and sleep problems operate together to predict four attention-deficit/hyperactivity disorder (ADHD) symptom domains. Methods: A sample of 306 college students completed ratings of sleep quality, EFs, and ADHD symptoms from January to December 2014. Simultaneous multiple regressions were used to examine (a) the unique contribution of EFs and sleep problems to ADHD symptoms, (b) the relations among EFs, sleep problems, and GPA, and (c) the relations between specific EF facets (i.e., time management, emotion regulation, problem solving, self-restraint, and self-motivation) and ADHD symptoms. Results: While approximately 52.8% of participants were categorized as poor-quality sleepers, 10.6% of the sample reported an ADHD diagnosis. EF ratings were associated uniquely with ADHD symptoms after controlling for sleep quality. All EF facets were related to ADHD symptoms. Conclusion: ADHD symptoms are associated with all EF facets even after controlling for sleep quality.     

Relationship of sleep quality and attention deficit hyperactivity disorder symptoms with quality of life in college students

Abstract

Objective: Attention deficit hyperactivity disorder (ADHD) negatively influences various aspects of life such as social relations, adaptive skills, and occupation. In addition, many university students experience sleep problems, academic failure, and low quality of life (QOL). We investigated the relationship among ADHD symptoms, sleep quality, and QOL of college students, and identified the factors related to their QOL. Participants and Methods: Using a survey questionnaire, data were collected from 195 students from March–May 2017. Results: QOL of students was related to ADHD symptoms and sleep quality. Factors significantly associated with better QOL were fewer ADHD symptoms, good sleep quality, male sex, high academic performance, and high economic status. The explanatory power of these variables on QOL was 32.0%. Conclusion: To improve the QOL of college students, a multifaceted approach that includes assessment of ADHD symptoms and sleep quality is needed.     

A screening tool for detecting eating disorder risk and diagnostic symptoms among college-age women

Objective: As eating disorders (EDs) often emerge during college, managing EDs would ideally integrate prevention and treatment. To achieve this goal, an efficient tool is needed that detects clinical symptoms and level of risk. This study evaluated the performance of a screen designed to identify individuals at risk for or with an ED. Participants: Five hundred forty-nine college-age women. Methods: Participants completed a screen and diagnostic interview. Results: Using parsimonious thresholds for ED diagnoses, screen sensitivity ranged from 0.90 (anorexia nervosa) to 0.55 (purging disorder). Specificity ranged from 0.99 (anorexia nervosa) to 0.78 (subthreshold binge eating disorder) compared to diagnostic interview. Moderate to high area under the curve values were observed. The screen had high sensitivity for detecting high risk. Conclusions: The screen identifies students at risk and has acceptable sensitivity and specificity for identifying most ED diagnoses. This tool is critical for establishing stepped care models for ED intervention.     

Perfectionism and Binge Drinking in Canadian Students Making the Transition to University

Objective: In September 2005, the authors explored the relationship between perfectionism and binge drinking in a sample of first-year college students. Participants: The authors recruited 207 first-year college students (76 men, 131 women) to complete the Multidimensional Perfectionism Scale (MPS) and Frost Multidimensional Perfectionism Scale (F-MPS). Methods: The authors divided participants into 3 groups on the basis of frequency of binge drinking and conducted multivariate analyses of variance to compare the binge drinking groups on the 3 MPS subscales and the 5 F-MPS subscales. Results: The group with 2 or more binge drinking episodes in the past 2 weeks had higher levels of parental criticism and lower levels of self-oriented perfectionism, but they did not have lower scores on a measure of personal standards. Conclusions: These findings suggest that certain perfectionists binge drink in response to harsh parental treatment and that, at least initially, the pursuit of extreme standards of personal perfection is incompatible with binge drinking. The authors discuss the theoretical and practical implications of these findings.     

Eating Disorder Symptoms Among College Students: Prevalence,Persistence, Correlates,and Treatment-Seeking

Abstract

Objective: To examine the prevalence, correlates, persistence, and treatment-seeking related to symptoms of eating disorders (EDs) in a random sample of college students. Participants: A random sample of students at a large university were recruited for an Internet survey in Fall 2005 and a follow-up survey in Fall 2007. Methods: ED symptoms were measured using the SCOFF screen and adjusted for nonresponse using administrative data and a nonresponse survey. Results: 2,822 (56%) students completed the baseline survey. Among undergraduates the prevalence of positive screens was 13.5% for women and 3.6% for men. Among students with positive screens, 20% had received past-year mental health treatment. In the follow-up sample (N = 753), ED symptoms at baseline significantly predicted symptoms 2 years later. Conclusions: Symptoms of EDs were prevalent and persistent among college students in this study. These findings suggest that brief screens can identify a large number of students with untreated EDs.     

Eating Disorders and Body Image of Undergraduate Men

Eating disorders and body dissatisfaction among undergraduate men are less documented and researched than are eating disorders and body dissatisfaction among undergraduate women. Objective and Participants: In this study, the authors examined these issues in undergraduate men to identify similarities and differences between this population and undergraduate women. Methods: In a random sample of undergraduates, the authors categorized respondents by gender and by presence or absence of an eating disorder. The authors compared undergraduate men with an eating disorder with (1) undergraduate women with an eating disorder and (2) undergraduate men without an eating disorder. Results: The patterns of responses suggest that undergraduate men with an eating disorder are preoccupied with body shape and tone but not necessarily with losing weight. Conclusions: The authors discuss implications for future prevention as well as clinical and research efforts based on male symptoms within the diagnostic category of bulimia nervosa and eating disorder, not otherwise specified.     

The Utility of a Gender-Specific Definition of Binge Drinking on the AUDIT

Abstract

Objective: Although binge drinking is commonly defined as the consumption of at least 5 drinks in 1 sitting for men and 4 for women, the Alcohol Use Disorders Identification Test (AUDIT) defines binge drinking as the consumption of 6 or more drinks in 1 sitting for both men and women. This study examined the effect of using gender-specific binge drinking definitions on overall AUDIT scores. Participants: Participants were 331 college men and 1224 college women. Methods: Participants completed a self-report questionnaire, which included the AUDIT. Results: Findings showed that defining binge drinking as 4 or more drinks for women, rather than 6 or more, does impact their AUDIT scores and could affect the percentage of women classified as hazardous users. Among men, AUDIT scores were unaffected by the use of a gender-specific definition of binge drinking. Conclusions: Results suggest that the AUDIT might be underidentifying hazardous users among college women.     

Evaluating the consistency of scales used in adult attention deficit hyperactivity disorder assessment of college-aged adults

Objective: Neurocognitive evaluations are commonly integrated with clinical assessment to evaluate adult Attention Deficit Hyperactivity Disorder (ADHD). Study goal is to identify measures most strongly related to ADHD diagnosis and to determine their utility in screening processes. Participants: 230 students who were evaluated at the Vanderbilt University Psychological and Counseling Center between July 2013 and October 2015. Methods: We retrospectively examined charts, including clinical diagnosis, family history, childhood parental reported and current self-reported ADHD symptoms, psychiatric comorbidities, and continuous performance test (CPT). Result: Positive report of childhood and current ADHD symptoms, and lack of comorbid psychiatric symptoms were strongly associated with clinical diagnosis. CPT results were not associated with an ADHD diagnosis. The absence of reported childhood and current ADHD symptoms may serve as a contradictory marker for ADHD diagnosis. Conclusion: Clinical assessment of ADHD symptoms and ADHD childhood history, but not CPT, contributes to an accurate diagnosis of ADHD in college-aged adults.     

An Integrative Group Treatment Model for Women with Binge Eating Disorder: Mind,Body and Self in Connection

Binge eating disorder (BED) is the most prevalent eating disorder reported among women, and its recent diagnostic recognition in the DSM-5 (APA 2013) calls for further discussion on effective treatment. Women with BED commonly report a diet/binge cycle that can exacerbate a disconnection between mind and body and reinforce feelings of shame and isolation. This article presents an integrative group treatment model for women with BED that has shown positive outcomes in clinical practice. The group model addresses key biopsychosocial factors associated with BED and incorporates mindfulness principles tailored to problems of the disorder. A core foundation of the group model is the relational context that fosters connections between women members and promotes self-efficacy. The discussion includes etiology of BED and current empirical support for integrating mindfulness skills in treatment for binge eating problems, as well as the author’s clinical experience in formulating a short-term group model. The eight-session semi-structured group format integrates evidence-based treatments in resonance with treatment-based evidence that reflects the distinct clinical needs of women with BED. Clinical vignettes illustrate how the group model can provide an anchoring therapeutic support to women with BED for linking experiences of mind, body, and self.     

Social Connectedness,Self-Esteem,and Depression Symptomatology Among Collegiate Athletes Versus Nonathletes

Objective: The authors compared collegiate athletes and nonathletes to see whether there were significant differences in the perceived levels of social connectedness, self-esteem, and depression and if an interaction among the variables of athlete status, gender, GPA, BMI, and levels of weekly exercise and sleep were associated with depression symptomatology. Participants: Participants were 227 college students. Method: The authors surveyed students using the Center for Epidemiologic Studies Depression Scale, the Rosenberg Self-Esteem Scale, and the Social Connectedness Scale-Revised. Results: Athletes had significantly greater levels of self-esteem and social connectedness, as well as significantly lower levels of depression, than did nonathletes. However, the statistically strongest predictors of depression in this cohort were the variables of gender, self-esteem, social connectedness, and sleep. Conclusion: This study adds to the limited and inconsistent research in the empirical knowledge base regarding depression among collegiate athletes.     

University Binge Drinking Patterns and Changes in Patterns of Alcohol Consumption Among Chinese Undergraduates in a Hong Kong University

Abstract

Objective: To examine patterns of binge drinking and changes in drinking patterns among Chinese university students. Participants and Methods: Responses to an anonymous questionnaire were compared between a random sample of 411 second year Chinese undergraduate students in 2006 and 2,630 first year students from the previous year. Students reporting any symptoms of alcohol abuse were classified as alcohol abusers whereas those reporting repeated inability to curtail use were categorized as alcohol dependent. Results: After 1 year of university, greatly increased rates of past-month drinking of different degrees were found in both genders. Binge drinking among second year undergraduates was significantly correlated with male gender, living in a student residence hall, smoking, drinking to relieve stress, and having friends who frequently drank. Conclusions: Alcohol misuse is a health hazard to Chinese students in a university environment. Proactive policies aimed at preventing harmful alcohol use should be considered by university authorities.     

Drunkorexia: Understanding the Co-occurrence of Alcohol Consumption and Eating/Exercise Weight Management Behaviors

Abstract

Objective: Examine the co-occurrence of alcohol consumption, physical activity, and disordered eating behaviors via a drunkorexia perspective. Participants: Nationally representative sample (n = 22,488) of college students completing the Fall 2008 National College Health Assessment. Methods: Hierarchical logistic regression was employed to determine if physical activity and disordered eating behaviors uniquely predicted binge drinking, while controlling for age, race, gender, year in college, Greek membership, and place of residence. Results: Physical activity and disordered eating made unique, statistically significant contributions. Moreover, including physical activity and disordered eating behaviors allowed for the correct classification of an additional 431 cases (ie, binge drinkers) over and above the predictive ability of the covariate-only model. Conclusions: Findings corroborate prior research indicating highly active college students are more likely to binge drink than their nonactive peers, and highlight the potential of a drunkorexia perspective in explaining the counterintuitive alcohol–activity association among college students.     

The College Health Advisor and the College Age Adoptee

Abstract

Eating disorders are among the most common psychopathologies on college campuses. Research on ethnic differences in eating disorder symptoms and prevalence has resulted in conflicting conclusions. Some studies find that particular ethnic groups have a higher prevalence of a symptom; others find that members of that ethnic group have a lower prevalence of the same symptom. The authors explored the role of body mass index (BMI), one potential confound. They used a reliable measure of eating disorder symptoms to assess differences between Hispanic, Asian, and non-Hispanic White college women from two separate samples. After controlling for BMI, ethnic differences in eating disorder symptoms of concern about weight and shape disappeared, but differences in restrained eating remained. Inconsistent findings in the ethnic-difference literature on eating disorders may result from systematic group differences in BMI. Implications for college health programs, counseling, and case finding are discussed.     

Pilot study of a personality-based approach to assessing eating disorder and Obsessive Compulsive Disorder symptom risk in college men and women

Abstract

Objective: To conduct a pilot test of the validity of using empirically derived personality types to characterize eating disorder (ED) risk in college students and resolve discrepancies regarding the role of perfectionism and obsessive-compulsive disorder (OCD) symptoms.

Participants: Man and woman undergraduate students (N?=?169) at a small, private university. Data were collected from February to May 2016 and 2018. Methods: Participants completed self-report measures of personality (perfectionism, impulsivity, and effortful control) and psychopathology (EDs, OCD). Results: Our analyses replicated three validated personality types: overcontrolled, undercontrolled, and resilient. Analysis of variances demonstrated perfectionism, ED, and OCD symptoms were significantly elevated in the overcontrolled subtype. There was no interaction by sex. Conclusions: These findings suggest that personality types may be useful for classifying ED risk and OCD symptoms in college students across sexes. Further study and relevance to prevention and intervention efforts to reduce the burden of EDs on college campuses will be discussed.     

Posttraumatic stress disorder symptomatology and comorbid depressive symptoms among abused women referred from emergency department care

Posttraumatic stress disorder (PTSD) is common among victims of intimate partner violence (IPV) as is comorbid depression. Comorbid depression may exacerbate PTSD severity and chronicity. This study sampled female IPV victims from an urban emergency department to assess the relationship between PTSD symptomatology in the previous 12 months and current depressive symptomatology and to evaluate independent predictors of PTSD symptomatology. Half of respondents had symptoms consistent with PTSD. Those with PTSD symptomatology had significantly higher mean total depression scores and mean scores on 3 of 4 depression subscales than those without PTSD. Depressive symptomatology, being married, sexual IPV, severity of physical IPV, and partner's consumption of 5 or more alcoholic drinks per occasion at least once a month independently predicted PTSD symptomatology. Our findings underscore the important roles these factors play in IPV-related PTSD and the need for prompt identification and intervention of those at risk.