The present study examined patterns of serious mental illness (SMI), specific mental health syndr... more The present study examined patterns of serious mental illness (SMI), specific mental health syndromes, and service use among older (65ϩ) and younger (18 -64) adults throughout the United States, and the extent to which various factors predict SMI and the use and magnitude of mental health treatment. Despite recent developments designed to improve mental healthcare access and treatment for older adults, older individuals were found to receive outpatient mental healthcare at very low rates. Compared to younger adults, older adults were three times less likely to report receiving treatment. Although prevalence estimates for SMI and specific syndromes were markedly lower among older than younger adults, older individuals most in need of care were highly unlikely to report receiving treatment. Findings point to the importance of perceived need in mental healthcare use. Significantly, however, those older adults that made it into services typically reported benefiting considerably from treatment, at least as much as all other age groups. Several predisposing, enabling, and need factors related to mental illness and service use were identified that have important implications for how we plan for, design, and deliver mental health services to older and younger Americans.
Objective: We developed and tested the psychometric properties of Spanish versions of the Trait a... more Objective: We developed and tested the psychometric properties of Spanish versions of the Trait and State Food Cravings Questionnaires (FCQ–T and FCQ–S respectively). Method: The instruments were translated and adapted to Spanish and administered to undergraduate students from a Southern university in Spain (N=271). The data were analyzed using confirmatory factor analysis to compare the factor structure of the English and Spanish versions of both questionnaires. Results: The factors structure of both questionnaires obtained excellent fit indices across their Spanish versions with the one exception that some factors of the FCQ–S were more highly intercorrelated among the Spanish sample than the American. Discussion: This study supports the conceptualization of food cravings as universal multidimensional motivational states that can be reliably measured and supports the use of the Spanish versions of the FCQ.
This study evaluated the score reliability and equivalence of factor structure of the Sociocultur... more This study evaluated the score reliability and equivalence of factor structure of the Sociocultural Attitudes towards Appearance Questionnaire-3 (SATAQ-3) [1] in a sample of female college students from the four largest ethnic groups in the USA. Participants were 1245 women who self-identified as European American/White (n = 543), African American/Black (n = 137), Asian American (n = 317), or Latina/Hispanic (n = 248). All completed the SATAQ-3 and a demographic questionnaire. To test the factor similarity and score reliability across groups, we used exploratory factor analysis and calculated Cronbach's alphas (respectively). Score reliability was high for all groups. Tests of factor equivalence suggested that the four pre-established factors of the SATAQ-3 (i.e., knowledge, perceived pressure, thin-ideal internalization, athletic-ideal internalization) were similar for women of all ethnic groups. Only two items (20 and 27) did not consistently load on the previously identified ...
Cultural diversity & ethnic minority psychology, 2000
To determine if the Hopkins Symptom Checklist-21 demonstrates equivalent validity across differen... more To determine if the Hopkins Symptom Checklist-21 demonstrates equivalent validity across different ethnic groups, the authors tested the factor structure of the instrument with a sample of European American (n = 514), African American (n = 154), and Latino (n = 229) college students using confirmatory factor analysis with tests of invariance across groups. For the most part, a 3-factor model with Performance, General, and Somatic factors fit equally well for all 3 racial/ethnic groups. Differences involved only a few items in terms of either the strength of a factor loading or an error term. The results generally support the validity of the use of the instrument for measurement of distress in these different racial/ethnic groups.
We investigated the question of whether anorexia and bulimia nervosa occur on a continuum versus ... more We investigated the question of whether anorexia and bulimia nervosa occur on a continuum versus being discrete classes using two taxometric procedures: Mean Above Minus Below a Cut (MAMBAC) and Maximum Covariance (MAXCOV) analysis. ...
As a preliminary step in researching "orthorexia nervosa," an alleged syndrome characterized by a... more As a preliminary step in researching "orthorexia nervosa," an alleged syndrome characterized by a pathological fixation on healthy eating, we designed the 21-item Eating Habits Questionnaire (EHQ) to assess the cognitions, behaviors, and feelings related to an extreme focus on healthy eating. Study 1 (n = 174) examined the factor structure of the EHQ and refined the instrument with exploratory factor analysis. Results suggested a 3factor solution with the following subscales: knowledge of healthy eating, problems associated with healthy eating, and feeling positively about healthy eating. The subscales displayed good internal consistency (α = .87 to .91) and test-retest reliability (r =.74 to .87).
Based on previous literature, we proposed and tested a model of the relationships between child s... more Based on previous literature, we proposed and tested a model of the relationships between child sexual abuse (CSA), body image, dieting, and bulimic behavior. The model specified that body image functioned as a mediator between CSA and eating disturbance. Multiple measures of each of the constructs of interest were collected from a sample of 222 college age women, and the data were analyzed using structural equation modeling. Both the measurement model and the proposed structural model demonstrated an adequate fit. As with previous research, results support a model in which body image strongly affects dieting behavior, which in turn directly affects bulimic behavior. The results did not appear to support the proposed mediational model involving the hypothesized indirect effect of CSA on eating pathology. There was, however, a small direct relationship between CSA and bulimic behavior and a moderate relationship between CSA and posttraumatic symptomatology.
Most patients consulting physicians have a mixture of physical and mental complaints that require... more Most patients consulting physicians have a mixture of physical and mental complaints that require careful differential diagnosis. A somatoform disorder is diagnosed when the primary disorder is a mental disorder with prominent physical complaints. The assessment and treatment of somatoform disorders requires patience and compassion to maintain a therapeutic alliance, but randomized controlled trials show that treatment with antidepressants or cognitive-behavioral therapy reduce health care use and subjective distress.
The relationship between a reported history of trauma and dissociative symptoms has been explaine... more The relationship between a reported history of trauma and dissociative symptoms has been explained in 2 conflicting ways. Pathological dissociation has been conceptualized as a response to antecedent traumatic stress and/or severe psychological adversity. Others have proposed that dissociation makes individuals prone to fantasy, thereby engendering confabulated memories of trauma. We examine data related to a series of 8 contrasting predictions based on the trauma model and the fantasy model of dissociation. In keeping with the trauma model, the relationship between trauma and dissociation was consistent and moderate in strength, and remained significant when objective measures of trauma were used. Dissociation was temporally related to trauma and trauma treatment, and was predictive of trauma history when fantasy proneness was controlled. Dissociation was not reliably associated with suggestibility, nor was there evidence for the fantasy model prediction of greater inaccuracy of recovered memory. Instead, dissociation was positively related to a history of trauma memory recovery and negatively related to the more general measures of narrative cohesion. Research also supports the trauma theory of dissociation as a regulatory response to fear or other extreme emotion with measurable biological correlates. We conclude, on the basis of evidence related to these 8 predictions, that there is strong empirical support for the hypothesis that trauma causes dissociation, and that dissociation remains related to trauma history when fantasy proneness is controlled. We find little support for the hypothesis that the dissociation-trauma relationship is due to fantasy proneness or confabulated memories of trauma.
The present study examined patterns of serious mental illness (SMI), specific mental health syndr... more The present study examined patterns of serious mental illness (SMI), specific mental health syndromes, and service use among older (65ϩ) and younger (18 -64) adults throughout the United States, and the extent to which various factors predict SMI and the use and magnitude of mental health treatment. Despite recent developments designed to improve mental healthcare access and treatment for older adults, older individuals were found to receive outpatient mental healthcare at very low rates. Compared to younger adults, older adults were three times less likely to report receiving treatment. Although prevalence estimates for SMI and specific syndromes were markedly lower among older than younger adults, older individuals most in need of care were highly unlikely to report receiving treatment. Findings point to the importance of perceived need in mental healthcare use. Significantly, however, those older adults that made it into services typically reported benefiting considerably from treatment, at least as much as all other age groups. Several predisposing, enabling, and need factors related to mental illness and service use were identified that have important implications for how we plan for, design, and deliver mental health services to older and younger Americans.
Objective: We developed and tested the psychometric properties of Spanish versions of the Trait a... more Objective: We developed and tested the psychometric properties of Spanish versions of the Trait and State Food Cravings Questionnaires (FCQ–T and FCQ–S respectively). Method: The instruments were translated and adapted to Spanish and administered to undergraduate students from a Southern university in Spain (N=271). The data were analyzed using confirmatory factor analysis to compare the factor structure of the English and Spanish versions of both questionnaires. Results: The factors structure of both questionnaires obtained excellent fit indices across their Spanish versions with the one exception that some factors of the FCQ–S were more highly intercorrelated among the Spanish sample than the American. Discussion: This study supports the conceptualization of food cravings as universal multidimensional motivational states that can be reliably measured and supports the use of the Spanish versions of the FCQ.
This study evaluated the score reliability and equivalence of factor structure of the Sociocultur... more This study evaluated the score reliability and equivalence of factor structure of the Sociocultural Attitudes towards Appearance Questionnaire-3 (SATAQ-3) [1] in a sample of female college students from the four largest ethnic groups in the USA. Participants were 1245 women who self-identified as European American/White (n = 543), African American/Black (n = 137), Asian American (n = 317), or Latina/Hispanic (n = 248). All completed the SATAQ-3 and a demographic questionnaire. To test the factor similarity and score reliability across groups, we used exploratory factor analysis and calculated Cronbach's alphas (respectively). Score reliability was high for all groups. Tests of factor equivalence suggested that the four pre-established factors of the SATAQ-3 (i.e., knowledge, perceived pressure, thin-ideal internalization, athletic-ideal internalization) were similar for women of all ethnic groups. Only two items (20 and 27) did not consistently load on the previously identified ...
Cultural diversity & ethnic minority psychology, 2000
To determine if the Hopkins Symptom Checklist-21 demonstrates equivalent validity across differen... more To determine if the Hopkins Symptom Checklist-21 demonstrates equivalent validity across different ethnic groups, the authors tested the factor structure of the instrument with a sample of European American (n = 514), African American (n = 154), and Latino (n = 229) college students using confirmatory factor analysis with tests of invariance across groups. For the most part, a 3-factor model with Performance, General, and Somatic factors fit equally well for all 3 racial/ethnic groups. Differences involved only a few items in terms of either the strength of a factor loading or an error term. The results generally support the validity of the use of the instrument for measurement of distress in these different racial/ethnic groups.
We investigated the question of whether anorexia and bulimia nervosa occur on a continuum versus ... more We investigated the question of whether anorexia and bulimia nervosa occur on a continuum versus being discrete classes using two taxometric procedures: Mean Above Minus Below a Cut (MAMBAC) and Maximum Covariance (MAXCOV) analysis. ...
As a preliminary step in researching "orthorexia nervosa," an alleged syndrome characterized by a... more As a preliminary step in researching "orthorexia nervosa," an alleged syndrome characterized by a pathological fixation on healthy eating, we designed the 21-item Eating Habits Questionnaire (EHQ) to assess the cognitions, behaviors, and feelings related to an extreme focus on healthy eating. Study 1 (n = 174) examined the factor structure of the EHQ and refined the instrument with exploratory factor analysis. Results suggested a 3factor solution with the following subscales: knowledge of healthy eating, problems associated with healthy eating, and feeling positively about healthy eating. The subscales displayed good internal consistency (α = .87 to .91) and test-retest reliability (r =.74 to .87).
Based on previous literature, we proposed and tested a model of the relationships between child s... more Based on previous literature, we proposed and tested a model of the relationships between child sexual abuse (CSA), body image, dieting, and bulimic behavior. The model specified that body image functioned as a mediator between CSA and eating disturbance. Multiple measures of each of the constructs of interest were collected from a sample of 222 college age women, and the data were analyzed using structural equation modeling. Both the measurement model and the proposed structural model demonstrated an adequate fit. As with previous research, results support a model in which body image strongly affects dieting behavior, which in turn directly affects bulimic behavior. The results did not appear to support the proposed mediational model involving the hypothesized indirect effect of CSA on eating pathology. There was, however, a small direct relationship between CSA and bulimic behavior and a moderate relationship between CSA and posttraumatic symptomatology.
Most patients consulting physicians have a mixture of physical and mental complaints that require... more Most patients consulting physicians have a mixture of physical and mental complaints that require careful differential diagnosis. A somatoform disorder is diagnosed when the primary disorder is a mental disorder with prominent physical complaints. The assessment and treatment of somatoform disorders requires patience and compassion to maintain a therapeutic alliance, but randomized controlled trials show that treatment with antidepressants or cognitive-behavioral therapy reduce health care use and subjective distress.
The relationship between a reported history of trauma and dissociative symptoms has been explaine... more The relationship between a reported history of trauma and dissociative symptoms has been explained in 2 conflicting ways. Pathological dissociation has been conceptualized as a response to antecedent traumatic stress and/or severe psychological adversity. Others have proposed that dissociation makes individuals prone to fantasy, thereby engendering confabulated memories of trauma. We examine data related to a series of 8 contrasting predictions based on the trauma model and the fantasy model of dissociation. In keeping with the trauma model, the relationship between trauma and dissociation was consistent and moderate in strength, and remained significant when objective measures of trauma were used. Dissociation was temporally related to trauma and trauma treatment, and was predictive of trauma history when fantasy proneness was controlled. Dissociation was not reliably associated with suggestibility, nor was there evidence for the fantasy model prediction of greater inaccuracy of recovered memory. Instead, dissociation was positively related to a history of trauma memory recovery and negatively related to the more general measures of narrative cohesion. Research also supports the trauma theory of dissociation as a regulatory response to fear or other extreme emotion with measurable biological correlates. We conclude, on the basis of evidence related to these 8 predictions, that there is strong empirical support for the hypothesis that trauma causes dissociation, and that dissociation remains related to trauma history when fantasy proneness is controlled. We find little support for the hypothesis that the dissociation-trauma relationship is due to fantasy proneness or confabulated memories of trauma.
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