Source: https://www.dmu.ac.uk/about-dmu/academic-staff/health-and-life-sciences/vicki-aldridge/vicki-aldridge.aspx
Timestamp: 2019-04-18 14:53:04+00:00

Document:
Dr Vicki Aldridge's research interests lie in the development of eating behaviour and dietary change across the lifespan, with a particular focus on the characteristics and biopsychosocial underpinning of disordered feeding in childhood, as well as the behaviours themselves. She is also interested in the wider context (family, peers, culture, etc.) of both typical and atypical eating behaviours, and in the physical, psychological, and social outcomes of different eating patterns.
Bone Health in Adult Women with ED: A Longitudinal Community-Based Study Robinson, L.; Aldridge, V. K.; Clark, E. M.; Misra, M.; Micali, N. Although Eating Disorders (ED) are known to affect bone health and development, little is known about the longitudinal effect of ED and ED behaviours on bone health in community dwelling adult women. Women (n=3,507) enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) participated in a two-phase prevalence study to assess lifetime ED and ED behaviours (fasting, restrictive eating, vomiting and misuse of medication). Crude and adjusted linear regression methods investigated the association between ED diagnoses and behaviours, and total body, hip, leg and arm bone mineral density (BMD) DXA scans at mean ages of 48 and 52 years. Lifetime occurrence of Anorexia Nervosa (AN) was associated with lower BMD Z-scores for the whole body (mean difference (MD) =-0.28; 95% CI: -0.49, -0.05), hip (MD=-0.45; 95% CI -0.74, -0.16), leg (MD=-0.28; 95% CI -0.52, -0.03) and arm (MD=-0.44; 95% CI -0.68, -0.19) compared to no ED. This effect was mostly accounted for by lowest ever BMI. In post-hoc analyses, Restrictive AN, but not Binge-Purge AN was associated with a lower total body BMD Z-scores (MD=-0.37; 95% CI -0.62, -0.12). Lifetime Fasting and Restrictive Eating were associated with low BMD of the total body, hip, arm and leg in adjusted analyses, all p<0.05. Both lifetime ED diagnoses and ED behaviours in a large community sample were predictive of low BMD in mid-life. This study confirms that the effects of AN, fasting and restrictive eating, and low BMI on bone health seen in clinical samples also occur in community samples.
Observation and comparison of mealtime behaviours in a sample of children with avoidant/restrictive food intake disorder and a control sample of children with typical development Aldridge, V. K.; Dovey, T. M.; El-Hawi, N.; Martiniuc, A.; Martin, C. I.; Meyer, Caroline Objectives: Despite widespread use of behavioural observations to evaluate child feeding behaviours in research and clinical practice, few studies have comprehensively characterised mealtimes or identified features that differentiate children with and without disordered feeding; these were the aims of the current study. Methods: Mealtime observations were conducted for 18 children with Avoidant Restrictive Food Intake Disorder (ARFID) and 21 typically developing children. Observations were coded inductively, and associations between disorder and observed mealtime actions were examined. Results: Most behaviours were observed across both clinical and non-clinical mealtimes, and many did not differ in frequency between children with and without ARFID. However, significant group differences were observed in the frequencies of behaviours relating to food intake, visual and physical engagement with feeding, and movement during mealtimes. Conclusions: The comparability of behaviours across clinical and non-clinical groups suggests that eating behaviours exist on a continuum from ‘normal’ to ‘abnormal’, with group differences relating to frequency rather than type of behaviour. The behavioural differences observed in this study suggest that identification of children with ARFID should focus on child engagement with food and restlessness during mealtimes. Reliance on emotional and escape-maintained behaviours will lead to under-recognition of families in need of clinical support. The file attached to this record is the author's pre- peer reviewed version. The Publisher's final version can be found by following the DOI link.
Assessing test-retest reliability of psychological measures: persistent methodological problems Aldridge, V. K.; Dovey, T. M.; Wade, A. Psychological research and clinical practice rely heavily on psychometric testing for measuring psychological constructs that represent symptoms of psychopathology, individual difference characteristics, or cognitive profiles. Test-retest reliability assessment is crucial in the development of psychometric tools, helping to ensure that measurement variation is due to replicable differences between people regardless of time, target behavior, or user profile. While psychological studies testing the reliability of measurement tools are pervasive in the literature, many still discuss and assess this form of reliability inappropriately with regard to the specified aims of the study or the intended use of the tool. The current paper outlines important factors to consider in test-retest reliability analyses, common errors, and some initial methods for conducting and reporting reliability analyses to avoid such errors. The paper aims to highlight a persistently problematic area in psychological assessment, to illustrate the real-world impact that these problems can have on measurement validity, and to offer relatively simple methods for improving the validity and practical use of reliability statistics. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
Pharmacological treatment options for low Bone Mineral Density and secondary osteoporosis in Anorexia Nervosa: A systematic review of the literature.
Pharmacological treatment options for low Bone Mineral Density and secondary osteoporosis in Anorexia Nervosa: A systematic review of the literature. Robinson, L.; Aldridge, V. K.; Clark, E. M.; Misra, M.; Micali, N. Objective: Although there are several evidence-based treatments available to increase Bone Mineral Density (BMD) and reduce fracture risk in aging men and women, there are still uncertainties regarding which treatments are efficacious in reducing lifetime fracture risk in women with Anorexia Nervosa (AN). Methods: Medline, PsychInfo, Embase and the Cochrane Database were searched for English Language Studies. Inclusion criteria were studies of females of any age with AN who received pharmacological treatment with the primary aim to increase BMD or reduce fracture risk. Data were extracted from each study regarding pharmacological treatment and dosage used, BMD and bone formation marker outcomes; and participant characteristics including age, Body Mass Index (BMI), duration of AN, and duration of amenorrhea. Results: 675 studies were reviewed, of which 19 fit the inclusion criteria and were included in the final review, investigating a total of 1119 participants; 10 of the 19 included studies were double-blind RCTs. The remaining studies consisted of prospective observational studies, a retrospective cohort study, a case-control study and five non-randomised control trials. Bisphosphonates were effective in increasing BMD in adult women with AN, while estrogen administered transdermally resulted in significant increases in BMD in mature adolescents with AN. Administration of Oral contraceptives (OC) did not significantly increase BMD in randomised or controlled trials, however, lifetime OC use was associated with higher spinal BMD. Conclusion: Future research should clarify the safety of long-term bisphosphonate use in adult women with AN, and verify that transdermal estrogen replacement increases BMD in women with AN. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
Screening Avoidant/Restrictive Food Intake Disorder (ARFID) in children: Outcomes from utilitarian versus specialist psychometrics.
Screening Avoidant/Restrictive Food Intake Disorder (ARFID) in children: Outcomes from utilitarian versus specialist psychometrics. Dovey, T. M.; Aldridge, V. K.; Martin, C. I.; Wilken, M.; Meyer, Caroline This study assessed the specificity and sensitivity of two commonly used psychometric methods to assess ARFID in children. To achieve this, a sample of 329 mothers and one father completed the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and the Child Food Neophobia Scale (CFNS). A Receiver Operating Characteristic (ROC) analysis indicated that both measures were able to successfully differentiate a known clinical sample from those of typically developing population. Although the BPFAS was more accurate at differentiating ARFID from the general population, the CFNS was acceptable and on some metrics better than its longer counterpart. The ability of a food neophobia scale to differentiate clinical and population samples, and detect gradation of food avoidance within the population sample, suggests that the multitude of psychometric measures available may be measuring similar constructs. Therefore, confidence can be expected in cross-site comparisons despite each using different psychometric measures of food avoidance in children. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
A systematic review and meta-analysis of the association between eating disorders and bone density.
A systematic review and meta-analysis of the association between eating disorders and bone density. Robinson, L.; Aldridge, V. K.; Clark, E. M.; Misra, M.; Micali, N. This meta-analysis investigates the effect of an eating disorder on bone mineral density in two eating disorder subtypes. Following conflicting findings in previous literature, this study finds that not only anorexia nervosa, but also bulimia nervosa has a detrimental effect on BMD. Key predictors of this relationship are discussed. This systematic review and meta-analysis investigates bone mineral density (BMD) in individuals with anorexia nervosa (AN) and bulimia nervosa (BN) in comparison to healthy controls (HCs). AN has been associated with low BMD and a risk of fractures and mixed results have been obtained for the relationship between BN and BMD. Deciphering the effect these two ED subtypes on BMD will determine the effect of low body weight (a characteristic of AN) versus the effects of periods of restrictive eating and malnutrition which are common to both AN and BN. We conducted a systematic search through the electronic databases MedLine, EMBASE and PsychInfo and the Cochrane Library to investigate and quantify this relationship. We screened 544 articles and included 27 studies in a random-effect meta-analysis and calculated the standardised mean difference (SMD) in BMD between women with a current diagnosis of AN (n = 785) vs HCs (n = 979) and a current diagnosis of BN (n = 187) vs HCs (n = 350). The outcome measures investigated were spinal, hip, femoral neck and whole body BMD measured by DXA or DPA scanning. A meta-regression investigated the effect of factors including age, duration since diagnosis, duration of amenorrhea and BMI on BMD. The mean BMI of participants was 16.65 kg/m2 (AN), 21.16 kg/m2 (BN) and 22.06 kg/m2 (HC). Spine BMD was lowest in AN subjects (SMD, −3.681; 95 % CI, −4.738, −2.625; p < 0.0001), but also lower in BN subjects compared with HCs (SMD, −0.472; 95 % CI, −0.688, −0.255; p < 0.0001). Hip, whole body and femoral neck BMD were reduced to a statistically significant level in AN but not BN groups. The meta-regression was limited by the number of included studies and did not find any significant predictors. This meta-analysis confirms the association between low BMD and AN and presents a strong argument for assessing BMD not only in patients with AN, but also in patients with BN. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
The relative contributions of parent perceived child characteristics to variation in child feeding behaviour.
The relative contributions of parent perceived child characteristics to variation in child feeding behaviour. Aldridge, V. K.; Dovey, T. M.; Martin, C. I.; Meyer, Caroline Background: Few studies have examined the relative impact of co-occurring child characteristics on problematic feeding behaviour. The aim of the current study was to assess the relative contributions of parent perceived child characteristics in multi-variable models of child feeding behaviour. Methods: 161 mothers reported on their child’s feeding behaviour and a number of key child characteristics. These characteristics were entered into controlled multivariable models of child feeding behaviour, using child and parent frequency domains of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) as outcome measures. Results: Child feeding problems were positively associated with food neophobia and external behavioural and social issues, but not with most domains of temperamental difficulty or sensory sensitivity. Feeding problem frequency was associated with externalising symptoms, whilst parental perceptions of problems and coping were associated with social-interaction problems in the child. Conclusions: Population feeding problems appear to be external and interactive problems, rather than driven by innate or internalising factors. The association with externalising symptoms suggests that feeding problems at this level may fall within a wider profile of challenging behaviour. However, the existence of problematic feeding behaviours may only constitute a challenge for parents when the child’s social interactions are also seen to be deficient. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
Formative Feedback - Supporting and Enhancing Teaching and Learning in Statistics.
Screening for feeding disorders. Creating critical values using the behavioural pediatrics feeding assessment scale.
Screening for feeding disorders. Creating critical values using the behavioural pediatrics feeding assessment scale. Dovey, T. M.; Jordan, C.; Aldridge, V. K.; Martin, C. I. The aim of the current study was to discriminate between clinical and non-clinical samples on the Behavioural Pediatrics Feeding Assessment Scale (BPFAS). The objective was to present a cut-off value, that was derived statistically, which could be used to screen for feeding disorders. A sample of five hundred and seventy-three families with a target child ranging in age from 20 to 85 months took part in the current study. Sixty-four children had a known diagnosis of a feeding disorder and were embedded into a typically developing sample of families that had not sought professional intervention. All families completed the BPFAS in order to provide a known database to measure discriminative statistics. The Receiver Operating Characteristic (ROC) analysis indicated that the cut off value for the BPFAS was a Child Frequency score of 61 and a Child Problem score of six. This offered an 87% accuracy rate at these values. The current study offered definitive evidence that the BPFAS was accurate (both sensitive and specific) to determine differences between clinical and non-clinical samples in the United Kingdom. It is therefore advocated that BPFAS should be adopted in future studies exploring the impact of feeding disorders and problems in both clinical and research settings.
Measuring oral sensitivity in clinical practice: A quick and reliable behavioural method.
Measuring oral sensitivity in clinical practice: A quick and reliable behavioural method. Dovey, T. M.; Aldridge, V. K.; Martin, C. I. This article aims to offer a behavioural assessment strategy for oral sensitivity that can be readily applied in the clinical setting. Four children, ranging in age and with a variety of developmental and medical problems, were used as test cases for a task analysis of tolerance to touch probes in and around the mouth. In all cases, the assessment was sensitive to weekly measures of an intervention for oral sensitivity over a 3-week period. Employing an inexpensive, direct, specific to the individual, replicable, reliable, and effective measure for a specific sensory problem would fit better with the edicts of evidence-based practice. The current method offered the initial evidence towards this goal.

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