Bradley A. Green

Comparisons of body image dimensions by race/ethnicity and gender in a university population

OBJECTIVE We examined affective and cognitive components of body image related to physical appearance, weight, and health among 120 university men and women of three racial/ethnic groups: African American, European American, and Latino/a American. METHOD Participants completed a Background Information Sheet, the Multidimensional Body-Self Relations Questionnaire (MBSRQ), the Body-Esteem Scale (BES) with additional items, and the Balanced Inventory of Desirable Responding (BIDR). We tested for effects of race/ethnicity and gender on the body image measures while controlling for age, body size, social desirability, and socioeconomic status (SES). RESULTS African Americans reported greatest body satisfaction and least overestimation of weight. Latino/a Americans were equal to or higher than European Americans on all indices. Gender differences occurred on global body image, weight concerns, fitness, and health. There were no Gender x Race/Ethnicity interactions. DISCUSSION This pattern of racial/ethnic and gender differences shows a need for exploring a wider range of culturally relevant body image dimensions.

The Same Yet Different: Refocusing the Sexual Addiction Screening Test (SAST) to Reflect Orientation and Gender

In 1988, the Sexual Addiction Screening Test (SAST) was described as an early assessment tool for clinicians to use with patients who manifested sexually compulsive behavior. Early research acknowledged that while the SAST was very useful with heterosexual males, it did not do well with women or homosexual men. There were subsequent efforts to create instruments with “SAST- like” architecture for women and homosexual men. Called the W-SAST and the G-SAST, these instruments had little research to support their clinical utility. This article describes the development of a new version of the SAST (SAST-R) which is designed to be clinically relevant across populations. Item selection was based on a clinical population of inpatient sex addicts (N = 1604), as well as various contrasting populations. The new instrument has core items that show potential to be viable across gender and orientation. The addition of research scales should help resolve the issues around one instrument serving different populations. Preliminary studies using four separate samples of men, and three separate samples of women, are described which point to further research efforts.

Continuity and discontinuity models of bulimia nervosa: a taxometric investigation.

Past research evaluating the continuity and discontinuity models of bulimia has produced inconclusive results. In the current study, we performed a taxometric analysis of bulimia nervosa using means above minus below a sliding cut and maximum covariance analysis with a sample of women diagnosed with bulimia nervosa (n = 201) or women college students (n = 412). Indicators were derived from the Bulimia Test--Revised and the Eating Attitudes Test--26, and both a mixed sample and the nonclinical sample were analyzed. With both taxometric methods and both mixed and nonclinical samples, results were consistently suggestive of a latent taxon for bulimia. These results challenge a dimensional model of bulimia nervosa.

Do anorexia and bulimia nervosa occur on a continuum? A taxometric analysis

We investigated the question of whether anorexia and bulimia nervosa occur on a continuum versus being discrete classes using two taxometric procedures: Mean Above Minus Below a Cut (MAMBAC) and Maximum Covariance (MAXCOV) analysis. Participants were N = 959 women diagnosed as having anorexia nervosa (n = 165), bulimia nervosa (n = 562) or atypical eating disorder (n = 18) or were nonclinical controls (n = 214). Indicators for the taxometric analyses were derived from the Eating Disorder Inventory, and we also included body mass index (BMI). Results replicated earlier taxometric findings in that both purging and nonpurging types of bulimia seemed qualitatively different from normative eating behavior. The distinction between restricting and binge-eating/purging types of anorexia nervosa also seemed to be qualitative rather than quantitative. However, results most consistently supported the conclusion that anorexia nervosa, binge-eating/purging type, occurs on a continuum with bulimia nervosa (both purging and nonpurging types) and that the two types of bulimia nervosa differ in degree rather than in kind. Overall, the results suggest that anorexia nervosa, binge-eating/purging type, is more qualitatively distinct from anorexia, restricting type, than from either type of bulimia nervosa, perhaps suggesting that these disorders should be reclassified in future editions of the Diagnostic and Statistical Manual of Mental Disorders.

A Taxometric Investigation of the Latent Structure of Worry: Dimensionality and Associations With Depression, Anxiety, and Stress

Worry has been described as a core feature of several disorders, particularly generalized anxiety disorder (GAD). The present study examined the latent structure of worry by applying 3 taxometric procedures (MAXEIG, MAMBAC, and L-Mode) to data collected from 2 large samples. Worry in the first sample (Study 1) of community participants (n=1,355) was operationalized by worry engagement, absence of worry, and the worry feature of trait anxiety. Worry in the second sample (Study 2) of undergraduate participants (n=1,171) was operationalized by the tendency to experience worry, intolerance of uncertainty, beliefs about worry, and symptoms of GAD. Results across both samples provided converging evidence that worry is best conceptualized as a dimensional construct, present to a greater or lesser extent in all individuals. Findings from Study 2 also indicated that the latent dimension of worry generally has an equal association with symptoms of depression, anxiety, and stress across the entire continuum. These findings are discussed in relation to the conceptualization and assessment of worry in GAD and related disorders.

Trouble ahead, trouble behind: Narcissism and early maladaptive schemas

Narcissism is a multifaceted construct that is inconsistently defined and assessed between clinical psychology and social-personality psychology. The purpose of the present study was to examine the similarities and differences in the cognitive schemas underlying various forms of narcissism. This was accomplished by examining the associations of normal and pathological forms of narcissism with the early maladaptive schemas. The results showed important similarities in these associations (e.g., all of the narcissism scales were positively associated with the entitlement schema) as well as differences (e.g., vulnerable narcissism was the only form of narcissism that was positively associated with subjugation). Discussion focuses on the implications of these results for the ways in which individuals with these forms of narcissism perceive and navigate their social environments.

The impact of varying levels of confidentiality on disclosure of suicidal thoughts in a sample of United States National Guard personnel

OBJECTIVES Increasing rates of suicide in the military indicate current assessment approaches are not yielding accurate determinations of risk. Concern that endorsement of suicidal ideation may result in obstacles to career advancement may be resulting in nondisclosure. METHOD To test this, we recruited a sample of US National Guard personnel (n = 789; 81.7% male; 63.2% white) and administered two measures of current thoughts of suicide. One measure was integrated into our risk assessment protocol and soldiers were thus aware that answers could result in referral to on site military mental health professionals. The other measure was not integrated into the risk assessment protocol and soldiers were thus aware that results would not be reported to on site military mental health professionals. RESULTS As hypothesized, a higher proportion of individuals reported current thoughts of suicide on the measure not integrated into the risk protocol (9.4%) than on the measure that was (6.0%). Also as hypothesized, a higher proportion of those willing to endorse current thoughts of suicide on the measure not integrated into the risk protocol denied current thoughts of suicide on the one that was (61.5%) than vice versa (39.0%). Limitations include cross-sectional self-report data and a lack of counter-balancing of measures. CONCLUSIONS The results indicate that increasing the confidentiality of risk assessments within the National Guard increases the likelihood of reporting of current thoughts of suicide.

The Latent Structure of Anxiety Sensitivity—Revisited

Anxiety sensitivity has been implicated as a risk factor for the development and maintenance of panic and other anxiety disorders. Although researchers have generally assumed that anxiety sensitivity is a dimensional, rather than categorical, variable, recent taxometric research has raised questions concerning the accuracy of this assumption. The present study examined the latent structure of anxiety sensitivity by applying four taxometric procedures (MAXEIG, MAXCOV, MAMBAC, and L-Mode) to data collected from two large nonclinical samples (n = 1,025 and n = 744) using two distinct measures of anxiety sensitivity (Anxiety Sensitivity Profile and Anxiety Sensitivity Index—Revised). In contrast to previous taxometric analyses of anxiety sensitivity, results of the present research provided convergent evidence for a latent anxiety sensitivity dimension. Several potential explanations for the discrepancy between these findings and those of previous research are discussed, as well as the implications of these findings for the conceptualization and measurement of anxiety sensitivity.

Testing the main hypotheses of the interpersonal-psychological theory of suicidal behavior in a large diverse sample of United States military personnel.

BACKGROUND Preliminary data indicate the suicide rate in the United States military decreased in 2013, but the National Guard saw a continued increase. METHOD We examined the utility of the interpersonal-psychological theory of suicidal behavior (IPTS) in a sample of US military personnel drawn largely from the National Guard (n=934; 77.7% male; 59.5% white). RESULTS Results indicated the interaction of thwarted belongingness and perceived burdensomeness predicted suicidal ideation and resolved plans and preparations for suicide. In each case, risk was greatest at higher levels of both predictors. Furthermore, results indicated the interaction of thwarted belongingness, perceived burdensomeness, and acquired capability for suicide predicted prior suicide attempts. In this interaction term, the relationship between suicidal desire (thwarted belongingness and perceived burdensomeness) and suicide attempts was significant and positive only at high levels of acquired capability. All analyses were cross-sectional. CONCLUSIONS Results indicate the IPTS may be useful for conceptualizing suicide risk in the National Guard.

PATHOS: a brief screening application for assessing sexual addiction.

&NA;Sexual addiction is estimated to afflict up to 3% to 6% of the population. However, many clinicians lack clear criteria for detecting potential cases. Objectives:The present studies were conducted to assess the effectiveness of a brief sexual addiction screening instrument (ie, PATHOS Questionnaire) to correctly classify patients being treated for sex addiction and healthy volunteers. Methods:In study 1, a 6-item questionnaire, which utilizes the mnemonic “PATHOS,” was examined in regard to sensitivity and specificity using a sample combining patients being treated for sex addiction and healthy volunteers (970 men/80.2% patients; 938 women/63.8% patients). In study 2, a cross-validation sample of 672 men (93% patients) and 241 women (35.3% patients) completed the PATHOS screener. Results:Results of receiver operating characteristics analyses in study 1 demonstrated that the PATHOS captured 92.6% of the area under the curve and achieved 88.3% sensitivity and 81.6% specificity for classifying the male sample (n = 963) as patients and healthy subjects using a cutoff score of 3. Similarly, the PATHOS captured 90.2% of the area under the curve and, with a cutoff of 3, achieved 80.9% sensitivity and 87.2% specificity for the female sample (n = 808). In study 2, results of receiver operating characteristics analyses indicated that the PATHOS captured 85.1% of the area under the curve, with sensitivity of 70.7% and specificity of 86.9% for men (cutoff of 3). For women, the PATHOS captured 80.9% of the area under the curve and achieved 69.7% sensitivity and 85.1% specificity with the cutoff of 3. Conclusions:These studies provide support for the use of the PATHOS as a screening instrument to detect potential sexual addiction cases in clinical settings.