Experiences Of People Research Articles

Crafting Subverses: A Narrative Analysis of the Experience of Losing a Parent through Intimate Partner Homicide

Abstract Purpose Losing a parent due to intimate partner homicide is a traumatic experience, exacerbated by homicide and the associated grief being a taboo in many western cultures. This study investigated the experiences of young people and adults bereaved by parental intimate partner homicide during childhood, to gain a better understanding of how they make sense of and share their personal story after such a loss. Methods Within the context of a larger study, we conducted twelve semi-structured interviews with people with lived experience of such deaths in Australia and used narrative analysis to interpret the data. Results Participants were frequently confronted with imposed narratives (i.e., from family, practitioners, peers) about the homicide, their parents, and their own identities, leading to a deep sense of loneliness and feeling misunderstood, powerless, and silenced. In various ways, participants resisted imposed narratives and took control over their stories. This process was difficult but could lead to improved and more authentic relationships with oneself, family, and others. In this way, participants used their experiences to transform themselves and others, sometimes by becoming advocates or practitioners supporting others with similar experiences. Conclusions We named this process of taking control of one’s story “crafting subverses.” It involved making sense of and sharing experiences of trauma and grief for personal healing and social justice. Helping children craft their “subverses” may be an important aspect of gaining a deeper understanding of how to support them. Provision of carefully tailored peer mentoring, professional support and opportunities to influence programs and policy appear key to better support systems for those bereaved due to parental intimate partner homicide.

A Systematic Review of Residential Care for Children and Young People with Disabilities: Towards the Development of Quality Indicators

AbstractConsidering data that suggests an overrepresentation of children/youth with disabilities in Residential Care Homes (RCH), placing them in a situation of accumulation of risk factors and increased vulnerability, this study presents a systematic literature review (SLR) focused on this target group. Research questions address prevalence rates, characteristics and outcomes of children/youth with disabilities in RCH; characteristics and practices of RCH, and evidence-based interventions; and recommendations to improve practices to support the development of quality indicators to improve the experience of children and young people with disabilities in RCH. Methodology followed PRISMA-P and the protocol was registered with PROSPERO. Five databases were used and 31 studies were included. Results demonstrate the need for clear definitions of disability to ensure consistent data and guide policymaking for RCH. Moreover, results show gaps in research on the experiences of children/youth with disabilities in RCH, and on specific interventions for this population. Based on the recommendations offered by the literature, this SLR contributes to the development of quality indicators that consider the needs of children/youth with disabilities in RCH and promote their participation in all areas of life.

Empowering Young People in Shaping an Intersectional Future for Public Spaces

Public spaces, such as squares, urban parks, and communal areas are arenas that reflect societal values and power structures, influencing who has access and how they engage with these spaces. This viewpoint explores the application of intersectionality—considering factors like gender, race, and socioeconomic status—in understanding how diverse identities shape the lived experience of young people in public spaces. More specifically, it focuses on girls, and it reflects on the intersectional challenges girls face in four different contexts to include Belgium, South Africa, Iran, and Sweden. The analysis reveals the complexities of safety, accessibility, and inclusion girls face across all cases. This viewpoint underscores the value in using an intersectional lens in designing inclusive public spaces and highlights the pivotal role of young people as advocates for change.

"All the horrible emotions have passed, I still remained, and I was safe": A qualitative study of Lesbian and Gay people's lived experience of completing a full Dialectical Behaviour Therapy programme.

Lesbian and Gay people (LGP) experience higher rates of mental health difficulties, including self-harm, suicidal behaviours, as well as inequalities in health care, than their heterosexual peers. Dialectical Behaviour Therapy (DBT) is an evidence-based treatment for self-harm and suicidal behaviours, though there is little research on LGP's experiences of DBT. This research aims to explore LGP's experiences of completing a full DBT programme. A qualitative design with semi-structured individual interviews was utilised. The results were analysed using Interpretative Phenomenological Analysis. Six lesbian and two gay adults, aged between 22 and 47 years, living in the United Kingdom took part. All participants had completed a full programme of DBT within the 2 years prior to the interview. Four superordinate themes emerged from the data: (1) The DBT journey; (2) Connections and Sense of Community during DBT; (3) Sexuality both visible and invisible in DBT and (4) A Gender, Sexuality and Relationship Diverse (GSRD) affirmative future for DBT. Several clinical implications are suggested to improve DBT for LGP, for example to consider having other LGP within DBT groups, to create a more GSRD-affirming DBT (changes to the DBT manual, DBT therapists, DBT programme and physical DBT space), to adapt DBT techniques to manage sexuality-related difficulties and to adopt a GSRD-centric framework. Overall, DBT appears to be beneficial for LGP.

Automatic Gesture-Based Arabic Sign Language Recognition: A Federated Learning Approach

Featuring machine learning algorithms for recognizing hand gesture patterns adjusted for individuals with disabilities is an expanding trend in assisted living. This paper addresses the challenge of interpreting the semantics of image-based hand gestures by introducing a federated deep learning architecture for Arabic sign language recognition. The proposed model manages distributed learning through a client-server paradigm, wherein several edge nodes collaborate to jointly learn the discriminative features of confidential data without breaching its privacy. This model will enable more accessibility for people with deafness or impairment using image gestures. The federated learning procedure is primarily based on the ResNet32 deep backbone and federated averaging mechanism. The experimental results show the effectiveness of the proposed FL model, achieving an accuracy of 98.30% with 33 seconds on average for each client in a single training round. This demonstrates its high capabilities in recognizing Arabic sign language and improving the communication experience for people with disabilities.

Ethnic inequalities in primary care experiences for people with multiple long-term conditions: Evidence from the general practice patient survey

ObjectivesTo examine the relationship between ethnicity and experiences of primary care for people with multiple long-term conditions (MLTCs) and assess the relative importance of demographic, practice, and area-level factors as influences on primary care experiences across ethnic groups. Study designA retrospective study using 2018–19 GP Patient Survey data linked to General Practice Workforce data and small area data published by the Office for National Statistics. MethodsWe conducted multilevel regression analysis to assess the relationship between ethnicity and experience of accessing primary care and interacting with healthcare professionals. We built separate regression models for each outcome and included (i) each covariate separately, (ii) demographic factors and (iii) demographic, practice, and area-level factors. ResultsUpon full adjustment Arab, Bangladeshi, Chinese, Indian, Pakistani, other Asian, mixed white and Asian, and other white people with MLTCs have lower levels of satisfaction with primary care access and interacting with healthcare professionals compared with white British people. The influence of demographic, practice and area-level factors is not uniform across ethnic groups; demographic factors account for the inequalities in levels of satisfaction with access to primary care between white British people and Black other, mixed other, mixed white & Black Caribbean and Gypsy & Irish Travellers. However, practice and area-level factors strengthen inequalities in the experience of accessing primary care for Bangladeshi, Indian and Pakistani people. ConclusionsGiven the link between patient satisfaction and patient-related health outcomes, the lower levels of satisfaction with accessing primary care and interacting with healthcare professionals among the aforementioned minoritised ethnic groups are concerning and require further scrutiny. Qualitative studies are required to understand and address the sources of poor experiences in primary care for minoritised people with MLTCs to improve patient-centred healthcare and outcomes.

Access to transition-related health care among transmasculine people in India: A mixed-methods investigation.

Little research has examined the health care experiences of transmasculine people in India, where government initiatives to improve access to transition-related (also called gender-affirmative) care have recently been announced. We draw on data from 'Our Health Matters', a mixed-methods community-based participatory research project, to characterize the transition-related care experiences of transmasculine people in India. Peer researchers conducted 40 virtual qualitative interviews in Hindi or Marathi from July to September 2021. Between November 2022 and January 2023, 377 transmasculine people participated in a multi-mode survey available in five languages. Qualitative data were analysed with a combination of framework analysis and grounded theory techniques. Data were mixed using a convergent parallel approach. Transmasculine persons' care journeys began with information-seeking, relying on peers and internet searches. In choosing between the public and private healthcare systems, they weighed issues of quality and affordability: the public system was perceived as lower-quality and difficult to access but most could not afford private care, leading to delays in care. Indeed, unmet need was common; 36.4% of survey participants were planning but had not begun to receive transition-related care and 80.2% wanted at least one transition-related surgery. Although some participants encountered stigma and refusal of care when seeking hormones, survey participants reported largely positive experiences with their hormone prescribers, which may reflect the influence of peer referrals. Participants underwent psychological assessments prior to transition-related care, which some experienced as disempowering and a barrier to disclosing mental health challenges. Finally, participants who were able to access care reported improved well-being, although surgical dissatisfaction was not uncommon (26.2%). Trans-inclusive medical training and continuing education are critical to enhancing access to high-quality transition-related care. Transmasculine people generally relied on peers and grassroots organizations for information, system navigation, and financial assistance. Strengthening these existing community resources may improve access to care.

Emotional Intelligence Profiles among Lesbians, Gays and Bisexuals (LGB) People: Their Influence on Mental Health, Life Satisfaction, Self-esteem and the Development of Sexual Identity

Abstract Introduction Many studies have focused recently on the negative impact of homophobia or biphobia, seeking to identify protective factors for the LGB (lesbian, gay, and bisexual) community. Methods The present study aims to identify emotional intelligence (EI) profiles among a sample of 1215 LGB people in order to determine whether significant differences exist between them in terms of mental health, life satisfaction, self-esteem, and the development of sexual identity. To analyse the differential effect of EI on the variables, four cluster profiles were defined by combining the three dimensions of EI (attention, clarity, and repair). The first profile had low levels in all three dimensions; the second had high attention and low repair; the third had high general EI and the fourth had low attention and high repair. Results Significant differences were observed among profiles (p < .001; η2 = 0.126). Those with high EI indexes reported less anxiety and depression and had better levels of self-esteem, life satisfaction and acceptance of their non-normative sexual identity. Those with low rates in all areas of EI or high levels of attention were at risk of developing psycho-emotional problems. Discussion We can conclude that different EI profiles exist among LGB community and that these profiles influence mental health, life satisfaction and self-esteem outcomes and identity development in different ways. Policy Implications The findings reported here have practical policy implications for psychoeducational proposals and interventions aimed at improving the experiences of LGB people, particularly in terms of promoting individual characteristics that can help them cope with systematic oppression, such as emotion repair.

Living with psychotropic drugs: A community photovoice study in people with high treatment adherence in Southeastern Spain

Adherence to psychopharmacological treatment essentially involves a process of meaning-making. The objective of this study was to explore the experience of people undergoing chronic psychiatric treatment from the patients’ perspective. In 2018, using the photovoice methodology, four sessions were conducted with the participation of 11 individuals from a community school in a socially marginalized neighborhood of a southeastern Spanish city, some of whom were also users of a social rehabilitation and integration center and a day center. Participants took and selected 41 photographs under the premise: “Photograph your experience regarding health and medication.” A categorization of the emerging narratives was carried out during a dialogical session between participants and researchers, which was recorded for subsequent transcription and analysis. The experiences were divided into two major symbolic themes that seek to give therapeutic meaning to medication: one of conflict and the other of motivation.

Examining the Support Experiences of Autistic Young People with Multiple Marginalized Identities in the United Kingdom

Examining the Support Experiences of Autistic Young People with Multiple Marginalized Identities in the United Kingdom

Participation, barriers, facilitators and bullying experiences of trans people in sport and fitness: findings from a national community survey of trans people in Australia.

This study aimed to assess participation rates of transgender and gender diverse (trans) people in sport/fitness activities, compare mental health outcomes for trans people participating in sport/fitness with those who do not and explore internal/external barriers and bullying experiences faced by trans people in sport/fitness contexts. A cross-sectional online survey open to trans people aged ≥16 years living in Australia was conducted between February and April 2023 and it assessed rates of sport/fitness participation, barriers to participation and bullying experiences through multiple-choice questions. Mental health measures comprised the Kessler Psychological Distress Scale (K10) and self-reported history of self-harm and suicidality. Covariate-adjusted binary logistic regression models tested associations between interpersonal factors, sport/fitness variables and mental health outcomes. Of 664 respondents (median age 32 years), around one-third (32.8%) regularly participated in sport/fitness. Common internal barriers to participation included anxiety about others' reactions (63.9%), body dissatisfaction/dysphoria (56.5%) and fears about feeling accepted/affirmed by others (54.7%). Respondents commonly reported experiencing inadequate bathroom/changing facilities (44.4%), exclusionary rules and regulations surrounding gender (36.7%), and invasive or uncomfortable policies or procedures (23.3%). Over one-third (34.4%) of trans people had experienced gender-based bullying or exclusion. Regular sport/fitness participation was associated with significantly lower K10 scores (mean difference=-4.4, 95% CI-5.8, -2.9, p<0.001) and a 40% reduction in odds of recent thoughts of self-harm and suicide (aOR 0.6, 95% CI 0.5, 0.9, p=0.01; aOR 0.6, 95%CI 0.4, 0.9, p=0.02). Trans people face significant barriers to sport/fitness despite experiencing significant mental health and personal benefits from participation. Affirming and including trans people in sport and fitness should be a key priority for sport and fitness federations, organisations and policy-makers.

Exploring Sense of Coherence and Death Anxiety among patients with Chronic Illness in Greece

Abstract Introduction Chronic illness often brings about existential concerns, including fear of death, which can significantly impact individuals’ well-being. The concept of sense of coherence provides a framework for understanding how individuals perceive and cope with stressors, including those associated with chronic illness. Purpose This study investigated the correlation between Sense of Coherence, death anxiety, and chronic illness among Greek patients, aiming to understand how these factors interplay. Methods An electronic survey was distributed to chronic illness patients in Greece. Sense of Coherence was measured using the Sense of Coherence scale, while death anxiety was assessed using the Collett-Leste Fear of Death scale. Various chronic conditions were considered, and demographic data were collected. Results The final sample consisted of 118 participants (female 79.7%; death anxiety score=mean109.2, Sd = 19.2; sense of coherence score=mean55.12, Sd = 13.61). Women and the age group of 58-65 years presented higher death anxiety score followed by the group of 34-41 years. No differences were found between genders in terms of sense of coherence. The highest coherence was manifested in the age group of 50-57 years and the lowest in the age group of 42-49 years. A significant negative correlation was observed between sense of coherence and fear of death (rs(118)= -.299, p &amp;lt; .01). Further correlation tests were performed between axes of coherence, which indicated a stronger negative correlation in two of the three axes of the sense of coherence (Manageability and Meaningfulness) and among all the axes of fear of death, beyond the first, which concerns the loss of one’s own life. Conclusions The study suggests that individuals with a stronger sense of coherence experience lower death anxiety. Understanding these dynamics is crucial for tailored patient interventions and support strategies. Key messages • Gender and age-specific variations exist in how people approach and experience disease and mortality. • Understanding patients’ coping mechanisms and perceptions of illness is important in disease management.

Supporting Long Covid Care: a webtool to facilitate help-seeking among people with Long Covid

Abstract Background Long Covid (also known as Post-COVID19 Condition or Post-COVID Syndrome) is characterised by persistent symptoms following SARSCoV2 infection not explained by other pathology. Some evidence suggests that people from marginalised communities are more likely to experience Long Covid but are less likely to be represented in post-covid care in England. Objectives Findings from the STIMULATE-ICP case finding and HI-COVE studies show that some people living with Long Covid struggle to get adequate healthcare and social support. Barriers to obtaining support include a lack of awareness of Long Covid and supports available, uncertainty around the cause and complexity of symptoms, as well as experiences and expectations of stigma. The new Supporting Long Covid Care (SLCC) webtool was developed based on these findings and aimed to both facilitate help-seeking for people with probable Long Covid who are not receiving care and raise awareness among professionals. Extensive engagement with people with lived experience and professionals shaped the webtool. SLCC content was then beta-tested with stakeholders. Results SLCC (long-covid-care.org.uk) was launched in March 2024. One of its features is the acknowledgement that Long Covid can be a stigmatising condition. SLCC includes real-life quotes to connect emotionally with users, highlights the shared experiences of people living with Long Covid and illustrates the difficulties faced when seeking recognition and support. It encourages conversations with professionals, friends, family and others who may be relied on for support and offers resources to facilitate those conversations and inform next steps. SLCC is also an informative tool for healthcare professionals around Long Covid stigma. Conclusions SLCC is open to use by members of the public. Real-world evaluation and translation to other languages are now needed to explore if this webtool is beneficial and contributes towards addressing health inequalities. Key messages • SLCC encourages people with probable Long Covid to seek help and support. • SLCC raises awareness among healthcare professionals about the barriers and stigma people, particularly those from disadvantaged backgrounds, may face when considering reaching out for support.

Implementing patient navigation for cancer prevention among individuals with mentally ill-health

Abstract Issue In Europe, over 80 million people experience mental ill-health and there are 4 million new cancer diagnoses each year. Individuals experiencing mental ill-health exhibit higher rates of cancer morbidity and mortality, with this excess attributed to risky health behaviors and obstacles encountered when accessing often fragmented healthcare systems. Description of the problem The aim of Co-CAPTAIN is the pilot implementation and evaluation of the Patient Navigation Model (PNM) for the improvement of primary cancer prevention in individuals with mental ill-health, adapted through participatory co-design in the European context. The project will adopt a cohort-based study design, commencing data collection at baseline and succeeded by three follow-ups (6 weeks, 9 months, 18 months). It will utilize a mixed-methods approach, combining quantitative and qualitative methodologies to assess diverse outcomes of PNM, facilitating both exploratory and confirmatory research. Qualitative data will be obtained through semi-structured interviews, while quantitative data will be collected using validated questionnaires and items developed ad hoc. The project will involve four pilot sites in Europe (Austria, Greece, Poland and Spain), where the PNM will be adapted to the specificities of national healthcare and support systems. The implementation phase is expected to begin in June 2024. Results During implementation, gathering both quantitative and qualitative data will offer valuable insights into feasibility and effectiveness, establishing a baseline for reshaping health and social care policies for individuals with mental ill-health across Europe. Lessons Co-CAPTAIN project aims to reduce health disparities for individuals with mental ill-health by improving overall health and reducing cancer burdens, leading to cost reductions in European health and social care systems. Key messages • The project aims to deliver an innovative solution based on the PNM, to address health disparities among individuals with mental ill-health by reducing cancer burden. • Combination of qualitative and quantitative methodologies to assess diverse outcomes.

Mental Health Arts Festival as a tool for mental health promotion

Abstract Background of the problem 1 in 4 people experience mental health problems each year, and that number is only growing. Stigma and discrimination of mental health are widespread and affect the quality of life at the individual and societal level. The WHO identifies mental health arts festivals as an effective way to reduce stigma and improve mental health. Description of the problem We are not comfortable talking about mental health difficulties and the care we need. Consequently, individuals often withhold personal experiences to shield themselves from potential bias and harsh judgement. Methodology The Mental Health Arts Festival (MHAF) Bonds https://www.rysiaifest.lt/, https://www.facebook.com/Rysiaifest) seeks to contribute to the human rights based mental health knowledge creation across the partner organisations, involved communities and audiences, as well as contribute to local creation of artworks on the topic of mental health in open, accessible, safe space where every voice matters. The biannual MHAF brings together recognised artists, arts institutions, scientists, policy makers and communities of people with mental health issues (over 80 events, attracting about 4,500 spectators) for group exhibition, films, contemporary dance and live performances, literary readings, open microphones, followed by discussions and workshops. Qualitative study methodology is applied to assess the potential impacts of the MHAF. Lessons • Visual identity that seeks to challenge existing stigmatising views. • The festival has become the production or premier place of new artworks on the topics of mental health, spanning addiction, war-related trauma, transgenerational trauma, neurodiversity. Key messages • Mental health arts festivals promote mental health literacy and reduce negative attitudes towards health-seeking behaviour. • Art festivals should be an integral part of national programs to address stigma and promote mental health and well-being.

Minimally Invasive Spine Surgery for Lumbar Decompression or Disc Herniation

ABSTRACTMany people experience low back pain caused by degenerative disease of the lumbar spine; this includes spinal stenosis, spondylolisthesis, disc degeneration, and disc herniation. Conservative management of degenerative disease, which includes physical therapy, lifestyle modifications, and medications, is the initial approach. If this approach fails, a surgical procedure may be the next step. Previously, open lumbar surgery would have been the planned procedure; today, minimally invasive spine surgery gives patients another choice. Perioperative nurses should understand how minimally invasive spine surgery differs from the open procedure, the steps involved during a minimally invasive procedure, the benefits of this type of procedure, and nursing considerations for patients undergoing minimally invasive spinal procedures.

Trust, belief and transitions: people’s experiences of multidisciplinary inpatient treatment for persistent physical symptoms. A qualitative study

Purpose People with Persistent Physical Symptoms experience physical symptoms that are not wholly explained by a medical disorder or disease. Multidisciplinary treatment is recommended for people with severe difficulties and is provided in a small number of specialist centres in the UK. Only brief descriptions of this treatment are available, and the experiences of people receiving this treatment as an inpatient have not been explored. This study aimed to explore how people with persistent physical symptoms experience inpatient treatment from a specialist multidisciplinary team, and to identify which factors facilitated their engagement in the rehabilitation. Materials and Methods 18 people who had received inpatient multidisciplinary treatment for persistent physical symptoms participated in semi-structured interviews. The transcripts were analysed using reflexive thematic analysis. Results Participants’ experiences were influenced by whether they felt believed by the healthcare team, and whether they could place their own trust and belief in the staff team and the treatment approach. Their experiences involved a series of transitions; both in environment and understanding. Conclusions Improvements are possible for people receiving inpatient multidisciplinary treatment for severe PPS. Trusting relationships between patients and staff members take time to develop but play a major role in patients’ experiences of treatment.

A qualitative interview study on quality of life and ageing experiences of autistic adults

Quality of life across the lifespan has been established as a key research priority by the autism community. Still relatively little is known about the quality of life and ageing experiences of older autistic adults. Most studies to date have used generic measures of quality of life which may not accurately capture the experiences of autistic people. The aim of this qualitative study was to understand how autistic adults experience and define quality of life as they age. We conducted semi-structured interviews with 16 autistic adults aged 40+ from the UK and Luxembourg. Using reflexive thematic analysis, we identified five themes that contribute to quality of life: (1) Diagnosis is pivotal, (2) Connection with others, (3) Autonomy over space and time, (4) ‘Paperwork of life’, (5) Vulnerability. This study identifies autism-specific aspects of quality of life and highlights ways in which ageing and autism intersect and impact quality of life.

Who is sufficient, and why? A mixed-methods approach to the social determinants of sufficiency lifestyles in the pursuit of decarbonisation

Sufficiency consists of less materially intensive consumption patterns that focus on wellbeing rather than material wealth. Such consumption patterns are commonly referred to as sufficiency lifestyles and are increasingly seen as a key driver for achieving decarbonisation. However, while research finds that sustainable consumption and environmental behaviour are often associated with high social status, lower carbon footprints and lower consumption more broadly are associated in the literature with poverty and deprivation. This article aims to investigate whether a combination of low carbon footprint and high wellbeing exists, what socio-demographic characteristics are associated with it, and to explore the actual experiences of people engaged in sufficiency lifestyles through initiatives and their characteristics. We use a mixed-methods design with data from demographically representative surveys in Denmark, Germany, Italy and Latvia (N=5,080), and in-depth interviews with participants from sufficiency-oriented intentional communities (N=90). We find that sufficiency lifestyles are linked to a stronger inclination towards sufficiency orientation or a heightened stronger environmental identity, accompanied by a negative correlation with social deprivation aspects. Drawing on the interviews, we find that individuals engaged in sufficiency-oriented practices tend to benefit from economic, social and cultural resources that allow them to overcome energy dependency and constraints, and that their motivations are not limited to pro-environmental behaviour. Based on these empirical findings, we explore potential avenues for the diffusion of sufficiency-oriented lifestyles, including the establishment of binding rules through a democratic process that curb overconsumption while providing attractive low-carbon lifestyles for all.

Balancing Objective Markers and Subjective Experience in Eating Disorder Diagnoses: Commentary on Dang et al. (2024).

The results of Dang et al.'s recent systematic review and meta-analysis suggested that individuals diagnosed with other specified feeding or eating disorder (OSFED) and those diagnosed with specified eating disorders (EDs, such as bulimia nervosa) endorse similar, elevated levels of ED-related cognitions (but not behaviors). The DSM has traditionally conceptualized EDs primarily as disturbances in eating behavior, and the diagnostic boundaries for EDs are based on objective markers, such as behavioral frequencies and weight. Although focusing on objective markers for ED diagnoses and severity indices has advantages (e.g., clinical communication, measurement), pitfalls include diagnostic migration and low emphasis on ED cognitions. Dang et al.'s findings provide a basis for rethinking DSM's conceptualization of EDs as primarily behavioral. This commentary discusses the potential merits and challenges of emphasizing subjective cognitions when assigning ED diagnoses. We explore how objective markers (e.g., behavioral frequency, weight) and subjective experience (e.g., fear of weight gain) may be balanced to improve the clinical utility of ED diagnoses. In all, research that more deeply phenotypes the subjective experiences of people with EDs across contexts, identities, and cultures will enrich our understanding of eating pathology and may inform diagnostic revisions.