Objective This study examined the utility of a biopsychosocial model to explain both higher body mass index (BMI) and disordered eating. The study was designed to examine the predictors of higher BMI and a number of measures of disordered eating (dietary restraint, drive for muscularity, drive for thinness, binge eating, and compensatory behaviour).Method Young adults (N = 838) recruited from seven countries, grouped into four regions (Europe, North American countries, Australia, Japan), completed an online survey, with each completion being 12 months apart. The survey included assessments of BMI and disordered eating, and a range of biological, psychological and sociocultural factors expected to predict both outcomes.Results Results revealed unique patterns of association between predictors and BMI as well as different measures of disordered eating in the four geographical regions.Conclusions The findings identify the specific nature of biopsychosocial factors that predict both higher BMI and different aspects of disordered eating. They also demonstrate that caution needs to be exercised in generalising findings from one country to other countries.

Although a range of risk factors have been identified for disordered eating and weight status, the breadth of risk factors have been rarely considered within a single, comprehensive model. The robustness of these findings across countries also remains an open question. The present study sampled 6272 participants aged 18-30 years from eight countries in an attempt to evaluate combined and unique predictors for these two conditions, and to explore possible cross-country differences in these models. Participants completed a range of demographic, biological, behavioral, psychological, and sociocultural measures to test a comprehensive model of the contributions of these predictors for disordered eating and weight-related constructs (binge eating, body mass index, compensatory behaviors, dietary restraint, drive for muscularity, and drive for leanness). Structural invariance testing within a multigroup path analysis framework revealed that a single model across the eight countries provided poor model fit. Freeing of 22% of parameters across countries provided excellent fit and a satisfactory compromise for country-invariant and country-variant parameters in the model. Overall, predictors accounted for between 15% and 60% of variance in the outcome measures, with lowest explained variance for the disordered eating outcomes. Significant unique contributions to prediction were observed for each of the five risk factor variable types and across the eight countries. Thus, the findings show strong support for this model as an explanatory framework of both disordered eating and weight status.

Introduction Restrained, emotional and intuitive eating were examined in relation to each other and as correlates of participants' weight status, body image and self-esteem. In some past research, restrained and emotional eating have been associated with higher weight status and poorer mental health, while intuitive eating is more frequently linked to lower weight status and more positive well-being. However, these eating styles have rarely been examined together and never in a large cross-country sample. Method Six-thousand two-hundred and seventy-two (6272) emerging adults (M age = 21.54 years, SD = 3.13) completed scales from the Three-Factor Eating Questionnaire, the Eating Disorders Examination Questionnaire, the Intuitive Eating Scale-2, the Multidimensional Body Self Relations Questionnaire, the Rosenberg Self-Esteem Scale, and provided weight and height information that was used to calculate body mass index (BMI). Participants resided in Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States and provided information using an online survey. Results Path analyses for the entire sample revealed significant pathways between higher intuitive eating and higher body satisfaction and self-esteem, and lower BMIs among participants. Higher levels of restrained and emotional eating were associated with lower body satisfaction and self-esteem, and higher BMIs among participants. Minor cross-country differences were evident in these patterns of relations, but intuitive eating emerged as a consistent predictor across countries. Conclusion Overall, findings suggest that efforts should be made to increase intuitive eating among emerging adults and to support individual and macrolevel interventions to decrease restrained and emotional eating behaviours.

Abstract Purpose Physiotherapists often feel insecure when managing patients with chronic low back pain associated with psychological factors. This uncertainty could hinder physiotherapists in fostering strong patient-therapist alliances in chronic low back pain practice. The purpose of this study was to explore associations between patient-rated alliance, physiotherapists’ self-reported confidence in managing the patient and patient-reported psychological distress. Methods Patients with chronic low back pain (N = 21) self-reported their psychological status at baseline. After the intake session, physiotherapists self-reported their confidence (enthusiasm and competence) in managing the patient with chronic low back pain. Patient-rated alliance was measured after the third physiotherapy session. A linear mixed model estimated associations between alliance (dependent variable), physiotherapists’ confidence and patient-reported distress. Results The linear mixed model estimated a positive interaction effect (therapist confidence × patient distress) on patient-rated alliance (estimated effect, β = 0.15; 95% Confidence Interval = 0.03–0.27). Conclusions Higher self-reported confidence in managing the patient with chronic low back pain by physiotherapists was associated with higher patient-reported alliance after the third physiotherapy sessions. The positive effect between therapist confidence and patient-rated alliance appeared to be dependent on patient-reported psychological distress at baseline.

Der Körper und der Körper in Bewegung sind zwei wichtige Aspekte, die für die Pathologie von Essstörungen von entscheidender Bedeutung sind und die Eckpfeiler für die Psychomotorische Therapie. Konkret geht es darum, ein realistisches Selbstverständnis und Körperbild wiederherzustellen und die Hyperaktivität einzudämmen. Aus unserer 35-jährigen klinischen Erfahrung stellen psychomotorische Therapietechniken eine wirksame klinische Ergänzung zu den üblichen verfügbaren Behandlungen dar. Ziel dieses Beitrages ist es, praktische Leitlinien für einen psychomotorischen Therapieansatz bei Essstörungen vorzustellen.

Purpose:The primary purpose of this study was to investigate the current practice and opinions of members of the Irish Society of Chartered Physiotherapists (ISCP) with respect to the care of patients in psychological distress.Method:This was a cross-sectional, survey-based investigation of Irish physiotherapists. An electronic survey was sent by email to the ISCP membership. It consisted of closed- and open-ended questions, as well as opinion questions with Likert scale responses.Results:More than 80% of the respondents reported that they encountered patients with psychological distress at least once a week. A lack of education in the area of mental health emerged as a predominant theme. Reflecting on current practice, many discussed the importance of addressing underlying psychological issues before or in tandem with physical issues. Respondents who had engaged in further education in mental health, psychology, or both rated their confidence in recognizing the signs and symptoms of psychological distress higher (p < 0.001). Moreover, a greater proportion of these respondents routinely assessed for psychological distress in their clinical practice (p < 0.001).Conclusion:Physiotherapists regularly encounter patients whom they perceive to have high levels of psychological distress. Irish physiotherapists displayed positive attitudes toward patients' psychological well-being. However, additional education in mental health was a recognized need in the profession.

The aim of this study was to examine the cross-country invariance of five well-established measures of body weight and shape concern-related attitudes and behaviors (i.e., drive for leanness, drive for muscularity, strategies to increase muscle, strategies to lose weight, and weight and shape concerns). A secondary objective was to examine the effects of several sociodemographic factors (age, BMI, socioeconomic status, and gender) on item and latent factor scores of these constructs. A total of 6272 emerging adults (4218 women; Mage = 21.46, SD = 3.11) from Australia, Belgium, Canada, China, Italy, Japan, Spain, and the U.S. completed a self-report online survey as part of a larger study. Overall, support for partial invariance both across countries and in terms of the considered sociodemographic factors was found for reduced versions of the five measures. Significant differences in latent means were found across countries, these being of greater magnitude for drive for leanness and strategies to lose weight. The considered sociodemographic factors (most notably BMI and gender) were associated with the latent mean scores of the assessed constructs. The present study contributes to current literature by providing cross-cultural invariant versions of several measures of relevance in the field of body image.

Background: It has been shown that exercise programmes can influence mental health in patients with mental health disorders. Objective: The aim of this study was to verify the suitability of psychomotor therapy as a supporting method in the treatment of hospitalized patients with schizophrenia. Methods: In this randomized controlled double-blind study 142 in-patients with schizophrenia (age: mean 50.2 years, SD = 6.5, range 21-62) participated. In comparison with a control group (n = 60), the experimental group (n = 82) received an additional psychomotor therapy programme (3 times a week for a period of 14 weeks). The Brief Psychiatric Rating Scale (BPRS) was used to evaluate mental health status. Results: Participants in the psychomotor therapy demonstrated significant improvements for all subscales of the BPRS. Large effect sizes were found for subscales Anxiety/Depression, Energy, Thought Disturbance and Activation, and medium for Hostility. No significant difference between genders was found. Conclusion: The implementation of a psychomotor therapy programme in the treatment of hospitalized patients with schizophrenia has a significant positive effect on their mental health.

This study examined the measurement invariance of three scales that assessed emotional eating, restrained eating, and intuitive eating across eight countries (Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States) in order to determine their suitability for cross-country body image research. A total of 6272 young adults took part in this study. Participants completed an online survey including the Emotional Eating subscale of the Three Factor Eating Questionnaire-Revised 21, the Restraint subscale of the Eating Disorder Examination Questionnaire, and the Reliance on Hunger and Satiety Cues subscale of The Intuitive Eating Scale-2. Multi-group confirmatory factor analysis was used to evaluate potential cross-country differences in functioning of the measures. Partial invariance for all three scales was found, with only minor levels of non-invariance identified. Multiple indicator multiple cause models identified BMI and gender as potential influences on scores for these measures. Sources of invariance across groups are discussed, as well as implications for further substantive research across countries involving these measures.

Background There is a growing recognition of the importance of encouraging people with alcohol use disorders (AUD) to become more active as an achievable strategy to reduce the disability-associated burden. Objective We investigated whether physical activity and sedentary behaviour in men with AUD contribute to their quality of life (QoL). Methods Fifty male Ugandan inpatients with AUD (33.0±10.7 years) completed the World Health Organization Quality of Life Assessment brief version, Simple Physical Activity Questionnaire and the Alcohol Use Disorders Identification Test while waist circumference, body mass index and blood pressure were assessed. Linear multiple regression analysis explored the total variance in QoL explained by all predictor variables. Results SIMPAQ walking and SIMPAQ exercise explained 46% of the variability in physical QoL, 45% of the variability in psychological QoL, and 40% of the variability in environmental QoL. The SIMPAQ walking score predicted 37% of the variability in social QoL. Conclusion The current findings suggest that higher levels of walking and exercising are associated with a better QoL. Our study therefore provides a platform for future research to investigate the role of physical activity on QoL levels in people with AUD, also in low resourced settings in low-income countries such as Uganda.

This study aims to examine the reliability and validity of the Turkish version of Body Attitude Test among women with breast cancer. The study included 101 voluntary women with breast cancer stage 1, 2 or 3 from different regions of Turkey. The Turkish versions of Body Attitude Test, Body Shape Questionnaire and Eating Attitudes Test were applied twice with a 7- day interval. The test demonstrated high test-retest reliability (Intra-class Correlation Coefficient = 0.95) with a good internal consistency (Cronbach's alpha = 0.82; McDonald's omega = 0.89) for all domains. The confirmatory factor analysis resulted in 4 factor structures and at an acceptable good fit-in with x(2)/df for BAT. The Body Attitude Test correlated strongly with the Body Shape Questionnaire and Eating Attitudes Test (p < 0.05). The results support the Turkish version of the test is a valid and reliable instrument that can be used to measure the body attitude of women with breast cancer. This test can be used as an appropriate measurement tool in assessing the subjective attitude towards the body in women with breast cancer.

The aim of the current study was to examine the psychometric properties of two well-established measures of sociocultural influence and internalization of the thin/low body fat ideal and muscular ideal. Data from 6272 emerging adults (68.9 % female), aged 18-30 years from Australia, Belgium, Canada, China, Italy, Japan, Spain, and the U.S. were included in this study. Participants completed measures of pressure from mother, fathers, peers, and media, to both increase muscles and lose weight, as well as internalization of the thin/low body fat ideal and muscular ideal. Overall, support for partial invariance was found across the scales. In addition, group level differences were found between countries as well as along demographic factors including gender, age, body mass index, and socioeconomic status. These findings make an important contribution by identifying these scales as useful tools that will support future cross-country and cross-cultural examinations of explanatory models of the development of body image and eating concerns grounded within sociocultural theories. (C) 2020 Published by Elsevier Ltd.

Portuguese elite athletes with disabilities (n=14) were interviewed to explore the importance assigned to psychological preparation and their personal experiences on sport psychology. Semi-structured interviews were conducted using standard qualitative methodology. All the participants highlighted the importance of psychological preparation in sports performance. Moreover, it was evident a gap on applied sport psychology among the athletes. Most of the athletes never had any kind of psychological intervention for sport. Although some participants mentioned barriers to sport psychology intervention (e.g., athlete's age, perception of psychological skills as innate characteristics, and the opinion of others), most of the athletes expressed receptiveness to engage in psychological skills training and stressed the need for that support. Some recommendations for future sport psychology interventions are presented as well as the study limitations.

Positive body image refers to individuals' ability to conceptualize their bodies with love, respect, and appreciation. The study of positive body image is relatively new, and instruments used to investigate this multi-faceted construct have received limited use in non-English speaking countries. Thus, the aim of this investigation is to consider four measures that are associated with positive body image across eight different countries. Participants (n = 6272) completed the Body Appreciation Scale-2, the Body Areas Satisfaction Scale, the Physical Appearance Comparison Scale, and the Weight Bias Internalization Scale. Multi-group confirmatory factor analyses (MG-CFAs) and item-response theory (IRT) models were used to examine the measurement invariance of these surveys. Our results generally suggest that positive body image, weight bias, and appearance comparison can be assessed using brief assessments and that these four instruments can be used in different countries, but care should be taken to consider individuals' gender, BMI, and socio-economic position.

This study assessed the measurement invariance of selected self-report measures of perfectionism, impulsivity, self-esteem and social anxiety in samples of emerging adults from eight different countries. Participants (N = 6272) completed the Multidimensional Perfectionism Scale (MPS), the UPPS-P Impulsive Behavior Scale, the 5-item Rosenberg Self-Esteem Scale (5-item RSES) and the Social Interaction Anxiety Scale (SIAS-6). Multigroup confirmatory factor analysis was run to examine cross-measure equivalence. Evidence for structural invariance was found for all questionnaires, while weak invariance was supported only for the 5-item RSES and the SIAS-6, and a partial weak invariance was found for the MPS and the UPPS-P. No measure achieved strong invariance. Strict invariance was achieved for the 5-item RSES, whereas only a partial strict invariance was supported for the MPS, UPPS-P and SIAS-6. These results suggest that perfectionism, impulsivity, self-esteem, and social anxiety are subjected to linguistic/cultural influence as well as to the effects of socio-demographic variables and can be evaluated by using the selected measures in eight different countries worldwide - but results should be interpreted with caution.

The purpose of this study was to compare the functional exercise capacity of patients with alcohol use disorders (AUD) with an age-, gender-, and body mass index (BMI)-matched healthy control group. Thirty patients (22 males, 40.4 ± 10.5 years, illness duration = 9.7 ± 9.3 years) and healthy control subjects (22 males, 40.2 ± 10.7 years) participated. Participants performed a 6-min walk test (6MWT) to assess their functional exercise capacity, were asked about musculoskeletal problems and dyspnea, executed a standing broad jump to assess their muscular strength, and completed the International Physical Activity Questionnaire (IPAQ). Patients also filled in the Positive Affect and Negative Affect Schedule (PANAS) and Alcohol Use Disorders Identification Test (AUDIT). Our data show that patients with AUD walked a significantly shorter distance on the 6MWT (649.0 ± 72.9 m vs. 724.4 ± 89.0 m, p = 0.001). In patients with AUD, the variance in standing broad jump score explained 43.6% of the variance in the 6MWT score. The current study demonstrates that impaired muscle strength is negatively associated with functional outcomes in patients with AUD. Exercise interventions should be investigated in order to assess whether they can ameliorate muscle strength and daily life functioning of this vulnerable population.

The current study examined the impact of sedentary behaviour (SB) on quality of life (QoL) in people with psychotic disorders. Thirty-six Ugandan women (mean age = 33.9 ± 8.0 years) and 23 men (37.4 ± 11.8 years) with a DSM 5 diagnosis of psychosis completed the World Health Organization Quality of Life-Brief version and Simple Physical Activity Questionnaire (SIMPAQ). Medication use, physical co-morbidities, weight, height, blood pressure and smoking habits were recorded. Multiple regression analyses were undertaken. Variability in SIMPAQ sedentary and walking scores explained 56% of the variability in psychological QoL, while variability in SIMPAQ walking explained 46% of the variability in physical QoL. Health care professionals should not only consider increasing physical activity but also reducing SB to improve QoL in their patients.

The Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) is a questionnaire that is frequently used to measure the treatment orientation of physiotherapists and other healthcare providers toward low back pain (LBP). Previous validation studies of the PABS-PT have reported consistently that exploratory factor analysis (EFA) yielded a two-factor model with the factors "biomedical" and "biopsychosocial." However, there remain concerns regarding the composition of these two factors and the internal consistency of the "biopsychosocial" factor. The objective of this study was to replicate the previous validation study on the German PABS-PT. EFA was implemented to reexamine the underlying structure of the scale, and confirmatory factor analysis (CFA) was used to test the fit of the hypothesized two-factor model. Results of the initial validation study were not replicated. EFA indicated that a two-factor solution is an inadequate representation of the PABS-PT data, and CFA showed insufficient fit of the hypothesized two-factor model to the PABS-PT data. Our results indicate a need for caution when using the PABS-PT to measure physiotherapists' orientation toward LBP, particularly in measuring the magnitude of a biopsychosocial orientation.