Clinical Psychology Commons^™

“It’S Right Below The Surface”: Clinicians’ Experiences Of Shame In Therapy Work With Adult Clients With Body Shame, Body Image Concerns, Or Eating Disorder(S), Tess Carroll Keeley

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Shame–understood as a feeling in which one believes that they are inadequate, or wrong to their core–is a painful emotional experience that seems to be at the crux of many mental health concerns. Despite the pervasiveness of shame as an emotional experience, little research has demonstrated if shame is a clinical theme in therapy, and if so, how it is identified and treated. The purpose of this qualitative study was to explore if, and how, shame manifests during therapy sessions with clients who are experiencing eating disorders and/or body image concerns. A secondary purpose was to discover how clinicians’ training …

Manipulating Mindful Breathing Versus Mindful Eating: Examining The Effect Of Specific Mindfulness Mechanisms On Food Intake And Eating Disorder Symptoms., Irina Alexandrovna Vanzhula

Electronic Theses and Dissertations

Background. Understanding which specific mindfulness practices contribute to improvements in ED symptoms, as well as the mechanisms of action by which this change occurs, may help improve MBTs for EDs. The current study aims to compare the effects of various brief mindfulness exercises on state ED symptoms and food intake and to test whether a reduction in state rumination and state difficulties in emotion dysregulation and an increase in awareness of hunger, fullness, and satiety cues mediate these effects. Methods. Two hundred and two undergraduate females participated in the experiment. Participants were randomized to listen to one of the four …

Body Dissatisfaction And Disordered Eating Among College Women’S Social Networks: An Investigation Of Perceived Changes Following A Dissonance-Based Body Image Intervention, Rachel I. Macintyre

Psychology Theses & Dissertations

Body dissatisfaction is associated with numerous health consequences and is pervasive among college women. Effective interventions exist that reduce body dissatisfaction in college women by helping them resist sociocultural pressures to conform to the appearance ideal, such as the Body Project. Yet research is limited on whether social and behavioral processes help participants reduce their engagement in sociocultural appearance-ideal messages and contribute to the intervention’s effectiveness. The primary purpose of the present study was to examine these social and behavioral processes, including the changes in college women’s social networks associated with their participation in the Body Project. Undergraduate and graduate …

A Network Investigation Of Eating Disorder Symptoms And Risk Factors Before And After A Prevention Program In Adolescent Girls., Jordan E. Drake

College of Arts & Sciences Senior Theses

Eating disorders (EDs) are psychological disorders characterized by disturbances in eating that commonly develop during adolescence and may be influenced by risk factors, both ED-specific (i.e., factors linked to future ED symptoms) and transdiagnostic (i.e., factors underlying multiple psychological disorders). Network analysis allows for the study of the connections between ED symptoms and risk factors by identifying central symptoms (i.e., the most interconnected symptoms) and bridge symptoms (i.e., symptoms which strongly connect across the symptom and risk factor clusters). Examining networks of ED symptoms and risk factors in adolescence can inform how risk factors influence ED development, as well as …

Exploring Mindfulness As An Illness Pathway Between Eating Disorder And Post-Traumatic Stress Disorder Symptoms, Emma G. Roberts, Brenna M. Williams, Cheri Levinson

Grawemeyer Colloquium Papers

Eating disorders (EDs) and post-traumatic stress disorder (PTSD) have high rates of comorbidity. One shared protective factor for PTSD and ED symptoms is mindfulness. However, research on how mindfulness relates to ED-PTSD comorbidity is limited. Thus, the current study used network analysis to explore aspects of mindfulness as illness pathways bridging (i.e., connecting) symptoms among comorbid ED and PTSD symptoms. We hypothesized that mindfulness would negatively relate to ED and PTSD symptoms.

Participants (N=709 undergraduate students) completed self-report ED, PTSD, and mindfulness measures. Network analysis was conducted using R.

Five symptoms were identified as being the most central. …

Examining Cognitive And Behavioral Inflexibility : A Transdiagnostic Process Underpinning Maladaptive Exercise Behaviors And Attitudes, Mckenzie Miller

Legacy Theses & Dissertations (2009 - 2024)

Objective: Cognitive and behavioral inflexibility, or the inability to respond flexibly and adaptively to changing environmental demands, are hallmark features of eating disorders (ED). Individuals with EDs exhibit inflexibility across domains, often including in exercise behaviors, manifesting as exercise dependence and rigid workout routines. The purpose of this study was to assess how different motives for exercise are differentially associated with cognitive and behavioral flexibility, a marker of EDs. To the extent that inflexibility in exercise is a risk factor and symptom of disordered eating, increasing cognitive and behavioral flexibility as it relates to physical activity may be an effective …

Does Social Media Promote Disordered Eating?, Carly Feldstein

Dissertations and Theses

Hispanic people are the largest and fastest-growing minority group in the U.S. with a total of 18.5% of the U.S population being of Hispanic descent (United States Census Bureau, 2020). Although eating disorders (ED), particularly those involving binge eating, comprise a significant health concern, EDs are often overlooked in the Hispanic culture (Higgins et al., 2016; Opara & Santos, 2019). Hispanic individuals have comparable rates of anorexia nervosa, bulimia nervosa, and an even higher rate of binge eating disorders compared to non- Hispanic (NH) White individuals (Higgins et al., 2016). Within Hispanic adults, the lifetime prevalence of EDs is higher …

Examining The Ecological Validity Of The Power Of Food Scale, Lindsay M. Howard, Kristin E. Heron, Kathryn E. Smith, Ross D. Crosby, Scott G. Engel, Stephen A. Wonderlich, Tyler B. Mason

Psychology Faculty Publications

Purpose

Appetite for palatable foods may impact eating-related behaviors in everyday life. The present study evaluated the real-world predictive validity of the Power of Food Scale (PFS) using ecological momentary assessment (EMA).

Methods

30 women who reported binge eating completed the PFS and related measures. Subsequently, during a 14-day assessment period, participants completed five daily EMA surveys of appetite and binge eating via text message and web.

Results

Results of generalized estimating equations showed that higher PFS scores were associated with higher momentary levels of hunger, eagerness to eat, and urge to eat but were unrelated to fullness, preoccupation with …

Statistical Fit And Factor Structure Of The Food-Life Questionnaire In Emerging Adult Undergraduate Students, Arielle Wolinsky

Legacy Theses & Dissertations (2009 - 2024)

The Food-Life Questionnaire (FLQ) is a psychometrically sound measure of beliefs and attitudes towards food that was initially developed and validated for use with a general adult population; however, the psychometric properties of the measure have yet to be examined in an emerging adult population. The constructs captured by the FLQ are particularly relevant in emerging adulthood, because it is a time of increased risk for the development of disordered eating attitudes and behaviors. Using data from a large, demographically diverse sample of emerging adult undergraduate students (n = 679), the current study evaluated the fit of the original five-factor …

Developing A Clinician Self-Report Fidelity Measure For A Transdiagnostic, Evidence-Based Protocol At A Residential Eating Disorders Treatment Center, Jennifer M. Oswald

Legacy Theses & Dissertations (2009 - 2024)

Objective: Fidelity monitoring is a vital component of successful evidence-based practice implementation in routine treatment settings. However, resource-intensiveness and low clinician buy-in pose barriers to traditional observer-report monitoring, highlighting a need to explore the practical utility of self-report approaches. This study used a mixed-methods approach to (a) develop a self-report fidelity measure of a transdiagnostic evidence-based protocol in a residential eating disorders treatment center; (b) tailor the measure for optimal accuracy, acceptability, and ease of use; and (c) assess measure validity via convergence with observer ratings. Methods: N = 10 clinicians participated in cognitive interviewing to refine an initial draft …

Coercive And Compulsive Treatment Of Eating Disorders: Surveying Treatment Providers’ Attitudes And Behavior., Jessica Cowan

Antioch University Dissertations & Theses

Stigma toward individuals with eating disorders is common and well-documented. Individuals with eating disorders regularly report experiencing stigma associated with perceptions that they are to blame for their illness, that their illness is trivial compared to other conditions, or that they are engaging in disordered behavior to gain attention. These stigmatizing attitudes toward eating disorders are also reported by the general public and healthcare professionals, including those who treat eating disorders. Treatment of these illnesses at all levels of care often include paternalistic approaches such as coercion and compulsion that can have both adverse and advantageous consequences. While there are …

The Epidemiology Of Somatic Depression And Eating Disorders: The Relationship Between Depressive Subtypes And Symptoms Of Disordered Eating, Anita M. Sicignano

Dissertations and Theses

Depression is known to affect females in much greater numbers than males, with about three times as many women having the disorder as men (American Psychiatric Association, 2013). A similar gender disparity can be seen in eating disorders, where up to nine in ten sufferers are female (American Psychiatric Association, 2013). Studies have shown that most of the gender difference in depression occurs as a result of women experiencing a form of depression involving a number of body-centric symptoms, including headaches, weight changes, fatigue, and insomnia, which has been termed “somatic depression” (Silverstein et al., 2013). Some of the symptoms, …

Gender Differences In Treatment Seeking Gamblers With A Comorbid Eating Disorder, Maryam Sharif-Razi, Kristin M. Von Ranson

International Conference on Gambling & Risk Taking

Abstract: Recent literature suggests that gambling and eating disorders may co-occur more frequently than once thought. However, no studies have directly examined whether gender differences exist in comorbid gambling and eating disorders. The present study investigated gender differences in current gambling behaviors, gambling severity, gambling-related cognitive distortions, and psychiatric comorbidities in dual-diagnosed participants. The sample consisted of 349 treatment-seeking gamblers at a university hospital in São Paulo, Brazil. Gambling disorder and other psychiatric comorbidities were assessed via comprehensive clinical interviews. Of the total sample, 43 participants met criteria for both a gambling and eating disorder, and subsequently completed a series …

Integration Of Mindfulness-Based Approaches In The Treatment Of Eating Disorders: A Review Of The Literature, Kimberly Hubinger

Dissertations

In this literature review, mindfulness-based approaches and the effects mindfulness-based approaches have on the treatment of eating disorders was discussed. Professionals are continually seeking ways to enhance the treatment and improve outcomes when working with individuals suffering from eating disorders, and this literature review could help enhance the understanding of incorporating mindfulness techniques. The findings of this paper are meant to benefit clinicians working with patients diagnosed or struggling with an eating disorder.

Conceptualization Of Body Image And Eating Disorders Among South Asian American Women: A Qualitative Investigation, Neha J. Goel

Theses and Dissertations

Though it is known that eating disorders (EDs) affect individuals of all racial/ethnic backgrounds (Cheng, Perko, Fuller-Marashi, Gau, & Stice, 2019), people of color tend to be overlooked in the ED literature. South Asian Americans, a specific subset of individuals traditionally categorized within the larger umbrella group of “Asians,” have been notoriously neglected in both the broader mental health literature, and in the ED literature (Inman, Devdas, Spektor, & Pendse, 2014; Iyer & Haslam, 2003, 2006). Currently, very little information exists on the etiology and presentation of EDs amongst South Asian communities. Even less is known about culturally-specific barriers to …

Implicit And Explicit Attitudes Toward Physical Appearance Among Recurrent And Non-Binge Eating College Women, Mindy L. Mcentee

Psychology ETDs

Research has found that among individuals who binge eat, overvaluation of body weight/shape and internalization of a thin ideal are associated with higher levels of distress and functional impairment. These findings suggest implicit attitudes and beliefs may play an important role in understanding the complex relations between one’s cognitions and subsequent eating behavior; however, much of the research on binge eating has relied on explicit self-report measures which may not accurately reflect the way individuals automatically process body weight/shape information or the meaning one has associated with these characteristics. The present study sought to address this gap in the literature …

Mindful Eating And Eating Pathology: Correlation Between The Mindful Eating Questionnaire And The Eating Disorder Inventory-3rd Edition, Soujanya Sreedhara Chetluru

Masters Theses & Specialist Projects

The purpose of this study is to examine the relationship between mindful eating and eating pathology. This was accomplished by using two measures, the Eating Disorder Inventory, Third Edition (EDI-3), and the Mindful Eating Questionnaire (MEQ). Participants included in this study were 134 students from a midsized mid-south university who were asked to complete a demographics measure, EDI-3, and MEQ. Only three scales from the EDI-3 were considered; Drive for Thinness, Bulimia, and Body Dissatisfaction. Combined they provide an Eating Disorder Risk Composite (EDRC) score. Results indicated that there was no significant relationship between the MEQ overall score and the …

Examining Types Of Motivation For Exercise In Relation To Pathological Exercise In Eating Disorders, Christina Scharmer

Legacy Theses & Dissertations (2009 - 2024)

Exercise can serve adaptive and maladaptive functions among individuals with elevated eating disorder (ED) pathology; however, little is known about how best to distinguish healthy and problematic exercise within this population. The present study aimed to inform this distinction by examining associations between intrinsic and extrinsic motivations for exercise, problematic exercise, and ED pathology in a sample of undergraduate students (N=347, 70% female) with threshold or sub-threshold EDs. All participants completed the Eating Disorder Examination Questionnaire (EDE-Q), the Exercise Motivation Inventory-2 (EMI-2), the Compulsive Exercise Test (CET), and the Exercise Dependence Scale (EDS). Preliminary exploratory factor analysis of the EMI-2 …

Perseverative Thinking In Eating Pathology : Do Rumination Patterns Differ According To Symptom Type?, Lauren Eileen Ehrlich

Legacy Theses & Dissertations (2009 - 2024)

Rumination, defined as repetitive, negative, self-referential thinking, is strongly associated with the development and maintenance of many internalizing disorders. Although rumination was first examined within the depression literature, it is now considered a transdiagnostic risk factor that underlies many psychological disorders. Despite the negative consequences of engaging in these thought processes, rumination is a common cognitive process, perhaps due to positive metacognitive beliefs about the function of rumination. Recent work has demonstrated a link between eating pathology and a tendency to ruminate on eating disorder relevant themes, as well as beliefs about the usefulness of rumination. Our understanding of this …

The Relationships Among Trauma History, Disordered Eating, Body Dissatisfaction, And Social Anxiety, Rebekah Mitchell

College of Graduate Studies: Theses & Dissertations

Eating disorders are highly prevalent and cause significant psychological impairment, up to and including death (Arcelus, Mitchell, Wales, & Nielson, 2011). This research examined how trauma history in the general population explains variation in eating disorder risk. The purpose of the current study was to provide further evidence for the relationship between abuse history and eating disorder risk. Disordered eating behaviors, body dissatisfaction, and social anxiety are all known risk factors for the development of eating disorders (Brewerton, 2007). Trauma history is related to all three of these known risk factors (Brewerton, 2007) with sexual trauma being more linked to …

Eating Attitudes And Perception Of Peer Social Media, Sharon Smith

Murray State Theses and Dissertations

There is evidence that social factors influence eating-disordered behaviors through social modeling and social comparison. One way that researchers examine social comparison and perceptions of individuals with disordered eating behaviors is through vignette studies, but these studies may lack the nuance of how these behaviors are displayed outside of the lab, and therefore lack external validity. The current study examined how individuals who score high and low on the EAT-26 (a measure of eating behavior) perceive the eating behaviors of a fictional peer and possible social comparison target, presented in the form of a social media profile. Participants with higher …

Repetitive Negative Thinking And The Maintenance Of Social Appearance Anxiety : An Experimental Manipulation Using Psychophysiological And Subjective Measurement, Erin Elizabeth Reilly

Legacy Theses & Dissertations (2009 - 2024)

Social appearance anxiety (SAA), which refers to fear of having one’s appearance negatively evaluated by others, has been posited to be a risk factor for the development of both eating pathology and social anxiety, but the processes through which this factor is maintained over time remain unclear. The current study aims to evaluate repetitive negative thinking (RNT) as a process through which SAA is maintained over time. Undergraduate females (N = 126) attended an appointment during which they were asked to complete self-report measurements, make an impromptu speech task related to appearance to induce SAA, were randomized to either engage …

Does What You Think You Feel, Impact What You Actually Eat? : An Examination Of Alexithymia, Interoceptive Awareness, And Loss Of Control Eating In Young Women, Lisa Marie Anderson

Legacy Theses & Dissertations (2009 - 2024)

Affect regulation theories posit that loss of control (LOC) and binge eating are maintained via an emotion regulation process, through which eating relieves negative affect and aversive mood states. LOC has been identified as a key binge eating characteristic associated with psychopathology and poor psychological outcomes. As such, maladaptive emotion regulation has been identified as a central risk factor for binge eating, as theories posit that individuals binge eat in response to negative mood states. However, empirical studies testing the link between induced negative mood and subsequent food intake in people with LOC and binge eating have yielded inconsistent findings. …

Eating Pathology In Sexual Minority Men : Evaluating An Objectification Theory Framework And The Role Of Identity Acceptance Concerns, Joseph Michael Donahue

Legacy Theses & Dissertations (2009 - 2024)

Research supports objectification theory as providing a framework for understanding how eating disturbances can develop in females. However, research among men—specifically sexual minority men who are disproportionally affected by such issues—is deficient. The current study sought to further assess whether the relations hypothesized by objectification theory were significant among sexual minority males. In addition, the current study explored the role of sexual orientation acceptance concerns as a moderating variable. To evaluate the current study’s aims, sexual minority males (N=208) were recruited online and asked to complete self-report measurements related to the objectification theory, eating pathology, and sexual orientation identity. Results …

Sexism Makes Me Sick : An Examination Of Potential Mediators In The Link Between Sexism And Women's Mental Health, Kristin L. Mclaughlin

Legacy Theses & Dissertations (2009 - 2024)

It has been well established in the literature that discrimination is related to negative mental health outcomes. Consistent with this research, studies have found women’s exposure to sexist discrimination is associated with a host of mental health problems. Moreover, research on women’s exposure to a specific form of sexism called sexual objectification suggests links with specific psychological outcomes related to poor body image and eating problems. Based on a theoretical framework informed by system justification theory, this study attempted to unify and extend research on perceived sexism and objectification theory by investigating benevolent sexism and self-objectification as potential mediators of …

Examining Binge Eating Rates Between Caucasian-American And African-American Men, Elizabeth Anne Raky

Walden Dissertations and Doctoral Studies

Eating disorders (ED) are maladaptive eating patterns that can have social, biological, health, and occupational consequences. The purpose of this study was to explore and compare binge eating episodes, locus of control, and body dissatisfaction between African-American men (n = 66; 53.70%) and Caucasian-American men (n = 57; 46.30%). There is a current gap in the existing literature regarding the study of men who BE and a sampling bias with regard to ethnic minorities. Based on Bandura's social learning theory model and Rotter's locus of control, the purpose of this research was to determine and compare the relationship between BE, …

The Mediating Effects Of Self-Handicapping On Eating Disorder Symptomatology, Brooke Kelly Strumbel

ETD Archive

With the high prevalence of eating disorders (ED) and the functional impairment that they cause, there is a pressing need to more fully identify their risk factors and mechanisms. While perfectionism and negative affect are known risk factors for ED, the mechanisms by which they develop are not well understood. The present study examined the roles of self-handicapping, thought suppression, and maladaptive emotion regulation strategies, as potential mechanisms through which perfectionism and negative affect confer risk for ED. A sample of 161 female undergraduates completed measures of perfectionism, negative affect, thought suppression, self-handicapping, eating disorder tendencies, and an Implicit Association …

A Qualitative Analysis Of Clinician Attitudes And Experiences Learning And Implementing Transdiagnostic Evidence-Based Practices For Eating Disorders, Jennifer Marie Oswald

Legacy Theses & Dissertations (2009 - 2024)

Clinician experiences with the implementation of new practices are important factors in facilitating the use of new treatment models and evidence-based practices (EBPs). As such, they provide crucial information to behavioral health dissemination and implementation research. Qualitative interviewing allows researchers to learn from clinician experiences with greater depth and nuance. The present study qualitatively analyzed 8 clinicians’ experiences with the implementation of a new transdiagnostic treatment model for eating disorders (ED) at an intensive residential treatment center. Participating clinicians completed a semi-structured interview based on constructs from the Consolidated Framework for Implementation Research (CFIR), an organizing framework with demonstrated utility …

Parental Beliefs About Maladaptive Eating Behaviors In Adolescents, Teresa Loar Sage

Walden Dissertations and Doctoral Studies

Over 25 million people in the United States are affected by eating disorders, and understanding children's eating style can help determine maladaptive eating behaviors. This study was an investigation of parents' beliefs about their children's eating behaviors in relation to parental work status. Two theoretical frameworks were used to guide the study. Symbolic interactionism focused on communication between parents and children. Social learning theory focused on adolescents possibly learning their eating behaviors from observing their parents' eating habits. The research questions and hypotheses examined if there was a relationship between the work status of parents and their beliefs about maladaptive …

Ethnic And American Identity As Correlates Of Eating Pathology In College Women, Liya Markovna Rakhkovskaya

UNLV Theses, Dissertations, Professional Papers, and Capstones

According to popular racial and cultural formation theories, ethnic identity is defined as the process of identifying with the culture and practices one's ethnic group while American identity is the process of identifying with the mainstream/majority culture and practices of the United States. A small body of research suggests that ethnic identity and American identity are positively associated with mental health in ethnic minority and European American individuals, respectively. Furthermore, a growing body of research suggests that ethnic identity is associated with diminished eating pathology in minority women. However, the protective effects of ethnic identity against eating pathology are unexplored …