Browsing by Author "von Ranson, Kristin"

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    A Randomized Wait-List Controlled Trial of Dialectical Behaviour Therapy Guided Self-Help for Recurrent Binge Eating: A Pilot Study
    (2012-11-19) Masson, Philip; von Ranson, Kristin
    Empirically supported treatments (ESTs) exist but are not commonly used. Guided self-help (GSH) may be one tool to increase the dissemination of ESTs. This study examined the efficacy of a GSH treatment, for individuals with either full binge eating disorder (BED) or subthreshold BED, based on dialectical behaviour therapy (DBTgsh). Sixty individuals were randomized to either a DBTgsh condition or a wait-list condition (WL) for 13 weeks. Participants (mean age 42.8 years) were recruited from media advertisements. Individuals in the DBTgsh condition received a 40-minute orientation session, a copy of the manual, and six 20-minute support calls over 13 weeks. Participants were assessed at the beginning and end of the treatment period using diagnostic items from the Eating Disorder Examination and self-report measures. Participants in the DBTgsh condition were assessed at 6 months post-treatment. At the end of treatment, DBTgsh participants, compared to WL participants, reported significantly fewer binge eating episodes (2.1 versus 12.6) and significantly greater rates of abstinence from binge eating (50.0% versus 3.7%) in the last 28 days. In addition, after 13 weeks, participants in the DBTgsh condition reported greater increases in quality of life and emotional regulation ability and significant reductions in concerns about eating, shape, and weight, the tendency to be impulsive when in a negative mood, the tendency to eat when experiencing emotions, and the expectancy that food helps emotion regulation. Dietary restraint and the tendency to be impulsive when in a positive mood did not differ between the two groups. At 6 months post-treatment, most improvements in the DBTgsh group were maintained; rates of binge eating increased, but were still significantly lower than at baseline. DBTgsh may be an effective treatment for BED.
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    Augmenting an Online Self-Directed Intervention for Gambling Disorder with a Single Motivational Interview: A Randomized Controlled Trial 3-Month Follow-Up
    (2021-08-16) Brazeau, Bradley Wayne; Hodgins, David Carson; Konnert, Candace; von Ranson, Kristin; Dimitropoulos, Georgina
    Despite the success of gold standard cognitive-behavioural therapy for problem and disordered gambling, most individuals with gambling problems do not seek or receive professional treatment. Thus, the development of less intrusive interventions has been encouraged. A two-arm randomized controlled trial was conducted. Eligible participants (N = 123) were randomly assigned to complete an online self-directed workbook either alone or in combination with a digital motivational interview completed upon enrollment. Gambling severity, frequency, and expenditures were assessed along with other mental health outcome data at baseline and 3-month follow-up time points. Participant retention (83.7%) was very high compared to similar prior trials. Gamblers in both groups experienced similar reductions across all primary and secondary outcomes, with the exception of alcohol consumption. A number of methodological limitations and theoretical explanations could account for the overall lack of differential improvement by group, including inadequate interview completion rate and short duration of intervention. Participants’ use of the online program was limited but their ratings were generally positive; they emphasized information quality as a strength and program engagement as a weakness. Given that time spent on the program and number of logins were positively associated with reductions in gambling problems, future research should examine ways to enhance online intervention engagement and uptake.
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    Body Perception and Body Dissatisfaction: A Longitudinal Examination of Body Image and Disordered Eating Symptoms
    (2023-07-24) Magel, Chantelle A.; von Ranson, Kristin; Tomfohr-Madsen, Lianne; Madigan, Sheri
    Introduction: Body size perception and attitudes towards the body (e.g., body dissatisfaction) are two distinct but interconnected components of body image. The relationship between body perceptions and disordered eating is poorly understood. The objective of this project was to examine body size perception and elucidate how it changes and relates to disordered eating behaviours and attitudes across development when compared to body dissatisfaction. Method: In three studies, we analyzed data from the Minnesota Twin Family Study (MTFS), a population-based, prospective study of 1,359 predominantly (95%) White, reared-together female twins ranging from age 10 to 33, in which participants completed assessments approximately every three to five years. Study 1 examined the psychometric properties of a scale used to measure body size perception (Body Rating Scales (BRS); Chapter 2); Study 2 investigated the developmental trajectories of body mass index (BMI) and BRS body size perception scores across the study period (Chapter 3); and Study 3 compared the degree to which BMI, BRS body size perception scores, and body dissatisfaction impacted disordered eating behaviours and attitudes over time (Chapter 4). Results: In Study 1, the psychometric properties of the BRS support its validity as a measure of body size perception in girls and women. In Study 2, participants generally selected increasingly large perceived actual body sizes and increasingly small ideal body sizes across time and development, resulting in widening discrepancies between actual and ideal body size ratings until approximately age 30. In Study 3, body perception variables (i.e., larger actual body size ratings, smaller ideal body size, and greater actual-ideal discrepancies) predicted subsequent elevated disordered eating behaviours and attitudes across time more strongly than did body dissatisfaction as measured by self-report questionnaire ratings. Conclusion: Our results suggest that the BRS is a psychometrically-sound tool that may be used to evaluate body perception quickly and easily. Further, this research advances understanding of how body perceptions and ideals change across development, and highlights their relationship with subsequent disordered eating.
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    Development of Body Image and Eating Disorder Psychopathology: Normative and Pathological Trajectories
    (2022-07-28) Lacroix, Emilie; von Ranson, Kristin; Hodgins, David; Kopala-Sibley, Daniel
    Introduction: Body image is a critical area of wellbeing that predicts many important outcomes, including eating pathology. Unfortunately, there is no consensus about what constitutes normative body image development, or how people come to develop negative body image. The objective of this project was to advance understanding of both normative and pathological trajectories of body image and eating pathology development. Method: This dissertation includes a systematic review and meta-analysis (Chapter 2), and two primary longitudinal studies (Chapters 3 and 4). The meta-analysis summarized longitudinal data from 142 samples to characterize normative mean-level change in body image among females and males between ages 6 and 54. The two primary longitudinal studies took a person-centred approach to identify the most common trajectories of body image and eating pathology, and examine their predictors in two samples: a U.S. sample of 760 female twins assessed between ages 11 and 29; and a U.K. sample of 328 girls and 429 boys assessed between ages 11 and 15. Results: The meta-analysis identified gender-moderated patterns of normative body image development: boys showed small fluctuations in overall body image with net-improvements between ages 10 and 24, whereas girls showed worsening body image between ages 10 and 16, but improvements between ages 16 and 24. Mean-level changes were largest between ages 10 and 14, and stabilized by age 24. The two primary studies identified subgroups of boys and girls who deviated considerably from normative patterns of development; pathological subgroups showed greater proneness to stress, anxiety, and negative emotionality, social difficulties, dietary restraint, and lower global self-esteem. Conclusion: These studies advance theories of body image development. First, a critical period may occur slightly earlier than previously believed. Second, girls and boys may both, on average, experience improvements in body image during emerging adulthood. Third, pluripotent transdiagnostic risk factors such as personality characteristics merit increased attention alongside sociocultural variables that specifically increase risk for eating pathology.
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    Eating Pathology and Perceptions of the Parent-Child Relationship across Adolescence: Exploring Longitudinal Associations within a Monozygotic Twin Differences Design
    (2015-07-27) Wallace, Laurel; von Ranson, Kristin
    The current study explored associations between eating pathology and the parent-child relationship (i.e., parent-child regard and involvement) across adolescence. Secondary data analyses were conducted of a population-based sample of 446 monozygotic (MZ) twins (i.e., 223 twin pairs), their mothers, and their fathers. The study used a MZ twin differences design that facilitated examination of the parent-child relationship as a nonshared environmental factor. Importantly, the MZ twin differences design has been labelled as the most powerful and direct approach for identifying nonshared environmental influences on development. Data from assessments when the twins were approximately age 11, 14, and 17 years were included. Part 1 of the study used cross-lagged models to consider longitudinal, bidirectional associations among variables, including the temporal order of variables associated across time. Specifically, analyses examined whether twin differences in mother-child and father-child relationship problems emerged as a risk factor for, or outcome of, twin differences in eating pathology; in other words, whether the twin who reported greater parent-child relationship problems later reported greater eating pathology, as compared to her co-twin, and/or vice versa. Parts 2-5 further clarified and elaborated on findings and addressed several methodological limitations of past research, including controlling for the influence of body mass index on eating pathology, examining whether findings generalized to other psychopathology, and considering multiple informants’ ratings of the parent-child relationship. Overall, longitudinal associations of twin differences in eating pathology and twin differences in the parent-child relationship were generally neither strong nor robust. However, where longitudinal associations emerged, overall patterns indicated reciprocal associations between symptoms of eating pathology and parent-child relationship variables that shifted across developmental periods. Specifically, whereas twin differences in parent-child relationship variables more commonly predicted later twin differences in eating pathology across early adolescence, twin differences in eating pathology more commonly predicted later twin differences in parent-child relationship variables across later adolescence. In particular, the twin who reported greater eating pathology later reported more negative perceptions of the father-child relationship, as compared to her co-twin. These associations between eating pathology and parent-child relationship variables were observed independent of any confounding effects of genetics or the shared environment. Findings raise questions for future research regarding parental – in particular, paternal – responses to adolescent eating pathology and suggest the potential importance of efforts to support the parent-child relationship within the context of adolescent eating pathology.
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    Effects of Online Mindfulness-Based Cancer Recovery on Cognitive Function in Cancer Survivors Undergoing Chemotherapy
    (2022-09) Flynn, Michelle Jacqueline; Campbell, Tavis; Carlson, Linda; Hodgins, David; von Ranson, Kristin
    Introduction: Cancer survivors commonly report deterioration in cognitive function during and for several years following cancer treatment, adversely affecting their quality of life. Cognitive changes in cancer survivors likely occur due a complex interaction of disease-related, treatment-related, and psychological factors. One promising intervention for alleviating disruptions in cognitive function in cancer survivors is Mindfulness-Based Cancer Recovery (MBCR). Methods: A systematic review examined the effects of mindfulness-based interventions (MBIs) on cognitive function in cancer survivors. An observational study included 38 breast and colorectal cancer survivors to investigate predictors of self-reported and objectively-assessed cognitive function before chemotherapy treatment. Finally, an intervention study including 38 breast and colorectal cancer survivors investigated the effects of participating in an online MBCR group during (immediate group) or after (waitlist group) chemotherapy treatment in self-reported and objectively-assessed cognitive function. Results: Results of the systematic review indicated significant effects on self-reported cognitive function, favouring MBIs over inactive controls (e.g., waitlist, usual care) and active controls (e.g., metacognition training, walking groups). Mixed results were reported for objectively-assessed cognitive function. Results of the observational study indicated that mood disturbance was a significant predictor of self-reported cognitive function. Objectively-assessed cognitive function was not significantly correlated with other unwanted side effects. Results of the intervention study indicated an average worsening of self-reported cognitive function from pre- to post-MBCR/post-waiting regardless of group assignment. Small to large within-person and between-group effects were observed across timepoints for objectively-assessed cognitive function. Differences in objectively-assessed cognitive function across time were not statistically significant. Conclusion: Future research is warranted to further investigate the role of MBIs in improving both self-reported and objectively-assessed cognitive function in cancer survivors undergoing treatment. In particular, there is a need for studies adequately powered to detect cognitive changes between groups over time, using a range of cognitive assessment methods, with diverse samples.
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    Examining the Short-Term Longitudinal Relationships between Emotion Regulation and Addictive Behaviors among Community Women
    (2017) Farstad, Sarah; von Ranson, Kristin; Hodgins, David; Dobson, Keith
    The purpose of this study was to compare deficits in emotion regulation that are associated with binge eating, food addiction, problem gambling, and substance abuse in order to elucidate similarities and differences between eating pathology and both behavioral addictions (i.e., gambling) and substance addictions (i.e., alcohol and drug abuse). Participants were 202 women from the community who engaged in at-risk binge eating (39%), at-risk gambling (18%), or both behaviors (43%). Participants completed online assessments every two months for six months. The baseline and six-month surveys assessed self-reported emotion dysregulation, binge eating, food addiction, gambling, and substance abuse. The abbreviated two- and four-month surveys assessed only binge eating and gambling. Study 1 compared the facets of emotion regulation that were longitudinally associated with binge eating and the only formally-recognized behavioral addiction, gambling. Emotion dysregulation was associated with increased binge eating and problem gambling but positive urgency had the opposite association to eating pathology versus gambling: higher scores on positive urgency were associated with more severe problem gambling yet slower increases in eating-related impairment over time. Study 2 compared the facets of emotion regulation that were cross-sectionally and longitudinally associated with food addiction and substance abuse. Negative urgency emerged as a common cross-sectional correlate of food addiction and substance abuse, whereas positive urgency and non-acceptance of one’s negative emotions had different associations to food addiction versus substance abuse. Positive urgency predicted increased odds of endorsing future substance abuse problems and decreased odds of endorsing future food addiction, whereas being unaccepting of one’s negative emotions was associated with more severe food addiction symptoms and less severe alcohol-related problems. Overall, these findings suggest that binge eating and food addiction are not associated with the same key deficits in emotion regulation as existing behavioral and substance addictions.
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    Fear of Cancer Recurrence Experienced by Pediatric Survivors of Childhood Cancer
    (2024-03-14) Russell, Karleen Brooke; Tomfohr-Madsen, Lianne; Schulte, Fiona; von Ranson, Kristin; Guilcher, Greg; McDonough, Meghan; Galica, Jacqueline
    Introduction: Fear of cancer recurrence (FCR) is a common and sometimes debilitating concern among survivors of cancer. While much is known about FCR experienced by adults, research exploring FCR experienced by children and adolescents has only begun to emerge. Importantly, given the dynamic development of cognitive and social factors throughout childhood, pediatric survivors may experience FCR differently than adults. Method: A scoping review was undertaken to evaluate the existing literature on pediatric FCR. Additionally, given the absence of available tools to measure pediatric FCR, the psychometric properties of an adult FCR measure, the Cancer Worry Scale, was evaluated in a pediatric sample. Results: The scoping review identified 19 studies that met inclusion criteria. FCR was explored as a primary aim in only six. The prevalence of FCR in identified samples ranged from 43% to 90%. FCR was positively associated with somatic symptoms and negatively associated with quality of life and emotional functioning. Evaluation of the Cancer Worry Scale demonstrated acceptable psychometric properties for use with youth but pointed towards the utility of developing a new FCR measure intended specifically for use with youth. Conclusion: FCR is a prevalent and important concern for this population. Additional research is needed to better characterize and understand pediatric FCR.
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    Food and Eating Addiction: Severe Forms of Uncontrolled Eating? Examining an Extension of a Continuum Model
    (2017) Lacroix, Emilie; von Ranson, Kristin; Russell-Mayhew, Michelle; Hodgins, David
    This study examined the fit of a continuum model of uncontrolled eating as extended to measures of food and eating addiction, and investigated associations of these constructs with clinical impairment. Participants were 544 adults recruited through an online crowdsourcing tool, and 358 students. We tested the fit of structural equation models depicting a continuum of uncontrolled eating, and examined relationships among self-report measures of food and eating addiction, emotional eating, power of food, binge eating, and clinical impairment. Results supported the convergent validity of food and eating addiction measures with measures of theoretically similar forms of eating pathology. Food addiction demonstrated incremental validity in explaining clinical impairment above the general uncontrolled eating factor in both samples, and was equivalently associated with all types of impairment. Eating addiction was more strongly associated with personal (i.e., emotional) impairment, but did not account for variance in impairment beyond the general uncontrolled eating factor.
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    Frequency and Predictors of Manual Use and Evidence-Based Psychological Interventions Among Clinicians Treating Eating Disorders in British Columbia
    (2023-09-21) Bajaj, Deepika; von Ranson, Kristin; McMorris, Carly; Exner-Cortens, Deinera; Birnie, Katie
    Several evidence-based psychological interventions (EBPIs) exist for eating disorders (EDs). Yet, these interventions and manuals are underutilised in clinical practice. This study described psychological interventions British Columbia (BC) clinicians used to treat EDs and examined factors associated with manual and EBPI use. Participants were recruited from a list of 1,530 potential participants created for this study by identifying clinicians listing online that they treat EDs, as well as through social media advertisement and snowball recruitment. One hundred and twenty-six community counsellors and psychotherapists providing psychological intervention to individuals with EDs across BC described their ED clients, psychological interventions used, and their training. To examine predictors of EBPI and manual use, these participants provided demographic information and completed measures of affect, intolerance of uncertainty, and attitudes toward treatment manuals. Overall, 8% of respondents indicated that they often used manuals in their clinical work. Use of EBPIs by clinicians for treatment of anorexia nervosa, bulimia nervosa, and binge eating disorder ranged from 2%-15%. Logistic regression analyses identified two factors associated with manual use included: negative attitudes toward manuals were associated with infrequent use of manuals, whereas positive attitudes toward manuals were associated with increased likelihood of manual use. Unexpectedly, logistic regression analyses did not identify any factors that significantly predicted of EBPI use. The low uptake of EBPIs for the treatment of EDs suggests that ED client may be receiving suboptimal care, highlighting the need for future work to address barriers to EBPI use. Future research should explore beyond clinician characteristics and investigate how external and intervention factors may impact the adoption and implementation of EBPIs and manuals in ED treatment.
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    Functional Outcomes after Pediatric Mild Traumatic Brain Injury
    (2018-09-11) Deighton, Stephanie; Yeates, Keith; Brooks, Brian; von Ranson, Kristin
    Although most children recover quickly after a mild traumatic brain injury (TBI), a sizeable minority suffer negative long-term consequences. Thus, the objective of this study was to investigate functional outcomes in children after mild TBI and to examine post-acute post-concussive symptoms (PCS) and neurocognitive test performance as predictors. Children, ages 8 to 16, were recruited (135 with mild TBI and 70 with orthopedic injury). Participants and their parents provided ratings of functioning at baseline, 3 and 6 months post-injury. Although groups differed in functioning shortly after injury, no differences were apparent at 3 or 6 months. Post-acute PCS were significant predictors of parent- and child-reported functioning at 3 and 6 months. Neurocognitive test performance predicted child-reported functioning (but not parent-reported) when considered independently, but did not add incrementally to prediction above PCS. The findings suggest that higher levels of PCS put children at risk for poor functioning after an injury.
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    Insomnia Treatment Preferences of Expectant Couples
    (2016) Sedov, Ivan; Tomfohr-Madsen, Lianne; Campbell, Tavis; von Ranson, Kristin; Este, David
    Client treatment preferences are recognized as a key factor in delivery of evidence based practice. The current study investigated pregnant couples’ treatment preferences for insomnia; the modalities assessed included pharmacotherapy and cognitive behavioral therapy for insomnia (CBT-I). Method: Expectant couples completed an online questionnaire asking them to read expert validated treatment descriptions of pharmacotherapy and CBT-I; they then indicated their preference and perceptions of each approach. Results: Pregnant women indicated that if they were experiencing insomnia they would prefer CBT-I to pharmacotherapy (p < .001). Women rated CBT-I as more credible and indicated stronger positive reactions to it than pharmacotherapy (p < .001). Expectant fathers indicated that they would prefer CBT-I to pharmacotherapy for both their own (p < .001) and the mother’s insomnia (p < .001). Conclusion: The current findings suggest that expectant mothers and father prefer CBT-I to pharmacotherapy as a treatment for insomnia.
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    Relationships among Negative Affect, Impulsiveness, Disordered Eating and Problem Gambling in Males and Females across the Lifespan
    (2013-09-23) Farstad, Sarah; von Ranson, Kristin
    The purpose of this study was to examine personality traits associated with disordered eating, problem gambling, and comorbid eating and gambling problems to determine whether they shared similar underlying mechanisms. Participants were 1002 adult men and women from four age cohorts recruited through random digit dialing. Participants completed self-report measures of negative affectivity, the tendency to give into strong urges, the desire for excitement, difficulty persisting on tasks, disordered eating, and gambling. Negative affectivity and tendency to give into strong urges were associated with disordered eating and gambling severity, whereas desire for excitement was only associated with gambling. Individuals with comorbid eating and gambling problems had more extreme scores on some personality traits relative to non-disordered individuals but they did not differ from those with disordered eating or problem gambling. Negative affectivity and tendency to give into strong urges may represent shared mechanisms associated with disordered eating and problem gambling.
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    The Effects of a Sad Mood Induction on Attention Disengagement from Emotional Images in Remitted and Never Depressed Women
    (2016) Korol, Stephanie; Sears, Christopher; Dobson, Keith; von Ranson, Kristin; Climie, Emma
    Research suggests that depressed individuals experience more difficulty disengaging attention from negative information (e.g., Everaert et al., 2012; Joormann & D’Avanzato, 2010; Koster, et al., 2011), although not all studies have reached this conclusion (e.g., Karparova et al., 2005; Wisco et al., 2012). In the present study, differences in attention disengagement were examined in currently, remitted, and never depressed women. Eighty participants completed an attention disengagement task while viewing emotional images. The time taken to shift their gaze away from the image was used as the measure of attention disengagement. For remitted and never depressed women, the disengagement task was completed before and after a sad mood induction (MI). Currently depressed participants were not found to disengage more slowly from negative images than never depressed participants. There was evidence that the sad MI affected disengagement for the remitted depressed participants who were most affected by the sad MI. The implications of these findings are discussed.
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    The Relationship Between Mood and Temporal Patterns of Attention as a Function of Depression Vulnerability
    (2016) Fernandez, Amanda; Sears, Christopher; Dobson, Keith; von Ranson, Kristin; McGrath, Daniel; Bulloch, Andrew
    Cognitive theories propose that individuals who experience depression may have a latent vulnerability activated during stress that predisposes them to depression (Gotlib & Joormann, 2010). Previous studies found that dysphoric individuals exhibit a negative bias in their attention, attending to negative stimuli more than never depressed individuals and to positive stimuli less (e.g., Arndt et al., 2014). Few studies have examined attention in remitted depressed individuals. The present study examined attentional biases in never depressed, remitted depressed, and dysphoric women using eye-gaze tracking. Participants experienced either a neutral or sad mood induction (MI) and then their attention to images was recorded. There were no group differences in response to the sad MI; never depressed and remitted depressed women who received the sad MI increased their attention to positive images and decreased their attention to threat-related images. The absence of group differences between never depressed and remitted depressed are discussed.
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    Weight Bias: A Systematic Review of Characteristics and Psychometric Properties of Self-Report Questionnaires
    (Karger Publishers, 2017-06-10) Lacroix, Emilie; Alberga, Angela S.; Russell-Mayhew, Shelly; McLaren, Lindsay; von Ranson, Kristin
    Background: People living with overweight and obesity often experience weight-based stigmatization. Investigations of the prevalence and correlates of weight bias and evaluation of weight bias reduction interventions depend upon psychometrically-sound measurement. Our paper is the first to comprehensively evaluate the psychometric properties, use of people-first language within items, and suitability for use with various populations of available self-report measures of weight bias. Methods: We searched five electronic databases to identify English-language self-report questionnaires of weight bias. We rated each questionnaire's psychometric properties based on initial validation reports and subsequent use, and examined item language. Results: Our systematic review identified 40 original self-report questionnaires. Most questionnaires were brief, demonstrated adequate internal consistency, and tapped key cognitive and affective dimensions of weight bias such as stereotypes and blaming. Current psychometric evidence is incomplete for many questionnaires, particularly with regard to the properties of test-retest reliability, sensitivity to change as well as discriminant and structural validity. Most questionnaires were developed prior to debate surrounding terminology preferences, and do not employ people-first language in the items administered to participants. Conclusions: We provide information and recommendations for clinicians and researchers in selecting psychometrically sound measures of weight bias for various purposes and populations, and discuss future directions to improve measurement of this construct.
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    Women's Attention as a Function of Body Dissatisfaction and Images of Thin Models: An Eye-Tracking Study
    (2015-09-28) Tobin, Leah; von Ranson, Kristin
    To gain insight into cognitive underpinnings of body dissatisfaction, we compared attentional biases in body-dissatisfied and body-satisfied women, as well as the influence of thin media images on attention. Women (42 body-dissatisfied and 40 body-satisfied) completed a paradigm measuring attention to fat- and thin-related words via eye gaze, both before and after exposure to images of thin models. Participants self-reported on height, weight, and body dissatisfaction. Body-dissatisfied women paid more attention to weight words (both fat and thin) than body-satisfied women. Exposure to thin model images did not affect attention to weight words. Body mass index was related to attention to fat words only prior to image exposure. Our findings suggest that body-dissatisfied women display an attentional bias to weight words but not in the direction predicted by the cognitive model of eating disorders, and that brief exposures to models do not affect the attentional biases.