Jakki O. Bailey

What constitutes clinically significant binge eating? Association between binge features and clinical validators in college‐age women

OBJECTIVE To investigate the association between binge features and clinical validators. METHOD The Eating Disorder Examination assessed binge features in a sample of 549 college-age women: loss of control (LOC) presence, binge frequency, binge size, indicators of impaired control, and LOC severity. Clinical validators were self-reported clinical impairment and current psychiatric comorbidity, as determined via a semistructured interview. RESULTS Compared with women without LOC, those with LOC had significantly greater odds of reporting clinical impairment and comorbidity (ps < 0.001). Among women with LOC (n = 252), the indicators of impaired control and LOC severity, but not binge size or frequency, were associated with greater odds of reporting clinical impairment and/or comorbidity (ps < 0.05). DICUSSION: Findings confirm that the presence of LOC may be the hallmark feature of binge eating. Further, dimensional ratings about the LOC experience--and possibly the indicators of impaired control--may improve reliable identification of clinically significant binge eating.

An examination of the Clinical Impairment Assessment among women at high risk for eating disorder onset

Identifying measures that reliably and validly assess clinical impairment has important implications for eating disorder (ED) diagnosis and treatment. The current study examined the psychometric properties of the Clinical Impairment Assessment (CIA) in women at high risk for ED onset. Participants were 543 women (20.6 ± 2.0 years) who were classified into one of three ED categories: clinical ED, high risk for ED onset, and low risk control. Among high risk women, the CIA demonstrated high internal consistency (α = 0.93) and good convergent validity with disordered eating attitudes (rs = 0.27-0.68, ps < 0.001). Examination of the CIAs discriminant validity revealed that CIA global scores were highest among women with a clinical ED (17.7 ± 10.7) followed by high risk women (10.6 ± 8.5) and low risk controls (3.0 ± 3.3), respectively (p < 0.001). High risk women reporting behavioral indices of ED psychopathology (objective and/or subjective binge episodes, purging behaviors, driven exercise, and ED treatment history) had higher CIA global scores than those without such indices (ps < 0.05), suggesting good criterion validity. These data establish the first norms for the CIA in a United States sample. The CIA is psychometrically sound among high risk women, and heightened levels of impairment among these individuals as compared to low risk women verify the relevance of early intervention efforts.

Reducing eating disorder onset in a very high risk sample with significant comorbid depression: A randomized controlled trial.

OBJECTIVE Eating disorders (EDs) are serious problems among college-age women and may be preventable. An indicated online eating disorder (ED) intervention, designed to reduce ED and comorbid pathology, was evaluated. METHOD 206 women (M age = 20 ± 1.8 years; 51% White/Caucasian, 11% African American, 10% Hispanic, 21% Asian/Asian American, 7% other) at very high risk for ED onset (i.e., with high weight/shape concerns plus a history of being teased, current or lifetime depression, and/or nonclinical levels of compensatory behaviors) were randomized to a 10-week, Internet-based, cognitive-behavioral intervention or waitlist control. Assessments included the Eating Disorder Examination (EDE, to assess ED onset), EDE-Questionnaire, Structured Clinical Interview for DSM Disorders, and Beck Depression Inventory-II. RESULTS ED attitudes and behaviors improved more in the intervention than control group (p = .02, d = 0.31); although ED onset rate was 27% lower, this difference was not significant (p = .28, NNT = 15). In the subgroup with highest shape concerns, ED onset rate was significantly lower in the intervention than control group (20% vs. 42%, p = .025, NNT = 5). For the 27 individuals with depression at baseline, depressive symptomatology improved more in the intervention than control group (p = .016, d = 0.96); although ED onset rate was lower in the intervention than control group, this difference was not significant (25% vs. 57%, NNT = 4). CONCLUSIONS An inexpensive, easily disseminated intervention might reduce ED onset among those at highest risk. Low adoption rates need to be addressed in future research.

The Impact of Vivid Messages on Reducing Energy Consumption Related to Hot Water Use

Research suggests that vivid and personalized interventions influence proenvironmental attitudes and behaviors. Through the use of immersive virtual environment technology, people can experience vivid environmental scenarios that are personalized to the individual. An experiment was conducted to investigate the impact of vivid and/or personal messages on energy savings behavior related to hot water use. Participants experienced a virtual shower in which they received feedback (varying in vividness and/or personalization) on the amount of energy used to heat and transport the virtual water. Participants’ hot water use during hand washing in the physical world was tracked before and after treatment. Participants exposed to vivid messages used cooler water compared with not vivid messages. There was no significant effect for personal messages and no interaction effect. The results suggest that technology that leverages vividness may be effective in promoting proenvironmental behaviors.

Immersive Virtual Reality for Pediatric Pain

Children must often endure painful procedures as part of their treatment for various medical conditions. Those with chronic pain endure frequent or constant discomfort in their daily lives, sometimes severely limiting their physical capacities. With the advent of affordable consumer-grade equipment, clinicians have access to a promising and engaging intervention for pediatric pain, both acute and chronic. In addition to providing relief from acute and procedural pain, virtual reality (VR) may also help to provide a corrective psychological and physiological environment to facilitate rehabilitation for pediatric patients suffering from chronic pain. The special qualities of VR such as presence, interactivity, customization, social interaction, and embodiment allow it to be accepted by children and adolescents and incorporated successfully into their existing medical therapies. However, the powerful and transformative nature of many VR experiences may also pose some risks and should be utilized with caution. In this paper, we review recent literature in pediatric virtual reality for procedural pain and anxiety, acute and chronic pain, and some rehabilitation applications. We also discuss the practical considerations of using VR in pediatric care, and offer specific suggestions and information for clinicians wishing to adopt these engaging therapies into their daily clinical practice.

When does virtual embodiment change our minds

Can an avatar’s body movements change a person’s perception of good and bad? We discuss virtual embodiment according to theories of embodied cognition (EC), and afferent and sensorimotor correspondences. We present an example study using virtual reality (VR) to test EC theory, testing the effect of altered virtual embodiment on perception. Participants either controlled an avatar whose arm movements were similar to their own or reflected the mirror opposite of their arm movements. We measured their associations of “good” and “bad” with the left and right (i.e., space-valence associations). This study demonstrated how VR could be used to examine the possible ways that systems of the body (e.g., visual, motor) may interact to influence cognition. The implications of this research suggest that visual feedback alone is not enough to alter space-valence associations. Multiple sensory experiences of media (i.e., sensorimotor feedback) may be necessary to influence cognition, not simply visual feedback.

Developing a Novel Measure of Body Satisfaction Using Virtual Reality.

Body image disturbance (BID), considered a key feature in eating disorders, is a pervasive issue among young women. Accurate assessment of BID is critical, but the field is currently limited to self-report assessment methods. In the present study, we build upon existing research, and explore the utility of virtual reality (VR) to elicit and detect changes in BID across various immersive virtual environments. College-aged women with elevated weight and shape concerns (n = 38) and a non-weight and shape concerned control group (n = 40) were randomly exposed to four distinct virtual environments with high or low levels of body salience and social presence (i.e., presence of virtual others). Participants interacted with avatars of thin, normal weight, and overweight body size (BMI of approximately 18, 22, and 27 respectively) in virtual social settings (i.e., beach, party). We measured state-level body satisfaction (state BD) immediately after exposure to each environment. In addition, we measured participants’ minimum interpersonal distance, visual attention, and approach preference toward avatars of each size. Women with higher baseline BID reported significantly higher state BD in all settings compared to controls. Both groups reported significantly higher state BD in a beach with avatars as compared to other environments. In addition, women with elevated BID approached closer to normal weight avatars and looked longer at thin avatars compared to women in the control group. Our findings indicate that VR may serve as a novel tool for measuring state-level BID, with applications for measuring treatment outcomes. Implications for future research and clinical interventions are discussed.

Considering virtual reality in children’s lives

Companies are investing billions of dollars into creating virtual reality (VR) hardware and content, and millions of people have already gained access to VR technology (Solomon, 2014; Somaiya, 2015...

Immersive Virtual Reality and the Developing Child

Immersive virtual reality (IVR) pushes the limit of mediated experiences and digital representation by blocking out the physical world, and placing users directly into vivid and personal scenarios. This chapter provides an overview of IVR technology, and the way it relates to cognitive development, particularly during early childhood. We provide technological (i.e., tracking, rendering, embodiment of senses) and psychological (i.e., immersion vs. presence) definitions of IVR, and describe its unique attributes (i.e., the type of environments and the digital representation users can experience). We discuss how these unique attributes of IVR relate to topics of cognitive development such as executive functioning. Finally, we present trends in empirical research on children and IVR (i.e., areas of research, ages studied, sample sizes) and provide future research directions.

Evaluating control schemes for the third arm of an avatar

Recent research on immersive virtual environments has shown that users can not only inhabit and identify with novel avatars with novel body extensions, but also learn to control novel appendages in ways beneficial to the task at hand. But how different control schemas might affect task performance and body ownership with novel avatar appendages has yet to be explored. In this article, we discuss the design of control schemas based on the theory and practice of 3D interactions applied to novel avatar bodies. Using a within-subjects design, we compare the effects of controlling a third arm with three different control schemas (bimanual, unimanual, and head-control) on task performance, simulator sickness, presence, and user preference. Both the unimanual and the head-control were significantly faster, elicited significantly higher body ownership, and were preferred over the bimanual control schema. Participants felt that the bimanual control was significantly more difficult than the unimanual control, and elicited less appendage agency than the head-control. There were no differences in reported simulator sickness. We discuss the implications of these results for interface design.