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The Legacy of Hope Summit: A Consensus-Based Initiative and Report on Eating Disorders in the U.S. and Recommendations for the Path Forward
Get PDFBackground: Several unsuccessful attempts have been made to reach a cross-disciplinary consensus on issues fundamental to the field of eating disorders in the United States (U.S.). In January 2020, 25 prominent clinicians, academicians, researchers, persons with lived experience, and thought leaders in the U.S. eating disorders community gathered at the Legacy of Hope Summit to try again. This paper articulates the points on which they reached a consensus. It also: (1) outlines strategies for implementing those recommendations; (2) identifies likely obstacles to their implementation; and (3) charts a course for successfully navigating and overcoming those challenges.
Methods: Iterative and consensual processes were employed throughout the Summit and the development of this manuscript.
Results: The conclusion of the Summit culminated in several consensus points, including: (1) Eating disorder outcomes and prevention efforts can be improved by implementing creative health education initiatives that focus on societal perceptions, early detection, and timely, effective intervention; (2) Such initiatives should be geared toward parents/guardians, families, other caretakers, and frontline healthcare providers in order to maximize impact; (3) Those afflicted with eating disorders, their loved ones, and the eating disorders community as a whole would benefit from greater accessibility to affordable, quality care, as well as greater transparency and accountability on the part of in-hospital, residential, and outpatient health care providers with respect to their qualifications, methodologies, and standardized outcomes; (4) Those with lived experience with eating disorders, their loved ones, health care providers, and the eating disorders community as a whole, also would benefit from the establishment and maintenance of treatment program accreditation, professional credentialing, and treatment type and levels of care guidelines; and (5) The establishment and implementation of effective, empirically/evidence-based standards of care requires research across a diverse range of populations, adequate private and government funding, and the free exchange of ideas and information among all who share a commitment to understanding, treating, and, ultimately, markedly diminishing the negative impact of eating disorders.
Conclusions: Widespread uptake and implementation of these recommendations has the potential to unify and advance the eating disorders field and ultimately improve the lives of those affected. A cross-disciplinary group of eating disorder professionals, thought leaders, and persons with lived experience have come together and reached a consensus on issues that are fundamental to the battle against the life-threatening and life-altering illnesses that are eating spectrum disorders. Those issues include: (1) the need for early detection, intervention, prevention, and evidenced-based standards of care; (2) the critical need to make specialized care more accessible and affordable to all those in need; (3) the importance of developing uniform, evidenced-based standards of care; (4) the need for funding and conducting eating spectrum disorder research; and (5) the indispensability of advocacy, education, and legislation where these illnesses are concerned. During the consensus process, the authors also arrived at strategies for implementing their recommendations, identified likely obstacles to their implementation, and charted a course for successfully navigating and overcoming those challenges. Above all else, the authors demonstrated that consensus in the field of eating spectrum disorders is possible and achievable and, in doing so, lit a torch of hope that is certain to light the path forward for years to come
Food Insecurity & Dietary Restraint in a Diverse Urban Population
No full textThe primary aim of this study was to investigate self-reported reasons for engaging in dietary restraint (DR) in a food insecure urban population. It also tested whether DR was associated with increased eating disorder (ED) pathology when DR was broadly assessed. The initial sample (N = 503) consisted of adult clients visiting food pantries who completed the Eating Disorder Diagnostic Scale for DSM 5, the Radimer Cornell Food Insecurity Measure, and three items from the DR subscale of Eating Disorder Examination Questionnaire (EDE-Q); EDE-Q items were modified to allow participants to explain why they restricted. Analyses included participants (N = 259) who responded to one of the modified EDE-Q questions. Results indicated that participants engaged in DR for several reasons, including minimizing the effect of hunger for other family members (i.e., children), stretching food to make it last longer, and prioritizing medical expenses. Intentional efforts to limit food intake in this sample were correlated with increased ED pathology. Although it is not surprising that adults experiencing food insecurity engage in intentional DR, this study adds important information about why food insecure adults engage in DR and highlights the importance of assessing DR for reasons other than weight and shape concerns
Binge Eating Among Older Women: Prevalence Rates and Health Correlates Across Three Independent Samples
Get PDFBackground: Emerging research indicates that binge eating (BE; consuming unusually large amounts of food in one siting while feeling a loss of control) is prevalent among older women. Yet, health correlates of BE in older adult populations are poorly understood. The original study aimed to investigate BE prevalence, frequency, and health correlates in a sample of older adult women. Based on results from this first study, we then sought to replicate findings in two additional samples of older adult women from separate studies.
Method: Using self-reported frequencies of BE from three separate samples of older women with very different demographics, we compared BE prevalence, frequency, and health correlates among older women. Study 1 (N=185) includes data collected online (86% White; 59% overweight/obese status). Study 2 (N=64) was conducted in person at a local food pantry (65% Hispanic; 47% household income\u3c$10,000/year). Study 3 (N=100) comprises data collected online (72% White; 50% Masters/Doctoral Degree).
Results: Per DSM-5 frequency criterion of BE at least weekly, we found prevalence rates ranging from 19 to 26% across the three samples. Correlates of BE frequency included elevated negative mood, worry, BMI, and less nutritious food consumption.
Conclusions: Across three very different samples in terms of race/ethnicity, education, food security status, measurements, and sampling methodology, we found fairly consistent rates of self-reported BE at least weekly (19–26%). Results suggest that BE is related to negative health indices among older women and support the need for more research in this populatio
Geometry and Global Stability of 2D Periodic Monotone Maps
No full textWe establish conditions to ensure global stability of a competitive periodic system from hypotheses on individual maps. We study planar competitive maps of Kolgomorov type. We show how conditions for global stability for individual maps will remain invariant under composition and hence establish a globally stable cycle. Our main theoretical contribution is to show that stability for monotone non-autonomous periodic maps can be reduced to a problem of global injectivity. We provide analytic conditions that can be checked and illustrate our results with important competition models such as the planar Leslie-Gower and Ricker maps
Complex Collisions of Ultracold Molecules: A Toy Model
No full textWe introduce a model to study the collisions of two ultracold diatomic molecules in one dimension interacting via pairwise potentials. We present results for this system and argue that it offers lessons for real molecular collisions in three dimensions. We analyze the distribution of the adiabatic potentials in the hyperspherical coordinate representation as well as the distribution of near-threshold four-body bound states, systematically studying the effects of molecular properties, such as interaction strength, interaction range, and atomic mass. It is found that the adiabatic potential\u27s nearest-neighbor energy level distribution transitions from significant level repulsion characteristic of chaos (Brody distribution) to nonchaotic (Poisson distribution) as the two molecules are separated. For the near-threshold four-atom bound states, the case where all atoms have equal masses shows a Poissonian spacing distribution, while the unequal-mass system exhibits significant level repulsion characterized by a nonzero Brody parameter. We derive a semiclassical formula for the density of states and extract from it simple scaling laws with potential depth and range. We find good agreement between the semiclassical predictions for the density of states and the full quantum mechanical calculations
Old Style: Unoriginality and Its Uses in Nineteenth-Century U.S. Literature
No full textAn aesthetic of unoriginality shaped literary style and reader taste for decades of the nineteenth century. While critics in the twentieth century and beyond have upheld originality and innovation as essential characteristics of literary achievement, they were not features particularly prized by earlier American audiences, Claudia Stokes contends. On the contrary, readers were taught to value familiarity, traditionalism, and regularity. Literary originality was often seen as a mark of vulgar sensationalism and poor quality.
In Old Style Stokes offers the first dedicated study of a forgotten nineteenth-century aesthetic, explicating the forms, practices, conventions, and uses of unoriginality. She focuses in particular on the second quarter of the century, when improvements in printing and distribution caused literary markets to become flooded with new material, and longstanding reading practices came under threat. As readers began to prefer novelty to traditional forms, advocates openly extolled unoriginality in an effort to preserve the old literary ways. Old Style examines this era of significant literary change, during which a once-dominant aesthetic started to give way to modern preferences.
If writing in the old style came to be associated with elite conservatism—a linkage that contributed to its decline in the twentieth century—it also, paradoxically provided marginalized writers—people of color, white women, and members of the working class—the literary credentials they needed to enter print. Writing in the old style could affirm an aspiring author\u27s training, command of convention, and respectability. In dismissing unoriginality as the literary purview of the untalented or unambitious, Stokes cautions, we risk overlooking something of vital importance to generations of American writers and readers.https://digitalcommons.trinity.edu/mono/1173/thumbnail.jp
Oxytocin Attenuates the Stress-Induced Reinstatement of Alcohol-Seeking in Male Rats: Role of the Central Amygdala
Get PDFFactors such as stress and anxiety often contribute to alcohol-dependent behavior and can trigger a relapse of alcohol addiction and use. Therefore, it is important to investigate potential pharmacological interventions that may alleviate the influence of stress on addiction-related behaviors. Previous studies have demonstrated that the neuropeptide oxytocin has promising anxiolytic potential in mammals and may offer a pharmacological target to diminish the emotional impact on reinstatement of alcohol-seeking. The purpose of the present study was to investigate the effect of oxytocin on stress-induced alcohol relapse and identify a neural structure mediating this effect through the use of an ethanol self-administration and yohimbine-induced reinstatement paradigm. While yohimbine administration resulted in the reinstatement of ethanol-seeking behavior, the concurrent administration of yohimbine and oxytocin attenuated this effect, suggesting that oxytocin may disrupt stress-induced ethanol-seeking behavior. The central amygdala (CeA) is a structure that drives emotional responses and robustly expresses oxytocin receptors. Intra-CeA oxytocin similarly attenuated the yohimbine-induced reinstatement of ethanol-seeking behavior. These results demonstrate that oxytocin has the potential to attenuate stress-induced relapse into ethanol-seeking behavior, and that this mechanism occurs specifically within the central amygdala
An Initial Study of Practicing Psychologists\u27 Views of the Utility of Ecological Momentary Assessment for Difficult Psychotherapy Cases
Get PDFEcological momentary assessment (EMA) is a burgeoning area of research, and several clinical applications of the resulting data have been identified by researchers, suggesting potential benefit to psychotherapy practice. However, practitioners often do not use traditional empirically-supported tools for diagnosis and outcome monitoring (e.g., validated interview measures and questionnaires). Thus, it is not clear how readily practitioners will take up newer technology-enhanced assessment methods, despite current enthusiasm among researchers. The current study aimed to explore the perceived usefulness of EMA-based tools for clinical assessment and outcome monitoring of difficult psychotherapy cases, as well as to identify correlates of attitudes about the usefulness of these tools. Clinical psychologists in active therapy practice with adults (n = 375) completed an internet survey including the Attitudes toward Standardized Assessment scale and the Attitudes toward Standardized Assessment Scales-Monitoring and Feedback. Respondents characterized their current diagnostic and outcome monitoring practices and rated how helpful they would find several assessment and outcome monitoring resources for a difficult case, including both traditional instruments and EMA-based methods. EMA-based tools had lower perceived usefulness than existing instruments. Attitudes toward standardized assessment and outcome monitoring predicted the perceived utility of these methods, as did several professional variables. Practicing psychologists may not adopt EMA for clinical assessment more readily than traditional assessment tools. Recommendations for facilitating the uptake of new technologies by psychotherapists are offered
When My Parents Came to the Gay Ball: Comfort Work in Adult Child–Parent Relationships
No full textIn addition to the emotion work that occurs in families, I theorize that adult children also engage in comfort work with their parents, navigations, and strategies to reduce the discomfort of parents with their adult children’s lives. This study analyzes how gay and lesbian adults navigate the participation of their parents at events run by lesbian, gay, bisexual, transgender, and queer (LGBTQ) clubs or “krewes” in the Gulf South during Carnival season. I conducted over 50 days of ethnographic fieldwork during Mardi Gras events and 26 interviews with gay and lesbian members of krewes in Mobile, Alabama, and Baton Rouge, Louisiana. I argue that gay and lesbian adults negotiate their parents’ attendance in gay spaces by comfort work, mostly by creating comfort for their parents and managing disreputability through education. Ultimately, I conclude that parents’ attendance at LGBTQ events results in supportive reciprocation, “payoffs” of acceptance that are rich in emotional and symbolic significance for adult children
Access to Metal Centers and Fluxional Hydride Coordination Integral for CO\u3csub\u3e2\u3c/sub\u3e Insertion into [Fe\u3csub\u3e3\u3c/sub\u3e(μ-H)\u3csub\u3e3\u3c/sub\u3e]\u3csup\u3e3+\u3c/sup\u3e Clusters
No full textCO2 insertion into tri(μ-hydrido)triiron(II) clusters ligated by a tris(β-diketiminate) cyclophane is demonstrated to be balanced by sterics for CO2 approach and hydride accessibility. Time-resolved NMR and UV-vis spectra for this reaction for a complex in which methoxy groups border the pocket of the hydride donor (Fe3H3L2, 4) result in a decreased activation barrier and increased kinetic isotope effect consistent with the reduced sterics. For the ethyl congener Fe3H3L1 (2), no correlation is found between rate and reaction solvent or added Lewis acids, implying CO2 coordination to an Fe center in the mechanism. The estimated hydricity (50 kcal/mol) based on observed H/D exchange with BD3 requires Fe–O bond formation in the product to offset an endergonic CO2 insertion. μ3-hydride coordination is noted to lower the activation barrier for the first CO2 insertion event in DFT calculations