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Chester MA, Viranda T, Kaye WH, Berner LA. Evaluating the predictions of an interoceptive inference model of bulimia nervosa. J Eat Disord 2024; 12:57. [PMID: 38741168 DOI: 10.1186/s40337-024-01010-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/23/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVE Bulimia nervosa (BN) is associated with loss-of-control (LOC) eating episodes that frequently occur in response to negative emotions. According to recent neurocomputational models, this link could be explained by a failure to accurately update beliefs about the body in states of high arousal. Specifically, these interoceptive inference models suggest that under-relying on signals from one's body about sensory experience ("low sensory precision") and/or over-relying on previously held beliefs ("excessively precise priors") lead to inaccurate perception and maladaptive behaviors. We conducted an initial test of these core predictions of the interoceptive inference model in BN using self-report measures. METHODS We compared women with BN (n = 30) and age-, BMI-, and full-scale IQ-matched controls (n = 31) on trust in sensory information from the body and two types of beliefs about what can be done to regulate high negative affect. Within the BN group, we tested interrelations among these measures and explored their associations with LOC eating frequency. RESULTS Compared with healthy controls, the BN group reported lower levels of trust in sensory information and stronger beliefs that once upset, there is little one can do, apart from eating, to self-regulate. These beliefs were associated with each other and with lower body trust. Beliefs about the uncontrollability of emotion were associated with more frequent subjective binge-eating episodes. CONCLUSIONS Findings provide initial support for the core predictions of an interoceptive inference account of BN: low trust in sensory information ("sensory precision") may promote an overreliance on maladaptive "prior beliefs" about the effects of eating on negative emotions, ultimately interfering with accurate updating of beliefs about other strategies that could regulate emotions and maintain LOC eating. Low body trust, strong expectations about emotions, and their neurocomputational underpinnings could be promising combined treatment targets for BN.
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Affiliation(s)
- Maia A Chester
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Thalia Viranda
- Department of Information Science, Cornell Tech, New York, NY, USA
| | - Walter H Kaye
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Laura A Berner
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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2
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Gutierrez-Colina AM, Aichele S, Lavender JM, Sanchez N, Thorstad I, Gulley LD, Emerick JE, Schrag R, Thomas V, Spinner H, Arnold T, Heroy A, Haigney MC, Tanofsky-Kraff M, Shomaker LB. Associations of social and cognitive-behavioral variables with disinhibited eating and anxiety: An ecological momentary assessment study. Int J Eat Disord 2024; 57:1213-1223. [PMID: 38415929 DOI: 10.1002/eat.24177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE Among adolescents, disinhibited eating and anxiety commonly co-occur. Precision intervention approaches targeting unique mechanistic vulnerabilities that contribute to disinhibited eating and anxiety may therefore be helpful. However, the effectiveness of such interventions hinges on knowledge of between- and within-person associations related to disinhibited eating, anxiety, and related processes. METHOD A sample of 39 adolescent females (12-17 years) with elevated anxiety and above-average weight (BMI %ile ≥ 75th) completed measures of theoretically driven social and cognitive-behavioral variables, disinhibited eating, and anxiety via ecological momentary assessment over 7 days. Data were analyzed using mixed-effects models. RESULTS Between-person differences in social stressors were linked to emotional eating, eating in the absence of hunger, and anxiety, whereas between-person differences in negative thoughts were associated with all disinhibited eating variables and anxiety. Between-person differences in avoidance were not related to any outcome. Additionally, between-person differences in social stressors and negative thoughts-as well as within-person deviations (from person-average levels) of social stressors, negative thoughts, and avoidance-were associated with anxiety. In turn, between-person differences in anxiety predicted eating in the absence of hunger and emotional eating, and within-person deviations in anxiety were associated with emotional eating at any given time point. DISCUSSION Findings support elements of both the interpersonal and cognitive-behavioral models of disinhibited eating. Differential trigger effects on anxiety, both at the between- and within-person levels, and significant associations between anxiety and all eating-related outcomes, highlight the potential utility of interventions targeting individual differences in sensitivity to anxiety triggers. PUBLIC SIGNIFICANCE Findings provide support for the interpersonal and cognitive-behavioral models of disinhibited eating, highlighting anxiety as a salient vulnerability and potential mechanistic factor underlying disinhibited eating. Social, cognitive, and behavioral variables were differentially related to anxiety across participants, suggesting potential for future intervention tailoring and intervention selection based on adolescents' sensitivity to anxiety as a trigger for disinhibited eating behavior.
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Affiliation(s)
- Ana M Gutierrez-Colina
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Stephen Aichele
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Colorado School of Public Health, Aurora, Colorado, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Natalia Sanchez
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Isabel Thorstad
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Lauren D Gulley
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Jill E Emerick
- Department of Pediatrics, Uniformed Services University, Bethesda, Maryland, USA
| | - Ruby Schrag
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Victoria Thomas
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Holly Spinner
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Thomas Arnold
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Andrew Heroy
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Mark C Haigney
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Marian Tanofsky-Kraff
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University, Bethesda, Maryland, USA
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, Maryland, USA
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado, USA
- Colorado School of Public Health, Aurora, Colorado, USA
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3
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Peschel SKV, Fürtjes S, Voss C, Sigrist C, Berwanger J, Ollmann TM, Kische H, Rückert F, Koenig J, Beesdo-Baum K. Temporal associations between experiential avoidance and disordered eating behaviors in adolescents and young adults: findings from an epidemiological cohort study with ecological momentary assessment. Eat Weight Disord 2023; 28:58. [PMID: 37405497 DOI: 10.1007/s40519-023-01584-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023] Open
Abstract
PURPOSE Previous studies linking experiential avoidance (EA) and eating pathology have largely relied on single measurements based on traditional retrospective questionnaires. Taking advantage of available repeated assessments of EA and disordered eating behaviors (DEBs) in the everyday lives of young people from an epidemiological cohort, we aimed to investigate ecologically valid temporal associations between these constructs. METHODS A random population sample of N = 1180 14-21-year-olds from Dresden, Germany, participated at baseline (2015/2016). As part of smartphone-based ecological momentary assessment (EMA), participants reported on engagement in EA and four DEBs (skipping eating, eating large amounts of food, loss-of-control eating, and restrained eating) up to eight times per day for four days. Multilevel modeling of concurrent and time-lagged associations between EA and DEBs, was conducted among those with at least 50% EMA-compliance (n = 1069). RESULTS EA was associated with higher concurrent levels of all four types of concurrent DEBs. In addition, EA significantly predicted subsequent levels of restrained eating. Only loss-of-control eating significantly predicted subsequent EA, and this effect depended on the timespan between consecutive assessments. When this timespan was short, higher Loss-of-control eating predicted lower subsequent EA, while it predicted higher subsequent EA when the timespan was longer. CONCLUSION The present findings suggest that EA is temporally closely linked to greater engagement in DEBs, supporting theoretical assumptions that DEBs may serve an attempted avoidance function in the context of unpleasant inner experiences. Future studies may benefit from examining samples with more pronounced eating pathology. LEVEL OF EVIDENCE Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies.
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Affiliation(s)
- Stephanie K V Peschel
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Sophia Fürtjes
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christine Sigrist
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Johanna Berwanger
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Theresa M Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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4
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Klatzkin RR, Nadel T, Wilkinson LL, Gaffney K, Files H, Gray ZJ, Slavich GM. Lifetime stressor exposure, eating expectancy, and acute social stress-related eating behavior: A pre-registered study of the emotional eating cycle. Appetite 2023; 185:106494. [PMID: 36805424 PMCID: PMC11216972 DOI: 10.1016/j.appet.2023.106494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/30/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023]
Abstract
Eating behaviors in response to acute stressors are highly variable: whereas many individuals eat more following stressors, others eat less or show no change in food consumption. Understanding factors that predict individual differences in eating behaviors may help elucidate the psychosocial mechanisms underlying obesity, yet few experimental studies on this topic have been conducted to date. To address this issue, we conducted the present pre-registered study, where we investigated how lifetime stressor exposure moderates the extent to which eating expectancies enhance the learned association between stress-induced negative affect and snack intake. Participants were 44 women (30% non-White) between 18 and 50 years old (M = 27.9), with a mean body mass index of 25.6, who completed assessments of lifetime stressor exposure, eating behaviors, and eating expectancies (eating helps manage negative affect); in a subsequent visit, they were given snacks after an acute social stress task (TSST). The moderated moderation model (PROCESS model 3) yielded a significant three-way interaction. When eating expectancies were high, acute social stress-induced negative affect predicted greater M&M intake for women with very high total lifetime stressor exposure but less M&M intake for women with fewer lifetime stressors. These data thus highlight how lifetime stressor exposure interacts with eating expectancies and acute stress-induced negative affect to predict eating behavior. Replications in larger samples may help explain variability in stress-eating as well as how lifetime stressors contribute to obesity.
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Affiliation(s)
| | - Tzvi Nadel
- Department of Psychology, Rhodes College, Memphis, TN, USA
| | | | - Katie Gaffney
- Department of Psychology, Rhodes College, Memphis, TN, USA
| | - Helen Files
- Department of Psychology, Rhodes College, Memphis, TN, USA
| | - Zach J Gray
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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5
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Brassard SL, Laliberte M, MacKillop J, Balodis IM. Disgust sensitivity and behavioural inhibitory systems in binge eating disorder: associations with eating pathology. Eat Weight Disord 2023; 28:15. [PMID: 36805341 PMCID: PMC9941244 DOI: 10.1007/s40519-023-01544-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/21/2022] [Indexed: 02/23/2023] Open
Abstract
Disgust sensitivity refers to how unpleasant a disgusting experience is to an individual and is involved in the development of many psychiatric conditions. Given its link with food ingestion, there is an interest in understanding how an individual's susceptibility to disgust relates to dietary habits. One possible mechanism giving rise to this association is through the effects negative emotions have on high-order cognitive processes, but few studies take this model into account. The aim of this study was to characterize general disgust sensitivity in a clinical binge eating disorder (BED) population, and explore whether disgust sensitivity relates to inhibitory control and eating pathology. Following a case-controlled study design, our results show that: (1) disgust sensitivity and its subscales do not differ between BED and healthy controls, (2) higher disgust sensitivity in BED relates to greater behavioural inhibition, (3) inhibitory control reaction times relate to aspects of eating pathology, and (4) inhibitory control does not mediate relationships between disgust sensitivity and BMI among participants with BED. Understanding the role of disgust sensitivity in BED may allow us to understand how negative emotion systems maintain dysregulated eating behaviours with the potential to inform emotion-regulation treatment approaches. Level of evidence: Level III: Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Sarah L Brassard
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3P2, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - Michele Laliberte
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3P2, Canada.,Eating Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3P2, Canada.,Michael G. DeGroote Centre for Medicinal Cannabis Research, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - Iris M Balodis
- Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada. .,Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3P2, Canada. .,Michael G. DeGroote Centre for Medicinal Cannabis Research, Hamilton, ON, Canada. .,Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
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6
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Burr EK, Dvorak RD, Peterson R, De Leon AN. Greater negative affect reduction expectancies moderate the interactive relationship between emotion regulation difficulties and distress tolerance in predicting loss-of-control eating. Br J Health Psychol 2023; 28:47-61. [PMID: 35778877 DOI: 10.1111/bjhp.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/02/2022] [Accepted: 06/13/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Loss-of-control eating (LOCE) is often conceptualized as a negative reinforcement mechanism. However, LOCE does not consistently reduce negative affect (NA). One explanation for continued LOCE, despite a lack of NA reduction, may be expectations of NA reduction. Emotion regulation difficulties and low distress tolerance often predict LOCE, but have not been examined in the context of NA reduction expectancies. DESIGN This study examined the main and interactive relationships between emotion regulation difficulties, distress tolerance and NA reduction expectancies on LOCE in US adults (n = 3331). METHOD This study consisted of a battery of surveys administered to a national sample of US adults. RESULTS Results indicate NA reduction expectancies are robust, eclipsing the predictive effects of other emotion regulation variables. Distress tolerance was only able to attenuate the relationship between emotion regulation difficulties and LOCE when NA reduction expectancies were low. CONCLUSIONS These findings identify NA reduction expectancies as having a strong relationship with LOCE, such that the protective factor of distress tolerance is only relevant when such expectancies are low. Clinical implications suggest that targeting NA reduction expectancies in eating interventions that bolster emotion regulation difficulties and distress tolerance may improve the effectiveness of said interventions. Additionally, stand-alone expectancy interventions should be assessed for the purpose of LOCE reduction. Directions for future research are discussed.
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Affiliation(s)
- Emily K Burr
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Robert D Dvorak
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Roselyn Peterson
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Ardhys N De Leon
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
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7
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Sampedro-Piquero P, Zancada-Menéndez C, Bernabéu-Brotons E, Moreno-Fernández RD. The Relationship between Binge Drinking and Binge Eating in Adolescence and Youth: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:232. [PMID: 36612554 PMCID: PMC9819376 DOI: 10.3390/ijerph20010232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Adolescence and youth are critical periods in which alcohol consumption is usually initiated, especially in the form of binge drinking. In recent years, it is increasingly common to find adolescents and young people who also present binge behaviors towards unhealthy food with the aim of alleviating their anxiety (emotional eating) and/or because of impulsive personality. Despite the social and health relevance of this issue, it remains scarcely studied and more preventive research needs to be developed. Our meta-analysis study aimed to evaluate the relationship and co-occurrence of both binge behaviors during adolescence and young adulthood to clarify the link between binge drinking and eating. Selective literature search on different online databases was performed. We identified discrete but significant results regarding the direct association between binge drinking and binge eating in correlation coefficients and odds ratio. Future research should focus on the common psychological background and motives behind these problematic behaviors owing to their clinical implications for effective prevention and treatment.
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Affiliation(s)
- Patricia Sampedro-Piquero
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Clara Zancada-Menéndez
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja (UNIR), 26006 Logroño, Spain
| | - Elena Bernabéu-Brotons
- Facultad de Educación y Psicología, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
| | - Román D. Moreno-Fernández
- Facultad de Educación y Psicología, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
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8
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Testing the interaction of thinness/restriction and negative affect reduction expectancies on disordered eating behavior. Eat Behav 2022; 47:101663. [PMID: 36067649 DOI: 10.1016/j.eatbeh.2022.101663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 08/16/2022] [Accepted: 08/24/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Thinness/restriction expectancies (i.e., perceived rewards from thinness/dietary restriction) and negative affect reduction expectancies (i.e., beliefs that eating will reduce negative emotions) are associated with disordered eating, but have largely been studied in isolation despite evidence that individuals can endorse these expectancies simultaneously. Guided by the goal conflict model, we hypothesized that for individuals reporting high levels of one type of expectancy, stronger endorsement of the second expectancy category would be associated with more dietary restriction, binge eating, and compensatory behaviors. A secondary aim included testing an adapted goal conflict model. DESIGN Interaction effects were tested using multiple linear and negative binomial regressions. Exploratory indirect effect models tested the adapted goal conflict model. Given gender differences, hypotheses were tested separately by gender. MEASURES Participants (N = 406, 54.2% female, non-Hispanic White = 68.8%, Mage = 20.99, MBMI = 25.05) completed measures of thinness/restriction expectancies, negative affect expectancies, dietary restriction, binge eating, and compensatory behaviors (e.g., purging, laxative/diuretic use, compensatory exercise). RESULTS No statistically significant interaction of thinness/restriction and negative affect expectancies on disordered eating was observed for either the male or female sample. Main effects models revealed consistent findings across subsamples. Greater thinness/restriction expectancies were associated with more dietary restriction, binge eating, and compensatory behaviors. Greater negative affect reduction expectancies were associated with more binge eating. Exploratory indirect effect models yielded significant effects of each expectancy category on disordered eating. CONCLUSION Expectancies may be independent risk factors for disordered eating. Disordered eating prevention and intervention efforts may benefit from explicitly targeting thinness/restriction and negative affect expectancies.
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9
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Parker MN, Michael ML, Hunt RA, Ortiz A, Manasse SM, Juarascio AS. Eating expectancies and hedonic hunger among individuals with bulimia-spectrum eating disorders who plan binge-eating episodes. Int J Eat Disord 2022; 55:120-124. [PMID: 34643949 PMCID: PMC8766881 DOI: 10.1002/eat.23628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Binge planning (BP; i.e., preparatory thoughts and actions to facilitate future binge-eating episodes) is hypothesized to distract individuals from negative affect and increase the salience of food. Thus, individuals who engage in BP may report greater positive eating expectancies (i.e., beliefs about the outcomes of eating) and hedonic hunger (i.e., desire to eat for pleasure), as BP may increase the likelihood of obtaining these expected outcomes; but empirical tests of this possibility are needed. METHOD Prior to starting treatment, adults (N = 86) with bulimia-spectrum eating disorders were assessed for engagement in BP and self-reported on eating expectancies and hedonic hunger. RESULTS Twenty-nine participants (33.7%) reported planning at least one binge-eating episode in the previous 28 days. Compared to individuals who did not report BP, individuals who reported BP had greater expectancies that eating would alleviate negative affect (t = -2.54, p = .013) and boredom (U = 503.50, p = .006). Groups did not differ on levels of hedonic hunger (t = -1.68, p = .096). DISCUSSION These findings suggest that BP status is linked to expectancies that eating will reduce negative affect. However, more data are needed to determine the temporal relationships among eating expectancies, hedonic hunger and BP. TRIAL REGISTRATION NUMBERS NCT02716831, NCT03673540.
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Affiliation(s)
- Megan N. Parker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Megan L. Michael
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Rowan A. Hunt
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, 40292, USA
| | - Alessandra Ortiz
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Stephanie M. Manasse
- Center for Weight, Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Adrienne S. Juarascio
- Department of Psychology, Drexel University, Philadelphia, PA, USA,Center for Weight, Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
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10
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Cavicchioli M, Kraslavski A, Movalli M, Maffei C, Ogliari A. The investigation of mechanisms underlying addictive behaviors: a case-control study. J Addict Dis 2021; 40:306-325. [PMID: 34751104 DOI: 10.1080/10550887.2021.1989250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: The contradictory nature of behavioral addictions has sustained a nondefinitive debate regarding their construct validity. Objective(s): The current study aims at exploring mechanisms underlying two distinct classes of behaviors-behavioral addictions characterized by core alterations in reward processing systems (ARPS) and behaviors with a main function of maladaptive coping. Methods: This case-control study included 99 treatment-seeking individuals with a primary diagnosis of alcohol use disorder (male: N = 68; female: N = 31) and 74 healthy control (HC) subjects (male: N = 38; female: N = 36). The severity of maladaptive behaviors was measured through the Shorter PROMIS Questionnaire (SPQ). Latent mechanisms were assessed by the Disinhibition Domain of the Personality Inventory for DSM-5 (PID-5-DI) and the Acceptance and Action Questionnaire-II (AAQ-II). Results: The clinical group showed higher severity of behavioral addictions than HC. This difference was not replicated for the other class of maladaptive behaviors, except for compulsive buying. Ordinal regression analysis showed that the clinical group significantly predicted SPQ scores reflecting ARPS, SPQ shopping and starving subscales. This was not replicated for the overall SPQ score capturing maladaptive coping and binge eating behaviors. Controlling for PID-5-DI and AAQ-II scores, which were significantly associated to SPQ subscales, effects of the aforementioned clinical group were not significant. Conclusions: The study highlighted distinct and common mechanisms underlying different classes of maladaptive behaviors. Results supported future neuroscience research for clarifying the role of ARPS in compulsive sex and buying in order to consider them as addictive disorders.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Alexandra Kraslavski
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Anna Ogliari
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.,Child in Mind Lab, University "Vita-Salute San Raffaele", Milan, Italy
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11
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Predicting drive for thinness and bulimic symptoms in female adults: might an act-frequency approach to the measurement of eating attitudes be useful? CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01592-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Levinson CA, Williams BM, Christian C. What are the emotions underlying feeling fat and fear of weight gain? J Affect Disord 2020; 277:146-152. [PMID: 32828001 DOI: 10.1016/j.jad.2020.08.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/29/2020] [Accepted: 08/08/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Eating disorders (EDs) are most always accompanied by cognitive-affective comorbidities, such as anxiety and depression. In addition to these common comorbidities, EDs are unique in that they are characterized by affective symptoms centered on body image and weight. Two of these primary, yet understudied, affective symptoms are feelings of fatness and fears of weight gain, which are theorized to be maintaining symptoms of EDs and are highly common in those with EDs. Despite the importance of these symptoms, there is no research characterizing which cognitive-affective symptoms contribute to feelings of fatness and fears of weight gain. METHODS The current study (N=168 individuals with an ED) tested cross-sectional and prospective models of cognitive-affect variables (negative affect, guilt, shame, fear of negative evaluation, anxiety sensitivity, and depression) to identify which thoughts and emotions were uniquely associated and prospectively predicted feelings of fatness and fear of weight gain. RESULTS Depression both cross-sectionally and prospectively predicted feeling fat over and above all other forms of affect. Fears of negative evaluation and depression were uniquely associated with fears of weight gain, and shame prospectively predicted fear of weight gain. LIMITATIONS Variables were self-reported, and the sample primarily consisted of women. Fear of weight gain and feelings of fatness were assessed using single items. CONCLUSIONS This research suggests that depression may be an important intervention target when individuals with an ED report feeling fat. Additionally, treatment targeting fear of negative evaluation, depression, and shame may decrease fears of weight gain.
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Affiliation(s)
- Cheri A Levinson
- Department of Psychological & Brain Sciences, University of Louisville, Life Sciences Building 317, Louisville, KY 40292, United States.
| | - Brenna M Williams
- Department of Psychological & Brain Sciences, University of Louisville, Life Sciences Building 317, Louisville, KY 40292, United States
| | - Caroline Christian
- Department of Psychological & Brain Sciences, University of Louisville, Life Sciences Building 317, Louisville, KY 40292, United States
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13
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Li M, Chang EC, Chang OD, Lucas AG, Yang H. An examination of eating and thinness expectancies as predictors of eating disturbances in females: evidence for cultural differences between European American and Chinese college students. Eat Weight Disord 2020; 25:1285-1293. [PMID: 31377980 DOI: 10.1007/s40519-019-00761-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/25/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study sought to examine the utility of eating expectancy, thinness expectancy, and the interactive role of both, in predicting eating disturbances (viz., bulimic symptoms and drive for thinness) in European American and Chinese female college students. METHODS A sample of 237 European American and 221 Chinese female college students completed measures of eating and thinness expectancies and eating disturbances. RESULTS Results of hierarchical regression analyses revealed that thinness expectancy significantly predicted increases in both drive for thinness and bulimic symptoms (with these increases being greater for European Americans), whereas eating expectancy predicted increases in bulimic symptoms only. In addition, for European Americans, a significant interaction for bulimic symptoms was found, revealing a synergistic increase in bulimic symptoms for those with both a high thinness expectancy and a high eating expectancy. For Chinese, a significant interaction for drive for thinness was found, demonstrating that for those with a high thinness expectancy, a higher eating expectancy was actually associated with a lower drive for thinness. CONCLUSION The present findings point to the value of examining for the co-presence of both expectancies in predicting eating disturbances while also highlighting cultural variations in the study of eating pathology. LEVEL OF EVIDENCE Descriptive cross-sectional study, level V.
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Affiliation(s)
- Mingqi Li
- Department of Psychology, DePaul University, 1 East Jackson, Chicago, IL, 60604, USA.
| | - Edward C Chang
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA.
| | - Olivia D Chang
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA
| | - Abigael G Lucas
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA
| | - Hongfei Yang
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, Zhejiang Province, China
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14
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Parental internalizing disorder and the developmental trajectory of infant self-regulation: The moderating role of positive parental behaviors. Dev Psychopathol 2020; 34:1-17. [PMID: 32958086 DOI: 10.1017/s0954579420001042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Child self-regulation (SR), a key indicator for later optimal developmental outcomes, may be compromised in the presence of parental mental disorders, especially those characterized by affective dysregulation. However, positive parental behaviors have been shown to buffer against such negative effects, especially during infancy when SR shows great plasticity to environmental inputs. The current study investigated the effect of maternal and paternal lifetime and current internalizing disorders on the developmental trajectory of infant SR from 3 to 24 months, and the potential moderating role of positive parental behaviors. A latent growth model revealed that SR increased overall from 3 to 24 months. Mothers' positive parental behaviors demonstrated significant moderation effects, such that maternal lifetime internalizing disorder was associated with higher SR intercept only among those with low levels of positive parental behavior. Mothers' lifetime internalizing disorder was also associated with a lower linear slope in SR development with a moderate effect size. Fathers' current internalizing disorder was significantly associated with a higher intercept and lower linear slope of the SR trajectory. The current study expands the infant SR literature by describing its early developmental trajectory as well as early risk and protective factors within the parent-infant environment, taking into consideration developmental inputs from both parents.
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15
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Juarascio AS, Parker MN, Manasse SM, Barney JL, Wyckoff EP, Dochat C. An exploratory component analysis of emotion regulation strategies for improving emotion regulation and emotional eating. Appetite 2020; 150:104634. [DOI: 10.1016/j.appet.2020.104634] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 01/18/2023]
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16
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Erriu M, Cimino S, Cerniglia L. The Role of Family Relationships in Eating Disorders in Adolescents: A Narrative Review. Behav Sci (Basel) 2020; 10:E71. [PMID: 32252365 PMCID: PMC7226005 DOI: 10.3390/bs10040071] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Adolescents' eating disorders have been explored through various conceptual and empirical models. Only recently, scientific literature in this area has more specifically investigated the role of relationships, with particular attention to family functioning. Objective: This paper reviews family relationships aspects of eating disorders in adolescence. Methods: A narrative literature review of relational issues in adolescents' eating disorders was performed. Results: Empirical evidence of family relationships in adolescents' eating disorders confirms the relevance of relational aspects in the development and maintenance of the pathology. In particular, the contribution of the relational-systemic approach is wide, suggesting the need to refer to the family context for a better understanding of adolescents' sufferance. Additionally, the empirical contributions from the conceptual model of Developmental Psychopathology, highlighting the importance of risk and protection factors in family relationships, provides knowledge about the phenomenon of adolescents' eating disorders in terms of complexity. Conclusions: An integrated relational model aimed to explore adolescents' eating disorders is worthy of investigation to accomplish specific program of intervention.
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Affiliation(s)
- Michela Erriu
- Psychology and Medicine Faculty, Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.E.); (S.C.)
| | - Silvia Cimino
- Psychology and Medicine Faculty, Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.E.); (S.C.)
| | - Luca Cerniglia
- Psychology Faculty, Department of Psychology, International Telematic University Uninettuno, 00186 Rome, Italy
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17
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Fogelkvist M, Gustafsson SA, Kjellin L, Parling T. Acceptance and commitment therapy to reduce eating disorder symptoms and body image problems in patients with residual eating disorder symptoms: A randomized controlled trial. Body Image 2020; 32:155-166. [PMID: 32000093 DOI: 10.1016/j.bodyim.2020.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 01/09/2020] [Accepted: 01/14/2020] [Indexed: 01/26/2023]
Abstract
Body image problems are central aspects of eating disorders (ED), and risk factors both for the development of and relapse into an ED. Acceptance and commitment therapy (ACT) aims at helping patients accept uncomfortable internal experiences while committing to behaviors in accordance with life values. The aim of the present study was to compare the effectiveness of a group intervention, consisting of 12 sessions, based on ACT to treatment as usual (TAU) for patients with residual ED symptoms and body image problems. The study was a randomized controlled superiority trial. Patients with residual ED symptoms and body image problems were recruited from a specialized ED clinic in Sweden. The final sample consisted of 99 women, randomized to ACT or TAU. At the two-year follow-up, patients who received ACT showed a significant greater reduction in ED symptoms and body image problems and received less specialized ED care than patients in TAU. In conclusion, ACT was superior in reducing ED symptoms and body image problems.
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Affiliation(s)
- Maria Fogelkvist
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE 701 82 Örebro, Sweden.
| | - Sanna Aila Gustafsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE 701 82 Örebro, Sweden.
| | - Lars Kjellin
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE 701 82 Örebro, Sweden.
| | - Thomas Parling
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, The Centre for Psychotherapy, Education & Research, Liljeholmstorget 7, SE-117 63 Stockholm, Sweden.
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18
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Conradt E, Shakiba N, Ostlund B, Terrell S, Kaliush P, Shakib JH, Crowell SE. Prenatal maternal hair cortisol concentrations are related to maternal prenatal emotion dysregulation but not neurodevelopmental or birth outcomes. Dev Psychobiol 2020; 62:758-767. [PMID: 32002996 DOI: 10.1002/dev.21952] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/18/2019] [Accepted: 01/06/2020] [Indexed: 12/19/2022]
Abstract
Hair cortisol concentrations measured during pregnancy have emerged as a novel biomarker for prenatal stress exposure. However, associations between prenatal stress and distress, broadly defined, and hair cortisol concentrations during pregnancy are inconsistent. We examined relations among hair cortisol concentrations during the third trimester with (a) emotion dysregulation and (b) detailed measures of maternal prenatal stress. We also examined the predictive validity of maternal hair cortisol during pregnancy for adverse newborn health outcomes. Cortisol concentrations were derived from 6 cm of hair during the third trimester of pregnancy. Mothers reported on their emotion dysregulation and stress at this time. A standardized newborn neurobehavioral exam was conducted shortly after birth and newborn birth weight and gestational age were assessed from medical records. All hypotheses were preregistered on the Open Science Framework (osf.io/279ng). High levels of emotion dysregulation, but not stress, were predictive of high hair cortisol concentrations. Maternal prenatal BMI mediated the relation between maternal prenatal emotion dysregulation and hair cortisol concentrations. There was no association between hair cortisol and infant birth outcomes. This research supports the notion that transdiagnostic markers of psychopathology are important correlates of hair cortisol concentrations during pregnancy.
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Affiliation(s)
- Elisabeth Conradt
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.,Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.,Department of OB/GYN, University of Utah, Salt Lake City, UT, USA
| | - Nila Shakiba
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Brendan Ostlund
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Sarah Terrell
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Parisa Kaliush
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Julie H Shakib
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Sheila E Crowell
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.,Department of OB/GYN, University of Utah, Salt Lake City, UT, USA.,Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
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19
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Prefit AB, Cândea DM, Szentagotai-Tătar A. Emotion regulation across eating pathology: A meta-analysis. Appetite 2019; 143:104438. [PMID: 31479694 DOI: 10.1016/j.appet.2019.104438] [Citation(s) in RCA: 136] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/20/2019] [Accepted: 08/30/2019] [Indexed: 01/09/2023]
Abstract
The goal of this meta-analysis was to examine the associations between specific emotion regulation abilities (emotional awareness, emotional clarity) and strategies (acceptance of emotions, reappraisal, problem-solving, rumination, avoidance of emotions, and suppression), and eating pathology. A total of 96 studies and 239 effect sizes were included in the analysis. Relations between global and specific emotion regulation abilities and strategies and eating disorders and eating-related symptoms were examined. Results indicated medium-to-large effect sizes for the associations between adaptive emotion regulation and eating disorder and eating-related symptoms, and medium-to-large effect sizes for the associations between maladaptive emotion regulation and eating disorders and eating-related symptoms. In terms of specific emotion regulation strategies, large magnitude of associations were identified for the relations between lack of emotional awareness, clarity, acceptance, reappraisal, problem-solving, and eating disorders. Rumination, avoidance of emotions, and suppression also showed large associations with anorexia nervosa and bulimia nervosa. Overall, emotion regulation did not differ across eating disorders, a finding supporting the transdiagnostic character of emotion regulation problems in eating pathology. These findings have important theoretical and practical implications for prevention and intervention programs.
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Affiliation(s)
- Alice-Beatrice Prefit
- Evidence-based Assessment and Psychological Interventions Doctoral School, Babeș-Bolyai University, Cluj-Napoca, Romania; The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Diana Mirela Cândea
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania; Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Aurora Szentagotai-Tătar
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania; Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania.
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20
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Brosof LC, Munn-Chernoff MA, Bulik CM, Baker JH. Associations between eating expectancies and Eating disorder symptoms in men and women. Appetite 2019; 141:104309. [PMID: 31170435 DOI: 10.1016/j.appet.2019.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 05/30/2019] [Accepted: 06/03/2019] [Indexed: 01/27/2023]
Abstract
Eating expectancies, or learned expectations that an individual has about eating, prospectively predict eating disorder (ED) symptoms. Most studies examining eating expectancies have focused on one or two eating expectancies and their relation with bulimic symptoms. In addition, these studies have been conducted mostly in women. Thus, it is unclear whether: 1) associations between eating expectancies and ED symptoms vary between men and women, and 2) extend to ED symptoms other than bulimic symptoms. The current study (N = 197 undergraduate men and 246 undergraduate women) investigated sex variance in a model of eating expectancies and ED symptoms, including factors associated with ED symptoms (i.e., negative urgency, negative affect, alcohol use, drug use, and body mass index). Sex variance was tested using path analysis in a model including eating expectancies and associated factors, with excessive exercise, negative attitudes toward obesity, restricting, cognitive restraint, binge eating, purging, muscle building, and body dissatisfaction as dependent variables. Unconstrained (i.e., unconstrained paths across men and women) and constrained (i.e., constraining paths across men and women) models were tested. The unconstrained and constrained models differed significantly, indicating that the models varied by sex. For both sexes, eating expectancies were uniquely associated with ED symptoms. For men, Eating Manages Negative Affect was significantly associated with the most ED symptoms. In contrast, for women, Eating Leads to Feeling Out of Control was associated with the most ED symptoms. Previous findings regarding eating expectancies and ED symptoms in women may not generalize to men. Intervening on eating expectancies in a sex-specific way may help reduce specific ED symptoms.
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Affiliation(s)
- Leigh C Brosof
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | | | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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21
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Altered anticipation and processing of aversive interoceptive experience among women remitted from bulimia nervosa. Neuropsychopharmacology 2019; 44:1265-1273. [PMID: 30840983 PMCID: PMC6785154 DOI: 10.1038/s41386-019-0361-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/10/2019] [Accepted: 02/12/2019] [Indexed: 11/08/2022]
Abstract
Bulimia nervosa (BN) is characterized by dysregulated intake of food, which may indicate homeostatic imbalance. Critically important for homeostatic regulation is interoception, or the sensing and processing of body-relevant information. A well-documented link between avoidance of unpleasant body sensations and BN symptoms suggests that aversive interoceptive experiences may be particularly relevant to BN pathophysiology. This study examined whether individuals with a history of BN show aberrant neural processing of aversive interoceptive stimuli. Using a cued inspiratory breathing load paradigm, we compared women remitted from BN (RBN; n = 24; to reduce the confounding effects of active bulimic symptoms) and control women (CW; n = 25). During breathing load anticipation, the RBN group, relative to CW, showed increased activation in mid-insula, superior frontal gyrus, putamen, dorsal anterior cingulate, posterior cingulate, and amygdala. However, over the course of the aversive experience, neural activation in RBN relative to CW showed an aberrant decline in most of these regions. Exploratory analyses indicated that greater activation during breathing load anticipation was associated with past bulimic symptom severity and the duration of symptom remission. An exaggerated anticipatory response and an abnormally decreasing response during aversive homeostatic perturbations may promote hallmark bulimic behaviors-binge eating, dietary restriction, and purging. Our findings support a role for homeostatic instability in BN, and these altered patterns of brain activation may serve as novel targets for pharmacological, neuromodulatory, and behavioral interventions.
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22
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Relationships between eating disorder-specific and transdiagnostic risk factors for binge eating: An integrative moderated mediation model of emotion regulation, anticipatory reward, and expectancy. Eat Behav 2018; 31:131-136. [PMID: 30359908 PMCID: PMC6320675 DOI: 10.1016/j.eatbeh.2018.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 09/29/2018] [Accepted: 10/14/2018] [Indexed: 11/22/2022]
Abstract
Although relationships between negative affect, emotion dysregulation, and binge eating have been well-established, the mechanisms and individual risk factors that account for this relationship have yet to be elucidated. In addition to emotion dysregulation, altered reward functioning and negative affect eating expectancies (i.e., the expectancy that eating will relieve negative affect) are factors that have been previously linked to binge eating, though theoretical frameworks have not provided an integrated conceptualization of relationships between these domains. Therefore, the present study examined an integrative moderated mediation model among a sample of 101 adults with self-reported eating disorder (ED) symptoms who completed a battery of online questionnaires. Results supported the hypothesized model, which demonstrated that eating expectancies mediated the relationship between emotion dysregulation and binge eating frequency, and there was a positive association between emotion dysregulation and eating expectancies among individuals high in anticipatory reward. These findings provide preliminary support for an integrated approach to understanding transdiagnostic and ED-specific risk factors that potentiate binge eating.
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23
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Masuda A, Latner JD, Barlie JP, Sargent K. Understanding self-concealment within a framework of eating disorder cognitions and body image flexibility: Conceptual and applied implications. Eat Behav 2018; 30:49-54. [PMID: 29777970 DOI: 10.1016/j.eatbeh.2018.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 05/05/2018] [Accepted: 05/09/2018] [Indexed: 10/16/2022]
Abstract
Although self-concealment has been long recognized in the context of body image disturbance and disordered eating concerns, empirical evidence remains limited. Following cognitive behavioral therapy (CBT) models of disordered eating and body image concerns, the present cross-sectional study examined whether the construct of self-concealment was related to disordered eating and body image concerns. More specifically, we investigated whether eating disorder cognitions and body image flexibility, two factors linked to the maintenance of disordered eating concerns, are uniquely associated with self-concealment, while controlling for key demographic and sociocultural variables. Three-hundred thirty-six undergraduate women completed a web-based survey that included measures of interest. Results revealed that eating disorder cognitions associated with the fear of weight gain and body image flexibility were uniquely related to self-concealment in expected directions.
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24
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Wu J, Willner CJ, Hill C, Fearon P, Mayes LC, Crowley MJ. Emotional eating and instructed food-cue processing in adolescents: An ERP study. Biol Psychol 2018; 132:27-36. [PMID: 29097149 PMCID: PMC5801158 DOI: 10.1016/j.biopsycho.2017.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 10/29/2017] [Accepted: 10/29/2017] [Indexed: 10/18/2022]
Abstract
We examined the P3 (250-500ms) and Late Positive Potential (LPP; 500-2000ms) event-related potentials (ERPs) to food vs. nonfood cues among adolescents reporting on emotional eating (EE) behavior. Eighty-six adolescents 10-17 years old were tested using an instructed food versus nonfood cue viewing task (imagine food taste) during high-density EEG recording. Self-report data showed that EE increased with age in girls, but not in boys. Both P3 and LPP amplitudes were greater for food vs. nonfood cues (food-cue bias). Exploratory analyses revealed that, during the LPP time period, greater EE was associated with a more positive food-cue bias in the fronto-central region. This heightened fronto-central food-cue bias LPP is in line with a more activated prefrontal attention system. The results suggest that adolescents with higher EE may engage more top-down cognitive resources to regulate their automatic emotional response to food cues, and/or they may exhibit greater reward network activation to food cues than do adolescents with lower EE, even in the absence of an emotional mood induction.
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Affiliation(s)
- Jia Wu
- Yale Child Study Center, Yale School of Medicine, New Haven, CT
| | | | - Claire Hill
- School of Psychology & Clinical Language Sciences, University of Reading, UK
| | - Pasco Fearon
- Division of Psychology & Language Sciences, University College London, UK
| | - Linda C. Mayes
- Yale Child Study Center, Yale School of Medicine, New Haven, CT
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25
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Della Longa NM, De Young KP. Experiential avoidance, eating expectancies, and binge eating: A preliminary test of an adaption of the Acquired Preparedness model of eating disorder risk. Appetite 2018; 120:423-430. [DOI: 10.1016/j.appet.2017.09.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/16/2017] [Accepted: 09/21/2017] [Indexed: 10/18/2022]
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26
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Dreyfuss MFW, Riegel ML, Pedersen GA, Cohen AO, Silverman MR, Dyke JP, Mayer LES, Walsh BT, Casey BJ, Broft AI. Patients with bulimia nervosa do not show typical neurodevelopment of cognitive control under emotional influences. Psychiatry Res Neuroimaging 2017; 266:59-65. [PMID: 28605663 DOI: 10.1016/j.pscychresns.2017.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/03/2017] [Accepted: 05/04/2017] [Indexed: 11/20/2022]
Abstract
Bulimia nervosa (BN) emerges in the late teen years and is characterized by binge eating and related compensatory behaviors. These behaviors often co-occur with periods of negative affect suggesting an association between emotions and control over eating behavior. In the current study, we examined how cognitive control and neural processes change under emotional states of arousal in 46 participants with (n=19) and without (n=27) BN from the ages of 18-33 years. Participants performed a go/nogo task consisting of brief negative, positive and neutral emotional cues and sustained negative, positive and neutral emotional states of arousal during functional magnetic resonance imaging (fMRI). Overall task performance improved with age for healthy participants, but not for patients with BN. These age-dependent behavioral effects were paralleled by diminished recruitment of prefrontal control circuitry in patients with BN with age. Although patients with BN showed no difference in performance on the experimental manipulations of negative emotions, sustained positive emotions related to improved performance among patients with BN. Together the findings highlight a neurodevelopmental approach towards understanding markers of psychopathology and suggest that sustained positive affect may have potential therapeutic effects on maintaining behavioral control in BN.
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Affiliation(s)
- Michael F W Dreyfuss
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Melissa L Riegel
- Eating Disorders Research Unit, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Gloria A Pedersen
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Alexandra O Cohen
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Melanie R Silverman
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Jonathan P Dyke
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Laurel E S Mayer
- Eating Disorders Research Unit, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - B Timothy Walsh
- Eating Disorders Research Unit, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - B J Casey
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA; Department of Psychology, Yale University, New Haven, CT, USA
| | - Allegra I Broft
- Eating Disorders Research Unit, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA.
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Litwin R, Goldbacher EM, Cardaciotto L, Gambrel LE. Negative emotions and emotional eating: the mediating role of experiential avoidance. Eat Weight Disord 2017; 22:97-104. [PMID: 27460010 DOI: 10.1007/s40519-016-0301-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 07/07/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Emotional eating is a risk factor for eating pathology across the life- and weight-span. Research demonstrates that negative emotions are a precipitant of emotional eating, particularly among female college students. However, the underlying factors that explain this relationship are unclear. Experiential avoidance, a propensity toward being unwilling to remain in contact with aversive private experiences, may explain the association between negative emotions and emotional eating. The purpose of this study was to examine whether experiential avoidance would mediate the association between negative emotions and emotional eating. METHODS A sample of 132 women (17.4 % African American, 59.8 % White) completed measures of mood, experiential avoidance and emotional eating. Bias-corrected bootstrapping mediational analyses were conducted. RESULTS Experiential avoidance mediated the relationship between negative emotions and emotional eating b = -0.21, 95 % BC CI [-0.43, -0.07]. The indirect effect through experiential avoidance accounted for 9 % of the variance, which represents a medium effect (k 2 = 0.09, 95 % BC CI [0.03, 0.18]). CONCLUSIONS Results suggest that experiential avoidance is important for understanding the relationship between negative emotions and emotional eating and may inform potential strategies for prevention and treatment.
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Affiliation(s)
- Rachel Litwin
- Department of Psychology, La Salle University, 1900 W. Olney Ave., Philadelphia, PA, 19141-1199, USA.,CBT Westport, LLC, 1720 Post Road East, Suite 223, Westport, CT, 06880, USA
| | - Edie M Goldbacher
- Department of Psychology, La Salle University, 1900 W. Olney Ave., Philadelphia, PA, 19141-1199, USA.
| | - LeeAnn Cardaciotto
- Department of Psychology, La Salle University, 1900 W. Olney Ave., Philadelphia, PA, 19141-1199, USA
| | - Laura Eubanks Gambrel
- Department of Psychology, La Salle University, 1900 W. Olney Ave., Philadelphia, PA, 19141-1199, USA.,Department of Human Development and Psychological Counseling, Appalachian State University, 314B College of Education, Boone, NC, 28608, USA
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Hayaki J, Free S. Positive and negative eating expectancies in disordered eating among women and men. Eat Behav 2016; 22:22-26. [PMID: 27082666 DOI: 10.1016/j.eatbeh.2016.03.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 03/15/2016] [Accepted: 03/30/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Deficits in emotion regulation are known to characterize disordered eating patterns including binge eating, purging, and dietary restraint, though much of this work has been conducted exclusively on women. Eating expectancies, or expectations regarding reinforcement from food and eating, constitute one cognitive mechanism that is thought to serve as a proximal influence on eating behavior. Previous research shows that eating to manage negative affect (a negative eating expectancy) is associated with eating pathology in women, but less is known about eating as a reward or for pleasure (a positive eating expectancy). In addition, no prior work has examined eating expectancies among men. This study examines the role of emotion regulation and eating expectancies on disordered eating in women and men. MATERIALS AND METHODS Participants were 121 female and 80 male undergraduates who completed self-report measures of emotion regulation, eating expectancies, and disordered eating. RESULTS In women, body mass index (BMI), emotion regulation, and eating to manage negative affect directly predicted disordered eating in the final multivariate model, whereas eating for pleasure or reward was inversely associated with disordered eating. However, in men, emotion regulation predicted disordered eating, but not when eating expectancies were added to the model. In the final model, only BMI and eating to manage negative affect contributed significantly to the variance in disordered eating. CONCLUSIONS These findings suggest that some correlates of eating pathology, particularly eating expectancies, may vary by gender. Future research should continue to examine gender differences in the explanatory mechanisms underlying disordered eating.
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Affiliation(s)
- Jumi Hayaki
- Department of Psychology, College of the Holy Cross, United States.
| | - Sarah Free
- Department of Psychology, College of the Holy Cross, United States
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Jaremka LM, Belury MA, Andridge RR, Lindgren ME, Habash D, Malarkey WB, Kiecolt-Glaser JK. Novel Links between Troubled Marriages and Appetite Regulation: Marital Distress, Ghrelin, and Diet Quality. Clin Psychol Sci 2016; 4:363-375. [PMID: 27186446 PMCID: PMC4866816 DOI: 10.1177/2167702615593714] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Distressed marriages enhance risk for health problems; appetite dysregulation is one potential mechanistic pathway. Research suggests that ghrelin and leptin, appetite-relevant hormones connected to shorter and longer-term energy balance, may differentially affect people with a higher versus lower body mass index (BMI). During this double-blind randomized crossover study, both members of a couple (N=86 participants) ate a standardized meal at the beginning of two visits. Observational recordings of a marital conflict assessed marital distress. Ghrelin and leptin were sampled pre-meal and post-meal at 2, 4, and 7 hours. Diet quality was measured using the USDA 24-Hour Multiple-Pass Approach. People in more distressed marriages had higher post-meal ghrelin (but not leptin) and a poorer quality diet than those in less distressed marriages, but only among participants with a lower BMI. These effects were consistent for both spouses. Ghrelin and diet quality may link marital distress to its corresponding negative health effects.
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Affiliation(s)
- Lisa M. Jaremka
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE
| | - Martha A. Belury
- Department of Human Sciences, The Ohio State University, Columbus, OH
| | - Rebecca R. Andridge
- College of Public Health, The Ohio State University College of Medicine, Columbus, OH
| | - Monica E. Lindgren
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH
| | - Diane Habash
- Health and Rehabilitation Sciences, The Ohio State University Medical Center, Columbus, OH
| | - William B. Malarkey
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH
| | - Janice K. Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH
- Department of Psychiatry, The Ohio State University College of Medicine, Columbus, OH
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Schaumberg K, Schumacher LM, Rosenbaum DL, Kase CA, Piers AD, Lowe MR, Forman EM, Butryn ML. The role of negative reinforcement eating expectancies in the relation between experiential avoidance and disinhibition. Eat Behav 2016; 21:129-34. [PMID: 26854594 PMCID: PMC4856013 DOI: 10.1016/j.eatbeh.2016.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 01/09/2016] [Accepted: 01/19/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Eating-related disinhibition (i.e., a tendency to overeat in response to various stimuli) is associated with weight gain and poorer long-term weight loss success. Theoretically, experiential avoidance (i.e., the desire or attempts to avoid uncomfortable internal experiences), may predispose individuals to developing negative reinforcement eating expectancies (i.e., the belief that eating will help to mitigate distress), which in turn promote disinhibition. Such relationships are consistent with an acquired preparedness model, which posits that dispositions influence learning and subsequent behavior. Drawing from this framework, the current study represents the first investigation of relations between negative reinforcement eating expectancies, experiential avoidance (both general and food-specific) and disinhibited eating. In particular, the mediating role of negative reinforcement eating expectancies in the relation between experiential avoidance and disinhibited eating was examined. METHOD Participants (N=107) were overweight and obese individuals presenting for behavioral weight loss treatment who completed measures of general and food-related experiential avoidance, negative reinforcement eating expectancies, and disinhibition. RESULTS Experiential avoidance and negative reinforcement eating expectancies significantly related to disinhibition. Furthermore, the relation between experiential avoidance and disinhibition was mediated by negative reinforcement eating expectancies. DISCUSSION The current study supports an acquired preparedness model for disinhibition, such that the relation between experiential avoidance and disinhibition is accounted for by expectations that eating will alleviate distress. Findings highlight the potential role of eating expectancies in models accounting for obesity risk, and identify negative reinforcement eating expectancies as a potential treatment target for reducing disinhibition.
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Acceptance and Commitment Therapy for Women Diagnosed With Binge Eating Disorder: A Case-Series Study. COGNITIVE AND BEHAVIORAL PRACTICE 2015. [DOI: 10.1016/j.cbpra.2014.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Lavender JM, Wonderlich SA, Engel SG, Gordon KH, Kaye WH, Mitchell JE. Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature. Clin Psychol Rev 2015; 40:111-22. [PMID: 26112760 DOI: 10.1016/j.cpr.2015.05.010] [Citation(s) in RCA: 303] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 04/10/2015] [Accepted: 05/31/2015] [Indexed: 12/14/2022]
Abstract
Several existing conceptual models and psychological interventions address or emphasize the role of emotion dysregulation in eating disorders. The current article uses Gratz and Roemer's (2004) multidimensional model of emotion regulation and dysregulation as a clinically relevant framework to review the extant literature on emotion dysregulation in anorexia nervosa (AN) and bulimia nervosa (BN). Specifically, the dimensions reviewed include: (1) the flexible use of adaptive and situationally appropriate strategies to modulate the duration and/or intensity of emotional responses, (2) the ability to successfully inhibit impulsive behavior and maintain goal-directed behavior in the context of emotional distress, (3) awareness, clarity, and acceptance of emotional states, and (4) the willingness to experience emotional distress in the pursuit of meaningful activities. The current review suggests that both AN and BN are characterized by broad emotion regulation deficits, with difficulties in emotion regulation across the four dimensions found to characterize both AN and BN, although a small number of more specific difficulties may distinguish the two disorders. The review concludes with a discussion of the clinical implications of the findings, as well as a summary of limitations of the existing empirical literature and suggestions for future research.
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Affiliation(s)
- Jason M Lavender
- Neuropsychiatric Research Institute, Fargo, ND, USA; University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA.
| | - Stephen A Wonderlich
- Neuropsychiatric Research Institute, Fargo, ND, USA; University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Scott G Engel
- Neuropsychiatric Research Institute, Fargo, ND, USA; University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Kathryn H Gordon
- North Dakota State University, Department of Psychology, Fargo, ND, USA
| | - Walter H Kaye
- University of California, San Diego School of Medicine, San Diego, CA, USA
| | - James E Mitchell
- Neuropsychiatric Research Institute, Fargo, ND, USA; University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
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Schulte EM, Joyner MA, Potenza MN, Grilo CM, Gearhardt AN. Current considerations regarding food addiction. Curr Psychiatry Rep 2015; 17:563. [PMID: 25749750 DOI: 10.1007/s11920-015-0563-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
"Food addiction" is an emerging area, and behavioral and biological overlaps have been observed between eating and addictive disorders. Potential misconceptions about applying an addiction framework to problematic eating behavior may inhibit scientific progress. Critiques of "food addiction" that focus on descriptive differences between overeating and illicit drugs are similar to early criticisms of the addictiveness of tobacco. Although food is necessary for survival, the highly processed foods associated with addictive-like eating may provide little health benefit. Individual differences are important in determining who develops an addiction. If certain foods are addictive, the identification of possible risk factors for "food addiction" is an important next step. Not all treatments for addiction require abstinence. Addiction interventions that focus on moderation or controlled use may lead to novel approaches to treating eating-related problems. Finally, addiction-related policies that focus on environmental (instead of educational) targets may have a larger public health impact in reducing overeating.
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Affiliation(s)
- Erica M Schulte
- Department of Psychology, University of Michigan, 2268 East Hall, 530 Church Street, Ann Arbor, MI, 48109, USA,
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35
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The role of disordered eating cognition and body image flexibility in disordered eating behavior in college men. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2015. [DOI: 10.1016/j.jcbs.2015.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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36
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Lavender JM, Happel K, Anestis MD, Tull MT, Gratz KL. The interactive role of distress tolerance and eating expectancies in bulimic symptoms among substance abusers. Eat Behav 2015; 16:88-91. [PMID: 25464073 DOI: 10.1016/j.eatbeh.2014.10.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 08/15/2014] [Accepted: 10/23/2014] [Indexed: 10/24/2022]
Abstract
Difficulties tolerating distress and the expectancy that eating will relieve negative affect have been linked with bulimic symptoms, which commonly co-occur with other forms of psychopathology characterized by emotion dysregulation (e.g., substance abuse). Indeed, problems with emotional functioning may be of particular relevance to bulimic symptoms in at-risk populations with heightened emotion dysregulation (such as substance use disorder patients). This study examined the interactive role of two emotion-related constructs (distress tolerance and the expectancy that eating relieves negative affect) in relation to bulimic symptoms among patients (N=93) recruited from a residential substance abuse treatment facility. Participants completed the Bulimia Test-Revised, the Positive and Negative Affect Schedule, the Distress Tolerance Scale, and the Eating Expectancy Inventory. A hierarchical multiple regression analysis was conducted to examine the main effects and interaction of distress tolerance and negative affect eating expectancies in relation to bulimic symptoms, controlling for participant gender and overall negative affect. Significant main effects were found for both distress tolerance and negative affect eating expectancies, and these two constructs were found to significantly interact in the prediction of bulimic symptoms. Interventions that address these constructs may be useful in treating those with bulimic symptoms, as well as those with co-occurring bulimic symptoms and substance use disorders.
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Affiliation(s)
| | - Kate Happel
- Neuropsychiatric Research Institute, Fargo, ND, United States
| | - Michael D Anestis
- Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, United States
| | - Matthew T Tull
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States
| | - Kim L Gratz
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States
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37
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Perry RM, Hayaki J. Gender differences in the role of alexithymia and emotional expressivity in disordered eating. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014. [DOI: 10.1016/j.paid.2014.07.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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38
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Masuda A, Muto T, Tully EC, Morgan J, Hill ML. Comparing Japanese College Students’ and U.S. College Students’ Disordered Eating, Distress, and Psychological Inflexibility. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2014. [DOI: 10.1177/0022022114534982] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study investigated whether psychological inflexibility is related to disordered eating in Japanese undergraduate students and compared the strength and pattern of the associations with effects in a sample of undergraduate students from the United States. Data from 200 Japanese ( nfemale = 100) and 481 U.S. ( nfemale = 380) college students were used. Contrary to prediction, female gender and higher body mass index (BMI), but not psychological inflexibility, were uniquely related to higher levels of disordered eating while controlling for age and psychological distress in the Japanese group. In the U.S. group, greater psychological inflexibility was the only variable that was uniquely related to higher levels of disordered eating after controlling for other study variables. Our findings suggest that psychological inflexibility may not be a useful concept for understanding disordered eating within Japanese college students.
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39
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Vajda A, Láng A. Emotional Abuse, Neglect in Eating Disorders and their Relationship with Emotion Regulation. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.sbspro.2014.04.135] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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40
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Tuna E, Bozo Ö. Exploring the Link Between Emotional and Behavioral Dysregulation: A Test of the Emotional Cascade Model. The Journal of General Psychology 2013; 141:1-17. [DOI: 10.1080/00221309.2013.834289] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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41
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Masuda A, Hill ML. Mindfulness as therapy for disordered eating: a systematic review. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/npy.13.36] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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42
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Danner UN, Evers C, Sternheim L, van Meer F, van Elburg AA, Geerets TAM, Breteler LMT, de Ridder DTD. Influence of negative affect on choice behavior in individuals with binge eating pathology. Psychiatry Res 2013; 207:100-6. [PMID: 23167986 DOI: 10.1016/j.psychres.2012.10.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 10/22/2012] [Accepted: 10/25/2012] [Indexed: 11/27/2022]
Abstract
Research suggests that individuals with binge eating pathology (e.g., bulimia nervosa (BN) and binge eating disorders (BED)) have decision making impairments and particularly act impulsively in response to negative affect. The aim of this study was to examine the influence of negative affect on choice behavior in women with BN and BED. Ninety women (59 with BN or BED and 31 healthy controls) watched a sad or control film fragment and were subsequently asked to complete a choice behavior task (as measured by a variation of the Bechara Gambling Task (BGT)). Results showed that negative affect influenced choice behavior differently in healthy controls and in women with BN and BED after punishment (but not after reward). In the context of increased negative affect, punishment was associated with more disadvantageous choice behavior in both BN and BED women but not in healthy controls, while the effect was the exact opposite in both groups after a decrease in negative affect. Levels of sadness were not found to influence choice behavior after reward in either groups. These findings suggest that emotional states may have a direct impact on choice behavior of individuals with binge eating pathology and are not only related to pathological behavior itself.
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Affiliation(s)
- Unna N Danner
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, The Netherlands.
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43
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Pedlow CT, Niemeier HM. Sociotropic cognition and eating disordered attitudes and behavior in young adults. Eat Behav 2013; 14:95-101. [PMID: 23557802 DOI: 10.1016/j.eatbeh.2012.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2011] [Revised: 07/25/2012] [Accepted: 10/03/2012] [Indexed: 10/27/2022]
Abstract
Sociotropic cognition is a mindset characterized by a strong need for social approval and fear of interpersonal rejection. Sociotropic cognition has been associated with depression and health risk behavior in women, but few studies have specifically addressed eating disordered attitudes and behaviors, and studies including men are lacking. The purpose of the present study was to assess the influence of sociotropic cognition on eating-related attitudes and behaviors in men and women. Participants were N=362 undergraduate students (51% female; mean age=19.2±1.43) who completed measures of sociotropic cognition, depressed mood, eating disordered attitudes and behaviors, body shape satisfaction, and physical activity. Using hierarchical regression, the results demonstrated that sociotropic cognition was associated with greater dietary restraint, body shape, eating, and weight concerns, emotional eating, and global eating disordered score. Body shape dissatisfaction and emotional eating were found to mediate the relationship between sociotropic cognition and eating disordered behaviors. Sociotropic cognition appears to be an important predictor of body shape dissatisfaction and eating disordered behaviors in a non-clinical sample. Individuals high in sociotropic cognition may engage in eating disordered behavior in response to fears of social evaluation. These findings have implications for prevention and treatment of eating disorders. Cognitive-behavioral intervention strategies are suggested to reduce sociotropic cognition and its influence on eating disordered behavior.
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Affiliation(s)
- C Teal Pedlow
- Department of Psychology, University of Massachusetts Dartmouth, North Dartmouth, MA 02747-2300, USA.
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Nowakowski ME, McFarlane T, Cassin S. Alexithymia and eating disorders: a critical review of the literature. J Eat Disord 2013; 1:21. [PMID: 24999402 PMCID: PMC4081716 DOI: 10.1186/2050-2974-1-21] [Citation(s) in RCA: 156] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 04/25/2013] [Indexed: 02/05/2023] Open
Abstract
Alexithymia is characterized by difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. A number of theoretical models have suggested that individuals with eating disorders may find emotions unacceptable and/or frightening and may use their eating disorder symptoms (i.e., restricting food intake, bingeing, and/or purging) as a way to avoid or cope with their feelings. The current critical review synthesizes the literature on alexithymia and eating disorders and examines alexithymia levels across eating disorders (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified), the role of alexithymia in binge eating disorder, and the influence of alexithymia on the development of eating disorders as well as treatment outcome. The clinical implications of the research conducted to date and directions for future research are discussed.
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Affiliation(s)
- Matilda E Nowakowski
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada
| | - Traci McFarlane
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada ; Eating Disorder Program, The Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
| | - Stephanie Cassin
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada
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45
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Acceptance and Commitment Therapy for Eating Disorders: Rationale and Literature Review. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2012. [DOI: 10.1007/s10879-012-9223-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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46
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Fulton JJ, Lavender JM, Tull MT, Klein AS, Muehlenkamp JJ, Gratz KL. The relationship between anxiety sensitivity and disordered eating: the mediating role of experiential avoidance. Eat Behav 2012; 13:166-9. [PMID: 22365805 DOI: 10.1016/j.eatbeh.2011.12.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 10/21/2011] [Accepted: 12/22/2011] [Indexed: 11/18/2022]
Abstract
This study examined the role of experiential avoidance in the association between dimensions of anxiety sensitivity (AS) and disordered eating. A sample of 395 undergraduate students completed a series of questionnaires assessing the constructs of interest. Results indicate that the AS dimension of fear of cognitive dyscontrol was significantly uniquely associated with disordered eating. Furthermore, results provide support for a model in which experiential avoidance mediates the association between fear of cognitive dyscontrol and disordered eating. Findings of the present study highlight one potential mechanism underlying the association between AS and disordered eating, suggesting that efforts to avoid internal experiences may play a role in eating pathology. Clinical implications of these findings are discussed.
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Haedt-Matt AA, Keel PK. Revisiting the affect regulation model of binge eating: a meta-analysis of studies using ecological momentary assessment. Psychol Bull 2011; 137:660-681. [PMID: 21574678 DOI: 10.1037/a0023660] [Citation(s) in RCA: 497] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The affect regulation model of binge eating, which posits that patients binge eat to reduce negative affect (NA), has received support from cross-sectional and laboratory-based studies. Ecological momentary assessment (EMA) involves momentary ratings and repeated assessments over time and is ideally suited to identify temporal antecedents and consequences of binge eating. This meta-analytic review includes EMA studies of affect and binge eating. Electronic database and manual searches produced 36 EMA studies with N = 968 participants (89% Caucasian women). Meta-analyses examined changes in affect before and after binge eating using within-subjects standardized mean gain effect sizes (ESs). Results supported greater NA preceding binge eating relative to average affect (ES = 0.63) and affect before regular eating (ES = 0.68). However, NA increased further following binge episodes (ES = 0.50). Preliminary findings suggested that NA decreased following purging in bulimia nervosa (ES = -0.46). Moderators included diagnosis (with significantly greater elevations of NA prior to bingeing in binge eating disorder compared to bulimia nervosa) and binge definition (with significantly smaller elevations of NA before binge vs. regular eating episodes for the Diagnostic and Statistical Manual of Mental Disorders definition compared to lay definitions of binge eating). Overall, results fail to support the affect regulation model of binge eating and challenge reductions in NA as a maintenance factor for binge eating. However, limitations of this literature include unidimensional analyses of NA and inadequate examination of affect during binge eating, as binge eating may regulate only specific facets of affect or may reduce NA only during the episode.
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Lavender JM, Anderson DA, Gratz KL. Examining the Association Between Thought Suppression and Eating Disorder Symptoms in Men. COGNITIVE THERAPY AND RESEARCH 2011. [DOI: 10.1007/s10608-011-9403-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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49
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Lavender JM, Gratz KL, Tull MT. Exploring the Relationship between Facets of Mindfulness and Eating Pathology in Women. Cogn Behav Ther 2011; 40:174-82. [DOI: 10.1080/16506073.2011.555485] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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50
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Ferriter C, Ray LA. Binge eating and binge drinking: an integrative review. Eat Behav 2011; 12:99-107. [PMID: 21385638 DOI: 10.1016/j.eatbeh.2011.01.001] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Revised: 12/11/2010] [Accepted: 01/17/2011] [Indexed: 11/29/2022]
Abstract
The primary goal of this review is to provide a framework for understanding two highly overlapping behaviors: binge eating and binge drinking. Research is presented that suggests binge eating and drinking behaviors may share several important features, including personality correlates such as neuroticism and urgency, as well as affective characteristics, such as elevated levels of negative affect. Additionally, the review describes common explanatory models, which are helpful in terms of their potential to link these common features to the functions of, or reasons why individuals engage in, binge eating and drinking behaviors. Implications for understanding potentially common etiological pathways and development of interventions designed to target multiple behaviors are discussed.
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Affiliation(s)
- Caitlin Ferriter
- Department of Psychology, University of California, Los Angeles, CA 90095-1563, United States.
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