PSY 380 GCU Statistic Sequence and Test Discussion See attachments for requirements. You can type directly on the document provided and the article is atta

PSY 380 GCU Statistic Sequence and Test Discussion See attachments for requirements. You can type directly on the document provided and the article is attatched. PSY-380 Introduction to Probability and Statistics
Project 2
Using the GCU library databases, locate a scholarly article in a psychology journal that utilizes a
hypothesis or research question. Use e-library resources attached in course materials and
document PSY380-LibraryResources, if you need help finding an article. You will answer each
question below with full complete sentences using solid academic writing. Use in-text citations
when needed. A reference page with all resources listed using APA formatting is expected.
Respond to the following questions about your scholarly article. You may answer the questions
directly in this document or you may complete the assignment on a separate document.
1.
2.
3.
4.
5.
6.
7.
Provide the APA reference
Identify the hypothesis or research question(s) used in the study
Describe the study. What was the purpose of the study/or research question(s)?
Which test statistic was used?
Report the statistical results (using correct APA style formatting).
Interpret and explain the statistical results. Was the hypothesis supported?
What, if any, future research was suggested?
While APA style is not required for the body of this assignment, solid academic writing is
expected, and documentation of sources should be presented using APA formatting guidelines,
which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a scoring guide. Please review the scoring guide prior to beginning the
assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. You are required to submit this
assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
©2018 Grand Canyon University
Journal of Abnormal Psychology
© 2018 American Psychological Association
0021-843X/19/$12.00
2019, Vol. 128, No. 2, 119 –128
http://dx.doi.org/10.1037/abn0000400
A Prospective Test of the Temporal Sequencing of Risk Factor Emergence
in the Dual Pathway Model of Eating Disorders
Eric Stice and Mark J. Van Ryzin
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Oregon Research Institute, Eugene, Oregon
Prospective studies have identified risk factors that predict future onset of eating disorders, but none has
provided a test of the temporal sequencing of the emergence of risk factors hypothesized in a multivariate
etiologic model of eating disorder development. Using data from an 8-year prospective study of 496
adolescent girls, we first conducted receiver operator characteristic plots to identify cut-points for each risk
factor that optimally predicted future onset of threshold or subthreshold bulimia nervosa, binge eating disorder,
and purging disorder. We then used growth curve models to estimate the age at which each participant crossed
the disorder-predictive cutpoint for each risk factor, or if they did not, during follow-up, permitting a test of
whether the risk factors emerged in the sequence hypothesized in the Dual Pathway etiologic model. Overall,
47% of the 51 youth who showed onset of one of these eating disorders first showed emergence of
disorder-predictive levels of perceived pressure to be thin and/or thin-ideal internalization, before showing
onset of disorder-predictive levels of body dissatisfaction, before showing onset of disorder-predictive levels
of dieting and/or negative affect, before showing onset of the eating disorder; another 29% had one of these
steps out of order or did not cross one step in this model. Youth who did not show onset of an eating disorder
were significantly less likely to cross the disorder-predictive cut-points for each risk factor or to conform to
the sequence of risk factor emergence hypothesized in this model. Results provide novel support for the
temporal sequencing of risk factor emergence hypothesized in this multivariate etiologic model and suggest
that prevention programs that reduce perceived pressure to be thin and thin-ideal internalization among early
adolescent girls with these factors should reduce eating disorder onset, as well as downstream risk factors that
are also aversive (e.g., body dissatisfaction and negative affect).
General Scientific Summary
Finding suggest that typically, eating disorder-predictive levels of perceived pressure to be thin and
pursuit of the thin beauty ideal emerge before disorder-predictive levels of body dissatisfaction,
which emerge before disorder-predictive levels of dieting and negative affect, which emerge before
onset of threshold or subthreshold bulimia nervosa, binge eating disorder, or purging disorder.
Results imply that prevention programs should reduce perceived pressure to be thin and pursuit of the
thin beauty ideal among early adolescent girls, as this should both reduce eating disorder onset and
emergence of aversive downstream risk factors.
Keywords: risk factors, dual pathway model, prospective, bulimia nervosa, binge eating disorder
2013). It is critical to elucidate factors that predict future onset of
eating disorders, as this should inform etiologic theories, which is
vital for guiding the content of optimally effective prevention
programs and identifying high-risk subpopulations to target with
selective prevention programs. Although several prospective studies have identified risk factors that predict future onset of eating
disorders, none have provided a rigorous test of a multivariate
model that proposes how the risk factors work in concert to predict
future eating disorder onset, including the hypotheses regarding
the temporal sequencing of risk factor emergence.
The Dual Pathway model is an etiologic theory that hypothesizes how several well-studied psychosocial risk factors may operate together in a meditational fashion to predict future eating
disorder onset (Stice, 1994). This theory hypothesizes that pressure
for thinness and pursuit of the thin beauty ideal increases risk for
subsequent body dissatisfaction, which in turn increases risk for
Approximately 13% of females will experience an eating disorder at some point in their lives, which are characterized by
chronicity, emotional distress, functional impairment, and increased risk for future obesity, depression, suicide, substance
abuse, and mortality (Allen, Byrne, Oddy, & Crosby, 2013; Arcelus, Mitchell, Wales, & Nielsen, 2011; Stice, Marti, & Rohde,
This article was published Online First December 20, 2018.
Eric Stice and Mark J. Van Ryzin, Oregon Research Institute, Eugene,
Oregon.
This research was supported by National Institutes of Health grants
MH01708 and MH64560. The University of Texas Institutional Review
Board approved this study (Austin Adolescent Development Study).
Correspondence concerning this article should be addressed to Eric
Stice, Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403.
E-mail: estice@ori.org
119
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
120
STICE AND VAN RYZIN
subsequent dietary restriction and negative affect, which in turn
increase risk for subsequent onset of eating disorders characterized
by binge eating and compensatory weight control behaviors. A
previous study provided evidence that pressure to be thin and
pursuit of the thin beauty ideal predicted future increases in body
dissatisfaction, that body dissatisfaction predicted future increases
in dieting and negative affect, and that dieting and negative affect
predicted future increases in bulimic symptoms in adolescent girls
followed over 2-years (Stice, 2001). However, no prospective
study has provided a rigorous test of the temporal sequencing of
risk factor emergence hypothesized in this multivariate etiologic
theory. The goal of the present report is to introduce a new analytic
approach for testing hypotheses regarding the temporal sequencing
of risk factor emergence in multivariate etiologic models in relation to emergence of clinically significant eating pathology. This
analytic approach was specifically developed to test hypotheses
regarding the temporal relations among risk factors in multivariate
meditational models, and may, therefore, prove useful for testing
hypotheses about the temporal sequencing of risk factor emergence for other public health problems.
One impediment to testing the temporal sequencing of risk
factor emergence is that most risk factors are continuous variables,
making it challenging to determine at what age participants exhibit
a level of the risk factor that predicts future eating disorder onset.
We introduce a three-step approach that might be useful for
addressing this important research question. First, receiver operating characteristic (ROC) plots could be used to determine the
specific cutpoint of a risk factor that optimally predicts future
onset of eating disorders, balancing predictive sensitivity and
specificity. This approach could be used for each risk factor in a
multivariate etiologic model to generate reliable cut-points for
each risk factor that optimally predict future eating disorder onset.
Second, latent growth curve models could be used to generate
individual-level slopes and intercepts that reflect individual differences in the development of each risk factor. These individual
slopes and intercepts could then be used to estimate the specific
age at which each individual participant initially crossed the cutpoints for each risk factor that optimally predict future eating
disorder onset, or whether the participant did not cross these
cut-points during follow-up. Third, the ages at which participants
crossed each cutpoint could then be used to test hypotheses regarding the temporal sequencing of risk factor emergence posited
in multivariate meditational etiologic models, such as the Dual
Pathway model. This approach would permit a test of the hypothesis that disorder-predictive levels of perceived pressure to be thin
and/or internalization of the thin beauty ideal temporally precede
emergence of disorder-predictive levels of body dissatisfaction,
which in turn temporally precedes emergence of disorderpredictive levels of dieting and/or negative affect, which in turn
temporally precede emergence of eating disorders, as proposed a
priori (Stice, 1994). We hypothesize that adolescent girls who
subsequently develop eating disorders would show emergence of
disorder-predictive levels of each of these risk factors in this
etiologic model, and in the order specified above, whereas adolescent girls who remain eating disorder free will typically not exhibit
disorder-predictive levels these risk factors.
Although methodologists often counsel against dichotomizing
continuous variables, such as risk factors and eating pathology, the
objective of this report is to introduce a novel statistical approach
for examining the temporal sequencing of risk factor emergence as
it relates to onset of clinically meaningful eating pathology, which
seems to necessitate a focus on discrete events that happen at
particular developmental points in time. For this reason, we think
it might be necessary to dichotomize the risk factors and the
pathological outcome, and to translate these discrete events into
developmental ages. Further, several studies have established that
participants with threshold or subthreshold eating disorders show
significant elevations in psychosocial impairment, negative affect,
and mental health service utilization (Allen et al., 2013; Stice et al.,
2013; Stice, Marti, Shaw, & Jaconis, 2009). Thus, we elected to
predict age of emergence of threshold or subthreshold eating
disorders because this is one defensible way of ensuring that the
dichotomous outcome captures clinically meaningful eating pathology.
Studies suggest that risk factors that predict future onset of
bulimia nervosa, binge eating disorder, and purging disorder are
qualitatively distinct from those that predict future onset of anorexia nervosa. Specifically, prospective studies that used diagnostic interviews to assess eating disorder onset have found that
social pressure for thinness, pursuit of the thin beauty ideal, body
dissatisfaction, dieting, negative affect, alcohol use, low interoceptive awareness, social support deficits, psychosocial impairment,
early puberty, overeating, and elevated Body Mass Index (BMI)
predicted future onset of threshold or subthreshold bulimia nervosa
(Killen et al., 1996; Patton, Johnson-Sabine, Wood, Mann, &
Wakeling, 1990; Patton, Selzer, Coffey, Carlin, & Wolfe, 1999;
Stice & Bohon, 2013; Stice, Gau, Rohde, & Shaw, 2017; Stice,
Marti, & Durant, 2011). Similarly, social pressure for thinness,
pursuit of the thin beauty ideal, body dissatisfaction, dieting,
negative affect, psychosocial impairment, and overeating predicted
future onset of threshold or subthrehold binge eating disorder
(Stice et al., 2011, 2017). Likewise, pursuit of the thin beauty
ideal, body dissatisfaction, negative affect, dieting, psychosocial
impairment, and overeating predicted future onset of threshold or
subthreshold purging disorder (Stice et al., 2011, 2017). In contrast, low BMI, low dieting, and psychosocial impairment predicted onset of threshold or subthreshold anorexia nervosa (Stice
& Bohon, 2013; Stice et al., 2017). This pattern of findings implies
that the risk factors that predict onset of bulimia nervosa, binge
eating disorder, and purging disorder are different from those that
predict onset of anorexia nervosa, consistent with the thesis that
the dual pathway model predicts emergence of eating disorders
characterized by binge eating and compensatory weight control
behaviors, rather than anorexia nervosa (Stice, 1994). Therefore,
we offer the more nuanced hypothesis that adolescent girls who
subsequently develop threshold or subthreshold bulimia nervosa,
binge eating disorder, or purging disorder would show emergence
of disorder-predictive levels of each of these risk factors in the
Dual Pathway model, and in the order specified in that model,
whereas adolescent girls who subsequently develop threshold or
subthreshold anorexia nervosa or who remain eating disorder free
will typically not exhibit disorder-predictive levels these risk factors.
An improved understanding of the temporal sequencing of risk
factor emergence is important for several reasons. First, it would
provide a rigorous test of the temporal patterns articulated in
multivariate etiologic models, which is important for advancing
etiologic theory for these pernicious disorders. Second, this infor-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
TEMPORAL SEQUENCING OF RISK FACTOR EMERGENCE
mation should elucidate which risk factor emerges first, which
would be a logical target for prevention programs because the
interventions might interrupt the etiologic cascade of risk factors
that theoretically give rise to eating disorder onset at the earliest
possible time. Prevention programs that reduce the earliest emerging risk factor may also reduce downstream risk factors, such as
body dissatisfaction and negative affect, which are subjectively
distressing, irrespective of whether they eventuate in eating disorder onset. Third, information regarding which disorder predictive
risk factor emerges first should also identify high-risk subpopulations to target with selective prevention programs. Targeting those
at greatest risk, and as early as possible, may allow for more
cost-effective and efficacious prevention efforts for mental health
problems.
Method
Participants and Procedures
Participants were 496 adolescent girls recruited from public and
private middle schools in a large U.S. city (7th or 8th grade) who
had a mean age of 13 at baseline (SD ⫽ .71). The sample included
2% Asian/Pacific Islanders, 7% African Americans, 68% Caucasians, 18% Hispanics, 1% Native Americans, and 4% who specified other/mixed racial heritage, which was representative of the
schools from which we sampled. There were no ethnic differences
in the likelihood of developing an eating disorder when comparing
Caucasian (N ⫽ 336) to non-Caucasian (N ⫽ 160) participants,
␹2(1) ⫽ .24, p ⫽ .628. Average parental education, a proxy for
socioeconomic status, was 29% high school graduate or less, 23%
some college, 33% college graduate, and 15% graduate degree,
which was representative of the city from which we sampled.
The study was described as an investigation of adolescent mental and physical health. Participants were recruited through an
informed consent letter sent to parents of eligible girls that described the study (a second mailing was sent to nonresponders).
This resulted in a participation rate of 56%, similar to other
school-recruited samples that used comparable active consent procedures, structured interviews, and longitudinal follow-up (e.g.,
61% for Lewinsohn, Rohde, Seeley, Klein, & Gotlib, 2000). Female assessors with at least a bachelor’s degree in psychology
conducted semistructured interviews that assessed eating disorder
symptoms and recorded participant’s weight and height at baseline
and seven subsequent years for a total of eight annual assessments
(T1–T8). Assessors attended 24 h of training wherein they received instruction in structured interview skills, reviewed diagnostic criteria for relevant Diagnostic and Statistical Manual of Mental
Disorders-Fourth Edition (DSM–IV) disorders, observed simulated
interviews, and role-played interviews. Assessors were required to
demonstrate interrater agreement (k ⬎ .80) with supervisors on
tape-recorded interviews before collecting data. Assessors also
completed annual training workshops to minimize interviewer
drift. At each of annual assessment, participants completed questionnaires measuring the risk factors. Participants received a gift
certificate or cash for completing each assessment.
121
past year was assessed with the 10-item Perceived Sociocultural
Pressure Scale (Stice et al., 2011). Response options ranged from 1 ⫽
none to 5 ⫽ a lot. Items were averaged for this scale and those below.
This scale has shown internal consistency (␣ ⫽ .88), 2-week test–
retest reliability (r ⫽ .93), and predictive validity for future onset of
bulimic symptoms (Stice et al., 2011; ␣ ⫽ .85 at T1).
Thin-ideal internalization. The 6-item Ideal-Body Stereotype Scale–Revised assessed pursuit of the thin beauty ideal over
the past year (Stice et al., 2011). Response options ranged from
1 ⫽ strongly disagree to 5 ⫽ strongly agree. This scale has shown
internal consistency (␣ ⫽ .91), 2-week test–retest reliability (r ⫽
.80), predictive validity for bulimic symptom onset, and sensitivity
to intervention effects (Stice et al., 2011; ␣ ⫽ .81 at T1).
Body dissatisfaction. The 9-item Body Dissatisfaction Scale
(Stice, 2001) assessed dissatisfaction with various body parts over the
past year. Response options ranged from 1 ⫽ extremely satisfied to
5 ⫽ extremely dissatisfied. This scale has shown internal consistency
(␣ ⫽ .94), 3-week test–retest reliability (r ⫽ .90), predictive validity
for eating disorder onset, and sensitivity to intervention effects (Stice
et al., 2011; Stice, Marti, Spoor, Presnell, & Shaw, 2008; ␣ ⫽ .94 at
T1).
Dieting. The 10-item Dutch Restrained Eating Scale (van
Strien, Frijters, van Staveren, Defares, & Deurenberg, 1986) assesses the frequency of various dieting behaviors over the past
year. Response options ranged from 1 ⫽ never to 5 ⫽ always. This
scale has shown …
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