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Klatzkin RR, Nadel T, Lallo B, Mosby E, Perkins D, Qureshi H, McKay NJ, Slavich GM. Lifetime stressor exposure is associated with greater rewarding effects of stress-related eating. Physiol Behav 2024; 284:114610. [PMID: 38866298 DOI: 10.1016/j.physbeh.2024.114610] [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: 11/01/2023] [Revised: 05/23/2024] [Accepted: 06/09/2024] [Indexed: 06/14/2024]
Abstract
Acute stressors tend to shift preferences toward comfort foods, yet they do not ubiquitously increase the amount of food consumed. Moreover, although many individuals eat more under stress, others eat less or show no change. Although the precise mechanisms explaining this variability in stress-related eating are unknown, they may be driven by individual differences in the rewarding effects of comfort eating, which are enhanced by greater lifetime stressor exposure. To investigate this possibility, we examined whether differences in lifetime stressor exposure predicted reductions in negative affect following snacking (i.e., negative reinforcement) and if this effect was specific to stress-related snacking or snacking in general. Participants were 26 women (23 % non-White) between 20 and 45 years old (M = 31), with a mean body mass index of 26, who completed three laboratory visits. Participants completed an assessment of lifetime stressor exposure (i.e., STRAIN) on the first visit and, on two subsequent laboratory visits in counterbalanced order, were given snacks after an acute social stress task (i.e., TSST) or rest period. Greater lifetime stressor exposure was related to greater post-ingestive decreases in negative affect following the acute social stressor but not following the rest period. If stress-related eating is more comforting for women with greater lifetime stressors and contributes to a stronger stress-eating association, then this may inform obesity-related clinical treatments that target behaviors and cognitions related to reward-based learning.
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Affiliation(s)
| | - Tzvi Nadel
- Department of Psychology, Rhodes College, Memphis, TN, United States
| | - Bella Lallo
- Department of Psychology, Rhodes College, Memphis, TN, United States
| | - Erica Mosby
- Department of Psychology, Rhodes College, Memphis, TN, United States
| | - Dot Perkins
- Department of Psychology, Rhodes College, Memphis, TN, United States
| | - Hadiyah Qureshi
- Department of Psychology, Rhodes College, Memphis, TN, United States
| | - Naomi J McKay
- Department of Psychology, SUNY Buffalo State, Buffalo, NY, United States
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, United States
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2
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Li SS, Kalan RE, Smith A, Mason TB, Smith KE. Momentary mechanisms of binge-eating symptoms using ecological momentary assessment: The moderating role of food addiction. EUROPEAN EATING DISORDERS REVIEW 2024. [PMID: 38857200 DOI: 10.1002/erv.3116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 05/09/2024] [Accepted: 06/02/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Food addiction (FA) shows phenotypic and diagnostic overlap with eating disorders characterised by binge eating, though it is unknown how momentary processes driving binge-eating symptoms differ by FA. The present study examined the possible moderating influence of FA severity on momentary mechanisms underlying binge-eating symptomatology using ecological momentary assessment (EMA). METHOD Adults (N = 49, mean age = 34.9 ± 12.1, cis-gender female = 77.1%) who met criteria for FA and/or binge-eating disorder completed baseline measures including the Yale Food Addiction Scale (YFAS) followed by a 10-day EMA protocol. Generalised linear mixed models assessed main effects of YFAS, momentary antecedents (affect, impulsivity, food cue exposure, appetite, and eating expectancies) and two-way interactions between YFAS and within-person antecedents. RESULTS FA severity moderated momentary associations between food cue exposure and subsequent binge-eating symptoms: the association was stronger among participants with lower but not higher YFAS scores. No other interactions were significant. CONCLUSIONS Some functional associations underlying binge-eating symptoms vary based on individuals' level of FA symptoms. Future research to further understand how observed associations may differ amongst diverse populations and over course of illness may also inform future prevention and interventions.
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Affiliation(s)
- Shirley S Li
- Keck School of Medicine of University of Southern California, Los Angeles, California, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Rachel E Kalan
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Alexandro Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
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Elsworth RL, Hinton EC, Flynn AN, Merrell LH, Hamilton-Shield JP, Lawrence NS, Brunstrom JM. Development of Momentary Appetite Capture (MAC): A versatile tool for monitoring appetite over long periods. Appetite 2024; 194:107154. [PMID: 38081544 DOI: 10.1016/j.appet.2023.107154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 01/08/2024]
Abstract
Understanding how an intervention impacts appetite in real-life settings and over several days remains a challenging and under-explored research question. To this end, we developed Momentary Appetite Capture (MAC), a form of ecological momentary assessment that combines automated text messaging with an online platform. Participants report their appetite using visual analogue scales (hunger, desire to eat, and fullness) and a virtual portion-size selection task. In two separate studies, we assessed the feasibility and test-retest reliability of MAC. Participants were prompted every 2 hours over a 14-hour window, and they repeated this assessment over two consecutive weekdays. For each participant, we calculated a daily time-averaged area under the curve (AUC) for each appetite measure. In Study One (N = 25) time-averaged AUC was significantly positively correlated across test days for hunger (r = 0.563, p = .003), desire to eat (r = 0.515, p = .008) and prospective portion size (r = 0.914, p < .001), but not for fullness (r = 0.342, p = .094). Participants completed 95% of MACs (380 of 400), and we used participant feedback to improve the MAC tool and study protocol for Study Two. In Study Two (N = 31), 94% of MACs were completed (468 of 496). Across days, time-averaged AUC was significantly positively correlated for hunger (r = 0.595, p = < .001), fullness (r = 0.501, p = .004), desire to eat (r = 0.585, p < .001), and prospective portion size (r = 0.757, p < .001). Together, these studies suggest that MAC could be an acceptable and reliable tool to track appetite throughout the day. In the future, MAC could be used to explore the impact of weight-loss interventions on natural fluctuations in appetite.
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Affiliation(s)
- Rebecca L Elsworth
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, UK.
| | - Elanor C Hinton
- NIHR Bristol Biomedical Research Centre, University of Bristol and University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Annika N Flynn
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, UK
| | - Lucy H Merrell
- Centre for Nutrition, Exercise and Metabolism, Department for Health, University of Bath, Bath, UK
| | - Julian P Hamilton-Shield
- NIHR Bristol Biomedical Research Centre, University of Bristol and University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Jeffrey M Brunstrom
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, UK; NIHR Bristol Biomedical Research Centre, University of Bristol and University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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MacDonald DE, Trottier K, Cao L, Crosby RD, Wonderlich SA, Engel SG, Olmsted MP. Momentary skills use predicts decreased binge eating and purging early in day treatment: An ecological momentary assessment study. Int J Eat Disord 2024; 57:548-557. [PMID: 38189475 DOI: 10.1002/eat.24128] [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: 05/25/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE Emerging research indicates that skills acquisition may be important to behavior change in cognitive behavior therapy (CBT) for eating disorders. This study investigated whether skills use assessed in real time during the initial 4 weeks of CBT-based day treatment was associated with momentary eating disorder behavior change and rapid response to treatment. METHODS Participants with DSM-5 bulimia nervosa or purging disorder (N = 58) completed ecological momentary assessments (EMA) several times daily for the first 28 days of treatment. EMA assessed skills use, the occurrence of binge eating and/or purging, and state negative affect. Rapid response was defined as abstinence from binge eating and/or purging in the first 4 weeks of treatment. RESULTS Greater real-time skills use overall, and use of "planning ahead," "distraction," "social support," and "mechanical eating" skills in particular, were associated with a lower likelihood of engaging in binge eating or purging during the same period. After controlling for baseline group differences in overall difficulties with emotion regulation, rapid and non-rapid responders did not differ in overall skills use, or skills use at times of higher negative affect, during the EMA period. DISCUSSION Momentary use of skills appears to play an important role in preventing binge eating and purging, and certain skills appear to be particularly helpful. These findings contribute to the literature elucidating the processes by which CBT treatments for eating disorders work by providing empirical evidence that skills use helps to prevent binge eating and purging behaviors. PUBLIC SIGNIFICANCE Individuals with eating disorders learn new skills during treatment to help them improve their symptoms. This study shows that for people with eating disorders, using skills helps prevent eating disorder behaviors in the moment. Certain skills may be particularly helpful, including planning ahead, distracting activities, support from others, and focusing on eating meals and snacks regardless of how one is feeling. These findings help us better understand how treatments work.
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Affiliation(s)
- Danielle E MacDonald
- Centre for Mental Health, University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Kathryn Trottier
- Centre for Mental Health, University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Li Cao
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Ross D Crosby
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - Stephen A Wonderlich
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - Scott G Engel
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Marion P Olmsted
- Centre for Mental Health, University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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A Retrospective Literature Review of Eating Disorder Research (1990–2021): Application of Bibliometrics and Topical Trends. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137710. [PMID: 35805366 PMCID: PMC9265657 DOI: 10.3390/ijerph19137710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 12/24/2022]
Abstract
Despite the growing importance of eating disorders in society and academic literature, only a few bibliometric review studies using bibliometric analysis were available. Hence, this study aimed to explore and uncover hidden research topics and patterns in articles in terms of eating disorders over the last 30 years. In total, 4111 articles on eating disorders were analyzed using bibliometrics, network analyses, and structural topic modeling as the basis of mixed methods. In addition to general statistics about the journal, several key research topics, such as eating disorder (ED) treatment, ED symptoms, factors triggering ED, family related factors, eating behaviors, and social factors, were found based on topic correlations. This study found the key research variables that are frequently studied with EDs, such as AN, BN, BED, and ARFID. This study may help clinicians comprehend important risk factors associated with EDs. Moreover, the findings about key ED research topics and their association can be helpful for future studies to construct a comprehensive ED research framework. To our knowledge, this is the first study to use topic modeling in an academic journal on EDs and examine the diversity in ED research over 30 years of published research.
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Strahler J, Wachten H, Neuhofer S, Zimmermann P. Psychological Correlates of Excessive Healthy and Orthorexic Eating: Emotion Regulation, Attachment, and Anxious-Depressive-Stress Symptomatology. Front Nutr 2022; 9:817047. [PMID: 35356731 PMCID: PMC8959669 DOI: 10.3389/fnut.2022.817047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/04/2022] [Indexed: 01/13/2023] Open
Abstract
Orthorexia nervosa, the pathological obsession with eating healthy, shares risks and significant comorbidity with other mental disorders. Based on a behavioral conceptualization of the overlap, emotion regulation, attachment style, and anxious-depressive-stress symptomatology are prominent but insufficiently researched endophenotypes for orthorexia nervosa. This study aimed at identifying ways in which difficulties in emotion regulation and attachment-related anxiety and avoidance become apparent in orthorexia nervosa and healthy orthorexia. Additionally, the moderating role of anxious, depressive, and stress symptoms was explored. A convenience sample of 399 adults (266 women) completed questionnaires to measure orthorexia nervosa and healthy orthorexia, difficulties in emotion regulation, partnership-related bond, and anxious-depressive-stress symptomatology. The healthy orthorexia subscale was negatively associated with lack of emotional awareness but no other subscale of difficulties in emotion regulation or attachment-related anxiety and avoidance. Orthorexia nervosa scores were positively linked to difficulties in emotion regulation as well as attachment-related anxiety and avoidance. Multiple linear regression indicated non-acceptance of emotional responses and impulse control difficulties to be the strongest predictors for orthorexia nervosa. Both subscales also mediated the effects of attachment style on orthorexia nervosa with anxious-depressive-stress symptomatology moderating some of these effects. Individuals with higher orthorexia nervosa tendencies showed difficulties in emotion regulation, a common feature also of affective and eating disorders. Improvement in understanding the psychological features of orthorexia nervosa can enable a better differentiation from other disorders, advances in the development of treatment approaches and treatment planning, and outlines directions for future research on mechanisms.
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Affiliation(s)
- Jana Strahler
- Department of Sport Psychology, Albert-Ludwigs-University Freiburg, Freiburg im Breisgau, Germany
- Department of Health Psychology and Applied Diagnostics, University of Wuppertal, Wuppertal, Germany
- *Correspondence: Jana Strahler
| | - Hanna Wachten
- Department of Sport Psychology, Albert-Ludwigs-University Freiburg, Freiburg im Breisgau, Germany
- Department of Psychotherapy and System Neuroscience, Justus Liebig University Giessen, Giessen, Germany
| | - Shanna Neuhofer
- Department of Psychotherapy and System Neuroscience, Justus Liebig University Giessen, Giessen, Germany
| | - Peter Zimmermann
- Department of Developmental Psychology, University of Wuppertal, Wuppertal, Germany
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Moulder RG, Daniel KE, Teachman BA, Boker SM. Tangle: A metric for quantifying complexity and erratic behavior in short time series. Psychol Methods 2022; 27:82-98. [PMID: 33507767 PMCID: PMC8552416 DOI: 10.1037/met0000386] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Temporal complexity refers to qualities of a time series that are emergent, erratic, or not easily described by linear processes. Quantifying temporal complexity within a system is key to understanding the time based dynamics of said system. However, many current methods of complexity quantification are not widely used in psychological research because of their technical difficulty, computational intensity, or large number of required data samples. These requirements impede the study of complexity in many areas of psychological science. A method is presented, tangle, which overcomes these difficulties and allows for complexity quantification in relatively short time series, such as those typically obtained from psychological studies. Tangle is a measure of how dissimilar a given process is from simple periodic motion. Tangle relies on the use of a three-dimensional time delay embedding of a one-dimensional time series. This embedding is then iteratively scaled and premultiplied by a modified upshift matrix until a convergence criterion is reached. The efficacy of tangle is shown on five mathematical time series and using emotional stability, anxiety time series data obtained from 65 socially anxious participants over a 5-week period, and positive affect time series derived from a single participant who experienced a major depression episode during measurement. Simulation results show tangle is able to distinguish between different complex temporal systems in time series with as few as 50 samples. Tangle shows promise as a reliable quantification of irregular behavior of a time series. Unlike many other complexity quantification metrics, tangle is technically simple to implement and is able to uncover meaningful information about time series derived from psychological research studies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Rehn S, Raymond JS, Boakes RA, Leenaars CHC. A systematic review and meta-analysis of animal models of binge eating - Part 1: Definitions and food/drink intake outcomes. Neurosci Biobehav Rev 2021; 132:1137-1156. [PMID: 34742923 DOI: 10.1016/j.neubiorev.2021.10.036] [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: 09/13/2021] [Revised: 10/19/2021] [Accepted: 10/28/2021] [Indexed: 12/09/2022]
Abstract
Binge eating involves consuming excessive amounts of food within a discrete period of time and is associated with significant impairments in binge-eating disorder and bulimia nervosa. While research on clinical binge eating has provided valuable aetiological insights, animal models allow for closer examination of environmental, biological, and developmental risk factors. Numerous animal models of binge eating exist and differ widely in operational definitions of bingeing, animal characteristics and methodological parameters. The current review aimed to synthesise the available published evidence on these models. A systematic review of binge definitions in 170 articles found most studies displayed good face validity. Meta-analyses on 150 articles confirmed that the amount of food or drink consumed by animals under binge conditions was larger than that of non-binge conditions across many protocols. The meta-regression revealed species, strain, and sex moderated binge effect size, with the largest effect observed in studies with female animals and mice. Risk of bias assessment identified that improved reporting of allocation, baseline characteristics and outcome assessment is required in future studies.
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Affiliation(s)
- Simone Rehn
- The University of Sydney, Faculty of Science, School of Psychology, Sydney, 2006 NSW, Australia.
| | - Joel S Raymond
- The University of Sydney, Faculty of Science, School of Psychology, Sydney, 2006 NSW, Australia; The University of Sydney, Brain and Mind Centre, 94 Mallett Street, Camperdown, Sydney, NSW 2050, Australia
| | - Robert A Boakes
- The University of Sydney, Faculty of Science, School of Psychology, Sydney, 2006 NSW, Australia
| | - Cathalijn H C Leenaars
- Institute for Laboratory Animal Science, Hannover Medical School, 30625, Hannover, Germany; Department for Health Evidence, Radboud University Medical Centre, 6600, Nijmegen, The Netherlands
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Somatic symptoms and binge eating in women's daily lives. J Psychosom Res 2020; 135:110161. [PMID: 32504896 PMCID: PMC7365755 DOI: 10.1016/j.jpsychores.2020.110161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/06/2020] [Accepted: 05/20/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The present study aimed to determine whether the momentary severity of women's somatic symptoms was concurrently and prospectively associated with their engagement in binge eating in naturalistic settings. METHOD Thirty women (Mage = 34.13, SD = 13.92) who had engaged in binge eating at least once over the month prior to study entry completed a 14-day ecological momentary assessment (EMA) protocol. During each of the 14 days, participants received five semi-random surveys via text message that assessed momentary somatic symptom severity (i.e., headaches, stomachaches/pain, chest/heart pain, faintness/dizziness, shortness of breath, fatigue) and disordered eating behaviors. Generalized estimating equations were used to determine whether momentary somatic symptoms were concurrently and prospectively (i.e., by participants' next assessment) associated with the occurrence of binge eating behavior, while controlling for age and body mass index. RESULTS At the within-person level, more severe stomachaches/pain, faintness/dizziness, shortness of breath, and fatigue were concurrently associated with an increased likelihood of engaging in binge eating. Further, at the between-person level, more severe stomachaches/pain, chest/heart pain, shortness of breath, and fatigue in general were associated with binge eating across the EMA protocol. Momentary stomachache/pain severity also prospectively predicted women's engagement in binge eating behavior at the next assessment. CONCLUSIONS The present results provide initial evidence that multiple somatic symptoms may serve as momentary correlates or proximal antecedents of binge eating behavior in women's daily lives. Somatic symptoms may consequently prove useful to target in eating disorder treatments, perhaps via interoceptive exposure interventions.
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Goldschmidt AB, Smith KE, Lavender JM, Engel SG, Haedt-Matt A. Trait-level facets of impulsivity and momentary, naturalistic eating behavior in children and adolescents with overweight/obesity. J Psychiatr Res 2019; 110:24-30. [PMID: 30580080 PMCID: PMC6360116 DOI: 10.1016/j.jpsychires.2018.12.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 01/08/2023]
Abstract
Impulsivity, and specific subdomains of inhibitory control and reward sensitivity, are trait-level factors that have been implicated in the onset and maintenance of pediatric obesity and disordered eating, but their associations with real-world eating behavior are unknown. We investigated associations of these trait-level constructs with naturalistic, momentary measures of loss of control (LOC) eating and overeating severity in a heterogeneous sample of youth (n = 40), aged 8-14y, with overweight/obesity. Self-report, parent-report, and behavioral data on trait-level impulsivity, reward sensitivity, and inhibitory control, respectively, were collected in the context of a 14-day ecological momentary assessment (EMA) protocol in which participants reported on their eating behavior, mood, hunger, and palatability of foods consumed in real-time. Generalized estimating equations revealed that more perseverative errors on a behavioral measure of visuomotor processing speed and a lower self-reported tendency to act without thinking (at a trend level) were related to greater overall LOC severity. Momentary associations between negative affect and LOC severity were stronger among individuals with greater perseverative errors. Results suggest that trait-level facets of impulsivity may directly influence an individual's tendency to engage in dysregulated eating behaviors, and may also impact susceptibility to state-level factors associated with occurrence of these behaviors. Momentary interventions for LOC eating may require tailoring to address temperamental factors related to impulsivity and inhibitory control.
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Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Weight Control and Diabetes Research Center, 196 Richmond St., Providence, RI, 02903, USA.
| | - Kathryn E Smith
- Sanford Research, 120 8th St. South, Fargo, ND, 58103, USA; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, 1919 Elm St. North, Fargo, ND, 58102, USA
| | - Jason M Lavender
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA; Department of Psychology, Illinois Institute of Technology, 3424 South State St., Chicago, IL, 60616, USA
| | - Scott G Engel
- Sanford Research, 120 8th St. South, Fargo, ND, 58103, USA; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, 1919 Elm St. North, Fargo, ND, 58102, USA
| | - Alissa Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, 3424 South State St., Chicago, IL, 60616, USA
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Forman EM, Goldstein SP, Zhang F, Evans BC, Manasse SM, Butryn ML, Juarascio AS, Abichandani P, Martin GJ, Foster GD. OnTrack: development and feasibility of a smartphone app designed to predict and prevent dietary lapses. Transl Behav Med 2019; 9:236-245. [PMID: 29617911 PMCID: PMC6610167 DOI: 10.1093/tbm/iby016] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Given that the overarching goal of weight loss programs is to remain adherent to a dietary prescription, specific moments of nonadherence known as "dietary lapses" can threaten weight control via the excess energy intake they represent and by provoking future lapses. Just-in-time adaptive interventions could be particularly useful in preventing dietary lapses because they use real-time data to generate interventions that are tailored and delivered at a moment computed to be of high risk for a lapse. To this end, we developed a smartphone application (app) called OnTrack that utilizes machine learning to predict dietary lapses and deliver a targeted intervention designed to prevent the lapse from occurring. This study evaluated the feasibility, acceptability, and preliminary effectiveness of OnTrack among weight loss program participants. An open trial was conducted to investigate subjective satisfaction, objective usage, algorithm performance, and changes in lapse frequency and weight loss among individuals (N = 43; 86% female; body mass index = 35.6 kg/m2) attempting to follow a structured online weight management plan for 8 weeks. Participants were adherent with app prompts to submit data, engaged with interventions, and reported high levels of satisfaction. Over the course of the study, participants averaged a 3.13% weight loss and experienced a reduction in unplanned lapses. OnTrack, the first Just-in-time adaptive intervention for dietary lapses was shown to be feasible and acceptable, and OnTrack users experienced weight loss and lapse reduction over the study period. These data provide the basis for further development and evaluation.
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Affiliation(s)
- Evan M Forman
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Stephanie P Goldstein
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Fengqing Zhang
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Brittney C Evans
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Adrienne S Juarascio
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Pramod Abichandani
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Gerald J Martin
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Gary D Foster
- Weight Watchers International, New York, NY, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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12
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Wonderlich JA, Breithaupt L, Thompson JC, Crosby RD, Engel SG, Fischer S. The impact of neural responses to food cues following stress on trajectories of negative and positive affect and binge eating in daily life. J Psychiatr Res 2018; 102:14-22. [PMID: 29558632 DOI: 10.1016/j.jpsychires.2018.03.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 02/12/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022]
Abstract
Stress and affect have been implicated in the maintenance of binge eating for women with symptoms of bulimia nervosa (BN). Neuroimaging and ecological momentary assessment (EMA) have separately examined how these variables may contribute to eating disorder behavior. Though both methodologies have their own strengths, it's unclear how either methodology might inform the other. This study examined the impact of individual differences in neural reactivity to food cues following acute stress on the trajectories of positive affect (PA) and negative affect (NA) surrounding binge eating. Women (n = 16) with BN symptoms viewed palatable food cues before and after a stress induction in the scanner. For two weeks, participants responded to prompts assessing affect and binge episodes several times a day. EMA data revealed NA increased and PA decreased before binge episodes in the natural environment. Additionally, NA decreased while PA increased following binge episodes. Changes in activation in the ACC, amygdala, and the vmPFC significantly moderated the relationship of affect to binge eating. However, lateral differences of each brain region uniquely moderator the trajectory of PA, NA, or both to binge eating. Specifically, those with less change in BOLD response reported significantly increasing NA and decreasing PA prior to binges, while women with greater decreases reported no change in affect. Following binge eating, individuals with decreased change in BOLD response reported decreasing NA and increasing PA. This may suggest individual differences in neural response to food cues under stress appear to underlie affect driven theory on the antecedents to binge eating.
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Affiliation(s)
| | | | - James C Thompson
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | - Ross D Crosby
- 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
| | - Sarah Fischer
- Department of Psychology, George Mason University, Fairfax, VA, USA
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Gagnon C, Bégin C, Laflamme V, Grondin S. Temporal Processing of Joyful and Disgusting Food Pictures by Women With an Eating Disorder. Front Hum Neurosci 2018; 12:129. [PMID: 29681806 PMCID: PMC5897655 DOI: 10.3389/fnhum.2018.00129] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/19/2018] [Indexed: 01/22/2023] Open
Abstract
The present study used the presentation of food pictures and judgements about their duration to assess the emotions elicited by food in women suffering from an eating disorder (ED). Twenty-three women diagnosed with an ED, namely anorexia (AN) or bulimia nervosa (BN), and 23 healthy controls (HC) completed a temporal bisection task and a duration discrimination task. Intervals were marked with emotionally pre-rated pictures of joyful and disgusting food, and pictures of neutral objects. The results showed that, in the bisection task, AN women overestimated the duration of food pictures in comparison to neutral ones. Also, compared to participants with BN, they perceived the duration of joyful food pictures as longer, and tended to overestimate the duration of the disgusting ones. These effects on perceived duration suggest that AN women experienced an intense reaction of fear when they were confronted to food pictures. More precisely, by having elevated the arousal level and activated the defensive system, food pictures seemed to have speeded up the rhythm of the AN participants’ internal clock, which led to an overestimation of images’ duration. In addition, the results revealed that, in both tasks, ED women presented a lower temporal sensitivity than HC, which was related to their ED symptomatology (i.e., BMI, restraint and concern) and, particularly, to their weaker cognitive abilities in terms of attention, processing speed and working memory. Considered all together, the findings of the present experiment highlight the role of fear and anxiety in the manifestations of AN and point out the importance of considering non-temporal factors in the interpretation of time perception performance.
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Affiliation(s)
| | | | | | - Simon Grondin
- École de Psychologie, Université Laval, Québec, QC, Canada
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14
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Strahler J, Nater UM. Differential effects of eating and drinking on wellbeing—An ecological ambulatory assessment study. Biol Psychol 2018; 131:72-88. [DOI: 10.1016/j.biopsycho.2017.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 12/07/2016] [Accepted: 01/18/2017] [Indexed: 10/20/2022]
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15
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Turner BJ, Yiu A, Claes L, Muehlenkamp JJ, Chapman AL. Occurrence and co-occurrence of nonsuicidal self-injury and disordered eating in a daily diary study: Which behavior, when? Psychiatry Res 2016; 246:39-47. [PMID: 27657802 DOI: 10.1016/j.psychres.2016.09.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/18/2016] [Accepted: 09/10/2016] [Indexed: 10/21/2022]
Abstract
Although research has explored between-person traits that may account for the co-occurrence of non-suicidal self-injury (NSSI) and disordered eating (DE), little is known about within-person processes that predict when each behavior occurs. This study describes the socioemotional contexts of NSSI and DE behaviors during a two-week daily diary period. Young adults (aged 18-35) who reported ≥1 episode of NSSI and ≥1 episode of DE (binge eating, purging, or fasting) during the diary period were included (N=25). NSSI and DE co-occurred approximately one third of the time. Participants were more likely to act on NSSI thoughts following arguments and feelings of rejection. They were more likely to act on binge eating/purging thoughts after eating or watching television, and when they felt self-hatred. They were more likely to act on fasting thoughts after discussing upsetting memories, and when they were in a public setting. NSSI days were marked by more intense negative mood in the evenings relative to fasting days, and greater fatigue in the morning relative to binge eating/purging days. This study underscores the utility of using experience-sampling methods to develop and test within-person models to advance our understanding of co-occurring behaviors.
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Affiliation(s)
- Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, BC, Canada; Department of Psychology, Harvard University, Cambridge, MA, USA.
| | - Angelina Yiu
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Department of Psychiatry, Antwerp University, Antwerp, Belgium
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16
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Bos FM, Schoevers RA, aan het Rot M. Experience sampling and ecological momentary assessment studies in psychopharmacology: A systematic review. Eur Neuropsychopharmacol 2015; 25:1853-64. [PMID: 26336868 DOI: 10.1016/j.euroneuro.2015.08.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 08/12/2015] [Accepted: 08/13/2015] [Indexed: 12/15/2022]
Abstract
Experience sampling methods (ESM) and ecological momentary assessment (EMA) offer insight into daily life experiences, including symptoms of mental disorders. The application of ESM/EMA in psychopharmacology can be a valuable addition to more traditional measures such as retrospective self-report questionnaires because they may help reveal the impact of psychotropic medication on patients' actual experiences. In this paper we systematically review the existing literature on the use of ESM/EMA in psychopharmacology research. To this end, we searched the PsycInfo and Medline databases for all available ESM/EMA studies on the use of psychotropic medication in patients with DSM-III-R and DSM-IV disorders. Dissertations were excluded. We included 18 studies that applied ESM/EMA to study the effects of medication on patients with major depressive disorder, substance use disorder, attention-deficit hyperactivity disorder, psychotic disorder, and anxiety disorder. We found that ESM/EMA may allow researchers and clinicians to track patients during different phases of treatment: before treatment to predict outcome, during treatment to examine the effects of treatment on symptoms and different aspects of daily life experience, and after treatment to detect vulnerability for relapse. Moreover, ESM/EMA can potentially help determine how long and in what contexts medications are effective. Thus, ESM/EMA may benefit both researchers and clinicians and might prove to be an effective tool for improving the treatment of psychiatric patients.
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Affiliation(s)
- Fionneke M Bos
- Department of Psychology, University of Groningen, Groningen, The Netherlands.
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Marije aan het Rot
- Department of Psychology, University of Groningen, Groningen, The Netherlands; School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
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Brownley KA, Peat CM, La Via M, Bulik CM. Pharmacological approaches to the management of binge eating disorder. Drugs 2015; 75:9-32. [PMID: 25428709 DOI: 10.1007/s40265-014-0327-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In the USA, binge eating disorder (BED) is the most common eating disorder, with a lifetime prevalence of ~3.5 % in adult women, 2.0 % in adult men, and 1.6 % in adolescents. BED is characterized by frequent episodes of binge eating that are accompanied by a sense of loss of control over eating and result in marked psychological distress. BED is highly co-morbid with obesity and with depression and other psychiatric conditions, and it is associated with substantial role impairment. Currently, there are no US FDA-approved pharmacological treatments for BED. Animal and human studies implicate underlying dysregulation in dopamine, opioid, acetylcholine, and serotonin neurocircuitry within brain reward regions in the pathogenesis and maintenance of BED. To date, the efficacy of various agents that target these and other neurotransmitter systems involved in motivated feeding behavior, mood regulation, and impulse control have been investigated in the treatment of BED. Several antidepressant and anticonvulsant agents have demonstrated efficacy in reducing binge eating frequency, but only in limited cases have these effects resulted in patients achieving abstinence, which is the primary goal of treatment; they also range from less (fluvoxamine) to more (topiramate) effective in achieving weight loss that is both clinically meaningful and significantly greater than placebo. Collectively, the literature on pharmacological treatment approaches to BED is limited in that very few agents have been studied in multiple, confirmatory trials with adequate follow up, and almost none have been evaluated in large patient samples that are diverse with respect to age, sex, and ethnicity. In addition, prior trials have not adequately addressed, through study design, the high placebo response commonly observed in this patient population. Several novel agents are in various phases of testing, and recent animal studies focusing on glutamate-signaling circuits linking the amygdala to the lateral hypothalamus offer new avenues for exploration and potential therapeutic development. Studies of newly FDA-approved medications for long-term obesity treatment and further explorations of dietary supplements and neutraceuticals with appetite- and mood-altering properties may also be worthwhile.
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Affiliation(s)
- Kimberly A Brownley
- Department of Psychiatry, CB #7175, University of North Carolina, Chapel Hill, NC, 27599-7175, USA,
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Macpherson-Sánchez AE. Integrating fundamental concepts of obesity and eating disorders: implications for the obesity epidemic. Am J Public Health 2015; 105:e71-85. [PMID: 25713933 PMCID: PMC4358173 DOI: 10.2105/ajph.2014.302507] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2014] [Indexed: 12/12/2022]
Abstract
Physiological mechanisms promote weight gain after famine. Because eating disorders, obesity, and dieting limit food intake, they are famine-like experiences. The development of the concept of meeting an ideal weight was the beginning of increasing obesity. Weight stigma, the perception of being fat, lack of understanding of normal growth and development, and increased concern about obesity on the part of health providers, parents, and caregivers have reinforced each other to promote dieting. Because weight suppression and disinhibition provoke long-term weight increase, dieting is a major factor producing the obesity epidemic. The integrated eating disorder-obesity theory included in this article emphasizes that, contrary to dieters, lifetime weight maintainers depend on physiological processes to control weight and experience minimal weight change.
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Affiliation(s)
- Ann E Macpherson-Sánchez
- Ann E. Macpherson-Sánchez is with the Department of Agricultural Education, University of Puerto Rico, Mayagüez
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Characterization of eating patterns among individuals with eating disorders: What is the state of the plate? Physiol Behav 2014; 134:92-109. [DOI: 10.1016/j.physbeh.2014.02.045] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/15/2014] [Accepted: 02/17/2014] [Indexed: 12/28/2022]
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Witt AA, Lowe MR. Hedonic hunger and binge eating among women with eating disorders. Int J Eat Disord 2014; 47:273-80. [PMID: 24014479 DOI: 10.1002/eat.22171] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/02/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Hedonic hunger, the appetitive drive to eat to obtain pleasure in the absence of an energy deficit, is associated with overeating and with loss of control over eating, but has not been investigated among individuals with eating disorders. OBJECTIVE (1) to compare participants with anorexia nervosa, restricting type (AN-R), anorexia nervosa, binge-purge type (AN-B/P), and bulimia nervosa (BN) on scores on the Power of Food Scale (PFS), a self-report measure of hedonic hunger; (2) to examine the relation between PFS scores and frequency of binge eating; and (3) to examine whether pre-treatment PFS scores predict weight change during treatment. METHOD The PFS and measures of eating disorder symptomatology were administered to female patients with AN (N = 119) and BN (N = 144) at admission to residential treatment. RESULTS Participants with BN scored higher on the PFS compared to participants with AN-R or AN-B/P; there was a trend for those with AN-B/P to score higher than those with AN-R. PFS scores were positively associated with binge eating frequency among participants with BN; these associations remained significant when controlling for restraint and weight suppression. A similar pattern was found among participants with AN. PFS scores predicted weight change in AN but not BN. DISCUSSION Results suggest that hedonic processes may be important in stimulating binge eating. Furthermore, hedonic appetite may facilitate weight restoration in AN. Further research should investigate whether pre-treatment PFS scores have prognostic significance with respect to eating disorder symptoms.
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Affiliation(s)
- Ashley A Witt
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania
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21
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Abstract
OBJECTIVE The context of eating episodes in obesity is poorly understood. This study examined emotional, physiological, and environmental correlates of pathological and nonpathological eating episodes in a heterogeneous sample of obese adults. METHODS Community-based participants (n = 50; 84% female [n = 42]; mean [standard deviation] body mass index = 40.3 [8.5]; mean [standard deviation] age = 43.0 [11.9]) recorded all eating episodes and their emotional, physiological, and environmental correlates via ecological momentary assessment for 2 weeks. Generalized estimating equations examined relations between these variables and eating episodes characterized by both self-identified loss of control (LOC) while eating and overeating (binge eating; BE), LOC only, overeating only (OE), and neither LOC nor OE (nonpathological eating). RESULTS Episodes involving loss of control (BE and LOC) were associated with heightened preepisode and postepisode negative effects (Wald χ range, 15.67-24.39; p values < .001), whereas those involving overeating (BE and OE) were associated with the lowest preepisode and postepisode hunger (Wald χ range, 18.14-39.75; p values <.001). LOC episodes were followed by heightened postepisode cravings (Wald χ = 25.87; p < .001) and were most likely to occur when participants were alone (Wald χ = 13.20; p = .004). CONCLUSION BE and LOC eating were more consistently associated with emotional and physiological cues than OE and nonpathological eating, whereas most environmental variables did not differ among eating episode types. Results support distinctions among the different constructs characterizing aberrant eating and may be used to inform interventions for obesity and related eating pathology.
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Reward-sensitive women overeat in a varied food environment, but only when hungry. Eat Behav 2012; 13:317-20. [PMID: 23121781 DOI: 10.1016/j.eatbeh.2012.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 04/18/2012] [Accepted: 05/31/2012] [Indexed: 11/22/2022]
Abstract
In the current study we tried to elucidate the relationship between a personality trait, reward sensitivity, and an environmental variable; food variety. Based on scarce previous research we predicted that reward sensitivity would interact with variety in the food environment so that especially high reward sensitive individuals would be vulnerable to overeating in a varied food environment. It turned out that especially the high reward individuals did indeed overeat in a varied food environment. However, this was only the case for the highly reward sensitive individuals who experienced feelings of hunger. In other words, reward sensitivity does not affect food intake in varied food environments as long as feelings of hunger are not present. Future research should concentrate on identifying other factors that interact with the person and the environment to discourage reward-related overeating.
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Martino SC, Scharf DM, Setodji CM, Shadel WG. Measuring exposure to protobacco marketing and media: a field study using ecological momentary assessment. Nicotine Tob Res 2012; 14:398-406. [PMID: 22039076 PMCID: PMC3313782 DOI: 10.1093/ntr/ntr223] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 08/24/2011] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The aims of this study were to validate ecological momentary assessment (EMA) as a method for measuring exposure to tobacco-related marketing and media and to use this method to provide detailed descriptive data on college students' exposure to protobacco marketing and media. METHODS College students (n = 134; ages 18-24 years) recorded their exposures to protobacco marketing and media on handheld devices for 21 consecutive days. Participants also recalled exposures to various types of protobacco marketing and media at the end of the study period. RESULTS Retrospectively recalled and EMA-based estimates of protobacco marketing exposure captured different information. The correlation between retrospectively recalled and EMA-logged exposures to tobacco marketing and media was moderate (r = .37, p < .001), and EMA-logged exposures were marginally associated with the intention to smoke at the end of the study, whereas retrospective recall of exposure was not. EMA data showed that college students were exposed to protobacco marketing through multiple channels in a relatively short period: Exposures (M = 8.24, SD = 7.85) occurred primarily in the afternoon (42%), on weekends (35%), and at point-of-purchase locations (68%) or in movies/TV (20%), and exposures to Marlboro, Newport, and Camel represented 56% of all exposures combined and 70% of branded exposures. CONCLUSIONS Findings support the validity of EMA as a method for capturing detailed information about youth exposure to protobacco marketing and media that are not captured through other existing methods. Such data have the potential to highlight areas for policy change and prevention in order to reduce the impact of tobacco marketing on youth.
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Zunker C, Peterson CB, Crosby RD, Cao L, Engel SG, Mitchell JE, Wonderlich SA. Ecological momentary assessment of bulimia nervosa: does dietary restriction predict binge eating? Behav Res Ther 2011; 49:714-7. [PMID: 21764036 DOI: 10.1016/j.brat.2011.06.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Revised: 06/14/2011] [Accepted: 06/15/2011] [Indexed: 12/20/2022]
Abstract
The purpose of this study was to examine the relationship between caloric restriction (CR) and binge eating (BE) using ecological momentary assessment (EMA). Participants included 133 women with bulimia nervosa (BN) who completed an EMA protocol for 2 weeks. Logistic regression analyses tested whether CR increased the probability of BE episodes. The results revealed that the odds of BE increased on the day that restriction occurred as well as on the following day. In addition, both restriction and BE on one day predicted the likelihood of BE the subsequent day, but restriction for two days prior to the episode failed to add additional information for predicting BE. These findings support the cognitive behavioral therapy (CBT) model of BN, suggesting that self-reported dietary restriction is predictive of subsequent BE episodes, and that reducing dietary restriction in treatment may lead to improvements in bulimic symptoms.
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Primack BA, Silk JS, DeLozier CR, Shadel WG, Dillman Carpentier FR, Dahl RE, Switzer GE. Using ecological momentary assessment to determine media use by individuals with and without major depressive disorder. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE 2011; 165:360-5. [PMID: 21464384 PMCID: PMC3074228 DOI: 10.1001/archpediatrics.2011.27] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To use ecological momentary assessment techniques to measure the association of major depressive disorder (MDD) with media use. DESIGN Data were collected using an ecological momentary assessment protocol with cellular telephone-based brief interviews. SETTING Participants received as many as 60 telephone calls from a trained staff member during 5 extended weekends in an 8-week period. PARTICIPANTS One hundred six adolescent participants who were part of a larger neurobehavioral study of depression in Pittsburgh from January 1, 2003, through December 31, 2008. MAIN EXPOSURE At each call, participants were asked whether they were using the following 5 types of media: television or movies, music, video games, Internet, and print media, such as magazines, newspapers, and books. MAIN OUTCOME MEASURES We developed multivariable models to determine the independent association of each type of media use with MDD, controlling for sociodemographic variables. RESULTS Of the 106 participants, 46 were diagnosed as having MDD. In multivariable models controlling for age, sex, and race, each increasing quartile of audio use was associated with an 80% increase in the odds of having MDD (odds ratio, 1.8; 95% confidence interval, 1.1-2.8; P = .01 for trend). Conversely, each increasing quartile of print media use was associated with a 50% decrease in the odds of having MDD (odds ratio, 0.5; 95% confidence interval, 0.3-0.9; P = .009 for trend). CONCLUSIONS Major depressive disorder is positively associated with popular music exposure and negatively associated with reading print media such as books. Further research elucidating the directionality and strength of these relationships may help advance understanding of the relationships between media use and MDD.
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Affiliation(s)
- Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
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