Association of anger with bulimic and other impulsive behaviours among non-clinical women and men

Hunger games: Associations between core eating disorder symptoms and responses to rejection by peers during competition

OBJECTIVE

Individuals with eating disorder (ED) symptoms are sensitive to social threat and report maladaptive interpersonal styles that may contribute to and exacerbate negative evaluation from others. Research in this area has relied primarily on self-report. The current study examined associations between behavioral responses to social threat and core ED symptoms using a behavioral paradigm. Based on previous findings that individuals with binge-eating report being more reactive and confrontational, whereas individuals with dietary restriction tend to be more submissive and avoidant of conflict, we hypothesized that binge eating would be associated with a greater tendency to retaliate against rejection perpetrators, whereas dietary restriction would be associated with a lower tendency to retaliate when rejected.

METHOD

Undergraduate women (N = 132) completed a self-report measure of ED symptoms and participated in an online "Survivor"-type game in which they voted to either accept or reject computerized coplayers, while also receiving acceptance or rejection feedback from others.

RESULTS

Neither ED symptom was associated with how often participants retaliated against coplayers who rejected them. However, dietary restriction was related to more rejection votes overall (i.e., the tendency to reject others regardless of how others voted).

DISCUSSION

Findings suggest that individuals with dietary restriction may rely on a maladaptive defensive strategy aimed at pre-empting rejection, or alternatively, have difficulty shifting from habitual self-isolating behavior that results from over-involvement with restricting symptoms. Interventions targeting hypersensitivity to social threat or interpersonal flexibility may help reduce interpersonal stress and mitigate its impact on restricting symptoms.

The association between shame and substance use in young people: a systematic review

Background. Shame has been associated with a range of maladaptive behaviours, including substance use. Young people may be particularly vulnerable to heightened shame sensitivity, and substance use is a significant problem amongst UK adolescents. Although there appears to be a relationship between shame and substance use, the direction of the relationship remains unclear.

Aim. The purpose of this study was to undertake a systematic review of the literature relating to shame and substance use in young people.

Method. Five electronic databases were searched for articles containing terms related to ‘adolescence,’ ‘shame’ and ‘substance use.’ Six articles were included in the final analyses.

Results. Adverse early experiences, particularly sexual abuse, predict shame-proneness, and substance use is a mechanism by which some individuals cope with negative feelings. In general, there is a dearth of literature investigating the shame-substance use relationship in adolescent samples. The available literature associates shame-proneness with poorer functioning and suggests that it may potentially lead to psychopathology and early-onset substance use. Scant attention has been paid to the cognitive and emotional processes implicated. Further research is required to ascertain the strength of the shame-substance use relationship in young people and to develop appropriate interventions for this population.

Impulsive behaviors as an emotion regulation strategy: examining associations between PTSD, emotion dysregulation, and impulsive behaviors among substance dependent inpatients

Recent investigations have demonstrated that posttraumatic stress disorder (PTSD) is associated with a range of impulsive behaviors (e.g., risky sexual behavior and antisocial behavior). The purpose of the present study was to extend extant research by exploring whether emotion dysregulation explains the association between PTSD and impulsive behaviors. Participants were an ethnically diverse sample of 206 substance use disorder (SUD) patients in residential substance abuse treatment. Results demonstrated an association between PTSD and impulsive behaviors, with SUD patients with PTSD reporting significantly more impulsive behaviors than SUD patients without PTSD (in general and when controlling for relevant covariates). Further, emotion dysregulation was found to fully mediate the relationship between PTSD and impulsive behaviors. Results highlight the relevance of emotion dysregulation to impulsive behaviors and suggest that treatments targeting emotion dysregulation may be useful in reducing impulsive behaviors among SUD patients with PTSD.

Self-silencing and anger regulation as predictors of disordered eating among adolescent females

The main purpose of this study was to examine how self-silencing, emotional regulation, and body-esteem differentiated healthy eating from different patterns of disordered eating. A community sample of adolescent females was classified as either: 1) Restrained Eaters (n=104, M(age)=14.48); 2) Emotional Eaters (n=125, M(age)=14.52); or, 3) Healthy Eaters (n=396, M(age)=13.71). A discriminant function analysis revealed two significant functions. The first function differentiated the two disordered eating groups (i.e., the restrained and emotional eaters) from the healthy group, with the disordered eating groups scoring significantly higher on levels of self-silencing and anger regulation, and lower on body-esteem. The second function differentiated between the restrained and emotional eaters, with the emotional eaters reporting higher levels of externalized self-perception and anger, and lower levels of body-esteem. The results suggest that body-esteem and anger suppression were the most influential variables in differentiating between groups. The findings are discussed in terms of the implications for disordered eating prevention and treatment programs.

The road less traveled: Associations between externalizing behaviors and eating pathology

OBJECTIVE

Few studies have examined associations between externalizing behaviors and eating disorders in either sex. The current study investigated sex differences in associations between internalizing and externalizing symptoms and disordered eating.

METHOD

A sample of 541 men and women completed self-reported measures of disordered eating (e.g., binge eating), internalizing symptoms (e.g., anxiety), and externalizing behaviors (e.g., delinquency). Hierarchical linear modeling was used to examine sex differences in associations between these symptoms and disordered eating.

RESULTS

Internalizing symptoms showed the strongest associations with disordered eating in both sexes. Hyperactivity and aggression were more strongly associated with disordered eating in men, whereas alcohol use was more strongly associated with disordered eating in women.

DISCUSSION

Results indicated several sex similarities in associations between internalizing symptoms and disordered eating, but some important sex differences among externalizing behaviors. Externalizing behaviors may play a significant role in the development of disordered eating uniquely within men and women.

Predictors and mediators of treatment outcome in patients with binge eating disorder

A randomized controlled trial (N=52) was conducted comparing cognitive-behavioral therapy with a waiting list control group to identify mediators and predictors of treatment outcome. Reduction of weight concerns mediated abstinence of binge eating at post-treatment. Abstinence was marginally mediated by changes in eating and shape concerns, depressive symptoms and global severity of general psychopathology. Neither treatment outcome nor status at 1-year follow-up could be predicted by severity of eating disorder, comorbid psychopathology or maladaptive core beliefs at baseline or at post-treatment. The only predictor for abstinence at both post-treatment and 1-year follow-up was the coping style palliative reacting: higher scores predicted less favorable outcomes. Lower expression of emotions at post-treatment predicted more reduction of eating disorder psychopathology at follow-up. No other patient characteristics allowing treatment-patient matching could be identified.

It doesn't happen here: eating disorders in an ethnically diverse sample of economically disadvantaged, urban college students

The bulk of eating disorder studies have focused on white, middle-upper class women, excluding ethnically and economically diverse women and men. Accordingly, our knowledge of prevalence rates and risk factors is reliant on this narrow literature. To expand upon the current literature, we examined eating disorders in ethnically diverse low-income, urban college students. We surveyed 884 incoming freshmen during an orientation class to assess the frequency of eating disorder diagnosis and the risk factors of child physical abuse and sexual abuse before and after age 13. We found 10% of our sample received an eating disorder diagnosis, 12.2% of the women and 7.3% of the men. The majority of these students were Latino/a or "other," with White women receiving the fewest diagnoses. For all women, both child physical abuse and both indices of sexual abuse contributed equally to the development of an eating disorder. For men only the sexual abuse indices contributed to an eating disorder diagnosis. These results indicate that ethnic minority populations do suffer from relatively high rates of self-reported eating disorders and that a history of trauma is a significant risk factor for eating disorders in these diverse populations of both women and men.