The Arizona healthcare system is changing and although its effects can be seen in almost every realm of the medical field, psychiatry is a specialty that is still experiencing hardship. There are scarce resources available for the ever-growing and struggling patient pool, especially in rural areas and minority populations. A comorbid cycle of untreated psychiatric illness contributes to the burden on emergency department and primary care medicine, as well as homelessness, crime, and suicide within the state. Arizona currently has a dismal spot in the rankings for American states with appropriate access to psychiatric resources, leaving many who need treatment without it. Compared to states with similar populations who are at the top of these rankings, Arizona spends more government money for behavioral health services, indicating a disparity in productivity and questioning monetary waste. Demographic statistics and other relevant scientific literature reveals that Arizona's psychiatric system lacks appropriate structure, and is failing the mental health care system both in monetary and societal constructs. These issues highlight the need for remedies and identify areas for future reform. Recommendations on such reform include permanent change in legislation and department models to improve crisis ward work, communication and networking during transition of care, integration of and access to continuum of care, and community education. They also include creating incentive and certification programs within the state in order to increase the number of available providers, especially in rural areas. These recommendations are directed to specifically reduce the burden of mental illness on emergency medical services, increase productivity, and decrease chronic untreated mental disease and monetary waste.

Background: Body acceptance programs on college campuses indicated that collegiate women often report feeling pressure to dress in a sexualized manner, and use makeup to enhance beauty. Currently, no quantitative measures exist to assess attitudes and daily behaviors that may arise in response to perceived pressure to wear makeup or dress in a provocative manner. The goal of the current studies was to develop brief self-report questionnaires aimed at assessing makeup and sexualized clothing use and attitudes in young women.

Methods: An exploratory factor analysis in a sample of 403 undergraduate women was used in Study 1 to create items to measure the pressure women feel to wear makeup and sexualized clothing. A confirmatory factor analysis (N = 153) was used in Study 2 to confirm the factor structure found in Study 1. An incremental validity analysis was also conducted in Study 2. Across both studies, participants completed online questionnaires.

Results: In Study 1, items were developed for two questionnaires to assess perceived pressure to wear makeup and discomfort when not wearing makeup, and perceived pressure to wear sexualized clothing, and body image concerns with regards to sexualized clothing. The exploratory factor analyses revealed Unconfident and Unease scales for the Makeup Questionnaire (MUQ) and Body Dissatisfaction and Pressure scales for the Sexualized Clothing Questionnaire (SCQ). In Study 2, the confirmatory factor analyses confirmed the factor structure for the MUQ and SCQ. The incremental validity analysis revealed that these measures can be used to predict self-objectification and shape and weight concern in women.

Conclusion: These studies provide preliminary support for the factor structure of two novel questionnaires aimed at assessing perceived pressure to wear makeup and sexualized clothing.

Prior research has identified that clinicians in the treatment of eating disorders often do not adhere closely to empirically-supported treatments (EST), and are particularly likely to modify Cognitive-Behavioral therapy (CBT). Several reasons for this phenomenon, dubbed "clinician drift", have been identified, including level of clinician training, education, and type of patient care. In addition to the phenomenon of clinician drift, there has been a growing controversy within the field of clinical psychology about the compatibility of ESTs and multiculturalism. Some argue that the standardization inherent to EST resists the concept of cultural adaptability; while others have countered that cultural adaptability is essential in order for empirically supported treatments to remain relevant, ethical, and effective. In order to shed more light on this issue, this study examined how clinicians tend to drift from CBT in the treatment of Latinos suffering from eating disorders, in order to accommodate Latino culture and elements of eating behavior specific to Latino populations. We both attempted to replicate prior findings regarding predictors of clinician drift, as well as build upon the little existing research into the "culturally-motivated clinician drift." It was discovered that no therapist characteristics or client characteristics were predictive of drift. However, the majority of the sample still adapted or abandoned at least part of the CBT treatment. Their responses regarding the weaknesses of CBT for their Spanish-speaking clients can provide insight into how the treatment can be modified for more diverse clients.

In this study, potential differences in the manifestation and rates of eating disorders and symptoms (body dissatisfaction, weight and shape concerns, food restriction, and compensatory behaviors) in college women across sexual orientations were examined. The sociocultural model of eating disorders was also examined for these women across sexual orientations. The participants were organized into three different sexual orientation groups for analysis: heterosexual (group 1), bisexual, pansexual, and polysexual (group 2), and lesbian, gay, queer, transsexual, asexual, and other (group 3). Using cross-sectional data, it was revealed that there were significant group differences when comparing the three sexual orientation groups on loss of control over eating, but no significant group differences on body dissatisfaction, thin ideal internalization, and weight-related eating pathology, and total eating disorder symptoms scores. The sociocultural model was not predictive of eating disorder symptoms among non-heterosexual groups. Longitudinal analyses revealed that the sociocultural model of eating disorders prospectively predicts eating disorder symptoms among heterosexual women, but not non-heterosexual women. Both cross-sectional and longitudinal analyses indicate that non-heterosexual women may be protected from societal pressure to subscribe to the thin ideal and its subsequent internalization. However, the comparison group of heterosexual women in our study may not have been completely representative of undergraduate women in terms of total eating disorder symptoms or eating pathology. Additionally, regardless of sexual orientation, our sample reported more total eating disorder symptoms and emotional eating than previous studies. These findings have both clinical and research implications. Future research is needed to determine what risk factors and treatment target variables are relevant for non-heterosexual women.

Previous studies suggest an association between depression and anxiety in childhood and adolescence and increased risk for cardiovascular disease later in life. The aim of the present study was to test whether depression and anxiety symptoms in young adulthood were associated with retinal vessel diameter, a subclinical marker of cardiovascular disease. We further tested whether associations for depression were similar to associations for anxiety. Participants completed questionnaires about their depression and anxiety symptoms and underwent retinal imaging. Retinal vessel diameter was assessed using computer software. Results showed no association between depression or anxiety symptoms and retinal vessel diameter, suggesting that retinal vessel diameter may not signal subclinical cardiovascular risk in young adults with symptoms of depression and anxiety.

Today's society increasingly sexualizes women (Kilbourne, 2003). Women are constantly confronted with an image of beauty through various forms of media. Body acceptance programs on college campuses have found that women often report feeling pressure to dress in a sexualized manner, cover up their so-called flaws with make-up, and continually strive to be thin. Currently, no measure exists to assess the daily behaviors of women to wear make-up or dress in certain ways due to body image concerns. Thus, the goal of the current studies was to develop a brief self-report questionnaire on make-up and sexualized clothing for college women. In Study 1, items were developed from qualitative data collected by the Body Project Prevention Program to assess pressure to wear make-up, discomfort when not wearing make-up, pressure to wear sexualized clothing, and body image concerns with regards to sexualized clothing. Exploratory factor analyses revealed a Confidence and a Comfort subscale for the Make-up Questionnaire (MUQ) and a Body Dissatisfaction and Pressure subscale for the Sexualized Clothing Questionnaire (SCQ). Confirmatory factor analyses in Study 2 confirmed the factor structure for the MUQ and SCQ. Study 3 compared scores on the MUQ and SCQ among intervention and control groups across time points. A gain score analysis revealed that women in the intervention did not become significantly healthier over time in comparison to the control group on the MUQ and SCQ subscales. However, the treatment condition did become significantly healthier over time in regard to other measures of eating pathology. These studies provide insight into the pressures women feel to wear make-up and sexualized clothing.

Literature on the undocumented population in the United States is rich, and is growing in the area of the 1.5 generation (which refers to undocumented individuals, typically under age 30, who have grown up in the U.S.), but is scant regarding the health of this population, how they alleviate illnesses and what resources they have to do so. While Deferred Action for Childhood Arrivals (DACA) provides temporary benefits to undocumented youth, a DACA health gap persists. Even for those who are awarded DACA, when compared to their citizen counterparts, resources are still unequal. The 1.5 generation faces unique health challenges and even with policy progress, circumstances tied to their documentation status leave them reverting back to limited resources. In this study, ten members of this generation were interviewed. Findings show that they suffer from minor physical health challenges, but significant mental and emotional health challenges without the means to access adequate healthcare comparable to their citizen counterparts.

Introduction: The current study aimed to explore the prevalence rates of binge-eating and weight compensatory behaviors across sexual minority undergraduate men and women. Methods: The sample included 3411 undergraduate men and women from a large public university. Participants completed a self-report online questionnaire regarding various personality, social networking, and health behaviors. Results: Analyses showed no difference in binge-eating for women, but statistically significant differences across sexual orientation groups for weight compensatory behaviors. Analyses for men showed statistically significant differences between sexual orientation groups for objective-binge eating and self-induced vomiting. There were no differences among men for other behaviors. Discussion: These findings demonstrate both statistically and clinically significant differences across sexual orientation groups indicating that gender as well as sexual orientation bear a correlation to the propensity to engage in certain disordered eating behaviors.

This study assessed the effects of running an eating prevention program on body image satisfaction/behavior and the leadership skills of collegiate women. The sample included a group of 43 undergraduate women who voluntarily chose to become peer-educators in the eating prevention program called the Body Project. Self-report questionnaires evaluating both the preoccupation with personal body image and general leadership skills were distributed and collected electronically. The results were analyzed to determine that being a peer leader in the Body project did not increase eating disorder symptoms but actually decreased the symptoms. It was also determined that being a peer educator had no effect on leadership skills. Therefore, being a peer leader is beneficial for reducing eating disorder symptoms, but not for advancing leadership skills.

Pediatric obesity is a public health concern due to its elevated prevalence rates and its relation to concurrent and long-term physical and psychosocial consequences. Pediatric obesity has been found to be associated with problem behaviors, albeit with inconsistent findings. The mechanism of this relation is unclear. It is possible that they have a shared etiology. Self-regulation and parenting practices are two factors that have been implicated in the development of problem behaviors and are garnering evidence for their relation with pediatric obesity. The goal of the present study was to examine whether self-regulation (SREC), positive behavior support (PBSEC), and coercive limit-setting (CLSEC) in early childhood are shared etiological factors of pediatric obesity and problem behaviors. Using multinomial logistic regression the likelihood of belonging to four outcome groups (Comorbid, Problem behavior only, Overweight only, and Typically developing) at age 10 based on these factors was assessed. Analyses controlled for intervention group assignment, child gender, child African-American or Bi-racial, child Hispanic, cumulative risk, child body size impression at age 2, and parent body size impression at baseline. In the models examining SREC alone, for every 1 standard deviation increase in SREC, there was a reliable reduction in the odds of the child belonging to the comorbid and problem behavior only groups at age 10, compared to the typically developing group (OR = 0.386, 95% CI [0.237, 0.628], OR = 0.281, 95% CI [0.157, 0.503], respectively). This relation was maintained when SREC was in the same model as PBSEC and CLSEC. PBSEC and CLSEC alone did not impact the likelihood of belonging to any of the outcome groups. A significant interaction was found between SREC and CLSEC, such that at high levels of both SREC and CLSEC the odds of a child belonging to the overweight only group at age 10 increased, compared to the typically developing group. Results highlight CLSEC as a parenting practice that may place a highly regulated child at risk for becoming overweight. Overall, the findings suggest that problem behaviors and pediatric obesity do not have a shared etiology.