Master of Education (MEd), Bowling Green State University, 2023, Human Movement, Sport and Leisure Studies /Kinesiology

Excessive and compulsive exercise (CE) are often contributing factors in the etiologies of eating disorders (ED). Despite this, current studies indicate that exercise can play a positive role in ED treatment (Berends et al., 2016; Calogero & Pedrotty, 2004). Specifically, studies indicate positive treatment outcomes including improvements in body composition, muscular strength, depression, and anxiety with exercise inclusion in ED treatment (Calogero & Pedrotty, 2004; Chantler et al., 2006; Fossati et al., 2004; Pendleton et al., 2002). However, the use of exercise as an intervention in ED treatment is overlooked, as no guidelines for exercise implementation exist (Cook et al., 2016). Therefore, the purpose of this study was to review current procedures utilized by ED treatment facilities regarding exercise as part of treatment. Professionals who work with ED treatment facilities in the United States were contacted with a request to complete the survey. The survey consisted of questions focusing on whether exercise is currently being implemented as part of the treatment plan in their respective ED treatment facilities. Of particular interest was identification of the mode(s) of exercise included, who prescribes exercise, and the use of individualized exercise programs. Nine participants began the survey, and of those nine participants, four participants completed the survey. Descriptive statistics were provided for all survey metrics. Out of total participants, exercise was most frequently indicated as included within treatment. Comparatively, out of total participants, individualized exercise was most frequently indicated as not included within treatment. Additionally, the inclusion of aerobic, resistance, and flexibility exercise were indicated most frequently for total participants. Future research should seek to investigate exercise procedures in ED treatment facilities on an expansive level. Additionally, future research is also needed to investigate the effect (open full item for complete abstract)

Committee: Jessica Kiss Ph.D. (Committee Chair); Carrie Hamady Ed.D. (Committee Member); David Tobar Ph.D. (Committee Member) Subjects: Kinesiology

Psy. D., Antioch University, 2020, Antioch Seattle: Clinical Psychology

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 ethical, clinical, and legal justifications for these treatment approaches, this study provides a novel exploration of the relationships between stigma toward individuals with eating disorders and coercive and compulsive treatment. This was accomplished using a survey methodology to assess the attitudes and treatment practices of treatment providers across the United States. The results of this study suggest that there is no significant relationship between treatment providers' attitudes toward individuals with eating disorders and coercive or compulsive treatment methods. Implications for clinical practice and future research are discussed and center on the need for additional inquiry to better understand the complexities of these two variables in light of the ongoing debate concerning the risks and v benefits of coercive and compulsive treatment. This dissertation is available open access at AURA, http://aura.antioch.edu and Ohio Link ETD Center, https://etd.ohiolink.edu

Committee: Chris Heffner Psy.D., Ph.D. (Committee Chair); Shannon Albert Psy.D. (Committee Member); Cara Dalbey Psy.D. (Committee Member) Subjects: Behavioral Sciences; Clinical Psychology; Ethics; Health Care; Mental Health; Psychology; Quantitative Psychology; Social Psychology

Honors Theses, Ohio Dominican University, 2020, Honors Theses

Eating disorders are serious mental illnesses with high levels of stigma and a heightened awareness of the judgements of an individual based on the health and portions of food on their plate. The purpose of this study was to investigate the influence of public eating and stigma awareness in the development of eating disorders in high risk college aged individuals. Participants were randomized and placed into observed and unobserved eating groups, offered a buffet of healthy and unhealthy foods, and after a timed eating period filled out a series of questionnaires. Results indicated that there was no significant difference in caloric intake or health intake between the observed and unobserved groups. Furthermore, the knowledge of mental illness stigmas in society had no impact on risk, the health of the selected foods, or caloric intake. Analysis did show that a BMI classified as obese or overweight was significantly correlated with a higher risk for eating disorder development. This indicates that stigma awareness and awareness of public perceptions of food may not contribute to eating disorder development, however, a higher BMI may be a risk factor for eating disorder development.

Committee: Valerie Matthews Ph.D. (Advisor); Kathleen Gorman - Ezell Ph.D. (Other); Martin Brick Ph.D. (Committee Member); John Marazita Ph.D. (Committee Chair) Subjects: Psychology

MS, University of Cincinnati, 2011, Education, Criminal Justice, and Human Services: Health Education

The purpose of this study was to examine university students' perceived importance of knowledge of eating disorders, overall confidence in appropriately intervening with a friend who has an eating disorder and whether their perceived importance of knowledge and confidence levels differed based on sex, current involvement in disordered eating and extent of social connections. This study sought to fill current gaps in the literature regarding disordered eating. This information is important to strengthen future educational efforts related to the identification and acknowledgement of eating disorders with friends and family. A total of 421 participants were surveyed during the spring 2010 quarter at a Midwest university. The sample included students from a variety of courses. Valid and reliable subscales were developed for the 86-item questionnaire. Descriptive statistics, multivariate analysis of variance, Chi-square analysis, and Pearson correlations were used to analyze the data. Results indicated participants' confidence addressing disordered eating in their friends was moderate. Further, participants felt having knowledge about disordered eating was important and that disordered eating is a significant issue on college campuses. Both importance of having information and confidence addressing disordered eating differed significantly based on sex. Females felt this issue was of greater importance, in addition to expressing more confidence addressing the issue. Recommendations have been included for future studies.

Committee: Keith King PhD (Committee Chair); Rebecca Vidourek PhD (Committee Member) Subjects: Health Education

Psy. D., Antioch University, 2022, Antioch Santa Barbara: Clinical Psychology

This systematic literature review explores the relationship between mental disorders and nutrition through a review 547 available articles. Of these, 74 were selected for inclusion in this review. The research question guiding this inquiry was: What is the effect of nutrition on the mental health of individuals in the United States? A PRISMA flow diagram was used to develop systematic assessments of the existing research to produce a dataset of literature to answer the research question. It was found that nutrition and health are critically linked, with supplements being associated with positive health outcomes. It was also found that research is shifting to focus on the connection between the gut and the brain. The culmination of this review is that nutritional changes and support can positively impact anxiety and depression, and probiotic treatments have been linked to better dopamine regulation. Each disease is reviewed in relation to existing evidence on nutritional supplements that impact health symptoms. The findings of this review indicated that nutrition could have a notable impact on managing health conditions. It is recommended that models for health and nutrition be updated to encompass nutritional issues in the treatment of mental health disorders with a critical focus on patients' nutritional intake. This dissertation is available in open access at AURA, https://aura.antioch.edu/ and OhioLINK ETD Center, https://etd.ohiolink.edu.

Committee: Brett Kia-Keating EdD (Committee Chair); Christina Donaldson PhD (Committee Member); Kelli Davis PhD (Committee Member) Subjects: Health; Mental Health; Nutrition; Psychobiology; Psychology

PHD, Kent State University, 2014, College of Arts and Sciences / Department of Psychological Sciences

Although a considerable body of research has assessed the antecedents and consequences of binge episodes among individuals with Bulimia Nervosa (BN), the maintaining mechanisms of bulimic symptomatology have yet to be fully understood. Furthermore, it is unclear how the daily symptoms of individuals with Purging Disorder (PD) compare to BN. The present study examined the cognitions, emotions, and eating behaviors of individuals with bulimic spectrum disorders and controls using Ecological Momentary Assessment methodology. A sample of 42 women with Bulimic Spectrum disorders (BN: n=33; PD: n=9) and controls (n=31) completed daily diary assessments on mobile devices for 10 days. Results indicated that individuals with BN reported more objective binge episodes (OBEs) than those with PD and controls, yet those with BN and PD did not differ in the frequency of subjective binge episodes (SBEs). Negative affect was predictive of cognitive, yet not behavioral, aspects of dietary restriction, and increases in negative affect and guilt were predictive of OBEs, but not SBEs. Contrary to the affect regulation model, binge episodes did not effectively regulate affect. Furthermore, affect lability was associated with higher levels of eating psychopathology and OBE frequencies. Whereas OBEs predicted subsequent cognitive restraint, neither OBEs nor SBEs predicted post-eating body dissatisfaction, increased negative affect or guilt, or thoughts of exercise or purging. Findings highlight the differential relationships between eating psychopathology, cognitive and behavioral aspects of dietary restriction, and affective changes among individuals with BN and PD, as well as the similarities and differences in BN and PD symptomatology.

Committee: Janis Crowther (Advisor); Joel Hughes (Committee Member); Jeffery Ciesla (Committee Member); Manfred Van Dulmen (Committee Member); Richard Adams (Committee Member); Susan Roxburgh (Committee Member) Subjects: Clinical Psychology; Health; Mental Health; Psychology

MA, Kent State University, 2011, College of Arts and Sciences / Department of Psychological Sciences

Purging Disorder (PD) is an understudied pattern of behaviors within the Eating Disorder Not Otherwise Specified (EDNOS) diagnostic category. Although such categorization suggests PD is not as clinically significant as other eating disorders, recent evidence has suggested otherwise. However, it remains to be determined if PD is distinct from other clinically significant eating disorder categories. Thus, the present study sought to assess the phenomenology, clinical significance, and distinctiveness of PD. Group scores on measures of eating pathology, body image disturbance, and psychological correlates were compared (using MANOVA) among a female undergraduate sample (N= 91) of PD (n= 17), Bulimia Nervosa (BN; n=35), restrained eaters (n=18), and healthy controls (n=21). Results indicated the PD group both differed from and resembled the BN and restrained eater groups on different variables. Findings support the conceptualization of PD as existing along a spectrum of bulimic spectrum disorders rather than as a distinct diagnostic category.

Committee: Janis Crowther (Advisor) Subjects: Psychology

Master of Health and Human Services, Youngstown State University, 2025, Department of Health Professions

This thesis covers the topics related to adults using social media and how health-related content could affect them. There are attributes that are perceived and pushed on social media that can make someone more inclined that they have to look a certain way. This type of notion can affect anyone of all ages and genders. This survey asked about topics related to social media posts, taking advice from influencers, how social media posts can make us feel, and others. The survey covered questions with yes or no responses, multiple choice with selections from “never, not often, often, and very often,” and a question with an extended response. The results were split into total percentages, age groups, and their genders, with their corresponding age. The results showed that everyone who participated agreed that social media can affect someone mentally, even if it does not affect them personally. The different age groups and genders showed a similarity between some questions and differences between others. Results showed that participants between 18-24 years old were more likely to see content that related to ideal body types, but those aged 25 and up were more likely to interact with false hope content that is an attempt to achieve these body types. The participants' opinions were taken into account when it came to all questions, including the last one. This survey was able to clarify that this cohort can understand that the suggested workouts and diets used in this study are likely to be a scam or are considered a quick fix. This can be difficult to figure out when browsing the internet.

Committee: Dan Van Dussen PhD (Advisor); Zara Rowlands PhD (Committee Member); Danny Cesene EdD (Committee Member) Subjects: Nutrition; Social Research

Master of Arts (MA), Bowling Green State University, 2024, Psychology/Clinical

Eating disorders are complex psychological conditions often exacerbated by comorbidities with anxiety disorders. In addition to general anxiety, there are specific anxieties, such as anxiety about food and body, that are related to various eating disordered behaviors. The aim of the present study was to assess general anxiety and specific anxieties in relation to eating disorder behaviors and body checking and avoidance behaviors. Undergraduate student participants (N = 151) completed an online survey assessing general anxiety (State-Trait Anxiety Inventory), anxiety about eating (Fear of Food Measure), body anxiety (Physical Appearance State and Trait Anxiety Scale), eating behaviors (Dutch Eating Behavior Questionnaire), body checking (Body Checking Questionnaire), and body avoidance (Body Image Avoidance Questionnaire). Two hierarchical regression analyses were conducted to examine: (1) the unique relationship between anxiety about eating and eating disorder behaviors, after controlling for general anxiety and (2) the unique relationship between body anxiety with body checking and avoidance behaviors, after controlling for general anxiety. The hypotheses were: (1) that anxiety about eating would explain unique variance in eating disorder behavior, and (2) that body-related anxiety would explain unique variance in body checking and avoidance. General anxiety was no longer a significant predictor when anxiety about eating was included in the model for ED behavior, suggesting that anxiety about eating may be more predictive of ED behaviors compared to general anxiety. Both general anxiety and body-related anxiety were significant predictors for BCA behaviors, although the inclusion of body-related anxiety accounted for the greatest proportion of variance in BCA behaviors.

Committee: Dara Musher-Eizenman Ph.D. (Committee Chair); William O'Brien Ph.D. (Committee Member); Abby Braden Ph.D. (Committee Member) Subjects: Psychology

Psy. D., Antioch University, 2024, Antioch New England: Clinical Psychology

The field of clinical psychology has long privileged cognitive and affective experience and information over that which is stored in, and communicated by, the body (Caldwell, 2018; Young, 2006). Despite the profound and complex web of interactions between mind and body in EDs, this subspecialty has been no exception. The need for improvements in eating disorder (ED) treatment outcomes is well documented and transtheoretically accepted. Current practice guidelines for the treatment of adult EDs recommend the utilization of cognitive, behavioral, and interpersonal strategies to target problematic thinking and deficits in emotion regulation that are thought to fuel ED behaviors (American Psychiatric Association, 2023). While effective in some cases, these treatments fail to help a substantial number of patients and relapse rates among individuals who do respond are high (Berkman et al., 2007; Linardon et al., 2018; Murray et al., 2019; Tomba et al., 2019; van Hoeken & Hoek, 2020). It has been hypothesized that the utilization of techniques that help increase positive embodiment could augment current evidence-based treatments for EDs (Cook-Cottone, 2020; McBride & Kwee, 2018; Piran & Teall, 2012). There is theoretical and adjacent empirical evidence supporting this hypothesis; however, the relationship between embodiment and EDs has yet to be quantitatively explored. Utilizing the recently developed Experience of Embodiment Scale (EES; Piran et al. 2020), and the well-established and widely utilized Eating Disorder Examination Questionnaire, Short Form (EDE-QS; Gideon et al., 2016), the present study utilized quantitative, non-experimental, self-report survey research to explore the relationship between embodiment and ED symptomatology in 250 adults living in the United States. Findings suggest that there is a strong and significant relationship between disrupted embodiment and ED symptoms. Implications for clinical practice and ongoing treatment development and r (open full item for complete abstract)

Committee: Katherine Evarts Psy.D. (Committee Chair); Karen Meteyer Ph.D. (Committee Member); Jennifer Leslie Ph.D. (Committee Member) Subjects: Behavioral Sciences; Clinical Psychology; Counseling Psychology; Physiological Psychology; Psychology; Psychotherapy; Therapy

Doctor of Philosophy (PhD), Ohio University, 2024, Counselor Education (Education)

Eating disorder mental health literacy (ED-MHL) refers to one's knowledge and beliefs about eating disorders which aid their recognition, management, and prevention. While programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) are recognized for the content and quality of their programs, they do not currently require specific training in eating disorders counseling despite increasing prevalence and the highest mortality rates of any psychiatric disorder. The primary purpose of the current study with 239 participants was to examine mental health literacy among counselor trainees in identifying and treating eating disorders. Additional aims of this study included determining whether gender and racial identity combinations of fictional clients impacted counselor trainee ability to correctly diagnose an eating disorder; exploring the relationship between orthorexia and ED-MHL using the ORTO-R scale; and analyzing whether these variables (ability to correctly diagnose an atypical eating disorder based on a vignette, ORTO-R score, and select sociodemographic items) could be used to predict ED-MHL. Findings indicated that counselor trainees possessed overall low levels of ED-MHL, and there were no factors predictive of the ability to correctly diagnose an atypical eating disorder. The results of this study have several implications for various stakeholders, including counselor trainees, counselor supervisors, counselor educators, healthcare providers, and those directly impacted by eating disorders and negative body image. These implications, as well as limitations to the study and suggestions for future research, are presented.

Committee: Christine Suniti-Bhat (Advisor); Bilal Urkmez (Committee Member); Jonathan Procter (Committee Member); Gordon Brooks (Committee Member) Subjects: Counseling Education; Mental Health

Psy. D., Antioch University, 2023, Antioch New England: Clinical Psychology

Gender diverse individuals experience a multitude of oppressive interactions within our society and receive incessant messages of invalidation, oppression, and aggression. These chronic stressors have been shown to increase the risk of developing disordered eating behaviors within this population. The current study aims to explore how internalized transphobia may affect the development of disordered eating behavior as viewed through the Minority Stress Framework. This study explored the lived experience of being gender diverse in our society and how this may relate to the development of disordered eating behavior while also investigating protective factors. This study utilized a qualitative phenomenological methodology, recruiting seven gender diverse adults over the age of 18 who exhibited disordered eating behaviors. Participants completed a demographic questionnaire and the Transgender Identity Survey (Bockting et al., 2020), followed by a semistructured exploratory interview to gain narrative data directly from trans people, a population known to experience internalized transphobia (Bockting, 2015). Chronic body image struggles, low self-esteem, trauma history, and harmful expectations related to gender expression appeared as the major contributing factors to the development of disordered eating behaviors. These harmful influences appeared to hinder the ability of multiple participants in their exploration of their gender identity. Gender-affirming care, meaningful activities, community, and affirming clothing emerged as the major protective factors in the lives of the participants. The contributions toward the field of gender studies gleaned from this study include aiding psychologists in developing or applying preventative measures to reduce the risk of disordered eating in gender diverse individuals, as well as in better understanding and appreciating the complexities of gender diverse adults' experiences.

Committee: Karen Meteyer PhD (Committee Chair); Kate Evarts PsyD (Committee Member); Kathi Borden PhD (Committee Member) Subjects: Behavioral Sciences; Clinical Psychology; Counseling Psychology; Gender; Gender Studies; Glbt Studies; Health; Psychology

Doctor of Psychology (Psy.D.), Xavier University, 2022, Psychology

Eating disorders are increasingly prevalent in young women, constituting a serious public health concern. Maladaptive use of social networking sites (SNSs) is associated with increased eating disorder risk factors and symptomology among young women, suggesting that eating disorder prevention programs targeting this behavior may be beneficial. The present study tested a modified version of the Body Project that was shortened to a single, 2-hour session to address attrition problems of previous versions and adapted to include elements specifically targeting maladaptive SNS use. Female undergraduates (N = 128) were blindly assigned to a high-dissonance intervention, a low-dissonance intervention, or a no-treatment control group during a two-step enrollment process. Using a repeated measures design to assess for differential change in outcomes (i.e., thin-ideal internalization, body dissatisfaction, dietary restraint, negative affect, eating disorder symptomology) between conditions across time from baseline to posttest and 1-month follow-up, a 3 (Time) x 3 (Condition) mixed factorial multivariate analysis of variance (MANOVA) identified a significant Time x Condition interaction. Notably, follow-up analyses indicated participants in both active conditions experienced significant decreases in eating disorder symptomology and multiple eating disorder risk factors across time. Against expectations, the active conditions did not produce significant reductions on any of the measured outcomes relative to controls at posttest or 1-month follow-up. Results are promising in that they suggest minimal exposure to this modified intervention can produce positive effects which may enhance the feasibility and accessibility of eating disorder prevention options for busy college students.

Committee: Kathleen Hart Ph.D., ABPP (Committee Chair); Morrie Mullins Ph.D. (Committee Member); Susan Kenford Ph.D. (Committee Member) Subjects: Psychology; Psychotherapy

PHD, Kent State University, 2022, College of Education, Health and Human Services / School of Lifespan Development and Educational Sciences

This qualitative research sought to answer two questions: (a) how do gay men experience objectification; and (b) what are the effects of this objectification on the lives of these men? These questions were answered through the use of Interpretative Phenomenological Analysis (IPA). Seven men who identified as gay participated in the interviews. The focus of these interviews was to gain a better understanding of how objectification is experienced by gay men as well as exploring the impact that perceived or experienced objectification has on their lives. Using the steps of data analysis in IPA (J. A. Smith et al., 2009), two main themes and four subthemes emerged. The first theme to emerge was that gay men view objectification as part of being in gay culture. Two subthemes supporting this theme are that groups or categories arise based on objectification and objectification is rarely, if ever, challenged within the gay community. The second theme was that there are social and emotional repercussions that come out of the objectification. The subthemes that emerged here were that the men interviewed had specific concerns for themselves and also had concerns for the community as a whole.

Committee: Jason McGlothlin (Committee Co-Chair); Maureen Blankemeyer (Committee Member); Lynne Guillot-Miller (Committee Co-Chair) Subjects: Counseling Education; Mental Health

Doctor of Philosophy, Case Western Reserve University, 2022, Sociology

The growing prevalence and severity of both clinical and subclinical eating disorders resulted in the inclusion of a Healthy People 2020 objective aimed at reducing the proportion of individuals who engage in disordered eating behaviors. At the same time, survivors of intimate body trauma (childhood abuse, sexual assault, dating violence, etc.) are coming forward with their own violence narratives at unprecedented rates thanks to global support movements such as #MeToo. Research on the development of disordered eating behaviors after the experience of recurrent intimate body trauma (IBT) over the life course is limited but has been linked in compensatory &/or coping mechanistic ways. This dissertation explored the relationships that may exist between poor body image, a range of maladaptive eating behaviors, comorbid mental health issues, and experiences of IBT over the early life course. This research specifically utilized secondary data analysis from a large, nationally representative sample of U.S. men and womxn followed over 24 years (1994-2018) to expand on the methodology and findings from previous clinical, small-scale studies. Drawing on sociological theories related to cumulative disadvantage, stress proliferation, and toxic socialization this dissertation systematically explored the impact(s) of IBT over the early life course. A sociological understanding of the cumulative impact trauma has on the body is necessary to evaluate who may be at most risk for future revictimization and their associated mental health outcomes. Findings from this dissertation revealed that survivors of recurrent IBT experiences are roughly 2 to 4 times more likely to suffer from a range of mental health issues as compared to those who have not experienced sexual violence. Additionally, according to analysis results, queer IBT survivors are at risk of developing maladaptive mental health outcomes at a rate of 2 to 3 times that of heterosexual survivors. Analysis results al (open full item for complete abstract)

Committee: Brian Gran (Committee Chair); Eileen Anderson (Committee Member); Jessica Kelley (Committee Member); Susan Hinze (Committee Member) Subjects: Behavioral Psychology; Criminology; Gender; Gender Studies; Health; Mental Health; Personal Relationships; Psychology; Public Health; Social Psychology; Social Research; Social Work; Sociology; Statistics

Master of Science, Miami University, 2021, Kinesiology, Nutrition, and Health

Eating disorders and alcohol abuse are serious and sometimes fatal issues that are prevalent among college students. According to the National Eating Disorder Association, 20% of college students of all genders have or have previously had an eating disorder (NEDA, 2014). Likewise, reports indicate that up to 35% of those who abuse or are dependent on alcohol or other substances also have an eating disorder (NEDA, 2019). More specifically, nearly 1 in 10 Bulimia patients have a comorbid substance abuse disorder, usually alcohol use (Ulfvebrand et al, 2015). The current exploratory study investigates Booze Bulimia, a maladaptive behavior that is hypothesized to involve heavy alcohol consumption and self-induced vomiting (SIV) to control body shape and weight. The behavior combines the problems associated with both drinking and bulimia. Results of this study suggest that Booze Bulimia behaviors are positively correlated with both alcohol use and alcohol problems. Those who are likely to engage in Booze Bulimia are also likely to consume more alcohol, drink more often, and experience more problems as a result of their alcohol consumption.

Committee: Rose Marie Ward (Advisor); Matthew McMurray (Committee Member); Paul Branscum (Committee Member) Subjects: Behavioral Psychology; Health; Kinesiology; Psychology; Public Health

MS, University of Cincinnati, 2021, Allied Health Sciences: Nutrition

ABSTRACT Objective: To assess the prevalence of, and association between, eating psychopathology and vegetarianism within a cohort of collegiate ballet dancers at a Midwestern university. Design: Participants were recruited via email and asked to anonymously complete the EAT26 and EDI-3 SC questionnaire as part of a survey regarding dietary preferences, behaviors and anthropometrics. Participants: Members of a collegiate ballet program (n=39) were contacted via email to complete a survey. A total of 29 dancers completed the survey but 4 were removed due to exclusion criteria, leaving a total sample of 25 participants. Methods: Surveys were completed in REDCAP and the data were compiled and analyzed for significant associations. A Mann-Whitney U test was conducted to identify the association between EAT26 scores and vegetarianism. Population means were calculated and compared to determine if ballet dancers presented as at-risk for eating psychopathology and with greater prevalence of vegetarianism than nationally representative samples. Caseness for eating psychopathology was determined by scoring 20 or higher on the EAT26. The prevalence and frequency of compensatory behaviors were assessed using the EDI-3 SC. Main Outcome Measure: Of the 25 participants who completed the study, all were female, most were in their first (n=9) or second (n=9) year in college., with an average age of 19.2 (SD 1.2). Twenty four percent(n=6) reported they followed some form of a vegetarian diet. The mean of the EAT26 scores for omnivores was 9.8 (SD 10.3) while it was 20.2 (SD 12.4) for vegetarians (p-value for group comparison = 0.079). Within this cohort, 28% (n=7) scored 20 or greater on the EAT26 and 12% (n=3) had a prior eating disorder diagnosis, suggesting this population may be at considerable risk for eating psychopathology. Eating disordered behaviors included SIV (n=2), laxative/diuretic/diet pill use (n=2), binge eating (n=9) and excessive exercise (n=1 (open full item for complete abstract)

Committee: Abigail Peairs Ph.D. (Committee Chair); Sarah Couch Ph.D. (Committee Member) Subjects: Nutrition

Master of Science, The Ohio State University, 2021, Human Ecology: Human Nutrition

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder with a US pediatric prevalence of 10%. It presents with inattention and hyperactivity/impulsivity as well as emotional dysregulation (ED) symptoms such a s irritability and defiant behavior, typical of Oppositional Defiance Disorder (ODD) and Disruptive Mood Dysregulation Disorder (DMDD). The etiology of ADHD is multi-factorial with suggested effects related to diet. Objectives: Building on prior studies, this study examines the association of diet quality with ADHD and emotional dysregulation symptoms among a pediatric population. Methods: This cross-sectional study utilized baseline data for 134 children age 6-12 years old with symptoms of ADHD/ED enrolled in a randomized control trial of multi-nutrient supplementation. Diet quality was based on Healthy Eating Index-2015 (HEI-2015) determined from the Vioscreen food frequency questionnaire. ADHD, ODD and DMDD symptoms were assessed using the Child and Adolescent Symptom Inventory-5. Other ED symptoms were assessed using the Strengths and Difficulties Questionnaire. Analysis for association was conducted using linear regression models, adjusting for covariates when necessary. Results: We found family income level to be significantly inversely associated with severity of hyperactivity (p = 0.04), emotional problems (p=0.01), conduct problems (p=0.002), along with ODD (p=0.004) and DMDD (p=0.005) symptoms. Mean HEI-2015 score was 63.4 (SD=8.8) and it was not significantly associated with any of the outcome symptoms. However, scores of HEI components vegetables (β= -0.118, p=0.016) and refined grains (β=0.052, p=0.017) were both associated with inattention even after adjusting for covariates. Similarly, total fruit (β= -0.423, p=0.037) was associated with conduct problems even after adjusting for covariates. Conclusions: While better vegetable and total fruit scores were associated with better symptoms in aspect (open full item for complete abstract)

Committee: Irene Hatsu PhD, RD (Advisor); Tanya Orchard PhD, RD (Committee Member); James Odei PhD (Committee Member) Subjects: Mental Health; Nutrition

Master of Arts, Miami University, 2021, Psychology

Despite the severity and high rate of co-occurrence between eating disorders (ED) and obsessive-compulsive disorder (OCD), less is known regarding the temporal sequencing of their comorbidity and whether and how symptoms may influence one another over time. The current study sought to answer these questions by testing if a bidirectional, temporal relationship exists between ED symptoms and OCD obsessions and compulsions, across five time points, each one week apart using auto-regressive cross-lagged panel modeling. The final sample consisted of 358 symptomatic individuals from the community, the majority of whom identified as White and male. Bivariate correlations revealed that ED symptoms, obsessions and compulsions were associated with one another across the five weeks. Two cross-lagged panel models indicated that ED symptoms predicted OCD symptoms at numerous time points and vice versa. The model analyzing obsessions and compulsions separately found that only ED symptoms and obsessions predicted one another across different time points. Hence, our results provide preliminary evidence that there is a bidirectional, temporal relationship between ED symptoms and OCD symptoms among a community sample, particularly with respect to cognitive as opposed to behavioral symptoms.

Committee: April Smith Ph.D. (Committee Chair); Joshua Magee Ph.D. (Committee Member); Elise Clerkin Ph.D. (Committee Member) Subjects: Clinical Psychology

Master of Arts, The Ohio State University, 2020, Educational Studies

Medical trainees lack basic knowledge and education in eating disorders, including diagnostic criteria and effective treatment according to prior research by Anderson et. al. An educational intervention is needed during training to improve the recognition, diagnosis, and treatment of eating disorders among adolescent patients. The purpose of this study is to investigate the effectiveness of retrieval practice on knowledge acquisition in the field of eating disorder education among medical trainees. A secondary aim is to evaluate change in self-perceived comfort, knowledge, and skills concerning eating disorders. An exploratory prospective cluster-randomized trial was conducted over fourteen, four-week blocks. Participants were randomized by block to either the retrieval-based educational format (intervention group) or the conventional lecture-based format (control group). Groups completed 9-item, multiple choice pre- and post-rotation knowledge tests as well as pre- and post-rotation surveys. The intervention group outscored the control group on the post-rotation knowledge test, though this difference was not significant (p=0.288). Despite the control group reporting improvements overall in self-perceived competence managing patients with eating disorders, reports of increased competence was inversely correlated with knowledge test scores, approaching significance (r=-0.502, p=0.011). Standard lectures may confer false confidence to learners which may not accurately align with actual knowledge acquisition.

Committee: David Stein PhD (Committee Chair); John Mahan MD (Committee Co-Chair) Subjects: Education; Medicine