Avoidant coping moderates the relationship between stress and depressive emotional eating in adolescents

Emotional Eating in College Students: Associations with Coping and Healthy Eating Motivators and Barriers

BACKGROUND

Emotional eating, or eating in response to stress and other negative affective states, bears negative consequences including excessive weight gain and heightened risk of binge eating disorder. Responding to stress with emotional eating is not universal, and it is important to elucidate under what circumstances and by what mechanisms stress is associated with emotional eating. This is particularly important to understand among college students, who are at risk of experiencing heightened stress and negative changes to dietary habits.

METHOD

The present study investigated the relationships among perceived stress, emotional eating, coping, and barriers to and motivators of healthy eating both concurrently and 1 year later in a sample of young adult college students (n = 232).

RESULTS

At baseline, emotional eating was significantly associated with perceived stress (r = 0.36, p < .001), barriers to (r = 0.31, p < .001) and motivators of (r =  - 0.14, p < .05) healthy eating, and avoidance coping (r = 0.37, p < .001), but not approach coping. Furthermore, avoidance coping mediated (indirect effect b = 0.36, 95% CI = 0.13, 0.61) and moderated (b =  - 0.07, p = 0.04) the relationship between perceived stress and emotional eating. Contrary to study hypotheses, baseline stress levels were not associated with emotional eating 1 year later.

CONCLUSION

College students who utilize avoidance coping strategies may be particularly susceptible to the effects of stress on emotional eating. Healthy eating interventions targeting college students might address stress coping strategies in addition to reduction of barriers to healthy eating.

The Relationship Between Religious Orientation, Coping Strategies and Suicidal Behaviour

The aim of this study was to investigate the relationship between religious orientation, coping strategies and suicidal behaviour among secondary school adolescents and college students. A total of 196 participants (73 adolescents and 123 adults college students) completed the online survey consisting of the Religious-Orientation Scale-Revised, Brief COPE and Suicidal Behaviours Questionnaire-Revised. Adolescents in secondary school had higher odds of suicidal thoughts and behaviour than college students (OR 4.40, 95% CI: 1.133, 17.094, p = 0.032). Individuals who employed an avoidant coping strategy had higher odds of suicidal thoughts and behaviour after adjusting for other relevant variables, which indicated that when a person engages in avoidant coping strategy, it is most likely that they have a higher odds of suicidal thoughts and behaviour (OR 1.118, 95% CI: 1.050, 1.189, p < 0.001). There is an urgent need to initiate psychological interventions to reduce suicide behaviour risk among Malaysian secondary school adolescents.

Early life influences on the development of food addiction in college attending young adults

PURPOSE

There is little investigation into the causes of food addiction. The aim of this study was to determine the impact of early life influences on the development of food addiction in college-attending young adults aged 18-29.

METHODS

This study utilized a sequential explanatory mixed-methods research design. College-attending young adults were invited to complete an online survey measuring Adverse Childhood Experiences (ACEs), food addiction, depression, anxiety, stress, and demographic information. Correlations between food addiction and the other variables were analyzed and significant variables were placed into a nominal logistic regression model to predict the development of food addiction. Participants who met the criteria for food addiction were invited to participate in interviews to examine their childhood eating environment and when their symptoms emerged. Interviews were transcribed and thematically analyzed. Quantitative analysis was conducted using JMP Pro Version 16.0 and qualitative analysis was conducted using NVIVO Software Version 12.0.

RESULTS

Survey respondents (n = 1645) had an overall 21.9% prevalence of food addiction. Significant correlations were observed between food addiction and ACEs, depression, anxiety, stress, and sex (p < .01 for all). Depression was the only significant predictor of the development of food addiction (OR = 3.33 95% CI 2.19, 5.05). The most common eating environment described by interview participants (n = 36) was an emphasis on diet culture, ideal body image, and restrictive environments. Symptoms frequently emerged after transitioning into college and having the ability to make their own food choices.

CONCLUSION

These results show the impact of early life eating environments and young adulthood mental health on the development of food addiction. These findings contribute to the understanding of underlying causes of food addiction.

LEVEL OF EVIDENCE

Level V, Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Diet quality and eating behaviors of college-attending young adults with food addiction

BACKGROUND

College students are heavily influenced by their food environment and are an important population in which to study food addiction. This mixed-methods study aimed to examine diet quality and eating behaviors of college students with food addiction.

METHODS

Students attending a large university in November 2021 were invited to complete an online survey that measured food addiction, eating styles, eating disorder symptoms, diet quality, and anticipated feelings after eating. Kruskal-Wallis H determined differences between those with and without food addiction in mean scores of quantitative variables. Participants who met the symptom threshold for the presence of food addiction were invited to participate in an interview that elicited more information. Quantitative data was analyzed using JMP Pro Version 16.0 and qualitative data was thematically analyzed using NVIVO Pro Software Version 12.0.

RESULTS

Respondents (n = 1645) had a 21.9 % prevalence of food addiction. Individuals with mild food addiction had the highest scores in cognitive restraint. Those with severe food addiction had the highest scores in uncontrolled eating, emotional eating, and eating disorder symptoms. Individuals with food addiction showed significantly higher negative expectancies for healthy and junk food, lower intake of vegetables, higher intakes of added sugars and saturated fat. Interview participants had problems with sweets and carbohydrates most often and described eating until physically ill, eating in response to negative emotions, dissociation while eating, and strong negative feelings after eating.

CONCLUSION

Findings contribute to the understanding of the behaviors, emotions, and perceptions surrounding food by this population, providing potential behaviors and cognitions to target for treatment.

A predictor of emotional eating in adolescents: Social anxiety

This descriptive, cross-sectional study was conducted to determine the effect of social anxiety on emotional eating in adolescents. The sample consisted of 1027 adolescents between aged 14-18 studying in the 9-12th grades of the high schools in the Central Anatolia Region in the 2018-2019 academic year. Ethics Committee and institutional permission was obtained in this study, data were collected by a questionnaire, the Social Anxiety Scale for Children-Revised (SASC-R), and The Emotional Eating Scale Adapted for Use in Children and Adolescents (EES-C). Data were analyzed using descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test and simple linear regression analysis. Adolescents had a mean SASC-R and EES-C score of 43.49 ± 16.56 and 61.93 ± 18.68, respectively. It was found that there was a relationship between EES-C mean scores and SASC-R mean scores, and they explained 35.0 % of the scores they got from the EES-C scale (p < 0.05). In conclusion, adolescents had moderate emotional eating and social anxiety. The higher the social anxiety, the higher the emotional eating. School personnel, parents and healthcare professionals need education about social anxiety and eating disorders in adolescents in order to detect symptoms early and intervene to better support adolescents struggling with social anxiety.

Coping in adolescents: A mediator between stress and disordered eating

BACKGROUND

Adolescence is a developmental period that can place individuals at heightened risk of engaging in disordered eating patterns. Stress and coping have been included as etiological factors of eating pathology, yet the mechanism of this relationship in adolescent males and females remains understudied.

AIMS

This study investigated the role of coping as a mediator in the stress-disordered eating relationship in a sample of adolescents.

DEMOGRAPHICS/SETTINGS

Participants included 2262 grade 7-12 students from a larger cross-sectional study entitled, Research on Eating and Adolescent Lifestyles (REAL).

METHODOLOGY/ANALYSES

Participants completed measures of perceived stress, life stressors, coping style, and disordered eating. Multiple mediator models of coping were analyzed to examine the extent to which coping mediated the stress-disordered eating relationship, for males and females separately.

FINDINGS

Emotion-oriented coping was a significant partial mediator in the relationship between stress (perceived stress, life stressors) and disordered eating in male and female adolescents. Findings suggest adolescents experiencing high stress tend to engage in emotion-oriented coping, which may lead to greater levels of disordered eating.

IMPLICATIONS

Interventions targeting effective coping strategies for dealing with different stress types may prevent youth from disordered eating, thus reducing their risk of eating disorders during a vulnerable period in development.

A Comparison of Emotional Triggers for Eating in Men and Women with Obesity

OBJECTIVE

Emotional eating (EE) is prevalent in people seeking obesity treatment and is a contributor to poor weight loss outcomes. We aimed to delineate the emotions most associated with this type of eating, and whether they differ by sex in people undergoing obesity treatment.

METHODS

A cross-sectional study recruiting 387 adults from a hospital obesity management service. Emotional eating was measured using the Emotional Eating Scale (EES). Separate analyses included all participants, and those undergoing lifestyle interventions alone or in combination with obesity medication and/or bariatric surgery.

RESULTS

A total of 387 people (71% women) participated in the study (n = 187 receiving lifestyle modification alone; n = 200 in combination with additional treatments). Feeling 'bored' was most commonly and most strongly associated with the urge to eat, regardless of sex or treatment. Women had higher scores for total EES, for subscales of depression and anger, and individual feelings of 'blue', 'sad' and 'upset' compared to men.

CONCLUSIONS

Understanding why certain emotions differentially trigger an urge to eat in men and women, and finding strategies to break the link between boredom and eating may enable better personalisation of lifestyle interventions for people with obesity.

Body mass index and attention bias of food cues in women: a mediation model of body weight dissatisfaction

Food attention bias could be used to indicate diet-related diseases in individuals with obesity. The purpose of this study is to explore the relationship between body mass index (BMI) and food attention bias, and the mediating role of body weight dissatisfaction (BWD) on this relationship in women. Seventy-five participants were recruited to complete a visual dot task with eye tracking. The results showed that BMI would positively predict response latency and duration bias on high-calorie foods; the relationship between BMI and response latency of high-calorie food was a complete mediation of BWD; the relationship between BMI and duration bias of high-calorie food was a complete mediation of BWD; and BWD positively predicts response latency and duration bias on high-calorie foods. These findings suggest a positive relationship between BMI and food attention bias, and the effect of a complete mediation of BWD in women.

Children and Adolescents Dietary Habits and Lifestyle Changes during COVID-19 Lockdown in Italy

Background: We evaluated the changes in lifestyle during the COVID-19 pandemic lockdown in a sample of children and adolescents in order to assess any increase in risk factors for the onset of cardiovascular diseases in later ages. Methods: We conducted a cross-sectional study involving 965 parents who completed an online survey about dietary habits and lifestyle during the first lockdown in Italy (from 9 March 2020 to 18 May 2020) and compared their findings with the period before the pandemic. The inclusion criteria were parents (or caregivers) with Italian residency and with children aged between 5 and 18 years. Results: We identified 563 adolescents and 402 children. The mean age was 12.28 years (SD 3.754). The pandemic was associated with an increase in the consumption of high-calorie snack foods. The total amount of food in homes during lockdown compared with before the pandemic increased 50%. Relating to the parent-perceived child weight status, more parents reported obesity in their children after lockdown (+0.6% in the 5–11 age group and +0.2% in the 12–18 age group). We reported a reduction of physical activity, an increase of sedentary lifestyle and sleep habits changes. Conclusion: The COVID-19 pandemic was associated with changes in the lifestyles of children and adolescents; this could cause an increase in the incidence of obesity and of cardiovascular and metabolic diseases in adulthood.

Interaction Effects of DRD2 Genetic Polymorphism and Interpersonal Stress on Problematic Gaming in College Students

Problematic gaming has become a public concern, influenced both by genetic factors and stressful environments. Studies have reported the effects of dopamine-related genes and interpersonal stressors on problematic gaming, but gene and environment interaction (G × E) studies have not been conducted. In this study, we investigated the interaction effects of dopamine receptor D2 (DRD2) polymorphisms and interpersonal stress on problematic gaming and the mediating effect of avoidant coping to reveal the mechanism of the G × E process. We recruited 168 college students (mean age = 22; male 63.1%) and genotyped their DRD2 C957T (rs6277) and Taq1 (rs1800497) polymorphisms. The results of the mediated moderation analysis showed that, when experiencing interpersonal stressors, individuals with both the C957T T allele and the Taq1 A1 allele showed more elevated problematic gaming scores than non-carriers. Moreover, the interaction effect of the combined DRD2 polymorphisms and interpersonal stress was significantly mediated by avoidant coping. These findings suggest that the influence of interpersonal stress on problematic gaming can be changed as a function of DRD2 genotypes, which may be because of the avoidant coping styles of C957T T allele and Taq1 A1 allele carriers in response to stress.

Comparison of Food-Based and Music-Based Regulatory Strategies for (Un)Healthy Eating, Depression, Anxiety and Stress

There are many ways to regulate emotions. People use both adaptive (e.g., regulation by music) and maladaptive (e.g., regulation by food) strategies to do this. We hypothesized that participants with a high level of food-based regulatory strategies and a low level of music-based regulatory strategies (a group with the least adaptive form of emotion regulation) would have significantly greater levels of unhealthy eating behaviours, depression, anxiety and stress, as well as a significantly lower level of healthy eating behaviours than those with a low level of food-based regulatory strategies and a high level of music-based regulatory strategies (a group with the greatest adaptive form of emotion regulation). Participants (N = 410; M_age = 31.77, SD = 13.53) completed: the Brief Music in Mood Regulation Scale, the Emotional Overeating Questionnaire, the Healthy and Unhealthy Eating Behavior Scale, the Depression, Anxiety and Stress Scale and a socio-demographic survey. The four clusters were identified: (a) Cluster 1 (N = 148): low food-based regulatory strategies and high music-based regulatory strategies; (b) Cluster 2 (N = 42): high food-based regulatory strategies and high music-based regulatory strategies; (c) Cluster 3 (N = 70): high food-based regulatory strategies and low music-based regulatory strategies; (d) Cluster 4 (N = 150): low food-based regulatory strategies and low music-based regulatory strategies. Overall, our outcomes partially support our hypothesis, as higher levels of unhealthy eating behaviours, depression, anxiety and stress were observed in participants with high food-based and low music-based regulatory strategies as compared with adults with low food-based and high music-based regulatory strategies. To sum up, the results obtained indicate that during the COVID-19 pandemic the group of people regulating their emotional state and unhealthy eating predominantly with food is potentially characterized by worse functioning than the group of people regulating with music. Therefore, it can be concluded that people who regulate their functioning using food should be included in preventive measures by specialists. During the visit, psychologists and primary care physicians can ask patients about their daily strategies and based on this information specialists can estimate the potential risk of developing high levels of stress and anxiety, depressive disorders and unhealthy eating habits and provide specific (match) intervention.

Mindfulness-based intervention in adolescents at risk for excess weight gain: 1.5-year follow-up of pilot randomized controlled trial

BACKGROUND

Mindfulness-based intervention (MBI) may offer a novel means of preventing excess weight gain in adolescents, theoretically by decreasing stress-eating through altering executive functioning (EF) and food-reward sensitivity.

METHODS

N = 54 12-17y girls and boys at-risk for excess weight gain (i.e., BMI ≥70th percentile or two biological parents with reported obesity [BMI ≥30 kg/m2]) participated in a 1.5-year follow-up of a pilot randomized controlled trial comparing 6-week/6-session MBI (n = 29) and a health education (HE) control (n = 25). Laboratory stress-eating, food-reward sensitivity, EF, perceived stress, and BMI/adiposity were re-assessed at 1.5-years with validated measures. Changes from baseline to 1.5-year follow-up were explored with ANCOVA, accounting for the respective baseline outcome, age, and sex.

RESULTS

Compared to MBI (M = -21, SE = 59), HE had greater increases in stress-eating from baseline to 1.5-years (M = 194, SE = 63, Cohen's d = 0.59, p = .01). There were no other between-condition differences.

DISCUSSION

MBI may prevent worsening stress-eating for adolescents at-risk for excess weight gain. The potential for MBI as an intervention for stress-eating and ultimately, weight stabilization warrants testing in an adequately-powered trial.

Digital risks and adolescents: The relationships between digital game addiction, emotional eating, and aggression

Nowadays, weight gain and obesity are major health-threatening issues for children. Emotional eating, a negative health condition that can lead to obesity in children, is a defence mechanism for coping with negative emotions. This cross-sectional study aimed to evaluate the relationships between emotional eating behaviour and digital game addiction, which can cause stress and aggression in adolescents. This study was conducted with 856 adolescents from the Mediterranean region of Turkey. The data were collected using a personal information form, the Buss-Perry Aggression Questionnaire (BPAQ), the Digital Game Addiction Scale (DGAS-7), and the Emotional Eating Scale (EES). In this study, 32.4% of the adolescents were addicted to digital games. The male adolescents had higher BPAQ, DGAS, and EES mean scores. There was also a relationship between digital game addiction, aggressive behaviour, and emotional eating. This is a significant study because it shows that digital game addiction and aggressive behaviour are important determinants of emotional eating. The results of this study indicate that emotional eating is a component of digital game addiction that increases the risk of adolescent obesity.

Metacognitive beliefs and emotional eating in adolescents

PURPOSE

Metacognition refers to how people think about their own thoughts. Existing studies have found that compared to healthy controls, individuals with eating disorders manifest elevated levels of dysfunctional metacognitive beliefs. No studies to date have investigated what role metacognitive beliefs play in the manifestation of emotional eating, a well-known risk factor for the development of eating disorders. The purpose of the current study was to assess the associations between metacognitive beliefs and emotional eating in a community sample of adolescents.

METHODS

Participants were 135 middle school students (Mean age = 13.62 years; SD = 0.57) who completed the Emotional Eating Scale Adapted for Children and Adolescents-Short-Form, Metacognition Questionnaire for Children, Positive and Negative Affect Schedule for Children, and a demographic questionnaire.

RESULTS

Participants classified as high emotional eaters reported statistically significant higher negative metacognitive beliefs (Mean = 15.56; SD = 4.22) compared to participants classified as low emotional eaters (Mean = 12.85; SD = 4.31; p ≤ 0.001; t =  - 3.69). There was a significant positive association between emotional eating and negative metacognitive beliefs in the hierarchical multiple linear regression analysis (standardized beta coefficient = 0.25; p < 0.05) after controlling for socio-demographic variables and negative affect.

CONCLUSIONS

The current findings provide preliminary evidence that negative metacognitive beliefs may play a role in the manifestation of emotional eating in adolescents. Future prospective studies are needed to elucidate the temporal associations between emotional eating and negative metacognitive beliefs in this population.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

Stress-Induced Eating Among Racial/Ethnic Groups in the United States: a Systematic Review

OBJECTIVE

Racial/ethnic disparities in obesity may be due, in part, to minority groups consuming more energy-rich diets in response to greater stress exposure. The present study systematically reviewed the literature describing the effects of stress on food consumption among various racial/ethnic groups in the US.

METHODS

PubMed and PsycINFO databases were searched for studies reporting associations between stress and food consumption by different racial/ethnic groups, conducted between January 1, 1999 to November 25, 2019. The search included terms related to food consumption, stress, and race/ethnicity. After screening 3660 records, 30 studies were included for review.

RESULTS

The selected studies assessed diverse stressors and eating constructs; African-American and Hispanic/Latinx were the most commonly studied minority groups. Studies generally supported that diverse forms of stress exposure are associated with reduced healthy eating patterns and increased obesogenic eating patterns across racial/ethnic groups. However, studies that directly compared stress-eating associations among multiple racial/ethnic groups showed mixed results.

CONCLUSION

Members of diverse racial/ethnic groups are susceptible to stress-induced unhealthy eating patterns, though evidence is insufficient to conclude whether the degree of susceptibility differs among groups. Additional studies utilizing observational measures of food intake and culturally sensitive measures of stress are needed to identify the most influential stressors on dietary behaviors, to assess whether some stressors are more salient for given racial/ethnic groups, and to examine the extent to which stress-induced eating contributes to racial/ethnic disparities in obesity and obesity-related diseases.

The impact of food-related behaviours and emotional functioning on body mass index in an adult sample

PURPOSE

The aim of this study was to evaluate the impact of food-related behaviours (emotional eating, snacking) and emotional functioning (negative emotions, stress, emotional dysregulation) on body mass index in an adult sample. Direct and indirect relationships of the above-mentioned variables were examined.

METHODS

The total sample comprised 298 adults. All participants completed the Difficulties in Emotion Regulation Scale, the Positive and Negative Affect Schedule, the Feeling of Stress Questionnaire and the Three-Factor Eating Questionnaire.

RESULTS

Our findings showed that food-related behaviours and emotional functioning are related to body mass index in adults. In addition, emotional dysregulation and negative emotions did not have direct impact on snacking. Moreover, snacking did not have a direct impact on body mass index. However, snacking had an indirect effect on body mass index (through emotional eating). The other relationships were significant and consistent with the hypothesised positive direction.

CONCLUSION

We found significant relationships among (almost all) food-related behaviours, emotional functioning and body mass index in adults. However, future research on pathways from negative emotions/emotional dysregulation to snacking and from snacking to BMI should be conducted.

LEVEL OF EVIDENCE

Level V, descriptive study.

Convergent and discriminant validity of the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) Short-Form

BACKGROUND

Emotional eating is associated with a number of negative outcomes in children and adolescents, including higher levels of loss of control eating (i.e., the inability to control the amount of food consumed). There is a need for psychometrically sound and feasible measures that assess emotional eating in children and adolescents. The purpose of the current study was to evaluate the convergent and discriminant validity of the 10-item Emotional Eating Scale Adapted for Children and Adolescents (EES-C) Short-Form in a community sample of adolescents. We also sought to assess the reliability and structural validity of this measure.

METHODS

Participants were 128 adolescents ages 13 to 19 years (mean age = 15.10 years; SD = 2.09; 53.9% female). Most participants fell within the healthy BMI range (58.6%). Participants completed the EES-C Short-Form, the loss of control eating section of the Questionnaire on Eating and Weight Patterns-Adolescent Version 5, the Gratitude Questionnaire-Six-Item Form, and a demographic questionnaire.

RESULTS

Convergent validity of the EES-C Short-Form was supported in that adolescents who endorsed loss of control eating reported significantly greater levels of emotional eating (mean = 24.37; SD = 8.94) compared to adolescents who did not endorse loss of control eating (mean = 19.42; SD = 7.33; p ≤ .01; d = 0.61). The EES-C Short-Form was significantly correlated with a subjective measure of loss of control eating (r_s = -0.255; p = .004), further demonstrating convergent validity. The EES-C Short-Form exhibited discriminant validity as demonstrated by a small, non-significant correlation with the Gratitude Questionnaire-Six-Item Form (r_s = 0.086; p = .347). The EES-C Short-Form demonstrated acceptable reliability (Cronbach's alpha = 0.84; Ordinal alpha = 0.88; Coefficient omega = 0.85) and a unidimensional factor structure (CFI = 0.98; NNFI = 0.98; RMSEA = 0.08).

CONCLUSIONS

These data contribute to the existing research that support the EES-C Short-Form as a reliable and valid measure for assessing emotional eating in children and adolescents.

The behavioral pathway model to overweight and obesity: coping strategies, eating behaviors and body mass index

PURPOSE

Obese and overweight people deal with more daily problems and stressful situations than normal-weight individuals, for example, discrimination and bias. The aims of the present study were twofold: to identify differences between overweight and normal-weight people in coping strategies and eating behaviors, and to examine the relationship between coping strategies, eating behaviors and BMI.

METHODS

Sample of the present study consisted of 473 participants, 76.7% women (mean age = 32.7; SD = 11.4). Participants completed an ad hoc sociodemographic data questionnaire, the Coping Strategies Inventory, and the Dutch Eating Behavior Questionnaire. Welch's t test and X² comparison analysis were used to identify differences in coping strategies and eating behaviors, according two BMI groups, normal weight and overweight. To analyze the relationship between coping strategies, eating behaviors and BMI, a structural equation modeling was conducted.

RESULTS

Overweight participants score significantly higher in passive coping strategies such as self-criticism, wishful thinking and social withdrawal, and unhealthy eating behaviors such as emotional eating and restrained eating. Structural equation modeling included these variables, coping strategies are more likely to conduct to unhealthy eating behaviors and these are more likely to promote and maintain a high BMI. The model showed an adequate data fit.

CONCLUSIONS

This research proposes a relationship between the variables analyzed. It has been proved that passive coping strategies predict a high BMI via unhealthy eating behaviors, especially emotional eating. These results are promising to improve the current prevention obesity programs and weight control treatments.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

The Emotional Eating Scale Adapted for Children and Adolescents (EES-C): development and preliminary validation of a short-form

The 25-item Emotional Eating Scale for children and adolescents (EES-C) is a psychometrically sound instrument that measures the extent to which youth eat in response to negative emotions. Nonetheless, questionnaire length may serve as a barrier to routine administration in clinical and school settings, and diminish the likelihood of the measure being utilized in population-wide health studies. The present study reported on the development and preliminary validation of a short-form of EES-C using data from two previously published studies. Guidelines for the development of short-form questionnaires, content and factor analyses, and other indices including standard deviations, item-total correlations, inter-item correlations, Cronbach's alpha without the item, and floor/ceiling effects were examined to develop a 10-item EES-C Short-Form. The EES-C Short-Form demonstrated acceptable psychometric properties, including good internal consistency reliability (alpha = .87) and a high degree of overlapping variance with the original EES-C Total Score and Subscale Scores (r = .71 to .96). The EES-C Short-Form also manifested a unidimensional factor structure in an Exploratory Factor Analysis, supporting construct validity. Taken together, results from the current study provide preliminary evidence of the reliability and validity of a 10-item EES-C Short-Form.

How does psychosocial stress affect the relationship between socioeconomic disadvantage and overweight and obesity? Examining Hemmingsson's model with data from a Danish longitudinal study

Background

Chronic stress in childhood may increase the risk of overweight and obesity in young people. Erik Hemmingsson has suggested a new obesity causation model which focuses on psychosocial stress.

The aim was to examine the associations between socioeconomic disadvantage and overweight and obesity and examine if these associations attenuate, when the effect of the different domains from Eric Hemmingsson’s obesity causation model were taken into account.

Methods

A longitudinal study using data from The West Jutland Cohort Study (N = 2879). Outcome was overweight and obesity combined derived from self-reported weight and height at age 15, 18, 21 and 28 years. Exposure variables were equivalised household income, educational level and labour market participation of the mother derived from registers and psychosocial variables derived from questionnaires. A three-step adjustment model using logistic regression and stratified by gender was applied.

Results

Mother’s low educational level was associated with a 3-fold increased odds of obesity in 18 year-old-girls, which attenuated when adjusting for the domains adult distress, disharmonious family environment and offspring distress. In 28 year-old girls, a 2.5-fold increased odds of obesity was observed, which attenuated when mutual adjusted for other socioeconomic variables and attenuated even further when adjusting for all the domains. In 18-year-old boys, a 3-fold increased odds of obesity was observed which attenuated after adjustments for adult distress, disharmonious family environment and offspring distress. In 21-year old boys, a four-fold increased odds of obesity was observed that attenuated after adjustments. At age 28 years, a three-fold increased odds of obesity was observed, which vanished in the fully adjusted model.

Conclusions

Our study confirms to some extent that the associations between socioeconomic disadvantage and overweight and obesity can be explained by the domains included in Erik Hemmingsson’s model, although our results should be interpreted with caution. Adult distress, disharmonious family environment and offspring distress accounted for some of the association in girls, whereas in boys it was primarily offspring distress, which had the greatest impact. Young people’s educational attainment can act as a buffer in the relationship between mother’s lower educational level and obesity at age 28 years.

Acculturative stress and emotional eating in Latino adolescents

PURPOSE

Despite data that suggest Latino adolescents experience acculturative stress (i.e., feeling overwhelmed by conflicting cultural practices, language problems, and ethnic self-consciousness) and endorse elevated levels of emotional eating, there has been an absence of research examining the relations between acculturative stress and emotional eating in this population. The purpose of the present study was to (1) examine the associations between acculturative stress, emotional eating, and change in BMIz scores in Latino adolescents over a 3-month period, and (2) compare Latino and non-Latino adolescents on measures of acculturative stress, emotional eating, and body mass index (BMI).

METHODS

The sample comprised 168 Latino (mean age 13.69 years; SD 0.88) and 278 non-Latino (mean age 13.68 years; SD 0.79) middle and high school students. Participants completed the Emotional Eating Scale for Children and Adolescents (EES-C), the Social, Attitudinal, Familial, and Environmental Acculturative Stress Scale for Children (SAFE-C), and a demographic questionnaire. Participants had their height and weight measured after completing the questionnaires and at a second-time point, approximately 3 months after time 1 measurements. Independent samples t tests and Cohen's d effect sizes were used to investigate whether there were differences between Latino adolescents and non-Latino adolescents. Pearson correlations were computed to examine associations between acculturative stress, emotional eating, and change in BMIz scores in the Latino sample.

RESULTS

Latino adolescents endorsed significantly higher acculturative stress on the SAFE-C compared to non-Latino adolescents (Latino mean 30.81; non-Latino mean 25.64; p < 0.001; Cohen's d effect size = 0.35). In the Latino sample, acculturative stress was associated with higher levels of emotional eating. Latino and non-Latino adolescents endorsed similar levels of emotional eating.

CONCLUSIONS

The present findings provide preliminary evidence that acculturative stress may serve as a risk factor for emotional eating among Latino adolescents. Future obesity prevention and intervention programs developed for Latino adolescents may benefit from addressing acculturative stress, particularly among more recent Latino immigrants.

LEVEL OF EVIDENCE

Level 3, case-control analytic study.

Disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents

PURPOSE

The aim of this study was to examine the relationship between disordered eating attitudes and emotional/behavioral adjustment in Greek adolescents as well as the moderating role of gender and body mass index (BMI) in this relationship.

METHODS

Ninety adolescents, 11-18 years old, were assessed using anthropometric measurements; demographics, eating attitudes and level of emotional/behavioral adjustment were examined via self-reported questionnaires.

RESULTS

Disordered eating attitudes were prevalent in 17.8% of the sample. A significant relationship was found between disordered eating attitudes and Youth Self-Report (YSR) anxiety score (r = .22, p < .05). Gender significantly moderated the relationship between YSR anxiety symptoms and Eating Attitudes Test (EAT) scores (b = .59, p = .01) and this effect held true for the EAT bulimia subscale (b = .20, p = .03), but not for the dieting or the oral control subscales. Contrary to our hypothesis, BMI did not moderate the relationship between EAT and YSR anxiety sub-scores (b = .13, p > .05).

CONCLUSION

Girls with elevated anxiety levels appear to be at risk for exhibiting disordered eating attitudes, especially bulimic behaviors. This finding highlights the importance of developing gender-based preventive interventions tailored to these specific emotional/behavioral aspects.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.