Sarah M. Bankoff

A Systematic Review of Dialectical Behavior Therapy for the Treatment of Eating Disorders

Dialectical behavior therapy (DBT) has been proposed as an effective treatment for eating disorders (EDs). We conducted a systematic literature review to locate refereed journal articles testing DBT for the treatment of EDs. We identified 13 studies empirically evaluating treatment efficacy across various settings. Findings, based on mostly uncontrolled trials, indicate that DBT treatments appear effective in addressing ED behaviors and other forms of psychopathology in ED samples. The expectation that improvements in emotion regulation capabilities drive reductions in ED pathology was not fully supported. Further research is necessary to confirm the efficacy of modified DBT treatments for EDs.

The use of dialectical behavior therapy skills training as stand-alone treatment: a systematic review of the treatment outcome literature.

OBJECTIVE Dialectical behavior therapy (DBT) skills training is currently being administered as stand-alone treatment across a variety of clinical settings, serving diverse client populations. However, there is little empirical support for this use. METHOD In this systematic review, we identified 17 trials employing a treatment that included DBT skills training in the absence of the other DBT modalities. RESULTS While the literature reviewed provides preliminary evidence of the utility of DBT skills training to address a range of mental health and behavioral problems, methodological limitations of published studies preclude us from drawing strong conclusions about the efficacy of skills training as a stand-alone treatment. CONCLUSION We present an overview of the implementation of DBT skills training across clinical settings and populations. We found preliminary evidence supporting the use of DBT skills training as a method of addressing a range of behaviors. We provide recommendations for future research.

Patient–provider relationship predicts mental and physical health indicators for HIV-positive men who have sex with men

We used secondary data analysis to examine associations among aspects of patient–provider relationships and mental and physical health indicators. Positive patient perceptions of patient–provider relationships were associated with fewer mental health symptoms in this outpatient sample of HIV-positive men who have sex with men (N = 171). Regression analyses revealed the role of anxiety and depression in explaining associations between two aspects of patient–provider relationships (i.e. quality of information offered and provider interactional style) and health-related quality of life. The findings demonstrated the importance of patient–provider relationships to improving physical health and functioning and maintaining engagement in care, among HIV-positive men who have sex with men.

Psychosocial correlates of HIV-monoinfection and HIV/HCV-coinfection among men who have sex with men

Rates of hepatitis C virus (HCV) among HIV-positive men who have sex with men (MSM) appear to be high and rising. In other demographic groups, HIV/HCV-coinfection is associated with poor physical and psychological outcomes. In this study, we examined health-related and psychosocial correlates of HIV/HCV-coinfection in a clinic sample of MSM. Cross-sectional data were collected from 171 MSM. One-third of the sample was coinfected. Higher rates of depressive and PTSD symptoms were observed in coinfected patients. Coinfected men were more likely to report perfect 30-day medication adherence, but exhibited lower CD4 cell counts and more past year emergency room visits. Despite consistent engagement with care and higher rates of medication adherence, HIV/HCV-coinfected MSM exhibited significantly more mental health problems. Medical and mental health providers should be especially attentive to the mental health status of HIV/HCV-coinfected MSM, despite adequate health behaviors and physical health status.

Patterns of Disordered Eating Behavior in Women by Sexual Orientation: A Review of the Literature

Most disordered eating research has focused on White, heterosexual women. More empirical work is needed to better understand disordered eating among women of diverse backgrounds. Given evidence of disparities between heterosexual and sexual minority (i.e., non-heterosexual) women in other health behaviors (e.g., tobacco use) and outcomes (e.g., cardiovascular disease), it appears important to study disordered eating behaviors among sexual minority women. In this article, we review the extant literature on disordered eating behaviors in women across sexual orientations, with a focus on research examining potential mechanisms of disparities in disordered eating, including awareness and internalization of sociocultural norms.

Finding Meaning after Same-Sex Partner Abuse: A Content Analysis of Experiences of Men with HIV

Given the high rates of partner abuse (PA) among sexual minority men with HIV, it is surprising that this phenomenon remains largely understudied in this group. The extant literature reveals little about the lived experiences of the men who experience abuse in their primary relationships. Furthermore, the role of meaning making in recovery from PA remains unclear for any demographic group. Knowledge of such appraisals may provide insight into the ways that sexual minority men with HIV understand or assign value to their abuse experiences. Here, we aim to qualitatively explore the ways in which such men (N = 28) find meaning following their experiences of PA. In general, most men reported a sense of personal strength from having endured and survived PA. Surprisingly, the men did not link their postabuse recovery experiences to their sexual minority identity nor to their HIV status. Some men mentioned an increased sense of agency and attention to their own needs in their postabuse lives. With the exception of positive relationships with providers, the men described little use of peer or family support and ongoing social isolation.

Older Adults' Memory for Verbally Presented Medical Information

Previous research demonstrates that patients typically have difficulty remembering information presented during healthcare consultations. This study examined how older adults learn and remember verbally presented medical information. Healthy older adults were tested for recall in experimental and field settings. Participants viewed a five-minute video of a simulated healthcare consultation and completed free recall, cued recall, and recognition memory tasks. Differences in performance were observed between older and younger adults in the experimental condition on all memory tasks and in the field condition on the cued recall task; older adults tended to remember less information than younger adults. Though older adults had difficulty spontaneously recalling medical information, they were able to take advantage of cues to access verbally learned information. Findings of this study highlight the importance of developing and implementing measures to maximize the abilities of older adults to learn and remember important medical information communicated by healthcare providers.

Examining weight and eating behavior by sexual orientation in a sample of male veterans

OBJECTIVE Eating disorders are understudied in men and in sexual minority populations; however, extant evidence suggests that gay men have higher rates of disordered eating than heterosexual men. The present study examined the associations between sexual orientation, body mass index (BMI), disordered eating behaviors, and food addiction in a sample of male veterans. METHOD Participants included 642 male veterans from the Knowledge Networks-GfK Research Panel. They were randomly selected from a larger study based on previously reported trauma exposure; 96% identified as heterosexual. Measures included the Eating Disorder Diagnostic Scale, the Yale Food Addiction Scale, and self-reported height and weight. RESULTS Heterosexual and sexual minority men did not differ significantly in terms of BMI. However, gay and bisexual men (n=24) endorsed significantly greater eating disorder symptoms and food addiction compared to heterosexual men. CONCLUSIONS Our findings that sexual minority male veterans may be more likely to experience eating disorder and food addiction symptoms compared to heterosexual male veterans highlight the importance of prevention, assessment, and treatment efforts targeted to this population.

Why does it happen? Explanations for men’s violence against women by women with interpersonal victimization histories

Abstract Men’s violence against women (MVAW) has been identified as a critical sociocultural problem. Gaining a better understanding of perspectives on the etiology of violence held by women with histories of male-perpetrated interpersonal violence provides insight into the processes of victimization and recovery. Furthermore, emerging research suggests that feminist beliefs may facilitate recovery and impact how survivors of MVAW perceive it. In this study, we aimed to explore, in women with histories of interpersonal violence, (1) the ways they explained the high prevalence of MVAW and (2) associations between the strength of their feminist beliefs and the participants’ explanations. Female college students (N = 32, ages 18–22) participated in qualitative interviews in which they were first presented with published statistics about the frequency of MVAW, then asked to provide explanations for the high prevalence of this phenomenon. Individual responses clustered into one or more of four factors: (1) societal influences, (2) blaming women, (3) familial influences, and (4) characteristics of men and women. The extent to which participants identified with feminist beliefs was associated with how they perceived their own victimization. Women who endorsed strong feminist beliefs more frequently cited societal influences on MVAW, whereas women who endorsed feminist beliefs less strongly were more likely to blame women for it and offered stereotypical views of women as passive and fragile.

Examining Associations of Sexual Attraction and Attitudes on Women's Disordered Eating Behavior

OBJECTIVE We aimed to expand the scant research on disordered eating in women identifying same-sex sexual attractions. METHOD We used multiple linear regressions to explore potential mechanisms driving disordered eating--both explicit and implicit weight bias and heterosexism--in a cross-sectional, online-recruited community sample of women (N = 437). Participants endorsed a range of sexual attractions from exclusively opposite-sex (21.1%) to exclusively same-sex (19.5%) attraction. RESULTS Findings revealed no associations between sexual attraction and disordered eating. Awareness of sociocultural norms valuing thinness accounted for disordered eating for all women, regardless of sexual attraction, and was influenced by attitudes regarding weight. Among women endorsing same-sex attractions, self-reported internalized heterosexism influenced disordered eating. DISCUSSION Findings contradict long-held beliefs that same-sex attracted women are protected from disordered eating. They emphasize a universal risk, for all women, of sociocultural norms valuing thinness, as well as the risk of internalized heterosexism among same-sex attracted women.