Villeneuve - Presentation Week 9

Understanding Recovery Trajectories in Adolescents with Bulimia Nervosa

Ella Villeneuve

How effectively does the proposed study measure the constructs of family support and recovery outcomes?

Does the longitudinal design appropriately address the research questions and hypotheses? Would an alternative design (e.g., cross-sectional) offer any advantages in terms of capturing immediate recovery impacts?

Questions I'm Looking For

Are the chosen measures for treatment access (NHQDR), family support (Family Support Scale), and recovery outcomes (EDE-Q 6.0) appropriate for this adolescent population? Is there a need for additional measures?

Gap in Knowledge: Despite existing literature, there is a lack of understanding regarding how family support and treatment access interact within the context of socioeconomic disparities, particularly their impact on recovery trajectories in high school women.

Overview of my topic

Longitudinal Study Design

Prevalence of Eating Disorders: The rising prevalence of eating disorders among adolescents, particularly bulimia nervosa (BA), is a significant public health concern (Rienecke et al., 2016). BA is characterized by recurrent binge eating followed by purging, affecting the psychological and physical well-being of young women, who are the most affected demographic (McLean et al., 2014). Impact of Socioeconomic Status: Research indicates that lower-income individuals often face substantial barriers in accessing adequate mental health treatment, which can complicate recovery from BA (Castaldelli-Maia & Bhugra, 2022). In contrast, findings suggest that adolescents from higher SES backgrounds may experience increased risk for developing eating disorders, which challenges traditional views on the relationship between SES and mental health (Koch et al., 2022).

Research Question and Hypothesis for Study 1

Research Question

How does socioeconomic status affect the recovery trajectory of high school women diagnosed with bulimia nervosa?

Hypothesis

High school women from low-income households will experience a slower and more difficult recovery from bulimia nervosa compared to their peers from high-income households. This hypothesis is based on the expectation that lower SES may lead to reduced access to resources and support critical for recovery.

+ INFO

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Measurement Validity and Reliability: Each instrument has established psychometric properties, ensuring that the measures used are both reliable (consistent results across time) and valid (accurately measuring the constructs of interest).

Operationalization: The use of standardized questionnaires ensures the constructs of family support and recovery outcomes are measured reliably and validly. These tools have been validated in similar populations.

dependent

Independent

Variables:

Study 1 Methods

Participants: The study aims to recruit a total of 200 high school women across the country aged 14-18 diagnosed with bulimia nervosa according to the DSM-5/psychiatric diagnosis. The sample will be evenly split between those from low-income households (below average yearly income) and high-income households (well above average yearly income). This population is chosen to specifically examine the impact of socioeconomic disparities on recovery outcomes. Participants will be chosen from surveys/outpatient programs with informed consent given. Participants with personality disorders and other mental disorders will not be included.

Access to Enhanced Treatment

Assessed using the National Healthcare Quality and Disparities Report (NHQDR) to identify barriers to treatment.

Family Support

Measured through the Family Support Scale (FSS) by Durnst (1984), which evaluates perceived support across 13 categories.

Recovery Outcomes

Measured using the Eating Disorder Examination Questionnaire (EDE-Q 6.0), which assesses the severity of eating disorder symptoms.

Procedure and design

Procedure: Participants will be recruited via flyers and surveys distributed in local high schools, community centers, and through outpatient mental health clinics. Informed consent will be obtained from both participants and their guardians prior to data collection. Participants will complete the surveys in a controlled environment to ensure privacy, with assessments conducted every two months over a four-year period to monitor recovery trajectories.Design: The study will be a non-experimental, longitudinal design, allowing for the assessment of changes in recovery outcomes over time. This design is particularly suited for understanding the dynamics of recovery in relation to family support and treatment access.

Pearson Correlation: This will be used to assess the strength and direction of the relationships between treatment access, family support, and recovery outcomes across the entire sample.Two-Way ANOVA: This will analyze the impact of family support on recovery outcomes, comparing low and high SES groups under varying levels of family support (low, medium, high). This approach will determine if the effects of family support significantly differ between the two socioeconomic groups.

Data Analysis

Castaldelli-Maia, J. M., & Bhugra, D. (2022). Analysis of global prevalence of mental and substance use disorders within countries: Focus on sociodemographic characteristics and income levels. International Review of Psychiatry, 34(1), 6–15. https://doi-org.ezproxy./10.1080/09540261.2022.2040450 Koch, S. V., Larsen, J. T., Plessen, K. J., Thornton, L. M., Bulik, C. M., & Petersen, L. V. (2022). Associations between parental socioeconomic‐, family‐, and sibling status and risk of eating disorders in offspring in a Danish national female cohort. International Journal of Eating Disorders, 55(8), 1130–1142. https://doi-org.ezproxy./10.1002/eat.23771 McLean, S. A., Paxton, S. J., Massey, R., Hay, P. J., Mond, J. M., & Rodgers, B. (2014). Stigmatizing attitudes and beliefs about bulimia nervosa: Gender, age, education and income variability in a community sample. International Journal of Eating Disorders, 47(4), 353–361. https://doi-org.ezproxy./10.1002/eat.22227 Rienecke, R. D., Sim, L., Lock, J., & Le Grange, D. (2016). Patterns of expressed emotion in adolescent eating disorders. Journal of Child Psychology and Psychiatry, 57(12), 1407–1413. https://doi-org.ezproxy./10.1111/jcpp.12594

References

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You can present the figures this way...

Pose a dramatic question; it is the essential ingredient for keeping the audience's attention. It is usually posed subtly at the beginning of the story to intrigue the audience and is resolved at the end.

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Even if you explain it orally later

Pose a dramatic question; it is the essential ingredient for keeping the audience's attention. It is often posed subtly at the beginning of the story to intrigue the audience and is resolved at the end.