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Dicker-Oren SD, Gelkopf M, Greene T. Anxiety and restrained eating in everyday life: An ecological momentary assessment study. J Affect Disord 2024; 362:543-551. [PMID: 39019225 DOI: 10.1016/j.jad.2024.07.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 07/08/2024] [Accepted: 07/14/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Restrained eating has been related to psychological distress like anxiety and eating disorder symptomatology, but little is known about this relationship in daily life in non-clinical populations. We aimed to understand concurrent and temporal associations between momentary anxiety and restrained eating in everyday life within and across persons in a non-clinical sample, and examined whether this association remains after controlling for eating disorder symptomatology. METHODS We used a 10-day ecological momentary assessment (EMA) protocol. Participants (n = 123) completed a baseline survey with demographics and eating disorder symptomatology questions, and three EMA surveys per day reporting anxiety and restrained eating intentions. We applied mixed-effects and random intercept cross-lagged models to analyze the data. RESULTS Momentary anxiety and restrained eating were concurrently significantly positively associated within and between persons. When participants had more anxiety than was typical for them, they were more likely to intend to restrain eating, and people with overall higher anxiety symptoms tended to report greater restrained eating over the study period. These associations remained significant after adjusting for eating disorder symptomatology. There were no significant temporal cross-lagged effects. Anxiety-restrained eating association did not spill over into the next assessment window. LIMITATIONS The time window between prompts may have been too long to capture potential temporal effects, and we did not examine actual behavioral food restrictions. CONCLUSION Daily-life anxiety may be related to concurrent restrained eating intentions, above and beyond baseline eating disorder symptomatology. Research is needed exploring daily-life anxiety as a potential intervention target to address restrained eating.
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Affiliation(s)
- S D Dicker-Oren
- The Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - M Gelkopf
- The Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - T Greene
- Department of Clinical, Educational and Health Psychology, University College London, United Kingdom.
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Seiferth C, Fiedler J, Färber T, Pape M, Schroeder S, Herpertz S, Steins-Loeber S, Wolstein J. Bi-directional associations of core affect and physical activity in adults with higher body weight: An ecological momentary assessment study. J Health Psychol 2024; 29:1115-1128. [PMID: 38284358 PMCID: PMC11344957 DOI: 10.1177/13591053241228202] [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] [Indexed: 01/30/2024] Open
Abstract
Affect is known to be predictive of and enhanced by higher physical activity (PA) levels in the general population. This secondary analysis aimed to increase the understanding of the bi-directional relationship between PA and core affect (i.e. valence, energetic arousal, and calmness) among adults with higher body weight. Affect and PA were assessed in naturalistic settings via ecological momentary assessment using a mixed sampling scheme from 157 participants (body mass index: 32.99 ± 3.78 kg/m2). Multilevel models revealed that being more physically active in the 15 minutes prior to the assessment predicted an increase in energetic arousal and a decrease in calmness. Subsequently, feeling more energetic and agitated was associated with increased PA within the following 15 minutes. Valence (i.e. pleasure-displeasure) was not associated with PA nor predictive of subsequent PA. Digital PA interventions may target the enhancement of feelings of energy and present psychoeducation about these distinct psychological benefits.
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Affiliation(s)
| | | | | | - Magdalena Pape
- LWL-University Hospital, Ruhr University Bochum, Germany
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Lampe EW, Srivastava P, Presseller EK, Wilkinson ML, Trainor C, Manasse SM, Juarascio AS. Latent Change Trajectories in Mood During Focused CBT Enhanced for Eating Disorders Are Associated With Global Eating Pathology at Posttreatment and Follow-Up Among Individuals With Bulimia Nervosa Spectrum Disorders: A Preliminary Examination. Behav Ther 2024; 55:950-960. [PMID: 39174272 DOI: 10.1016/j.beth.2024.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 01/09/2024] [Accepted: 01/31/2024] [Indexed: 08/24/2024]
Abstract
Bulimia nervosa (BN) is characterized by recurrent loss of control over eating (LOC) and inappropriate compensatory behaviors. Although cognitive-behavioral therapy (CBT) is efficacious for BN, many patients continue to experience symptoms at posttreatment. One potential driver of this low treatment response may be low mood, which maintains BN symptoms through negative reinforcement. Thus, it is important to understand how mood changes over enhanced cognitive-behavioral therapy (CBT-E) and whether these changes are associated with improved treatment outcomes. Participants (N = 56) with BN-spectrum eating disorders (EDs) received 16 sessions of the focused version of CBT-E. The Eating Disorder Examination (EDE) was used to measure ED symptoms (global ED pathology, frequency of binge episodes, and compensatory behaviors) at pre- and posttreatment. Latent growth mixture modeling (LGMM) of affective ratings via digital self-monitoring identified latent growth classes. Kruskal-Wallis H tests examined the effect of trajectory of change in mood on pre- to posttreatment symptom change. LGMM yielded a four-class model that best fit the data representing distinct mood trajectories over the course of treatment: (a) highest baseline mood, linear improving; (b) moderate baseline mood, stable; (c) moderate baseline mood, quadratic worsening; and (d) lowest baseline mood, quadratic improving. Participants who demonstrated worsening mood over treatment (i.e., individuals in the "moderate baseline mood, quadratic worsening" class) had significantly higher EDE global scores at posttreatment and follow-up compared to participants with stable mood across treatment. Change in LOC eating frequency and compensatory behaviors across treatment did not significantly differ by mood class. The main effect of mood class or interaction effect between time and mood class on objective binge episodes, subjective binge episodes, and compensatory behaviors was not significant. There were no significant differences in global ED pathology at either posttreatment or follow-up for any other class comparisons. These results suggest that certain trajectories of change in mood during treatment are particularly associated with change in pre- to posttreatment EDE global score. If replicated, our findings could suggest that future iterations of CBT-E should target mood early in treatment in order to maximize reductions in global eating pathology.
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Gallinat C, Moessner M, Wilhelm M, Keuthen N, Bauer S. Patterns of Skin Picking in Skin Picking Disorder: Ecological Momentary Assessment Study. Interact J Med Res 2024; 13:e53831. [PMID: 39024568 PMCID: PMC11294777 DOI: 10.2196/53831] [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: 10/23/2023] [Revised: 12/12/2023] [Accepted: 05/03/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Skin picking disorder (SPD) is an understudied mental illness that is classified as a body-focused repetitive behavior disorder. Literature suggests that pathological skin picking is strongly integrated into the daily lives of affected individuals and may involve a high degree of variability in terms of episode characteristics, frequency, and intensity. However, existing data on the phenomenology of SPD are limited and typically involve retrospective assessments, which may fail to accurately capture the behavior's variability. OBJECTIVE This study aimed to investigate skin picking in the daily lives of individuals with SPD by using ecological momentary assessment (EMA). The first aim focused on the description of skin picking patterns (eg, characteristics, intensity, and distribution of episodes and urges), and the second aim explored differences in characteristics and patterns between automatic and focused skin picking. METHODS Participants were recruited online and underwent a web-based screening, a diagnostic telephone interview, and a comprehensive online self-report questionnaire before participating in an EMA protocol. The latter included 10 consecutive days with 7 pseudorandom, time-contingent assessments per day between 8 AM and 10 PM. The EMA questionnaire assessed the current skin picking urge, the occurrence of the behavior, and a detailed assessment of the episodes' characteristics (eg, length, intensity, and consciousness) if applicable. RESULTS The final sample consisted of 57 participants, who completed at least 70% of the scheduled assessments (n=54, 94.7% female: mean age 29.3, SD 6.77 years). They completed 3758 EMAs and reported 1467 skin picking episodes. Skin picking occurred frequently (mean 2.57, SD 1.12 episodes per day and person) in relatively short episodes (10-30 min; 10 min: nepisodes=642, 43.8%; 20 min: nepisodes=312, 21.3%; 30 min: nepisodes=217, 14.8%), and it was distributed quite evenly throughout the day and across different days of the week. Focused and automatic episodes were relatively balanced across all reported episodes (focused: nepisodes=806, 54.9%) and over the course of the day. The analyses showed statistically significant differences between self-reported triggers for the different styles. Visual or tactile cues and the desire to pick the skin were more important for the focused style (visual or tactile cues: mean focused style [Mf]=4.01, SD 0.69 vs mean automatic style [Ma]=3.47, SD 0.99; P<.001; SMD=0.64; desire to pick: Mf=2.61, SD 1.06 vs Ma=1.94, SD 1.03; P<.001; SMD=0.82), while boredom and concentration problems were more prominent in automatic skin picking (boredom: Mf=1.69, SD 0.89 vs Ma=1.84, SD 0.89; P=.03; SMD=-0.31; concentration problems: Mf=2.06, SD 0.87 vs Ma=2.31, SD 1.06; P=.006; SMD=-0.41). CONCLUSIONS These results contribute to an enhanced understanding of the phenomenology of SPD using a more rigorous assessment methodology. Our findings underscore that picking can impact affected persons multiple times throughout their daily lives. TRIAL REGISTRATION German Clinical Trials Register DRKS00025168; https://tinyurl.com/mr35pdwh.
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Affiliation(s)
- Christina Gallinat
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Maximilian Wilhelm
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Mental Health (DZPG), partner site Mannheim-Heidelberg-Ulm, Heidelberg, Germany
| | - Nancy Keuthen
- Trichotillomania and Excoriation Disorder Program, Center for OCD and Related Disorders, Massachusetts General Hospital, Boston, MA, United States
| | - Stephanie Bauer
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
- German Center for Mental Health (DZPG), partner site Mannheim-Heidelberg-Ulm, Heidelberg, Germany
- Heidelberg University, Heidelberg, Germany
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Mason TB, Morales JC, Smith A, Smith KE. Factor Structure, Reliability, and Convergent Validity of an Ecological Momentary Assessment Binge-Eating Symptoms Scale. Eval Health Prof 2024:1632787241249500. [PMID: 38670932 DOI: 10.1177/01632787241249500] [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: 04/28/2024]
Abstract
Ecological momentary assessment (EMA) of binge-eating symptoms has deepened our understanding of eating disorders. However, there has been a lack of attention on the psychometrics of EMA binge-eating symptom measures. This paper focused on evaluating the psychometric properties of a four-item binge-eating symptom measure, including multilevel factor structure, reliability, and convergent validity. Forty-nine adults with binge-eating disorder and/or food addiction completed baseline questionnaires and a 10-day EMA protocol. During EMA, participants completed assessments of eating episodes, including four binge-eating symptom items. Analyses included multilevel exploratory factor analysis, computation of omega and intraclass correlation coefficients, and multilevel structural equation models of associations between contextual factors and binge-eating symptoms. A one within-subject factor solution fit the data and showed good multilevel reliability and adequate within-subjects variability. EMA binge-eating symptoms were associated with baseline binge-eating measures as well as relevant EMA eating characteristics: including greater unhealthful food and drink intake; higher perceived taste of food; lower likelihood to be planned eating; and lower likelihood of eating to occur at work/school and other locations and greater likelihood to occur at restaurants compared to home. In conclusion, the study findings support the psychometrics of a 4-item one-factor EMA measure of binge-eating symptoms.
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Biçaker E, Trolio V, Miller AE, Zhu LY, White C, Racine SE. Affective processes underlying restrictive eating in atypical anorexia nervosa: Comparisons to anorexia nervosa and bulimia nervosa using ecological momentary assessment. Int J Eat Disord 2024; 57:879-891. [PMID: 38192012 DOI: 10.1002/eat.24134] [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: 09/15/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE Certain symptom and risk/maintenance factor similarities between individuals with atypical anorexia nervosa (AN) and 'typical' AN have been documented, but few studies have investigated how atypical AN compares to bulimia nervosa (BN). Further, the role of affective mechanisms in maintaining restrictive eating in atypical AN has not been examined. The current study investigated whether atypical AN resembles AN and/or BN on affect-related processes using questionnaires and ecological momentary assessment (EMA). METHOD Women with atypical AN (n = 24), AN-restrictive subtype, (n = 27), AN-binge eating/purging subtype (n = 34), and BN (n = 58) completed questionnaires measuring depressive symptoms and emotion regulation difficulties. They also completed a 14-day EMA protocol during which they reported negative and positive affect and skipped meals five times/day (signal-contingent surveys) and restrictive eating after meals/snacks (event-contingent surveys). RESULTS Diagnostic groups generally did not differ on questionnaire measures nor affective patterns surrounding restrictive eating behaviors. Momentary changes in affect did not predict or follow restriction at meals/snacks, though higher momentary negative affect ratings predicted skipped meals, and higher positive affect was reported after skipped meals. Greater average negative affect and lower average positive affect predicted both restrictive eating behaviors. DISCUSSION Across diagnoses, reductions in food intake do not appear to be influenced by momentary changes in affect, though skipping meals may serve an emotion regulation function. Atypical AN seems to resemble AN and BN on affective processes underlying restrictive eating, raising further questions regarding the unique diagnosis of atypical AN. PUBLIC SIGNIFICANCE Though atypical anorexia appears to strongly resemble anorexia nervosa, it is less clear how this disorder relates to bulimia nervosa. It is further unknown whether affective-related processes underlie restrictive eating in atypical anorexia nervosa, and how these processes compare to those in anorexia nervosa and bulimia nervosa. Results suggest that atypical anorexia does not differ from anorexia nervosa or bulimia nervosa on emotion-related measures, nor in affective patterns surrounding restrictive eating behaviors.
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Affiliation(s)
- Ege Biçaker
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Vittoria Trolio
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Alexia E Miller
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Lisa Y Zhu
- Department of Psychology, University of Western Ontario, Social Science Centre, London, Ontario, Canada
| | - Chloe White
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Sarah E Racine
- Department of Psychology, McGill University, Montreal, Quebec, Canada
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Erbakan AN, Arslan Bahadir M, Gonen O, Kaya FN. Mindful Eating and Current Glycemic Control in Patients With Type 2 Diabetes. Cureus 2024; 16:e57198. [PMID: 38681461 PMCID: PMC11056196 DOI: 10.7759/cureus.57198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 05/01/2024] Open
Abstract
Objective Lifestyle adjustments are essential in the management of type 2 diabetes mellitus (T2DM). Mindful eating involves being more attentive to and aware of meals. This study aimed to investigate the relationship between mindful eating and glycemic control, as well as body mass index (BMI), in people with T2DM. Materials and methods This cross-sectional study included 448 participants who had been diagnosed with T2DM for at least six months. The participants were categorized into three groups based on their HbA1c levels. The Turkish adaptation of the Mindful Eating Questionnaire (MEQ-30) was employed to assess levels of mindful eating behavior. Obesity was defined as a BMI ≥ 30. Anthropometric measurements, laboratory tests, and questionnaire responses were also collected. Results Participants with well-controlled diabetes (HbA1c ≤7%) demonstrated significantly higher scores on the MEQ-30 and its various subgroups in comparison to those with poorly controlled diabetes (HbA1c >9%). The suboptimal glycemic control groups exhibited noticeable variations in mindful eating behaviors. Moreover, participants with lower BMIs displayed stronger inclinations toward mindful eating. Weak negative correlations were observed between BMI and specific MEQ-30 subgroups. Notably, subgroups such as emotional eating, eating control, eating discipline, and interference demonstrated weak negative correlations with the HbA1c levels. Conclusion Higher levels of mindful eating were associated with lower levels of HbA1c and BMI, indicating that incorporating mindful eating practices may present promising advantages for individuals diagnosed with type 2 diabetes, specifically in terms of glycemic control and weight management.
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Affiliation(s)
- Ayşe Naciye Erbakan
- Department of Internal Medicine, Göztepe Prof. Dr. Süleyman Yalçın Şehir Hastanesi, Medeniyet University, Istanbul, TUR
| | - Muzeyyen Arslan Bahadir
- Department of Internal Medicine, Göztepe Prof. Dr. Suleyman Yalcin City Hospital, Medeniyet University, Istanbul, TUR
| | - Ozlem Gonen
- Department of Internal Medicine, Göztepe Prof. Dr. Suleyman Yalcin City Hospital, Medeniyet University, Istanbul, TUR
| | - Fatos Nimet Kaya
- Department of Internal Medicine, Göztepe Prof. Dr. Suleyman Yalcin City Hospital, Medeniyet University, Istanbul, TUR
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Yin H, Zhu H, Gu J, Qin H, Ding W, Guo N, Fu J, Yang Y. Mobile-based ecological momentary assessment and intervention: bibliometric analysis. Front Psychiatry 2024; 15:1300739. [PMID: 38469030 PMCID: PMC10925651 DOI: 10.3389/fpsyt.2024.1300739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/07/2024] [Indexed: 03/13/2024] Open
Abstract
Objective The aim of this article was to review existing documents in the field of mobile-based EMA and EMI, provide an overview of current hot topics, and predict future development trends. Methods We conducted a bibliometric study on mobile-based EMA and EMI publications that were collected from the Web of Science Core Collection database. Biblioshiny and CiteSpace were utilized to analyze scientific productions, leading sources, authors, affiliations, documents, research hot topics, keywords, and trend topics. Results A total of 2222 documents related to EMA and EMI published between 1992 and 2023 were retrieved. In recent years, scholarly publications have generally increased in mobile-based EMA and EMI research, particularly in the last decade. JMIR mHealth and uHealth (n=86), as well as JMIR (n=73), showed the highest number of publications. The United States (n=1038), Germany (n=218) and Netherlands (n=175) were leading countries. Regarding keyword co-occurrence and trend topics analysis, mental health, health behaviors, and feasibility were hot topics in mobile-based EMA and EMI research. Future research trends included using EMA for tailoring EMI, just-in-time adaptive interventions (JITAI), and digital phenotyping. Conclusion This bibliometric study on mobile-based EMA and EMI is a valuable resource for understanding the field's evolution and future trends. Our analysis indicates that EMA and EMI have great potential in health behaviors and mental health, but implementation should consider feasibility and reactivity issues carefully. Emerging trends include EMA-tailored EMI, JITAI, and digital phenotyping. In the future, strengthening multidisciplinary cooperation will be necessary to promote the continued development of the field.
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Affiliation(s)
- Hongfan Yin
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Hanjing Zhu
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jia Gu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Hengwei Qin
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenjing Ding
- Reference Department, Library of Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ningyuan Guo
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jingjing Fu
- Department of Nursing, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Yang
- Department of Nursing, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
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Levinson CA, Osborn K, Hooper M, Vanzhula I, Ralph-Nearman C. Evidence-Based Assessments for Transdiagnostic Eating Disorder Symptoms: Guidelines for Current Use and Future Directions. Assessment 2024; 31:145-167. [PMID: 37997290 DOI: 10.1177/10731911231201150] [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] [Indexed: 11/25/2023]
Abstract
Eating disorders are severe and often chronic mental illnesses that are associated with high impairment and mortality rates. Recent estimates suggest that eating disorder prevalence rates are on the rise, indicating an increased need for accurate assessment and detection. The current review provides an overview of transdiagnostic eating disorder assessments, including interview, self-report, health and primary care screeners, and technology-based and objective assessments. We focused on assessments that are transdiagnostic in nature and exhibit high impact in the field. We provide recommendations for how these assessments should be used in research and clinical settings. We also discuss considerations that are crucial for assessment, including the use of a categorical versus dimensional diagnostic framework, assessment of eating disorders in related fields (i.e., anxiety and depression), and measurement-based care for eating disorders. Finally, we provide suggestions for future research, including the need for more research on short transdiagnostic screeners for use in health care settings, standardized assessments for ecological momentary assessment, development of state-based assessment of eating disorder symptoms, and consideration of assessment across multiple timescales.
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Affiliation(s)
| | - Kimberly Osborn
- University of Louisville, KY, USA
- Oklahoma State University, Stillwater, USA
| | - Madison Hooper
- University of Louisville, KY, USA
- Vanderbilt University, Nashville, TN, USA
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Sung H, Han AY, Seol GH. BodyThink program-based body image education improves Korean adolescents' attitudes toward cosmetic surgery: randomized controlled trial. BMC Nurs 2023; 22:481. [PMID: 38110930 PMCID: PMC10726550 DOI: 10.1186/s12912-023-01649-3] [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: 10/19/2023] [Accepted: 12/11/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The aims of this study were to modify the widely used BodyThink program to suit the circumstances of Korean schools and determine its effects on body esteem, body image, appearance stress, depression, and attitudes toward cosmetic surgery. METHODS Participants were 184 third-grade students from two middle schools in Korea, who were randomly assigned to a control or intervention group. Two of the participants dropped out; hence, data from 182 students were analyzed. The control group received the existing curriculum for 4 sessions, and the experimental group was provided with 4 sessions of the revised BodyThink program. Before and after the intervention, all participants completed questionnaires. RESULTS In the BodyThink group, improved body image, decreased depression, and positive improvements in attitudes toward cosmetic plastic surgery were observed after the intervention. DISCUSSION These results suggest that school health nurses can utilize interventions based on BodyThink program in their curricula to improve the physical and emotional health of adolescents. TRIAL REGISTRATION This study has been retrospectively registered with the Clinical Research information Service (CRIS) in Korea on October 5, 2023 (KCT0008839).
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Affiliation(s)
- Hyeonhwa Sung
- Department of Basic Nursing Science, College of Nursing, Korea University, Seoul, Republic of Korea
| | - A Young Han
- Department of Basic Nursing Science, College of Nursing, Korea University, Seoul, Republic of Korea
- Department of Nursing, College of Life Science and Industry, Sunchon National University, Suncheon, Republic of Korea
| | - Geun Hee Seol
- Department of Basic Nursing Science, College of Nursing, Korea University, Seoul, Republic of Korea.
- BK21 FOUR Program of Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, Republic of Korea.
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Anderson LM, Lim KO, Kummerfeld E, Crosby RD, Crow SJ, Engel SG, Forrest L, Wonderlich SA, Peterson CB. Causal discovery analysis: A promising tool in advancing precision medicine for eating disorders. Int J Eat Disord 2023; 56:2012-2021. [PMID: 37548100 DOI: 10.1002/eat.24040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/15/2023] [Accepted: 07/26/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE Precision medicine (i.e., individually tailored treatments) represents an optimal goal for treating complex psychiatric disorders, including eating disorders. Within the eating disorders field, most treatment development efforts have been limited in their ability to identify individual-level models of eating disorder psychopathology and to develop and apply an individually tailored treatment for a given individual's personalized model of psychopathology. In addition, research is still needed to identify causal relationships within a given individual's model of eating disorder psychopathology. Addressing this limitation of the current state of precision medicine-related research in the field will allow us to progress toward advancing research and practice for eating disorders treatment. METHOD We present a novel set of analytic tools, causal discovery analysis (CDA) methods, which can facilitate increasingly fine-grained, person-specific models of causal relations among cognitive, behavioral, and affective symptoms. RESULTS CDA can advance the identification of an individual's causal model that maintains that individuals' eating disorder psychopathology. DISCUSSION In the current article, we (1) introduce CDA methods as a set of promising analytic tools for developing precision medicine methods for eating disorders including the potential strengths and weaknesses of CDA, (2) provide recommendations for future studies utilizing this approach, and (3) outline the potential clinical implications of using CDA to generate personalized models of eating disorder psychopathology. PUBLIC SIGNIFICANCE STATEMENT CDA provides a novel statistical approach for identifying causal relationships among variables of interest for a given individual. Person-specific causal models may offer a promising approach to individualized treatment planning and inform future personalized treatment development efforts for eating disorders.
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Affiliation(s)
- Lisa M Anderson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Erich Kummerfeld
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ross D Crosby
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
- Accanto Health, St Paul, Minnesota, USA
| | - Scott G Engel
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Lauren Forrest
- Department of Psychiatry and Behavioral Health, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | | | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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12
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Kleiman EM, Rizvi SL, Duberstein PR. Initial Validation of an Ecological Momentary Assessment Measure of Self-Efficacy to Manage Negative Emotions. Assessment 2023; 30:2223-2233. [PMID: 36604797 DOI: 10.1177/10731911221146341] [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] [Indexed: 01/07/2023]
Abstract
Although ecological momentary assessment (EMA) provides an opportunity for the examination of intervention mechanisms in real time, there are few validated tools to assess key treatment mechanisms in EMA studies. Our focus in this study is a potentially critical treatment mechanism, improvement in self-efficacy for managing negative emotions. We examined the psychometric properties of the Patient-Reported Outcomes Measurement Information System (PROMIS) self-efficacy for managing negative emotions scale measured via EMA. Participants (n = 145 college students) in a clinical trial of Dialectical Behavior Therapy skills completed four daily EMAs for 6 weeks (13,153 total responses). Results indicated (a) excellent internal consistency and good factor structure, (b) sufficient variability at both the between- and the within-persons levels, and (c) strong construct and predictive validity. This study supports the validity of an EMA measure of self-efficacy for managing negative emotions that can be used in real time, both in intervention studies and in observational research.
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Affiliation(s)
- Evan M Kleiman
- Rutgers, The State University of New Jersey, Piscataway, USA
| | - Shireen L Rizvi
- Rutgers, The State University of New Jersey, Piscataway, USA
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13
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Dziewa M, Bańka B, Herbet M, Piątkowska-Chmiel I. Eating Disorders and Diabetes: Facing the Dual Challenge. Nutrients 2023; 15:3955. [PMID: 37764739 PMCID: PMC10538145 DOI: 10.3390/nu15183955] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Eating disorders and diabetes mellitus are distinct yet closely linked health conditions, presenting distinct challenges in terms of care and management. Eating disorders encompass a spectrum of mental health disorders characterized by abnormal eating behaviors and disruptions in weight regulation. Research indicates that individuals with diabetes might be at an elevated risk of developing eating disorders. The necessity to adhere to specific dietary guidelines, monitor blood sugar levels vigilantly, and manage drug administration can collectively contribute to the emergence of detrimental attitudes toward food and body image. On the other hand, incorrect eating behaviors such as binge eating and purging can disrupt blood sugar control, significantly impacting the development and management of diabetes. This intricate relationship emphasizes the crucial necessity for a comprehensive understanding and specialized care to effectively address the dual challenges faced by individuals dealing with both diabetes and eating disorders. This paper represents the inaugural comprehensive review delving into the intricate connection between eating disorders and diabetes, thereby illuminating previously under-researched areas. The insights gleaned from this review may contribute to developing integrated interventions that aim to improve the overall well-being and quality of life for individuals grappling with the complexities of eating disorders and diabetes.
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Affiliation(s)
| | | | | | - Iwona Piątkowska-Chmiel
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 8b Street, 20-090 Lublin, Poland
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14
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Martin G, Portingale J, Fuller-Tyszkiewicz M, Krug I. Do appearance comparisons mediate the effects of thinspiration and fitspiration on body dissatisfaction, happiness, and disordered eating urges in women's daily lives? Body Image 2023; 46:108-116. [PMID: 37271033 DOI: 10.1016/j.bodyim.2023.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 05/04/2023] [Accepted: 05/19/2023] [Indexed: 06/06/2023]
Abstract
We examined whether thinspo and fitspo exposure predicted women's body dissatisfaction (BD), happiness, and disordered eating (DE) urges (binge-eating/purging, restrictive eating, and exercise) in daily life. A further aim was to assess whether these effects were stronger for thinspo versus fitspo exposure and whether upward appearance comparisons mediated the effect of thinspo-fitspo exposure on BD, happiness, and DE urges. Participants (N = 380 women) completed baseline measures and a 7-day ecological momentary assessment (EMA) investigating state-based experiences of thinspo-fitspo exposure, appearance comparisons, BD, happiness, and DE urges. Multilevel analyses revealed that thinspo-fitspo exposure was associated with greater BD and DE urges (but unrelated to happiness) at the same EMA time point. However, there was no association between thinspo-fitspo exposure and BD, happiness, and DE urges at the next EMA time-point. Thinspo relative to fitspo exposure was associated with greater BD (but unrelated to happiness and DE urges) at the same EMA time-point. The proposed mediation models were not supported in time-lagged analyses; such that upward appearance comparisons did not mediate the effects of thinspo-fitspo exposure on BD, happiness, and DE urges. Current findings provide novel micro-longitudinal data on the potentially direct detrimental effects of thinspo-fitspo exposure on women's daily lives.
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Affiliation(s)
- Georgia Martin
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Jade Portingale
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, VIC, Australia; Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.
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15
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D'Adamo L, Sonnenblick RM, Juarascio AS, Manasse SM. Relations between forms of dietary restraint, restriction, and loss-of-control eating among adolescents seeking weight control: An ecological momentary assessment study. Eat Behav 2023; 50:101791. [PMID: 37544108 PMCID: PMC10528310 DOI: 10.1016/j.eatbeh.2023.101791] [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: 03/06/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE This study aimed to: 1) compare rates of dietary restraint and restriction between adolescents with and without loss-of-control (LOC) eating who were seeking weight control and 2) examine temporal relations between restraint/restriction and LOC eating. METHOD 37 adolescents seeking weight control (mean age: 15.4 ± 1.5; 62 % White; 57 % female; mean BMI percentile = 97.3 ± 3.1) completed a one-week ecological momentary assessment protocol and reported on dietary restraint/restriction and eating behavior prior to beginning a weight control intervention. Chi-square tests examined differences in frequency of restraint/restriction between participants with and without LOC eating. Multilevel models examined associations between dietary restraint/restriction and LOC eating at the next survey and on the next day. RESULTS Of 37 participants, 15 (41 %) reported engaging in LOC eating. Participants with LOC eating more frequently endorsed several forms of restraint and restriction versus participants without LOC eating. Attempting to avoid enjoyable foods and attempting to limit eating at one survey predicted greater likelihood of LOC eating at the next survey. CONCLUSIONS Findings suggest that attempted restraint, but not actual restriction, was associated with LOC eating. Research should explore additional factors that may influence these relationships, which could inform weight control treatments that address restraint/restriction.
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Affiliation(s)
- Laura D'Adamo
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA; Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
| | - Ross M Sonnenblick
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
| | - Adrienne S Juarascio
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
| | - Stephanie M Manasse
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
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16
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Williamson G, Cotter EW, Cao L, Guidinger C, Kelly NR. Ecological momentary assessment of state affect prior to and following loss of control eating in young men. Eat Behav 2023; 50:101782. [PMID: 37517107 DOI: 10.1016/j.eatbeh.2023.101782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/14/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Loss of control (LOC) eating is prevalent but understudied among young men. Affect regulation models propose that LOC eating functions as a maladaptive effort to escape from distressing affective states. As such, negative affect is thought to increase before and decrease after LOC eating. However, examinations with young men are lacking and it remains unclear whether specific emotional experiences are differentially implicated in their LOC eating. METHODS The current study examined the temporal roles of affect in LOC eating in 31 young men (18-35 years; Mage = 25.74 ± 5.61y; 46.7 % White; 30 % Black/African American; 10 % Hispanic/Latino, 10 % South Asian) who reported engaging in recurrent LOC eating. Participants completed a 14-day ecological momentary assessment protocol and recorded all eating episodes each day and their state affect five times per day. Generalized linear mixed models were conducted to examine the trajectories of global and item-level negative and positive affect pre- and post-LOC eating episodes. RESULTS Negative affect did not change significantly before or after LOC eating (ps > .05). Positive affect did not change significantly before LOC eating (ps > .05). Global positive affect, excitement, and happiness decreased significantly after LOC eating (ps ≤ .001). DISCUSSION Study findings contradict extant theory and empirical data largely from female samples. Negative affect did not increase risk for LOC eating, nor did LOC eating function to improve participants' mood; rather, positive mood slightly decreased after LOC eating. Further investigation around the observed decline in positive affect after LOC eating will clarify if this is a relevant intervention point in this population.
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Affiliation(s)
- Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America.
| | - Elizabeth W Cotter
- Department of Health Studies, American University, United States of America.
| | - Li Cao
- Sanford Center for Biobehavioral Research, United States of America.
| | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America.
| | - Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America.
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17
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Chwyl C, Crochiere RJ, Forman EM. The role of everyday activities on likelihood of dietary lapse: an ecological momentary assessment study. J Behav Med 2023; 46:532-539. [PMID: 36342563 PMCID: PMC10164199 DOI: 10.1007/s10865-022-00365-8] [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: 02/09/2022] [Accepted: 09/16/2022] [Indexed: 11/09/2022]
Abstract
Developing a more nuanced understanding of factors predicting risk of dietary lapse (i.e., instances of non-adherence to a reduced calorie diet) is important, because dietary lapses contribute to suboptimal weight outcomes. The study investigated, for the first time, how various everyday activities affected likelihood of dietary lapses at two timescales-both in-the-moment, and in the hours after engaging in an activity. Participants (N = 107) with overweight/obesity in a behavioral weight loss program completed ecological momentary assessment surveys on dietary adherence and daily activities for 3 weeks at mid-treatment. Generalized estimating equations revealed that socializing predicted greater concurrent lapse risk, while work/school, doing chores, cooking, or practicing a spiritual activity/prayer/meditation were associated with reduced lapse risk. In terms of subsequent effects, cooking and indoor hobbies were associated with greater lapse risk in the next few hours, whereas spiritual activity/meditation was associated with reduced risk. Certain activities may have affected concurrent and subsequent lapse risk due to: their influence on the presence of tempting food, the compatibility of engaging in the activity and eating simultaneously, and the reward reaped from the activity (potentially reducing desire for food-related reward). Findings speak to the importance of attending to the timescale of relationships between activities and lapses, which has clinical implications for providing nuanced and optimally timed interventions for overweight/obesity.
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Affiliation(s)
- Christina Chwyl
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, 3141 Chestnut St, Philadelphia, PA, USA.
| | - Rebecca J Crochiere
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, 3141 Chestnut St, Philadelphia, PA, USA
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, 3141 Chestnut St, Philadelphia, PA, USA
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18
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Thomas JG, Schumacher LM, Vithiananthan S, Jones DB, Smith KE, Chou T, Papasavas PK, Bond DS. Ecological momentary assessment of changes in eating behaviors, appetite, and other aspects of eating regulation in Roux-en-Y gastric bypass and sleeve gastrectomy patients. Appetite 2023; 183:106465. [PMID: 36701847 PMCID: PMC9975010 DOI: 10.1016/j.appet.2023.106465] [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: 08/05/2022] [Revised: 01/06/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023]
Abstract
Bariatric surgery can have profound impacts on eating behaviors and experiences, yet most prior research studying these changes has relied on retrospective self-report measures with limited precision and susceptibility to bias. This study used smartphone-based ecological momentary assessment (EMA) to evaluate the trajectory of change in eating behaviors, appetite, and other aspects of eating regulation in 71 Roux-en-Y gastric bypass and sleeve gastrectomy patients assessed preoperatively and at 3, 6, and 12-months postoperative. For some outcomes, results showed a consistent and similar pattern for SG and RYGB where consumption of sweet and high-fat foods and hunger, desire to eat, ability to eat right now, and satisfaction with amount eaten all improved from pre-to 6-months post-surgery with some degree of deterioration at 12-months post-surgery. By contrast, other variables, largely related to hedonic hunger and craving and desire for specific foods, showed less consistent patterns that differed by surgery type. While the findings suggest an overall pattern of improvement in eating patterns following bariatric surgery, they also highlight how a return to preoperative habits may begin as early as 6 months after surgery. Additional research is needed to understand mechanisms that promote changes in eating behavior after surgery, and how best to intervene to preserve beneficial effects.
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Affiliation(s)
- J Graham Thomas
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, RI196 Richmond St., Providence, RI, 02916, USA.
| | - Leah M Schumacher
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, RI196 Richmond St., Providence, RI, 02916, USA
| | - Sivamainthan Vithiananthan
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA110 Francis St., Boston, MA, 02215, USA
| | - Daniel B Jones
- Department of Surgery, Rutgers Health, Newark, NJ185 South Orange Avenue, Medical Sciences Building G-506, Newark, NJ, 07103, USA
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA1975 Zonal Ave., Los Angeles, CA, 90033, USA
| | - Tommy Chou
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, RI196 Richmond St., Providence, RI, 02916, USA
| | - Pavlos K Papasavas
- Departments of Surgery and Research, Hartford Hospital/Hartford HealthCare, Hartford, CT80 Seymour St., Hartford, CT, 06106, USA
| | - Dale S Bond
- Departments of Surgery and Research, Hartford Hospital/Hartford HealthCare, Hartford, CT80 Seymour St., Hartford, CT, 06106, USA
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19
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Velkoff EA, Smith AR. Temporal dynamics of interoceptive attention and positive and negative affect in adults engaging in disordered eating and nonsuicidal self-injury. J Clin Psychol 2023. [PMID: 36905648 DOI: 10.1002/jclp.23508] [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: 05/13/2022] [Revised: 12/28/2022] [Accepted: 03/01/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE Interoception (the sense of the body's state) is associated with eating disorders and nonsuicidal self-injury, potentially through relationships with affect. We examined the relationship between interoceptive attention and both positive and negative affect. METHODS Participants (N = 128) who reported recent self-harm (i.e., disordered eating and/or non-suicidal self-injury) completed ecological momentary assessment for 16 days. Participants completed multiple daily assessments of affect and interoceptive attention. We then tested the temporal dynamic relationship between interoceptive attention and affect. RESULTS There was a relationship between positive affect and interoceptive attention such that people with higher average positive affect, and times when people were above their typical positive affect, were associated with higher interoceptive attention. There was a negative relationship between negative affect and interoceptive attention, such that people with higher average negative affect, and times when people were above their own typical negative affect, were associated with lower interoceptive attention. CONCLUSIONS Better mood may associate with greater willingness to attend to body sensations. Our findings support active inference models of interoception and highlight the importance of refining our understanding of the dynamic nature of interoception and its relationship with affect.
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Affiliation(s)
- Elizabeth A Velkoff
- Department of Psychology, Miami University, Oxford, Ohio, USA.,Department of Psychiatry, The University of California, San Diego, California, USA
| | - April R Smith
- Department of Psychology, Miami University, Oxford, Ohio, USA.,Department of Psychology, Auburn University, Auburn, Alabama, USA
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20
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Christian C, Cusack CE, Ralph-Nearman C, Spoor SP, Hunt RA, Levinson CA. A Pilot, Time-Series Investigation of Depression, Anxiety, and Eating Disorder Symptoms in Adults Experiencing Major Depressive Symptoms: The Need for Eating Disorder Assessment and Research in Depression. Behav Ther 2023; 54:214-229. [PMID: 36858755 DOI: 10.1016/j.beth.2022.08.003] [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: 08/04/2021] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/27/2022]
Abstract
Major Depressive Disorder (MDD) is a prevalent psychiatric disorder impacting 10-16% of Americans in their lifetime. Approximately 60% of individuals with MDD have comorbid anxiety disorders. Additionally, although scarce research has examined eating disorders (EDs) in depression, a bidirectional association exists between ED and MDD symptoms. The current pilot study (N = 31 individuals with moderate to severe depression) modeled networks of depressive, anxiety, and ED symptoms using intensive time-series data. This study also tested if temporal central symptoms predicted six-month clinical outcomes. The most central symptoms were guilt, self-dislike, lack of energy, and difficulty concentrating. Several anxiety and ED symptoms were also central, including physical anxiety, social anxiety, body dissatisfaction, and desire for thinness. The central symptom crying predicted six-month depression with a medium effect size. These findings suggest anxiety and ED symptoms may influence the day-to-day course of depression in some individuals with comorbid diagnoses, but predictors of symptoms across hours may differ from predictors across longer time scales (i.e., months). Time scale should be considered when conducting and interpreting research on MDD. Research, assessment, and treatment for MDD should continue to explore transdiagnostic approaches including anxiety and ED symptoms to optimize care for individuals with complex presentations.
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21
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Srivastava P, Felonis CR, Piers AD, Nunez N, Fitzpatrick B, Juarascio A, Manasse S. Reward mediates the association between engagement in noneating activities and state body dissatisfaction: An ecological momentary assessment study. Int J Eat Disord 2023; 56:562-573. [PMID: 36444116 DOI: 10.1002/eat.23862] [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: 04/26/2022] [Revised: 10/27/2022] [Accepted: 11/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Momentary worsening (i.e., greater than one's average levels) of state body dissatisfaction (BD) has been implicated as a proximal risk factor for eating disorder (ED) behaviors in binge-spectrum EDs. Yet, research exploring the prospective association between noneating activities in daily life (e.g., chores, self-care/coping) and momentary state BD remains limited. Understanding the momentary link between engagement in noneating activities and state BD, and pathways through which engagement in said activities influences momentary state BD is critical to informing treatments. The current ecological momentary assessment (EMA) study examined whether (1) engagement in noneating activities at Time 1 prospectively predicted momentary state BD at Time 2 and (2) reward drawn from noneating activities at Time 1 mediates the prospective association between engagement in noneating activities at Time 1 and momentary state BD at Time 2. METHOD Sixty-six adults with transdiagnostic binge eating completed an EMA protocol over 7-14 days. Participants received six EMA signals per day (total EMA observations = 4038). Multilevel modeling was used to examine the research questions. RESULTS Engagement in an indoor hobby, outdoor recreation, socializing, and self-care/coping strategies prospectively predicted momentary state BD improvements, while using TV/social media and cooking prospectively predicted momentary state BD worsening. Reward drawn from engagement in these noneating activities mediated the associations. DISCUSSION If replicated, these findings suggest that increasing the frequency of certain noneating activities and enhancing their rewarding aspects to improve state BD and decrease ED behavior risk during treatment may be worthy of further exploration. PUBLIC SIGNIFICANCE Momentary worsening of state body dissatisfaction (BD) is a risk factor for eating disorder behaviors in individuals with binge eating. This study found that engaging in certain noneating activities (e.g., socializing) prospectively predicted momentary improvements in state BD, while other noneating activities (e.g., cooking) predicted momentary worsening of state BD. Reward drawn from activities mediated these relations. To improve state BD, treatments should target the frequency of, and reward obtained from these noneating activities.
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Affiliation(s)
- Paakhi Srivastava
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Christina R Felonis
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Amani D Piers
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Nicole Nunez
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Brighid Fitzpatrick
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne Juarascio
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie Manasse
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA.,Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
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22
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Parker MN, Lavender JM, Schvey NA, Tanofsky-Kraff M. Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents. Adolesc Health Med Ther 2023; 14:63-85. [PMID: 36860931 PMCID: PMC9969870 DOI: 10.2147/ahmt.s220102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/14/2023] [Indexed: 02/24/2023] Open
Abstract
Approximately 35 years after its initial publication, the Eating Disorder Examination (EDE) remains one of the most widely used semi-structured interviews for assessing eating disorder diagnoses and symptomatology. Although the interview provides certain advantages over other common measurement approaches (ie, questionnaires), there are particular considerations regarding the EDE that warrant attention, including in its use with adolescents. The aims of this paper are therefore to: 1) provide a brief overview of the interview itself, as well as a description of its origin and underlying conceptual framework; 2) describe relevant factors for administering the interview with adolescents; 3) review potential limitations regarding use of the EDE with adolescents; 4) address considerations for using the EDE with pertinent subpopulations of adolescents who may experience distinct eating disorder symptoms and/or risk factors; and 5) discuss the integration of self-report questionnaires with the EDE. Advantages of using the EDE include the ability for interviewers to clarify complex concepts and mitigate inattentive responding, enhanced orientation to the interview timeframe to improve recall, increased diagnostic accuracy compared to questionnaires, and accounting for potentially salient external factors (eg, food/eating rules imposed by a parent/guardian). Limitations include more extensive training requirements, greater assessment burden, variable psychometric performance across subgroups, lack of items evaluating muscularity-oriented symptoms and avoidant/restrictive food intake disorder diagnostic criteria, and lack of explicit consideration for salient risk factors other than weight and shape concerns (eg, food insecurity).
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Affiliation(s)
- Megan N Parker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jason M Lavender
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA,Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, MD, USA,The Metis Foundation, San Antonio, TX, USA,Correspondence: Jason M Lavender, Military Cardiovascular Outcomes Research Program, 4301 Jones Bridge Road, Building 17, Suite 2A, Bethesda, MD, 20814, USA, Email
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA,Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA,Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, MD, USA
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23
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Sheng R, Yang X, Zhou Y, Liu X, Xu W. COVID-19 and Eating Problems in Daily Life: The Mediating Roles of Stress, Negative Affect and Posttraumatic Stress Symptoms. Psychol Rep 2023; 126:34-51. [PMID: 34784823 PMCID: PMC9841454 DOI: 10.1177/00332941211045315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background The COVID-19 pandemic poses a challenge to individuals' mental health. People worldwide are experiencing increased stress, negative affect, and posttraumatic stress symptoms, which may lead to eating problems. The purpose of this study was to explore the impact of the perceived severity of COVID-19 on eating problems and the mediating effects of stress/negative affect/posttraumatic stress symptoms both at the personal level and interpersonal level. Methods: During the COVID-19 outbreak, a total of 108 college students were recruited to report their perceived severity of COVID-19, stress, negative affect, posttraumatic stress symptoms, and eating problems three times a day for seven consecutive days using Ecological Momentary Assessment. Results: State perceived severity of COVID-19 predicted fewer subsequent eating problems in daily life at the personal level. Both state negative affect and posttraumatic stress symptoms were positively associated with eating problems in daily life. At the interpersonal level, trait-like perceived severity of COVID-19, stress, negative affect, and posttraumatic stress symptoms were positively associated with overall eating problems. There were no mediating effects of stress/negative affect/posttraumatic stress symptoms on the relations between perceived severity of COVID-19 and eating problems at the personal/interpersonal level. Conclusions: The perceived severity of COVID-19, stress, negative affect, and posttraumatic stress symptoms might increase the risk of eating problems.
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Affiliation(s)
- Ruike Sheng
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Xiujie Yang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yuyang Zhou
- Department of Psychology, 5450Florida International University, Miami, Florida, United States
| | - Xiaoyan Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Wei Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China; School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China
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24
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Unique and shared correlates of disordered eating and non-suicidal self-injury among school-based adolescents. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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25
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Loss of control may uniquely predict negative affect among the disinhibited eating experiences of high-risk young men. Eat Behav 2022; 47:101674. [PMID: 36240577 DOI: 10.1016/j.eatbeh.2022.101674] [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: 04/20/2022] [Revised: 09/06/2022] [Accepted: 09/26/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Loss of control (LOC) eating is a disordered eating behavior that is prevalent but understudied among men. It is common for men with LOC eating to concurrently engage in diverse eating behaviors characterized as disinhibited. It remains unclear which eating qualities are most distressing for men. This study evaluated the link between disinhibited eating qualities and subsequent negative affect in young men. METHODS 42 men (18-35 y) who reported engaging in ≥4 LOC eating episodes in the prior month completed a 14-day ecological momentary assessment protocol. For each meal and snack, participants were asked to rate the extent to which they felt they overate; lost control; ate more than planned; ate mindlessly; had concerns about wasting food; and were encouraged to eat more by others. State negative affect was evaluated during random intervals five times per day. RESULTS After adjusting for previous negative affect and time between ratings, five of the six eating qualities were significantly and positively associated with subsequent negative affect according to between-participant findings (ps < 0.026). In within-participant analyses, only LOC was significantly and positively associated with subsequent negative affect (p = 0.044). DISCUSSION While a range of disinhibited eating qualities are correlated with negative affect in a sample of young men, a sense of LOC while eating may be a promising target for interventions focused on improving the psychological functioning of high-risk young men.
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Manasse SM, Haedt-Matt AA, Smith KE, Egbert AH, O’Sullivan K, Koren D, Engel S, Goldschmidt AB. The moderating role of sleep duration on momentary relations between negative affect and loss-of-control eating in children and adolescents. EUROPEAN EATING DISORDERS REVIEW 2022; 30:815-822. [PMID: 35474597 PMCID: PMC10860376 DOI: 10.1002/erv.2908] [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: 06/18/2021] [Revised: 03/01/2022] [Accepted: 04/08/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Loss-of-control (LOC) eating is associated with eating disorders and obesity, and thus it is imperative to understand its momentary risk factors in order to improve intervention efforts. Negative affect has been proposed as a momentary risk factor for LOC eating, but the evidence for its effects in children and adolescents is mixed. Short sleep duration (which is very common in youth), may be one variable that moderates the relation between negative affect and subsequent LOC eating. As such, we aimed to examine the moderating role of within-person sleep duration on the momentary relations between negative affect and subsequent LOC eating. METHOD We recruited children (N = 30) with overweight/obesity ages 8-14, who completed a 2-week ecological momentary assessment protocol assessing negative affect and LOC eating several times per day, while also wearing a sleep actigraphy device and completing sleep diaries. RESULTS Consistent with hypotheses, within-person sleep duration moderated the next-day momentary relation between within-person negative affect and LOC eating, such that shorter sleep duration strengthened the positive relation between negative affect and loss-of-control eating. CONCLUSIONS Results suggest that, in children and adolescents, fluctuations in sleep duration may influence susceptibility to losing control over eating after experiencing negative affect. Future research should further investigate other metrics of sleep disturbance as they relate to emotion regulation and LOC eating. Such research will set the stage for augmenting paediatric interventions to better target maintenance factors for LOC eating.
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Affiliation(s)
- Stephanie M. Manasse
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA
| | | | - Kathryn E. Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA
| | - Amy H. Egbert
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Weight Control and Diabetes Research Center/The Miriam Hospital, Providence, RI
| | - Katie O’Sullivan
- Department of Medicine, University of Chicago Medicine, Chicago, IL
| | - Dorit Koren
- Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA
| | | | - Andrea B. Goldschmidt
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Weight Control and Diabetes Research Center/The Miriam Hospital, Providence, RI
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Wayda-Zalewska M, Grzegorzewski P, Kot E, Skimina E, Santangelo PS, Kucharska K. Emotion Dynamics and Emotion Regulation in Anorexia Nervosa: A Systematic Review of Ecological Momentary Assessment Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13659. [PMID: 36294238 PMCID: PMC9603728 DOI: 10.3390/ijerph192013659] [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: 09/10/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Altered emotion dynamics and emotion regulation (ER) have been indicated in theoretical descriptions of abnormal emotional functioning, which contributes to the development and maintenance of anorexia nervosa (AN). Ecological momentary assessment (EMA) has recently become popular in research on eating disorders. It is a source of new insights into the psychopathology of AN as it enables intensive long-term tracking of everyday experiences and behaviours of individuals through repeated self-reports. The following systematic review aims to synthesize research on the use of EMA when evaluating emotion dynamics and ER in AN. Specific studies were identified with the use of MEDLINE, PsycINFO, and Scopus databases. A supplemental search was performed in reference lists of the relevant publications. As a result, 27 publications were identified and included in the systematic review. The findings from the reviewed studies point to various disturbed components of emotion dynamics as well as to unique associations of maladaptive ER strategies with specific abnormalities in emotion dynamics in AN. Limitations of the studies were discussed as well. An outlook for further research in the field was provided in the last section of the paper.
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Affiliation(s)
| | - Piotr Grzegorzewski
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, 01938 Warsaw, Poland
| | - Emilia Kot
- Faculty of Psychology, University of Warsaw, 00183 Warsaw, Poland
| | - Ewa Skimina
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, 01938 Warsaw, Poland
| | | | - Katarzyna Kucharska
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, 01938 Warsaw, Poland
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Bi-Directional Associations of Affective States and Diet among Low-Income Hispanic Pregnant Women Using Ecological Momentary Assessment. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3040022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Affective states play a role in dietary behaviors. Yet, little research has studied within-subjects associations between affect and diet during pregnancy. We examined the acute bidirectional relationships between affect and food intake and moderation by pre-pregnancy body mass index (BMI) in low-income, Hispanic pregnant women using ecological momentary assessment (EMA). Women (N = 57) completed four days of EMA during their first trimester. Women responded to five random prompts per day about their current affect and past two-hour food intake. Higher positive affect (PA) or lower negative affect (NA) predicted greater likelihood of fruit/vegetable consumption in the next two hours in women with lower pre-pregnancy BMI and lower likelihood in women with higher pre-pregnancy BMI. Higher PA predicted less likelihood of fast food consumption in the next two hours in women with lower pre-pregnancy BMI and slightly higher likelihood in women with higher pre-pregnancy BMI. Women with lower pre-pregnancy BMI had higher PA when they reported consuming chips/fries in the past two hours, and women with higher pre-pregnancy BMI had lower PA when they reported consumption of chips/fries in the past two hours. Results showed differential relationships between affect and food intake as a function of pre-pregnancy BMI.
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Lampe EW, Wons O, Taylor LC, Juarascio AS, Manasse SM. Associations between fear of weight gain and exercise in binge-spectrum eating disorders. Eat Weight Disord 2022; 27:2121-2128. [PMID: 35064918 PMCID: PMC9288521 DOI: 10.1007/s40519-022-01361-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/06/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Maladaptive exercise (i.e., exercise that is either driven or compensatory) is thought to momentarily down-regulate elevated fear of weight gain (FOWG). However, little research has examined associations between FOWG and exercise, and no research has measured FOWG at a momentary level or considered exercise type (i.e., maladaptive vs. adaptive). Thus, we examined both within- and between-subject associations between FOWG and exercise among individuals with trans-diagnostic binge eating. METHODS We recruited treatment-seeking adults (N = 58, 82.9% female) to complete a 7-14-day ecological momentary assessment protocol which assessed levels of FOWG and exercise engagement and type. Mixed models and generalized estimating equations assessed within-subject associations, and linear regression assessed between-subject associations. RESULTS There was no main effect of FOWG on exercise engagement at the next survey. However, unexpectedly, exercise type moderated this relationship such that the relationship between FOWG and exercise was strongest for episodes of adaptive exercise. Overall exercise frequency accounted for 10.4% of the variance in FOWG and exercise type explained an additional 1.7% of the variance in FOWG. CONCLUSION The findings of the current study indicate that momentary levels of FOWG are associated with subsequent adaptive exercise episodes, while higher overall levels of maladaptive exercise were associated with higher levels of FOWG. Future treatments should place a greater emphasis on reducing the frequency of maladaptive exercise by providing strategies for reducing FOWG. LEVEL OF EVIDENCE Level IV: Evidence obtained from multiple time series analysis such as case studies.
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Affiliation(s)
- Elizabeth W Lampe
- Department of Psychology, Drexel University, Philadelphia, PA, USA.
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA.
| | - Olivia Wons
- Department of Psychology, Drexel University, Philadelphia, PA, USA
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Lauren C Taylor
- 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
| | - Stephanie M Manasse
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
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Dicker-Oren SD, Gelkopf M, Greene T. The dynamic network associations of food craving, restrained eating, hunger and negative emotions. Appetite 2022; 175:106019. [PMID: 35500722 DOI: 10.1016/j.appet.2022.106019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Food craving, restrained eating, hunger, and negative emotions may predict and reinforce one another. However, less is known about how they interact together as a complex system in daily life. Therefore, we used a dynamic network approach to examine the associations between food craving, restrained eating, hunger and negative emotions in daily life. METHODS Food craving, restrained eating, hunger and negative emotions were measured using ecological momentary assessment three times a day over ten days in a community sample in Israel (n = 123). A two-step multilevel vector auto-regression network analysis was used to estimate temporal, contemporaneous and between-persons networks. RESULTS In the temporal network, restrained eating was the most central predictor of eating behaviors and negative emotions, predicting food craving and hunger as well as sadness and loneliness. Food craving was also predicted by hunger and stress, and hunger predicted loneliness. In the contemporaneous network, food craving was associated with hunger and feeling bored, and higher anger was associated with lower restrained eating. Stress and sadness were central negative emotions in the models. DISCUSSION This study suggests possible temporal and contemporaneous relationships between food craving, restrained eating, hunger and negative emotions, emphasizing their complex interactions in daily life. Restrained eating and stress should be investigated as potential targets for interventions addressing food craving and overeating.
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Affiliation(s)
- S D Dicker-Oren
- The Department of Community Mental Health, University of Haifa, Haifa, Israel.
| | - M Gelkopf
- The Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - T Greene
- The Department of Community Mental Health, University of Haifa, Haifa, Israel
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Goldstein SP, Hoover A, Thomas JG. Combining passive eating monitoring and ecological momentary assessment to characterize dietary lapses from a lifestyle modification intervention. Appetite 2022; 175:106090. [PMID: 35598718 DOI: 10.1016/j.appet.2022.106090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/21/2022] [Accepted: 05/17/2022] [Indexed: 01/26/2023]
Abstract
Dietary lapses (i.e., specific instances of nonadherence to recommended dietary goals) contribute to suboptimal weight loss outcomes during lifestyle modification programs. Passive eating monitoring could enhance lapse measurement via objective assessment of eating characteristics that could be markers for lapse (e.g., more bites consumed). The purpose of this study was to evaluate if passively-inferred eating characteristics (i.e., bites, eating duration, and eating rate), measured via wrist-worn device, could distinguish dietary lapses from non-lapse eating. Adults (n = 25) with overweight/obesity received a 24-week lifestyle modification intervention. Participants completed ecological momentary assessment (EMA; repeated smartphone surveys) biweekly to self-report on dietary lapses and non-lapse eating episodes. Participants wore a wrist device that captured continuous wrist motion. Previously-validated algorithms inferred eating episodes from wrist data, and calculated bite count, duration, and rate (seconds per bite). Mixed effects logistic regressions revealed no simple effects of bite count, duration, or eating rate on the likelihood of dietary lapse. Moderation analyses revealed that eating episodes in the evening were more likely to be lapses if they involved fewer bites (B = -0.16, p < .05), were shorter (B = -0.54, p < .05), or had a slower rate (B = 1.27, p < .001). Statistically significant interactions between eating characteristics (Bs = -0.30 to -0.08, ps < .001) revealed two distinct patterns. Eating episodes that were 1. smaller, slower, and shorter than average, or 2. larger, quicker, and longer than average were associated with increased probability of lapse. This study is the first to use objective eating monitoring to characterize dietary lapses throughout a lifestyle modification intervention. Results demonstrate the potential of sensors to identify non-adherence using only patterns of passively-sensed eating characteristics, thereby minimizing the need for self-report in future studies. CLINICAL TRIALS REGISTRY NUMBER: NCT03739151.
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Affiliation(s)
- Stephanie P Goldstein
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI, 02903, USA.
| | - Adam Hoover
- Holcombe Department of Electrical and Computer Engineering, Clemson University, Clemson, SC, 29634, USA
| | - J Graham Thomas
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI, 02903, USA
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32
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Bicaker E, Lane SP, Sadikaj G, Racine SE. The roles of negative emotion intensity, negative emotion differentiation, and self-compassion in loss of control eating. Int J Eat Disord 2022; 55:966-976. [PMID: 35488770 DOI: 10.1002/eat.23723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Negative affect intensity is robustly related to binge eating, but the relationship between negative emotion differentiation (i.e., the ability to differentiate negatively-valenced emotions) and binge eating is unclear. Further, little is known about factors that might reduce emotion intensity and/or enhance emotion differentiation, thereby reducing binge eating. Self-compassion is consistently linked to less binge eating, which may be due to decreased negative affect and/or an enhanced ability to differentiate emotions. The current study examined the roles of negative emotion intensity, negative emotion differentiation, and self-compassion in binge eating using ecological momentary assessment. METHOD Participants were 201 university students (52.2% female) who completed questionnaires assessing affect seven times a day, and engagement in loss of control (LOC) eating episodes at the end of each day, for 10 days. The average of sadness, fear, guilt, and hostility subscales represented negative emotion intensity; intraclass correlations across negative affect subscales defined negative emotion differentiation. Both daily (i.e., within-person) and trait (i.e., between-person) emotion variables were examined as predictors. RESULTS Between-person negative emotion intensity, but not negative emotion differentiation, significantly predicted LOC eating occurrence. Self-compassion had a significant effect on LOC eating frequency, and this relationship was partially mediated via negative emotion intensity, but not via negative emotion differentiation. DISCUSSION Lower levels of negative emotion intensity partially account for the relationship between greater self-compassion and less frequent LOC eating. These findings highlight the importance of cultivating self-compassion to down-regulate negative emotions and to reduce LOC eating. PUBLIC SIGNIFICANCE STATEMENT Our findings suggest that university students who approach their limitations compassionately experience fewer negative emotions in daily life and engage in less loss of control eating. Lower levels of negative affect partially explain this relationship between self-compassion and loss of control eating. These results highlight the importance of cultivating an understanding and a compassionate attitude toward oneself for reducing eating pathology.
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Affiliation(s)
- Ege Bicaker
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Sean P Lane
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana, USA
| | - Gentiana Sadikaj
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Sarah E Racine
- Department of Psychology, McGill University, Montreal, Quebec, Canada
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Manasse SM, Lampe EW, Srivastava P, Payne-Reichert A, Mason TB, Juarascio AS. Momentary associations between fear of weight gain and dietary restriction among individuals with binge-spectrum eating disorders. Int J Eat Disord 2022; 55:541-552. [PMID: 35088433 PMCID: PMC9377790 DOI: 10.1002/eat.23686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Fear of weight gain (FOWG) is increasingly implicated in the maintenance of binge-spectrum eating disorders (EDs; e.g., bulimia nervosa [BN], binge-eating disorder [BED]) through the pathway of increased dietary restriction. However, particularly in binge-spectrum EDs, research is nascent and based on retrospective self-report. To improve treatment outcomes, it is critical to better understand the momentary relations between FOWG and dietary restriction. METHOD Sixty-seven adults with binge spectrum EDs completed a 7-14-day ecological momentary assessment protocol that included items regarding FOWG, ED behaviors, and types of dietary restriction (e.g., attempted restraint vs. actual restriction) several times per day. Multilevel models were used to evaluate reciprocal associations between FOWG and dietary restriction, and to evaluate the indirect of effects of dietary restriction on the relation between FOWG and binge eating. RESULTS While main effects were not statistically significant, ED presentation significantly moderated the association between increases in FOWG at time1 and both attempted and actual avoidance of enjoyable foods at time2 such that those with BN-spectrum EDs were more likely to avoid enjoyable foods following increased FOWG compared to those with BED-spectrum EDs. Engagement in restriction at time1 was not associated with decreased FOWG at time2. DISCUSSION Prospective associations between FOWG and restriction suggest that individuals with BN may be more likely to restrict their eating following increased FOWG. These findings suggest FOWG may be an important target for future treatments.
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Affiliation(s)
- Stephanie M Manasse
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Elizabeth W Lampe
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Paakhi Srivastava
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Adam Payne-Reichert
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Adrienne S Juarascio
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
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Mason TB, Dayag R, Dolgon-Krutolow A, Lam K, Zhang D. A systematic review of maladaptive interpersonal behaviors and eating disorder psychopathology. Eat Behav 2022; 45:101601. [PMID: 35221209 DOI: 10.1016/j.eatbeh.2022.101601] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 01/08/2023]
Abstract
While maladaptive interpersonal behaviors have been implicated in models of psychopathology, particularly depression, maladaptive interpersonal behaviors have received limited attention in the eating disorder (ED) literature. Further, the extant literature on maladaptive interpersonal behaviors in relation to ED psychopathology has yet to be synthesized. Therefore, the aim of this systematic review was to characterize the literature on maladaptive interpersonal behaviors and ED psychopathology. Inclusion criteria for the review were: availability of the study in English, empirical journal article, inclusion of human subjects, and reporting an association between at least one maladaptive interpersonal behavior and one measure of ED psychopathology. Databases searched were PsycInfo and PubMed across all dates (up to September 2020). Data was extracted from articles, and main findings were synthesized; quality scores were provided using a modified version of the Newcastle Ottawa Scale. There were 35 studies with 36 independent samples included in the review. Most studies evidenced significant bivariate associations between maladaptive interpersonal behaviors and ED psychopathology. That is, higher levels of maladaptive interpersonal behaviors were generally associated with greater disordered eating, bulimic symptoms, and body image concerns. Although limited to a minority of studies, some studies identified prospective associations and significant mediators and moderators of associations. This systematic review supports further research on maladaptive interpersonal behaviors and ED psychopathology. Given a number of significant limitations in the literature identified in this review, there are an array of avenues for future research on maladaptive interpersonal behaviors and ED psychopathology.
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Affiliation(s)
- Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
| | - Rachel Dayag
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Anna Dolgon-Krutolow
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Kathy Lam
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Diana Zhang
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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35
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Rubeis G. iHealth: The ethics of artificial intelligence and big data in mental healthcare. Internet Interv 2022; 28:100518. [PMID: 35257003 PMCID: PMC8897624 DOI: 10.1016/j.invent.2022.100518] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/11/2022] [Accepted: 02/24/2022] [Indexed: 01/13/2023] Open
Abstract
The concept of intelligent health (iHealth) in mental healthcare integrates artificial intelligence (AI) and Big Data analytics. This article is an attempt to outline ethical aspects linked to iHealth by focussing on three crucial elements that have been defined in the literature: self-monitoring, ecological momentary assessment (EMA), and data mining. The material for the analysis was obtained by a database search. Studies and reviews providing outcome data for each of the three elements were analyzed. An ethical framing of the results was conducted that shows the chances and challenges of iHealth. The synergy between self-monitoring, EMA, and data mining might enable the prevention of mental illness, the prediction of its onset, the personalization of treatment, and the participation of patients in the treatment process. Challenges arise when it comes to the autonomy of users, privacy and data security of users, and potential bias.
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Mason TB, Do B, Chu D, Belcher BR, Dunton GF, Lopez NV. Associations among affect, diet, and activity and binge-eating severity using ecological momentary assessment in a non-clinical sample of middle-aged fathers. Eat Weight Disord 2022; 27:543-551. [PMID: 33866535 DOI: 10.1007/s40519-021-01191-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/07/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Knowledge of within-day factors associated with binge-eating severity among middle-aged fathers is limited. The purpose of the current report was to examine within-day associations of affect, diet, and activity in relation to binge-eating severity using ecological momentary assessment (EMA) in men. METHODS Twenty-three middle-aged fathers completed 8 days of EMA and wore accelerometers to objectively assess activity. Generalized estimating equations assessed relationships among affect, diet, and activity and binge-eating severity. RESULTS When positive affect was above average, men reported greater binge-eating severity in the next 2 h. Oppositely, when negative affect was above average, men reported less binge-eating severity in the next 2 h. At times when men reported consumption of sweets and fast food, they reported higher binge-eating severity during the same 2-h window. Men with greater average levels of light activity reported less overall binge-eating severity. CONCLUSIONS Findings show that affect, unhealthy food intake, and light activity could be targeted among middle-aged fathers to reduce binge-eating severity and prevent eating disorders. LEVEL OF EVIDENCE Level III: Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- Tyler B Mason
- Department of Preventive Medicine, University of Southern California, 2001 Soto St., Los Angeles, CA, 90032, USA.
| | - Bridgette Do
- Department of Preventive Medicine, University of Southern California, 2001 Soto St., Los Angeles, CA, 90032, USA
| | - Daniel Chu
- Department of Preventive Medicine, University of Southern California, 2001 Soto St., Los Angeles, CA, 90032, USA
| | - Britni R Belcher
- Department of Preventive Medicine, University of Southern California, 2001 Soto St., Los Angeles, CA, 90032, USA
| | - Genevieve F Dunton
- Department of Preventive Medicine, University of Southern California, 2001 Soto St., Los Angeles, CA, 90032, USA
| | - Nanette V Lopez
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
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Smith KE, Mason TB, Anderson LM, Schaefer LM, Crosby RD, Engel SG, Crow SJ, Wonderlich SA, Peterson CB. Naturalistically assessed associations between physical activity, affective functioning, and binge eating among adults with binge-eating disorder. Eat Disord 2022; 30:154-167. [PMID: 32397943 PMCID: PMC8628298 DOI: 10.1080/10640266.2020.1746121] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Binge-eating disorder (BED) is associated with overweight/obesity, physical inactivity, and disturbances in affective functioning. While research suggests that physical activity (PA) may have beneficial effects on BED symptoms, little is known about the daily correlates of PA. As a first step in understanding the processes linking PA and binge eating, this study examined associations between PA (i.e., self-reported time engaged in moderate-to-vigorous PA), affective functioning (i.e., positive and negative affect, body satisfaction, emotion regulation), and eating-related cognitions and behaviors (i.e., craving, overeating, loss of control eating) measured via ecological momentary assessment (EMA). Adults with BED (N = 91) completed a seven-day EMA protocol during which they completed repeated measures of these variables. Results indicated individuals who reported greater time engaged in PA over the EMA protocol evidenced higher positive affect and body satisfaction, and lower overeating (between-subjects effects). No significant within-subjects effects were observed. Findings demonstrate that individual differences in PA levels were related to more adaptive affective functioning and eating regulation in daily life. Results highlight the relevance of PA in BED, and the need for future studies to identify the timescale of these relationships using objective measurements of PA.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Lisa M Anderson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lauren M Schaefer
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA
| | - Ross D Crosby
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Scott G Engel
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA.,The Emily Program, Saint Paul, Minnesota, USA
| | - Stephen A Wonderlich
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA.,The Emily Program, Saint Paul, Minnesota, USA
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38
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Mason TB, Tackett AP, Smith CE, Leventhal AM. Tobacco product use for weight control as an eating disorder behavior: Recommendations for future clinical and public health research. Int J Eat Disord 2022; 55:313-317. [PMID: 34866222 PMCID: PMC8917997 DOI: 10.1002/eat.23651] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 01/22/2023]
Abstract
Tobacco product use (TPU; e.g., smoking, e-cigarettes, other emerging products) is elevated in eating disorders (EDs), yet the phenomenology of tobacco use within EDs has not received much attention. Due to the appetite suppressant effects of tobacco products as well as the array of availability of tobacco products in hedonic flavors (e.g., gummy bear, fruit), TPU may be used for weight control, such as to suppress appetite, satisfy cravings, or for meal replacement. The purpose of this article was to outline theoretical research on TPU for weight control as a mechanism in EDs as well as key areas for future research. We discuss the conceptualization and nature of TPU for weight control and how it may be related to EDs and associated behaviors, TPU patterns and smoking for weight control in EDs, and the effectiveness of current interventions and development of novel intervention protocols for individuals with EDs who use tobacco. Overall, this article outlines novel research questions on TPU in EDs and as a weight control behavior and provides recommendations to clarify the conceptualization and role of TPU within EDs.
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Affiliation(s)
- Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Alayna P Tackett
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
| | - Caitlin E Smith
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
- Institute for Addiction Science, University of Southern California, Los Angeles, California, USA
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Dougherty EN, Goldschmidt AB, Johnson NK, Badillo K, Engel SG, Haedt-Matt AA. Gender differences in the relation between interpersonal stress and momentary shape and weight concerns in youth with overweight/obesity. Body Image 2022; 40:249-255. [PMID: 35074653 PMCID: PMC8891090 DOI: 10.1016/j.bodyim.2022.01.006] [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: 08/29/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to examine relations between interpersonal stress and momentary shape and weight concerns among pre-adolescent and early adolescent boys and girls with overweight/obesity, using ecological momentary assessment (EMA). We also aimed to determine whether interpersonal stress was differentially related to shape/weight concerns in boys versus girls. Forty youth, ages 8-14 years (53% female), with overweight or obesity reported their state-level shape/weight concerns and negative affect and their recent interpersonal stress (i.e., stress experienced since the last EMA assessment) multiple times a day, for two weeks. Results indicated that interpersonal stress predicted shape/weight concerns in girls but was not related to shape/weight concerns in boys. At the between-person level, higher overall feelings of loneliness and social rejection and a higher overall desire for more friends predicted higher average levels of shape/weight concerns. At the within-person level, higher momentary ratings of loneliness, social rejection, and desire for more friends predicted lower shape/weight concerns. These data suggest that the tendency to experience interpersonal stress may be more detrimental to body satisfaction for girls with overweight/obesity than for boys with overweight/obesity. Interventions that focus on reducing interpersonal stress may be effective in ameliorating shape/weight concerns in girls with overweight/obesity.
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Affiliation(s)
| | | | | | | | - Scott G. Engel
- Sanford Research,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine & Health Sciences
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40
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Preliminary evidence of contextual factors’ influence on weight loss treatment outcomes: implications for future research. Int J Obes (Lond) 2022; 46:1244-1246. [PMID: 35184135 PMCID: PMC9156536 DOI: 10.1038/s41366-022-01070-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 11/16/2022]
Abstract
Background/Objectives: Behavioral health interventions, including behavioral obesity treatment, typically target psychosocial qualities of the individual (e.g., knowledge, self-efficacy) that are largely treated as persistent, over momentary contextual factors (e.g., affect, environmental conditions). The variance in treatment outcomes that can be attributable to these two sources is rarely quantified but may help inform future research and treatment development efforts. Subjects/Methods: The intraclass correlation coefficient (ICC) for weekly weight loss was calculated in three studies involving 10–12 weeks of behavioral obesity treatment delivered to adults via in-person group sessions, mobile application, or website. The ICC explains the proportion of variance between versus within individuals, and was used to infer the contribution of individual versus contextual factors to weekly weight loss. The analytic approach involved unconditional linear mixed effect models with a random effect for subject. Results: The ICCs were very low, ranging from 0.01 to 0.06, suggesting that momentary contextual factors may influence obesity treatment outcomes to a substantial degree. Conclusions: This study yielded preliminary evidence that the influence of contextual factors in behavioral obesity treatment may be underappreciated. Future research is needed to simultaneously identify and quantify sources of within- and between-subjects variance to optimize treatment approaches.
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Bell BM, Alam R, Mondol AS, Ma M, Emi IA, Preum SM, de la Haye K, Stankovic JA, Lach J, Spruijt-Metz D. Validity and Feasibility of the Monitoring and Modeling Family Eating Dynamics System to Automatically Detect In-field Family Eating Behavior: Observational Study. JMIR Mhealth Uhealth 2022; 10:e30211. [PMID: 35179508 PMCID: PMC8900902 DOI: 10.2196/30211] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/28/2021] [Accepted: 12/03/2021] [Indexed: 01/02/2023] Open
Abstract
Background The field of dietary assessment has a long history, marked by both controversies and advances. Emerging technologies may be a potential solution to address the limitations of self-report dietary assessment methods. The Monitoring and Modeling Family Eating Dynamics (M2FED) study uses wrist-worn smartwatches to automatically detect real-time eating activity in the field. The ecological momentary assessment (EMA) methodology was also used to confirm whether eating occurred (ie, ground truth) and to measure other contextual information, including positive and negative affect, hunger, satiety, mindful eating, and social context. Objective This study aims to report on participant compliance (feasibility) to the 2 distinct EMA protocols of the M2FED study (hourly time-triggered and eating event–triggered assessments) and on the performance (validity) of the smartwatch algorithm in automatically detecting eating events in a family-based study. Methods In all, 20 families (58 participants) participated in the 2-week, observational, M2FED study. All participants wore a smartwatch on their dominant hand and responded to time-triggered and eating event–triggered mobile questionnaires via EMA while at home. Compliance to EMA was calculated overall, for hourly time-triggered mobile questionnaires, and for eating event–triggered mobile questionnaires. The predictors of compliance were determined using a logistic regression model. The number of true and false positive eating events was calculated, as well as the precision of the smartwatch algorithm. The Mann-Whitney U test, Kruskal-Wallis test, and Spearman rank correlation were used to determine whether there were differences in the detection of eating events by participant age, gender, family role, and height. Results The overall compliance rate across the 20 deployments was 89.26% (3723/4171) for all EMAs, 89.7% (3328/3710) for time-triggered EMAs, and 85.7% (395/461) for eating event–triggered EMAs. Time of day (afternoon odds ratio [OR] 0.60, 95% CI 0.42-0.85; evening OR 0.53, 95% CI 0.38-0.74) and whether other family members had also answered an EMA (OR 2.07, 95% CI 1.66-2.58) were significant predictors of compliance to time-triggered EMAs. Weekend status (OR 2.40, 95% CI 1.25-4.91) and deployment day (OR 0.92, 95% CI 0.86-0.97) were significant predictors of compliance to eating event–triggered EMAs. Participants confirmed that 76.5% (302/395) of the detected events were true eating events (ie, true positives), and the precision was 0.77. The proportion of correctly detected eating events did not significantly differ by participant age, gender, family role, or height (P>.05). Conclusions This study demonstrates that EMA is a feasible tool to collect ground-truth eating activity and thus evaluate the performance of wearable sensors in the field. The combination of a wrist-worn smartwatch to automatically detect eating and a mobile device to capture ground-truth eating activity offers key advantages for the user and makes mobile health technologies more accessible to nonengineering behavioral researchers.
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Affiliation(s)
- Brooke Marie Bell
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, CT, United States.,Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Ridwan Alam
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Electrical and Computer Engineering, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States
| | - Abu Sayeed Mondol
- Department of Computer Science, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States
| | - Meiyi Ma
- Department of Computer Science, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States.,Department of Computer Science, School of Engineering, Vanderbilt University, Nashville, TN, United States
| | - Ifat Afrin Emi
- Department of Computer Science, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States
| | - Sarah Masud Preum
- Department of Computer Science, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States.,Department of Computer Science, Dartmouth College, Hanover, NH, United States
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - John A Stankovic
- Department of Computer Science, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States
| | - John Lach
- Department of Electrical and Computer Engineering, School of Engineering and Applied Science, University of Virginia, Charlottesville, VA, United States.,School of Engineering and Applied Science, The George Washington University, Washington, DC, United States
| | - Donna Spruijt-Metz
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Center for Economic and Social Research, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, CA, United States.,Department of Psychology, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, CA, United States
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Andersen CC, de Baca TC, Votruba SB, Stinson EJ, Engel SG, Krakoff J, Gluck ME. Food insecurity moderates the relationship between momentary affect and adherence in a dietary intervention study. Obesity (Silver Spring) 2022; 30:369-377. [PMID: 35088549 PMCID: PMC8820389 DOI: 10.1002/oby.23335] [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: 08/12/2021] [Revised: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Negative affect and food insecurity have been proposed to impede adherence to weight loss interventions. Therefore, this study examined the role of these variables on dietary adherence using Ecological Momentary Assessment. METHODS A total of 50 participants (19 male participants; age = 49 [SD 14] years) participated in an outpatient dietary study. Lean participants (n = 22; BMI ≤ 25 kg/m2 ) received a weight-maintaining energy needs (WMEN) diet, and participants with obesity (BMI ≥ 30) were randomized to receive either a WMEN diet (n = 14) or a 35% calorie-reduced diet (n = 14). Food insecurity was measured, and, twice daily, Ecological Momentary Assessment captured real-time affect ratings and adherence. Between-person (trait-level) and lagged within-person (state-level) scores were calculated. RESULTS Greater food insecurity and trait-level negative affect were associated with reduced adherence (p = 0.0015, p = 0.0002, respectively), whereas higher trait-level positive affect was associated with greater adherence (p < 0.0001). Significant interactions between affect and food insecurity revealed an association between higher trait positive affect and increased adherence at lower levels of food insecurity. Higher trait negative affect was more strongly associated with decreased adherence in participants with greater levels of food insecurity (-1 SD: B = -0.21, p = 0.22; mean: B = -0.46, SE = 0.13, p = 0.0004; +1 SD: B = -0.71, SE = 0.17, p < 0.0001). CONCLUSIONS Trait-level affect may be crucial in predicting dietary adherence, especially in those with greater food insecurity.
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Affiliation(s)
- Coley C. Andersen
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Tomás Cabeza de Baca
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Susanne B. Votruba
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Emma J. Stinson
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | | | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
| | - Marci E. Gluck
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA
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43
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Negative Affect and Maladaptive Eating Behavior as a Regulation Strategy in Normal-Weight Individuals: A Narrative Review. SUSTAINABILITY 2021. [DOI: 10.3390/su132413704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Emotions have a powerful influence on eating behavior, and eating behavior can have a powerful effect on emotions. The objective of the present narrative review was to evaluate the relationship between negative affect and maladaptive eating behavior as a regulation strategy in normal-weight individuals. A search of the literature within PubMed®, MEDLINE® and PsycINFO was conducted using a combination of the following terms: “affect”, “negative affect”, “affect regulation” and “maladaptive eating behavior”. A total of 106 papers were identified for full text review and were included in the final set of literature. The manuscript presents an overview of the literature on negative affect and maladaptive eating behavior. It offers a brief overview of restrained, uncontrolled and emotional eating in normal-weight individuals and looks at maladaptive eating behavior used to regulate their affect. Based on the previous research findings, we argue that using more adaptive strategies for emotion regulation (cognitive reappraisal) might result in downregulating integral negative affect to food and in improving eating behavior.
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44
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Chwyl C, Berry MP, Manasse SM, Forman EM. Rethinking emotional eating: Retrospective and momentary indices of emotional eating represent distinct constructs. Appetite 2021; 167:105604. [PMID: 34293393 PMCID: PMC8435005 DOI: 10.1016/j.appet.2021.105604] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/27/2021] [Accepted: 07/15/2021] [Indexed: 11/18/2022]
Abstract
Emotional eating (EE) has been proposed as a key weight loss barrier. However, most investigations of EE rely on retrospective self-reports, which may have poor construct validity. This study evaluated concordance between a common self-report EE measure and a novel method for assessing momentary EE using ecological momentary assessment (EMA). We further assessed the utility of both measures for predicting both BMI and weight outcomes. Participants with overweight or obesity enrolled in a weight loss trial (N = 163) completed a self-report measure of EE and underwent an EMA protocol that assessed momentary emotions and eating behaviors. Momentary EE was derived from EMA data using generalized linear mixed-effects models. Linear regression models examined associations between both EE measures and concurrent BMI as well as weight losses over 30 months. Retrospectively self-reported EE and momentary EE were negatively correlated with one another (r = -0.27). Higher momentary EE and higher retrospectively reported EE both predicted higher concurrent BMI, and higher retrospectively reported EE predicted poorer weight loss outcomes at all time points (p < 0.05). By contrast, higher momentary EE predicted improved weight outcomes at 1-year and 2-year follow-up (p < 0.05). Our findings extend prior research suggesting that retrospective self-report EE measures capture a different construct than intended and suggest that momentary EE could predict improved weight loss outcomes.
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Affiliation(s)
- Christina Chwyl
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA.
| | - Michael P Berry
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA.
| | - Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA.
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Sciences (WELL Center), Drexel University, Philadelphia, PA, USA.
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45
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Mason TB, Smith KE, Crosby RD, Engel SG, Peterson CB, Wonderlich SA, Jin H. Multi-state modeling of thought-shape fusion using ecological momentary assessment. Body Image 2021; 39:139-145. [PMID: 34358817 PMCID: PMC8654058 DOI: 10.1016/j.bodyim.2021.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 07/21/2021] [Accepted: 07/25/2021] [Indexed: 12/17/2022]
Abstract
Body dissatisfaction (BD) and preoccupation with thoughts of food (PTF) are intertwined and are components of thought-shape fusion. Thought-shape fusion describes the process by which PTF lead to beliefs about weight and shape. To study thought-shape fusion in daily life and explore various transitions between BD and PTF, 30 women with binge eating completed ecological momentary assessment for 14 days. BD and PTF were assessed using continuous rating scales at each prompt. Multi-state modeling, which analyzes micro-temporal transitions between discrete states, was used to examine transitions among four states created with BD and PTF ratings. The four states included low BD/low PTF, low BD/high PTF, high BD/low PTF, and high BD/high PTF. Affect and disordered eating were examined as covariates of state transitions. Results showed high BD states were self-perpetrating, such that when in high BD states, transition to low BD states were less likely. Regarding covariates, positive affect buffered against maladaptive transitions whereas negative affect and disordered eating increased risk. Findings highlighted high BD states as influential, and negative affect and disordered eating as risk factors and positive affect as preventive. This study enhances theory of thought-shape fusion and implicates transitions from BD to PTF as possible underlying transitions.
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Affiliation(s)
- Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States.
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, United States
| | - Ross D Crosby
- Department of Biobehavioral Research, Sanford Health, Fargo, ND, United States; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, United States
| | - Scott G Engel
- Department of Biobehavioral Research, Sanford Health, Fargo, ND, United States; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, United States
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Stephen A Wonderlich
- Department of Biobehavioral Research, Sanford Health, Fargo, ND, United States; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, United States
| | - Haomiao Jin
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
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46
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Mason TB, Smith KE, Crosby RD, Dvorak R, Engel SG, Crow S, Wonderlich SA, Peterson CB. Self-discrepancy as a Predictor of Eating Disorder Symptoms: Findings from Two Ecological Momentary Assessment Studies of Adults with Binge Eating. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10279-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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47
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Sim L, Peterson CB. The peril and promise of sensitivity in eating disorders. Int J Eat Disord 2021; 54:2046-2056. [PMID: 34536033 DOI: 10.1002/eat.23606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 01/04/2023]
Abstract
Differential susceptibility, a reconceptualization of the diathesis-stress model of psychopathology, describes gene-environment interactions that reflect individual differences in responsiveness to environmental influences, both detrimental and beneficial. This model has been described metaphorically by the classification of orchids, which thrive under optimal care but wither under adverse conditions, and dandelions, which weather broad environmental circumstances but are less responsive to careful cultivation. Etiological research in the field of eating disorders has largely focused on the identification of specific behavioral phenotypes, temperamental traits, genotypes and neurobiological processes that confer risk. In this article, we propose that these putative vulnerability factors represent phenotypes and endophenotypes of a genetic predisposition towards environmental sensitivity. We assert that this sensitivity not only transmits eating disorder risk but also confers resilience, depending on the circumstances. In particular, we propose that differential susceptibility can be used as a framework to organize disparate temperamental and neurobiological findings and their complex interplay with various developmental, environmental and sociocultural influences to increase eating disorder risk and treatment responsiveness. Finally, we assert that viewed through the lens of differential susceptibility, sensitivity can be leveraged to refine our interventions and develop novel treatment and prevention strategies to support favorable outcomes for individuals with eating disorders.
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Affiliation(s)
- Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, Minnesota, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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48
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Kot E, Grzegorzewski P, Kostecka B, Kucharska K. Self-disgust and disgust sensitivity are increased in anorexia nervosa inpatients, but only self-disgust mediates between comorbid and core psychopathology. EUROPEAN EATING DISORDERS REVIEW 2021; 29:879-892. [PMID: 34655142 DOI: 10.1002/erv.2862] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The possible role of abnormal disgust processing in the development and course of anorexia nervosa (AN) has been emphasized in theoretical models and research. However, disgust toward external stimuli and self-disgust have not yet been investigated together in a clinical sample of AN patients. Therefore, the purpose of the study was to measure these constructs and examine their role in shaping eating pathology in AN patients and healthy controls (HCs), considering comorbid depressive and anxiety psychopathology. The study also aimed at testing the possible mediational roles of both disgust types in the associations between comorbid psychopathology and eating disorders (EDs) characteristics. METHOD Altogether, 63 inpatients with AN and 57 HCs partook in the study. Participants completed the Eating Disorder Inventory-3, State-Trait Anxiety Inventory, Beck Depression Inventory-II, Disgust Scale-Revised and Self-Disgust Scale. RESULTS AN patients manifested higher self-disgust and disgust sensitivity than HCs. In addition, self-disgust predicted the severity of EDs characteristics and mediated the links of depressive symptoms and trait anxiety with EDs characteristics in both groups. DISCUSSION Our findings imply the putative role of self-disgust in the development of EDs psychopathology in HCs and in its maintenance in AN patients.
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Affiliation(s)
- Emilia Kot
- Department of Neuroses, Personality Disorders, and Eating Disorders, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Piotr Grzegorzewski
- Department of Neuroses, Personality Disorders, and Eating Disorders, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Barbara Kostecka
- II Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Kucharska
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
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49
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Kerver GA, Bond DS, Crosby RD, Cao L, Engel SG, Mitchell JE, Steffen KJ. Pain is adversely related to weight loss maintenance following bariatric surgery. Surg Obes Relat Dis 2021; 17:2026-2032. [PMID: 34600842 DOI: 10.1016/j.soard.2021.08.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Pain and obesity are frequently co-morbid health conditions; thus, it is unsurprising that pain is commonly experienced by individuals seeking bariatric surgery. While pain is generally reduced in the short-term after surgery, there is also variability in pain outcomes and less is known about how unresolved or recurring pain may relate to long-term weight loss and weight loss maintenance. OBJECTIVES This study evaluated trajectories of pain scores through 7 years following bariatric surgery and whether higher pain levels related to poorer weight loss and greater weight regain. SETTING Data were collected from 3 university hospitals, 1 private not-for-profit research institute, and 1 community hospital. METHODS Self-report measures of pain and weight change data were utilized for 1702 adults seeking Roux-en-Y gastric bypass surgery from the Longitudinal Assessment for Bariatric Surgery (LABS) cohort. A series of linear mixed models examined trajectories of pain scores and the concurrent predictive relationship between pain and weight outcomes from pre-surgery through 7 years post-surgery. RESULTS Overall bodily-, hip-, and knee-pain improved through 2 years, deteriorated from 2-5 years, and then slightly improved from 5-7 years following surgery (P < .001). Greater pain was concurrently associated with less weight loss and greater weight regain over time (P ≤ .006). CONCLUSION Pain is evident in the long-term following bariatric surgery and associated with suboptimal weight outcomes. More research is needed to identify mechanisms underlying this relationship, which may ultimately help develop appropriate pain assessment and treatment strategies to ensure optimal post-surgery outcomes.
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Affiliation(s)
- Gail A Kerver
- Sanford Center for Bio-behavioral Research, Fargo, North Dakota; Department of Psychiatry, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota.
| | - Dale S Bond
- Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, Rhode Island
| | - Ross D Crosby
- Sanford Center for Bio-behavioral Research, Fargo, North Dakota; Department of Psychiatry, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Li Cao
- Sanford Center for Bio-behavioral Research, Fargo, North Dakota
| | - Scott G Engel
- Sanford Center for Bio-behavioral Research, Fargo, North Dakota; Department of Psychiatry, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - James E Mitchell
- Sanford Center for Bio-behavioral Research, Fargo, North Dakota; Department of Psychiatry, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Kristine J Steffen
- Sanford Center for Bio-behavioral Research, Fargo, North Dakota; Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota
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Kaiser T, Butter B, Arzt S, Pannicke B, Reichenberger J, Ginzinger S, Blechert J. Time-Lagged Prediction of Food Craving With Qualitative Distinct Predictor Types: An Application of BISCWIT. Front Digit Health 2021. [DOI: 10.3389/fdgth.2021.694233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Food craving (FC) peaks are highly context-dependent and variable. Accurate prediction of FC might help preventing disadvantageous eating behavior. Here, we examine whether data from 2 weeks of ecological momentary assessment (EMA) questionnaires on stress and emotions (active EMA, aEMA) alongside temporal features and smartphone sensor data (passive EMA, pEMA) are able to predict FCs ~2.5 h into the future in N = 46 individuals. A logistic prediction approach with feature dimension reduction via Best Item Scale that is Cross-Validated, Weighted, Informative and Transparent (BISCWIT) was performed. While overall prediction accuracy was acceptable, passive sensing data alone was equally predictive to psychometric data. The frequency of which single predictors were considered for a model was rather balanced, indicating that aEMA and pEMA models were fully idiosyncratic.
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