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  1. Article ; Online: The Impact of COVID-19 on Health Behavior Engagement and Psychological and Physical Health Among Active Duty Military Enrolled in a Weight Management Intervention: An Exploratory Study.

    Morse, Jessica L / Wooldridge, Jennalee S / Herbert, Matthew S / Afari, Niloofar

    Military medicine

    2024  

    Abstract: Introduction: The COVID-19 pandemic profoundly affected the health and well-being of people globally. Some studies suggest individuals with overweight or obesity may have been more adversely impacted by pandemic restrictions. Additionally, military ... ...

    Abstract Introduction: The COVID-19 pandemic profoundly affected the health and well-being of people globally. Some studies suggest individuals with overweight or obesity may have been more adversely impacted by pandemic restrictions. Additionally, military personnel may have been more vulnerable to stress during the pandemic because of job demands (e.g., work in close quarters). Our research group was conducting a randomized clinical trial of a weight management intervention in active duty military personnel with overweight or obesity when the COVID-19 pandemic struck. Thus, we collected additional pandemic-related data from participants enrolled during the COVID-19 pandemic and conducted exploratory analyses to understand how the pandemic affected their stress levels and perceived abilities to engage in health behaviors like exercise and healthy eating. The aims of this exploratory study were to: (1) assess associations between pandemic-related stress and health behaviors with body fat percentage (BF%) and psychological and physical health, and (2) explore how pandemic-related stress and health behaviors affected BF% during and after the intervention.
    Materials and methods: A total of 29 active duty Navy personnel (55% female, 69% White) were enrolled after the onset of pandemic restrictions and completed measures assessing pandemic-related stress and health behaviors as well as measures of general psychological and physical health before the intervention. BF% was collected at 5 timepoints, including baseline, during, and following the intervention. Bivariate correlations assessed associations at baseline. Linearmixed-effects longitudinal models explored how pandemic-related stress and health behaviors affected BF%. Post-hoc analyses evaluated the effects of pandemic factors on BF% at each timepoint.
    Results: Most participants perceived of the pandemic as increasing stress and detracting from their abilities to engage in health behaviors (i.e., exercise and healthy eating). Higher pandemic stress was significantly associated with reporting exercise and healthy eating as more difficult, worse overall health, and more anxiety and general stress. Reporting exercise as harder during the pandemic also was associated with more psychological distress at baseline. A linearmixed- effects model controlling for age, sex, and number of intervention sessions attended revealed endorsing "exercise as harder" was associated with higher BF%. Post-hoc regression analyses revealed rating "exercise as harder" significantly predicted higher BF% 3 months post-intervention (B = 0.65, P = .01), whereas pandemic stress was not significantly associated with higher BF% at 3 month (B =0.14, P = .08) or 6 month (B = 0.21, P = .09) follow-up.
    Conclusions: As expected, most participants perceived of the pandemic as heightening stress and interfering with engagement in health behaviors. It is possible that pandemic-related stress may have exacerbated weight gain-promoting behaviors and/or interfered with achievement of desired weight management outcomes. Outside the context of the pandemic, it may be beneficial for healthcare providers to screen individuals for stress and perceptions of ease of engagement in health behaviors before enrollment in a weight management intervention. Further, tailoring interventions to mitigate stress and promote perceptions of ease in engaging in health behaviors may promote better weight management outcomes.
    Language English
    Publishing date 2024-03-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 391061-1
    ISSN 1930-613X ; 0026-4075
    ISSN (online) 1930-613X
    ISSN 0026-4075
    DOI 10.1093/milmed/usae092
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  2. Article ; Online: Psychometric validation of the celiac disease-specific quality of life survey (CD-QOL) in adults with celiac disease in the United States.

    Dochat, Cara / Afari, Niloofar / Arigo, Danielle

    Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation

    2023  Volume 32, Issue 8, Page(s) 2195–2208

    Abstract: Purpose: Celiac disease and its treatment negatively impact quality of life, indicating potential need for measurement of disease-specific quality of life domains to inform interdisciplinary intervention. The Celiac Disease Quality of Life Survey (CD- ... ...

    Abstract Purpose: Celiac disease and its treatment negatively impact quality of life, indicating potential need for measurement of disease-specific quality of life domains to inform interdisciplinary intervention. The Celiac Disease Quality of Life Survey (CD-QOL) has been used in clinical research; however, its factor structure has not been confirmed and psychometric properties have not been evaluated in English-speaking adults in the U.S.
    Aims: (1) Confirm the factor structure of the 20-item English CD-QOL; (2) assess psychometric properties including internal consistency reliability, convergent validity, known groups validity, and incremental validity.
    Methods: 453 adults with self-reported Celiac disease (M
    Results: Confirmatory factor analysis found superior fit for a bifactor structure with one general factor and four group factors. Ancillary bifactor analyses suggest the CD-QOL can be considered primarily unidimensional. Total and three subscale scores demonstrated acceptable internal consistency reliability. Convergent and known groups validity were supported. The CD-QOL demonstrated some incremental validity over the SF-36.
    Conclusion: The English CD-QOL can be used as a measure of disease-specific quality of life among adults with Celiac disease in the U.S. Compared to generic instruments, the CD-QOL appears to better capture specific cognitive and affective aspects of living with Celiac disease. Use of a total score is recommended. Its utility as a screening and outcome measurement tool in clinical settings should be examined.
    MeSH term(s) Adult ; Humans ; Female ; Male ; Quality of Life/psychology ; Celiac Disease/psychology ; Psychometrics ; Reproducibility of Results ; Surveys and Questionnaires
    Language English
    Publishing date 2023-03-16
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1161148-0
    ISSN 1573-2649 ; 0962-9343
    ISSN (online) 1573-2649
    ISSN 0962-9343
    DOI 10.1007/s11136-023-03380-7
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  3. Article ; Online: Celiac disease symptom profiles and their relationship to gluten-free diet adherence, mental health, and quality of life.

    Dochat, Cara / Afari, Niloofar / Satherley, Rose-Marie / Coburn, Shayna / McBeth, Julia F

    BMC gastroenterology

    2024  Volume 24, Issue 1, Page(s) 9

    Abstract: Background: A subgroup of adults with celiac disease experience persistent gastrointestinal and extraintestinal symptoms, which vary between individuals and the cause(s) for which are often unclear.: Methods: The present observational study sought to ...

    Abstract Background: A subgroup of adults with celiac disease experience persistent gastrointestinal and extraintestinal symptoms, which vary between individuals and the cause(s) for which are often unclear.
    Methods: The present observational study sought to elucidate patterns of persistent symptoms and the relationship between those patterns and gluten-free diet adherence, psychiatric symptoms, and various aspects of quality of life (QOL) in an online sample of adults with celiac disease. U.S. adults with self-reported, biopsy-confirmed celiac disease (N = 523; Mage = 40.3 years; 88% women; 93.5% White) voluntarily completed questionnaires as part of the iCureCeliac® research network: (a) Celiac Symptoms Index (CSI) for physical symptoms and subjective health; (b) Celiac Dietary Adherence Test for gluten-free diet adherence; (c) PROMIS-29, SF-36, and Celiac Disease Quality of Life Survey for psychiatric symptoms and QOL. Symptom profiles were derived using latent profile analysis and profile differences were examined using auxiliary analyses.
    Results: Latent profile analysis of CSI items determined a four-profile solution fit best. Profiles were characterized by: (1) little to no symptoms and excellent subjective health (37% of sample); (2) infrequent symptoms and good subjective health (33%); (3) occasional symptoms and fair to poor subjective health (24%); (4) frequent to constant symptoms and fair to poor subjective health (6%). Profiles 2 and 3 reported moderate overall symptomology though Profile 2 reported relatively greater extraintestinal symptoms and Profile 3 reported relatively greater gastrointestinal symptoms, physical pain, and worse subjective health. Profiles differed on anxiety and depression symptoms, limitations due to physical and emotional health, social functioning, and sleep, but not clinical characteristics, gluten-free diet adherence, or QOL. Despite Profile 3's moderate symptom burden and low subjective health as reported on the CSI, Profile 3 reported the lowest psychiatric symptoms and highest quality of life on standardized measures.
    Conclusions: Adults with celiac disease reported variable patterns of persistent symptoms, symptom severity, and subjective health. Lack of profile differences in gluten-free diet adherence suggests that adjunctive dietary or medical assessment and intervention may be warranted. Lower persistent symptom burden did not necessarily translate to better mental health and QOL, suggesting that behavioral intervention may be helpful even for those with lower celiac symptom burden.
    MeSH term(s) Adult ; Humans ; Female ; Male ; Celiac Disease/diagnosis ; Quality of Life ; Diet, Gluten-Free ; Mental Health ; Surveys and Questionnaires ; Patient Compliance
    Language English
    Publishing date 2024-01-02
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 2041351-8
    ISSN 1471-230X ; 1471-230X
    ISSN (online) 1471-230X
    ISSN 1471-230X
    DOI 10.1186/s12876-023-03101-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Migraine Prevalence, Environmental Risk, and Comorbidities in Men and Women Veterans.

    Gasperi, Marianna / Schuster, Nathaniel M / Franklin, Brooke / Nievergelt, Caroline M / Stein, Murray B / Afari, Niloofar

    JAMA network open

    2024  Volume 7, Issue 3, Page(s) e242299

    Abstract: Importance: Migraine is a prevalent and debilitating condition that substantially impacts quality of life. Investigating migraine prevalence, associated comorbidities, and potential military service exposures in veterans, focusing on gender differences, ...

    Abstract Importance: Migraine is a prevalent and debilitating condition that substantially impacts quality of life. Investigating migraine prevalence, associated comorbidities, and potential military service exposures in veterans, focusing on gender differences, is crucial for targeted interventions and management strategies.
    Objective: To determine the prevalence of migraine, associated health comorbidities, and potential military service and environmental exposures among men and women US veterans using a large-scale epidemiological sample from the Million Veteran Program (MVP).
    Design, setting, and participants: This cross-sectional study analyzed self-report survey data from the MVP, a large epidemiological sample of US veterans that was started in 2011 and has ongoing enrollment. Eligible participants were selected from the MVP database in 2023. The study included 491 604 veterans to examine migraine prevalence, health comorbidities, demographic characteristics, military service history, and environmental exposures. Data were analyzed from December 2022 to July 2023.
    Exposures: Military service and environmental factors, such as chemical or biological warfare exposure, were considered.
    Main outcomes and measures: The primary outcome was migraine prevalence among men and women veterans, assessed through self-reported diagnoses. Secondary outcomes included the association between migraine and health comorbidities, demographic characteristics, military service history, and environmental exposures.
    Results: Of the 491 604 veterans included in this study, 450 625 (91.8%) were men and 40 979 (8.2%) were women. The lifetime prevalence of migraine was significantly higher in women (12 324 of 40 979 [30.1%]) than in men (36 816 of 450 625 [8.2%]). Migraine prevalence varied by race and ethnicity, with the highest prevalence in Hispanic or Latinx women (1213 of 3495 [34.7%]). Veterans with migraine reported worse general health, higher levels of pain, increased pain interference with work, a higher likelihood of psychiatric and neurological health conditions, and greater lifetime opioid use. Specific aspects of military service, including service post-September 2001 and deployment in Operation Enduring Freedom and Operation Iraqi Freedom, and environmental factors, including Agent Orange, chemical and biological welfare, and antinerve agent pills history, were significantly associated with migraine prevalence.
    Conclusions and relevance: In this cross-sectional study of migraine, the results highlighted gender differences in migraine prevalence and associated health comorbidities among US veterans. The findings emphasized the need for interdisciplinary approaches to migraine management, increased awareness and education efforts, and population-based screening strategies, particularly for women and Hispanic veterans who are at greater risk. Our findings encourage further research into tailored interventions for specific subpopulations and the impact of military service and environmental exposures on migraine and related health conditions.
    MeSH term(s) Male ; Humans ; Female ; Veterans ; Cross-Sectional Studies ; Prevalence ; Quality of Life ; Migraine Disorders/epidemiology ; Pain
    Language English
    Publishing date 2024-03-04
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2024.2299
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Symptoms of major depressive disorder and post-traumatic stress disorder in veterans with mild traumatic brain injury: A network analysis.

    Shi, Shuyuan / Almklov, Erin / Afari, Niloofar / Pittman, James O E

    PloS one

    2023  Volume 18, Issue 5, Page(s) e0283101

    Abstract: Mild Traumatic Brain Injury (mTBI, or concussion) is a debilitating condition that often leads to persistent cognitive and mental health problems post-injury. Post-traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) are two most commonly ...

    Abstract Mild Traumatic Brain Injury (mTBI, or concussion) is a debilitating condition that often leads to persistent cognitive and mental health problems post-injury. Post-traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) are two most commonly occurring mental health problems following mTBI and are suggested to be strong contributors to the persistent post-concussion symptoms. Thus, it is important to understand the symptomatology of PTSD and MDD post-mTBI, to better inform targets for behavioral health interventions. Therefore, the current study examined the symptom structure of post-mTBI co-morbid PTSD and MDD through network approaches; we compared the network structure of participants with a positive mTBI screen (N = 753) to the network structure of participants with a negative mTBI screen (N = 2044); lastly, we examined a network of PTSD and MDD symptoms with clinical covariates in a positive mTBI sample. We found that feeling distant/cutoff (P10) and difficulty concentrating (P15) were the most central symptoms in the positive mTBI network and sleep problems were the most prominent bridge nodes across the disorders. No significant difference between the positive and negative mTBI network were found through network comparison tests. Moreover, anxiety and insomnia were strongly associated with sleep symptoms and irritability symptoms, and emotional support and resilience were potential buffers against most of the PTSD and MDD symptoms. The results of this study might be particularly useful for identifying targets (i.e., feeling distant, concentration and sleep problems) for screening, monitoring and treatment after concussion to better inform post-mTBI mental health care and to improve treatment outcomes.
    MeSH term(s) Humans ; Brain Concussion/complications ; Brain Concussion/epidemiology ; Brain Concussion/psychology ; Stress Disorders, Post-Traumatic/complications ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/psychology ; Veterans/psychology ; Depressive Disorder, Major/complications ; Depressive Disorder, Major/epidemiology ; Sleep Initiation and Maintenance Disorders/complications ; Sleep Initiation and Maintenance Disorders/epidemiology
    Language English
    Publishing date 2023-05-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0283101
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Daily Functioning of Veterans With Type 2 Diabetes: Protocol for an Ambulatory Assessment Study.

    Wooldridge, Jennalee S / Morse, Jessica L / Delgado, Jorge / Afari, Niloofar

    JMIR research protocols

    2023  Volume 12, Page(s) e53874

    Abstract: Background: Diabetes impacts nearly 25% of veterans. Many veterans do not engage in recommended physical activity and other diabetes self-management behaviors. Type 2 diabetes is generally asymptomatic; as such, the long-term consequences of inadequate ... ...

    Abstract Background: Diabetes impacts nearly 25% of veterans. Many veterans do not engage in recommended physical activity and other diabetes self-management behaviors. Type 2 diabetes is generally asymptomatic; as such, the long-term consequences of inadequate self-management and benefits of consistent self-management are not salient in the short term. Furthermore, self-management behaviors typically take place outside of medical visits; however, self-management-related factors are only assessed during medical visits, likely missing large amounts of variability. Thus, ambulatory assessment methods such as ecological momentary assessment (EMA), accelerometry, and continuous glucose monitoring are needed to understand the dynamics of daily self-management and identify potential intervention targets.
    Objective: The overarching goal of this study is to understand daily, time-varying factors (comorbid affective symptoms and social context) that influence physical activity, diabetes self-management, glycemic management, daily functioning, and quality of life in participants' natural environments.
    Methods: We are recruiting veterans with type 2 diabetes (target N=100). Participants are required to complete a battery of baseline assessments related to mental health, psychosocial factors, and self-management behaviors. Participants then receive 5 momentary EMA surveys and 1 daily EMA survey per day, in which veterans report comorbid affective symptoms (mood, stress, and pain), social support, social interactions, physical activity, and other self-management behaviors. Momentary surveys are delivered randomly during daily preprogrammed intervals over a 14-day sampling period. Accelerometry and continuous glucose monitoring are also used to assess physical activity and blood glucose, respectively. The first 6 participants also completed interviews assessing their experience in the study and barriers to participation. These test participants informed modifications to the protocol for the remaining participants.
    Results: The project received funding in April of 2023. Enrollment began in March of 2023 and is planned to be completed in April 2025. Among the 6 test participants, the overall EMA response rate was 87% (range 74%-95%). The response rate for the EMA survey including daily items (67%, range 21%-93%) was lower than the earlier shorter EMA surveys (89%, range 81%-96%). The mean rate of valid accelerometer wear of at least 20 hours per day was 93% (SD 11%), and continuous glucose monitoring data were available for 91% (SD 17%) of days on average. Participants reported few barriers to completing EMA surveys but noted the random timing of questions made it difficult to plan around, and the end-of-day survey was long. Two participants reported survey items reminded or motivated them to engage in diabetes self-management behaviors.
    Conclusions: Assessment tools developed from this study can inform clinical decision-making by considering barriers to self-management that occur in daily life. Clinical applications include tailored, adaptive technology-supported interventions to improve self-management that provide the right type and amount of support at the right time by adapting to an individual's changing internal and contextual state.
    International registered report identifier (irrid): DERR1-10.2196/53874.
    Language English
    Publishing date 2023-11-20
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2719222-2
    ISSN 1929-0748
    ISSN 1929-0748
    DOI 10.2196/53874
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Book: Metaphern und Übungen für die ACT-Arbeit

    Stoddard, Jill A. / Afari, Niloofar / Hayes, Steven C. / Kierdorf, Theo / Höhr, Hildegard

    Materialien für Therapeuten

    (www.gp-probst.de ; No. 25)

    2016  

    Author's details Jill A. Stoddard, Niloofar Afari ; mit einem Vorwort von Steven C. Hayes ; aus dem amerikanischen Englisch von Theo Kierdorf & Hildegard Höhr
    Series title www.gp-probst.de ; No. 25
    G. P. Probst
    Collection G. P. Probst
    Keywords Metaphor ; Acceptance and Commitment Therapy ; Mindfulness ; ACT ; Acceptance-and-Commitment-Therapie ; Achtsamkeitspsychologie ; Akzeptieren, Bereitschaft und das Kontrollbedürfnis als Problem ; Gewahrsein des gegenwärtigen Augenblicks ; Metaphern ; Selbst als Kontext ; Umgehen sprachlicher Fallen durch erlebensbasierte Arbeit ; Werte ; engagiertes Handeln ; kognitive Defusion ; Akzeptanz- und Commitment Therapie ; Metapher ; Übung
    Subject Üben ; Übungen ; Metaphorik ; Metaphern ; Acceptance and Commitment Therapy ; ACT
    Subject code 616.891425
    Language German
    Size 238 Seiten, 24 cm, 483 g
    Publisher G.P. Probst Verlag
    Publishing place Lichtenau/Westfalen
    Publishing country Germany
    Document type Book
    HBZ-ID HT018914883
    ISBN 978-3-944476-15-5 ; 3-944476-15-8
    Database Catalogue ZB MED Medicine, Health

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  8. Article ; Online: Design of the CHARGE study: A randomized control trial evaluating a novel treatment for Veterans with binge eating disorder and overweight and obesity.

    Boutelle, Kerri N / Afari, Niloofar / Obayashi, Saori / Eichen, Dawn M / Strong, David R / Peterson, Carol B

    Contemporary clinical trials

    2023  Volume 130, Page(s) 107234

    Abstract: A large number of Veterans experience binge eating and overweight or obesity, which are associated with significant health and psychological consequences. The gold-standard program for the treatment of binge eating, Cognitive Behavioral Therapy (CBT), ... ...

    Abstract A large number of Veterans experience binge eating and overweight or obesity, which are associated with significant health and psychological consequences. The gold-standard program for the treatment of binge eating, Cognitive Behavioral Therapy (CBT), results in decreases in binge eating frequency but does not result in significant weight loss. We developed the Regulation of Cues (ROC) program to reduce overeating and binge eating through improvement in sensitivity to appetitive cues and decreased responsivity to external cues, an approach that has never been tested among Veterans. In this study, we combined ROC with energy restriction recommendations from behavioral weight loss (ROC+). This study is a 2-arm randomized controlled trial designed to evaluate the feasibility and acceptability of ROC+, and to compare the efficacy of ROC+ and CBT on reduction of binge eating, weight, and energy intake over 5-months of treatment and 6-month follow-up. Study recruitment completed in March 2022. One hundred and twenty-nine Veterans were randomized (mean age = 47.10 (sd = 11.3) years; 41% female, mean BMI = 34.8 (sd = 4.7); 33% Hispanic) and assessments were conducted at baseline, during treatment and at post-treatment. The final 6-month follow-ups will be completed in April 2023. Targeting novel mechanisms including sensitivity to internal cures and responsivity to external cues is critically important to improve binge eating and weight-loss programs among Veterans. Clinicaltrials.govNCT03678766.
    MeSH term(s) Humans ; Female ; Middle Aged ; Male ; Overweight/therapy ; Binge-Eating Disorder ; Veterans ; Treatment Outcome ; Obesity/therapy ; Bulimia ; Weight Loss
    Language English
    Publishing date 2023-05-19
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, Non-U.S. Gov't
    ZDB-ID 2182176-8
    ISSN 1559-2030 ; 1551-7144
    ISSN (online) 1559-2030
    ISSN 1551-7144
    DOI 10.1016/j.cct.2023.107234
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  9. Article ; Online: Associations Among Stress, Internalized Weight Stigma, Emotional Eating, and Body Composition in Active-Duty Service Members Enrolling in a Randomized Controlled Trial of a Weight Management Program.

    Morse, Jessica L / Wooldridge, Jennalee S / Herbert, Matthew S / Tynan, Mara / Dochat, Cara / Afari, Niloofar

    International journal of behavioral medicine

    2023  Volume 31, Issue 1, Page(s) 145–150

    Abstract: Background: Obesity is a critical public health concern with particular relevance to US military personnel. Stress and internalized weight stigma ("stigma") may contribute to and maintain obesogenic processes and behaviors, including emotional eating. ... ...

    Abstract Background: Obesity is a critical public health concern with particular relevance to US military personnel. Stress and internalized weight stigma ("stigma") may contribute to and maintain obesogenic processes and behaviors, including emotional eating. In this secondary cross-sectional analysis, we examined (1) associations among stress and stigma with emotional eating and body fat percentage (BF%), (2) whether stress explains the association between stigma and emotional eating, and (3) whether emotional eating explains associations between stress and stigma with BF%.
    Method: Active-duty military service members (N = 178) completed BF% assessment and questionnaires assessing stress, stigma, and emotional eating.
    Results: Structural equation modeling path analyses showed that stress and stigma were both significantly associated with emotional eating (b = 0.35, p < 0.001 and b = 0.23, p < 0.001, respectively) and with BF% (b = 0.38, p < 0.001 and b = 0.29, p < 0.001, respectively) such that individuals who reported higher stress and stigma tended to report more emotional eating and had higher BF%. Stress partially explained the association between internalized weight stigma and emotional eating, and emotional eating partially explained the relationship between stress and BF% but did not significantly mediate the association between stigma and BF%.
    Conclusion: Greater stress and internalized weight stigma were associated with more emotional eating and higher BF%; however, emotional eating only partially explained the association between stress and BF%. Results highlight the importance of interventions targeting stress management skills, but additional research is needed to identify mechanisms that explain the association between stigma and BF%.
    MeSH term(s) Humans ; Cross-Sectional Studies ; Weight Prejudice ; Weight Reduction Programs ; Obesity/psychology ; Emotions ; Social Stigma ; Body Weight
    Language English
    Publishing date 2023-02-02
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 1187972-5
    ISSN 1532-7558 ; 1070-5503
    ISSN (online) 1532-7558
    ISSN 1070-5503
    DOI 10.1007/s12529-023-10157-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Functional decline during the COVID-19 pandemic among U.S. military veterans: Results from the National Health and Resilience in Veterans Study.

    Morse, Jessica L / Fischer, Ian C / Na, Peter J / Afari, Niloofar / Pietrzak, Robert H

    International journal of geriatric psychiatry

    2023  Volume 38, Issue 12, Page(s) e6040

    Abstract: Objectives: The coronavirus disease-2019 pandemic has contributed to widespread social and economic stressors, along with substantial health problems, including loss of life. To date, however, relatively few studies have examined the prevalence and ... ...

    Abstract Objectives: The coronavirus disease-2019 pandemic has contributed to widespread social and economic stressors, along with substantial health problems, including loss of life. To date, however, relatively few studies have examined the prevalence and correlates of declines in mental and physical functioning in U.S. military veterans, an older and potentially vulnerable segment of the U.S. adult population.
    Methods: Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, a nationally representative, longitudinal study of 3078 veterans. Veterans were surveyed prior to the pandemic (pre-pandemic) and 1 year later during the height of the pandemic (peri-pandemic). Multivariable analyses were conducted to identify risk and protective variables associated with pre-to-peri pandemic declines in self-reported physical and mental functioning.
    Results: The prevalence of veterans who experienced functional decline (≥0.5 standard deviation reductions) pre-to-peri-pandemic was 18.1% (N = 541) for physical functioning and 18.3% (N = 547) for mental functioning. Older age, greater adverse childhood experiences (ACEs), and pandemic-related posttraumatic stress symptoms were the strongest correlates of physical functional decline, while greater ACEs, loneliness, pandemic-related posttraumatic and social restriction stress symptoms, and lower protective psychosocial characteristics were the strongest correlates of mental functional decline.
    Conclusions: Although the majority of U.S. Veterans showed functional maintenance or improvement 1 year into the pandemic, nearly one-in-five experienced a decline in physical or mental functioning. Results could help inform identification of veterans who may be at risk for functional decline during large-magnitude stressors, such as national or global pandemics.
    MeSH term(s) Humans ; Veterans/psychology ; Pandemics ; Longitudinal Studies ; Resilience, Psychological ; COVID-19/epidemiology ; Stress Disorders, Post-Traumatic/epidemiology
    Language English
    Publishing date 2023-12-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 806736-3
    ISSN 1099-1166 ; 0885-6230
    ISSN (online) 1099-1166
    ISSN 0885-6230
    DOI 10.1002/gps.6040
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