Assessment of Eating Disorder and Comorbidity Risk and Resilience in a Nationally Representative Sample of Recent Military Enlistees
Abstract
Eating disorders (EDs) affect people of all ethnicities and socioeconomic levels and occur across the lifespan. EDs are more common than previously believed and affect 13.1%-15% of young women and 3% of young men. EDs are one of the deadliest mental disorders, with standardized mortality ratios that are two times higher than mortality due to heavy smoking. In 2019, the Government Accountability Office (GAO) investigated the scope and impact of EDs in the military. The GAO’s report stated that the military’s ED screening does not accurately identify Service Members with an ED. The Department of Defense (DOD) did not have ongoing efforts aimed at preventing EDs among active-duty Service Members due, in part, to (incorrect) assumptions that the prevalence of EDs was low relative to other medical conditions. The GAO indicated that no existing screening tools for EDs were developed or tested in military-relevant populations but mentioned that, if successful, our team’s 2018 Investigator-Initiated Award (#W81XWH-19-1-0207) could fill a critical need for DOD ED screening. Since publication of the GAO report, it has become exceedingly clear that EDs are a significant source of medical and psychiatric impairment among Service Members. The proposed research is, therefore, highly significant and impactful because our team successfully developed the first ED screening for use in Veterans, and we are poised to take the next step toward implementation of our screen within the DOD and Department of Veterans Affairs (VA) through additional testing in active-duty Service Members. Through our Fiscal Year 2018 Peer Reviewed Medical Research Program award, we created the Brief Assessment of Stress and Eating (BASE) for detecting EDs and related mental-health disorders. However, because some active-duty military Service Members have unique considerations that Veterans do not (e.g., the need to maintain a high level of physical fitness), additional testing of the BASE in military Service Members is needed. Thus, we propose to tailor the BASE for use in active Service Members, which is an important next step before implementation through the following specific aims: Aim 1: Test the ability of the BASE to identify military Service Members who may have an eating, mood, anxiety, or trauma-related disorder compared to existing screeners. Hypotheses: The BASE will be more accurate for identifying eating, mood, and anxiety (including trauma) disorders in military members than traditional screening instruments. Scores on the BASE will outperform existing screeners for predicting future psychosocial adjustment (i.e., impairment) in the first year of military service. Aim 2: Identify factors that predict (or protect from) the development of an ED in military Service Members in their first 3 years of service. Hypothesis 2a: History of dieting, unhealthy drive for muscularity, history of weight-based teasing or bullying, self-reported family history of an ED, high negative affect, perfectionism, and self-reported child sexual abuse at baseline will be significant pre-service predictors of ED onset. Hypothesis 2b: Military sexual trauma (MST), serving in a theater of combat, combat-related trauma, disordered-eating behaviors designed to achieve military weight and personal appearance requirements, weight gain, and number of deployments will be significant active-duty predictors of ED onset. Hypothesis 2c: Unit support and family support specific to military service will be significant negative predictors of ED onset. Aim 3: Assess longitudinal course and patterns of comorbidity between EDs and internalizing and externalizing psychopathology in military members with EDs in their first 3 years of service. Hypothesis: We predict that there will be significant bidirectional relationships among ED psychopathology, internalizing problems (mood, anxiety, and trauma symptoms), and externalizing problems (substance and alcohol use disorders) in
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310310
Entities
People
- Kelsie Forbush
Organizations
- United States Army
- University of Kansas