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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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2
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Perelman H, Gilbert K, Grilo CM, Lydecker JA. Loss of control in binge-eating disorder: Fear and resignation. Int J Eat Disord 2023; 56:1199-1206. [PMID: 36920120 PMCID: PMC10247475 DOI: 10.1002/eat.23929] [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: 10/31/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Binge-eating disorder involves overeating while feeling a loss of control (LOC). Emotions around LOC appear to vary; some patients fear LOC whereas others feel powerless or "resigned" to LOC. This study examined differences in psychopathology among treatment-seeking patients with binge-eating disorder categorized with fear of LOC, resignation to LOC, and no fear/resignation of LOC. METHOD Doctoral research clinicians administered diagnostic and semistructured interviews to characterize psychopathology and establish a diagnosis of binge-eating disorder in participants (N = 382). The interview assessed fear of LOC in the past month. Further queries assessed whether, in the absence of fear of LOC, patients were resigned to LOC or had no fear/resignation. RESULTS Patients with fear of LOC and resigned to LOC endorsed significantly greater global eating-disorder psychopathology than patients with no fear/resignation. Patients with fear of LOC reported greater distress about binge eating and greater depression than those with no fear/resignation. Patients resigned to LOC reported significantly more frequent binge-eating episodes than those with fear of LOC and no fear/resignation. Black individuals and men were more likely to report no fear/resignation than other demographic groups. DISCUSSION This study describes a novel clinical aspect of binge-eating disorder: resignation to LOC. Findings highlight the importance of including anticipatory cognitive-affective experiences in treatment formulations and planning. Future research should examine co-occurrence of these experiences and their association with impairment. Future research should also examine how fear of LOC and resignation to LOC change during treatment and whether they predict or moderate treatment outcomes. PUBLIC SIGNIFICANCE Adults with binge-eating disorder have anticipatory cognitive-affective experiences about loss of control (LOC) over eating (i.e., fear of LOC, resigned to LOC, no fear nor resignation of LOC). Individuals who experience fear of LOC and those who are resigned to LOC had more severe psychopathology than those without fear/resignation. Binge-eating disorder has the highest prevalence of the eating disorders; thus, findings have high public significance in guiding clinicians' treatment planning.
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Affiliation(s)
- Hayley Perelman
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Counseling Psychology and Applied Human Development, Boston University, Boston, Massachusetts, USA
| | - Kelsey Gilbert
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychology, University of Hartford, Hartford, Connecticut, USA
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Janet A Lydecker
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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3
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Kelly NR, Kosty D, Williamson G, Guidinger C, Cotter EW. Social media and dating app use are differentially related to same- and next-day disordered eating pathology in young men with loss of control eating. Eat Behav 2023; 49:101735. [PMID: 37146410 DOI: 10.1016/j.eatbeh.2023.101735] [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: 10/13/2022] [Revised: 03/30/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To evaluate whether social networking site (SNS) and dating app use is associated with disordered eating in young men. METHODS 42 men (18-35y) who reported ≥4 loss of control (LOC) eating episodes in the prior month completed a 14-day ecological momentary assessment (EMA) protocol. Five times throughout the day, participants responded to prompts regarding their dietary restraint, body dissatisfaction, and LOC eating. Each night at ~10 pm, participants reported their total time spent on SNSs and dating apps/websites within the last day. RESULTS 39 out of 42 cisgender men (Mage = 25.1 ± 5.3 years; 47 % non-Hispanic White, 29 % Black or African American; 63 % non-students; 87 % heterosexual) reported using SNSs and/or dating apps. Neither SNS nor dating app use was associated with body dissatisfaction. Dating app use with associated with higher same- (r2 equivalent = 0.022, p = .003) and next-day dietary restraint (r2 equivalent = 0.016, p = .02); SNS use was not. More SNS use was associated with lower odds of same- (OR [95 % CI] = 0.86 [0.75, 0.99], p = .044) and next-day LOC eating (OR [95 % CI] = 0.82 [0.71, 0.96], p = .011); links with dating app use were non-significant. DISCUSSION Non-significant links for SNS and dating app use with body dissatisfaction, and inverse associations with LOC eating, are contrary to research conducted with girls and women. Research is needed to evaluate whether the quality of SNS and dating app engagement (e.g., specific sites) are more closely related to men's disordered eating, and this work should consider muscularity concerns.
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Affiliation(s)
- 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.
| | - Derek Kosty
- The Prevention Science Institute, University of Oregon, United States of America
| | - 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
| | - 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
| | - Elizabeth W Cotter
- Department of Health Studies, American University, United States of America
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4
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Jenkins PE, Rienecke RD. Structural validity of the Eating Disorder Examination-Questionnaire: A systematic review. Int J Eat Disord 2022; 55:1012-1030. [PMID: 35503783 PMCID: PMC9543786 DOI: 10.1002/eat.23721] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The main aim was to perform a systematic literature review of studies investigating the factor structure of the Eating Disorder Examination-Questionnaire (EDE-Q), a widely used measure of eating pathology. Secondary aims were to summarize the quality of reporting of latent variable (factor) analyses in these studies and review support for different factor solutions. METHOD Literature was identified through Scopus, Medline, PsycInfo, and ProQuest databases published up to February 23, 2022 and outreach via an international listserv. All studies published in English reporting factor analysis of the EDE-Q were included with few restrictions. Sixty studies including 63,389 participants met inclusion criteria. RESULTS The originally proposed four-factor solution received little empirical support, although few alternative models have been robustly evaluated. Items assessing shape and weight concerns frequently coalesce in factor solutions, suggesting that these constructs are closely related. Investigations of brief versions of the EDE-Q have produced more consistent findings, suggesting that these measures, particularly a seven-item version, might be useful alternatives to the full version. Quality of studies was reasonable, with important methodological elements of factor analysis often reported. DISCUSSION The findings are of relevance to practitioners and researchers, suggesting that the "original" factor structure of the EDE-Q should be reconsidered and that use of a seven-item version is to be encouraged. PUBLIC SIGNIFICANCE Self-report questionnaires are widely used in the assessment of disordered eating. The current study found that there is little consensus about the structure of a common measure of eating psychopathology. There is more consistent support for a brief, seven-item, version assessing dietary restraint, body dissatisfaction, and overvaluation of weight and shape.
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Affiliation(s)
- Paul E. Jenkins
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Renee D. Rienecke
- Eating Recovery Center/Pathlight Mood & Anxiety CentersChicagoIllinoisUSA,Department of Psychiatry and Behavioral SciencesNorthwestern UniversityChicagoIllinoisUSA
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5
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Shank LM, Moursi NA, Tanofsky-Kraff M. Loss-of-Control Eating and Cardiometabolic Health in Relation to Overweight and Obesity. Curr Diab Rep 2022; 22:257-266. [PMID: 35403985 DOI: 10.1007/s11892-022-01466-z] [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] [Accepted: 02/15/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Loss-of-control (LOC) eating, the subjective feeling of being unable to control what or how much is being consumed, is common. The purpose of this review was to examine the relationships among LOC eating, cardiometabolic health, and weight management intervention outcomes. RECENT FINDINGS In youth and adults, LOC eating is associated with and predictive of psychological symptoms, high weight, and worsened cardiometabolic health. While LOC eating pre-intervention does not appear to impact outcomes, LOC eating during or following is associated with worsened outcomes from behavioral and surgical weight management interventions. When individuals are undergoing weight management interventions, it may be important to regularly assess for LOC eating. There is limited research on the examined relationships in diverse populations (e.g., males, individuals of a lower socio-economic status, racial/ethnic minority groups). Future research should examine these relationships across the lifespan in diverse populations, with a focus on how these relationships can be impacted through targeted interventions.
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Affiliation(s)
- Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Nasreen A Moursi
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD, 20892, USA.
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR) Program, USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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6
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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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7
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Hayes JF, Schumacher LM, Panza E, Dunsiger SI, Wing RR, Unick JL. Affective responses to overeating episodes in women participating in a behavioral weight loss program. Eat Behav 2022; 44:101599. [PMID: 35144169 PMCID: PMC8901183 DOI: 10.1016/j.eatbeh.2022.101599] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/03/2022] [Accepted: 01/29/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Much research has focused on precursors to dietary lapses in weight loss programs, but less is known about how individual responses to lapses may influence future non-adherence and program success. The current study examined affective responses to overeating lapses and their influence on subsequent overeating and overall weight loss. METHODS Women (n = 60) with overweight or obesity (BMI (mean ± SD): 34.3 ± 3.9 kg/m2; age: 48.1 ± 10.1 years) participated in a 3-month group behavioral weight loss intervention (BWLI). At baseline and 3 months, participants completed anthropometric assessments and a 10-day ecological momentary assessment protocol sent 5 times per day reporting on overeating and affect (stress, shame, anxiety, and feeling good about oneself). Across time points, multilevel models were used to examine affective responses to overeating and to predict likelihood of subsequent overeating. Linear regression models were used to examine the effect of affective responses to overeating (at baseline and collapsed across time points) on weight loss. RESULTS Following self-reported overeating episodes, compared to non-overeating episodes, feeling good about oneself decreased. These decreases lessened with time from overeating. Overeating predicted subsequent overeating episodes, with decreases in feeling good about oneself following overeating marginally predicting increased likelihood (p = 0.065). Neither overeating frequency at baseline nor change in overeating frequency predicted weight loss; however, greater decreases in anxiety following overeating were associated with less weight loss. CONCLUSIONS Self-reported overeating during a BWLI was associated with negative affective responses and may have increased the likelihood of subsequent overeating, but did not affect overall weight loss in this sample.
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Affiliation(s)
- Jacqueline F. Hayes
- Alpert Medical School of Brown University, Miriam Hospital, Providence, RI, United States of America,Corresponding author at: Weight Control and Diabetes Research Center at The Miriam Hospital/Brown University, 196 Richmond Street, Providence, RI 02903, United States of America. (J.F. Hayes)
| | - Leah M. Schumacher
- Alpert Medical School of Brown University, Miriam Hospital, Providence, RI, United States of America
| | - Emily Panza
- Alpert Medical School of Brown University, Miriam Hospital, Providence, RI, United States of America
| | - Shira I. Dunsiger
- Center for Health Promotion and Health Equity, Brown School of Public Health, Providence, RI, United States of America
| | - Rena R. Wing
- Alpert Medical School of Brown University, Miriam Hospital, Providence, RI, United States of America
| | - Jessica L. Unick
- Alpert Medical School of Brown University, Miriam Hospital, Providence, RI, United States of America
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8
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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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9
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Darling KE, Rancourt D, Evans EW, Ranzenhofer LM, Jelalian E. Adolescent Weight Management Intervention in a Nonclinical Setting: Changes in Eating-Related Cognitions and Depressive Symptoms. J Dev Behav Pediatr 2021; 42:579-587. [PMID: 33660668 PMCID: PMC8408271 DOI: 10.1097/dbp.0000000000000929] [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: 06/01/2020] [Accepted: 01/01/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The present study was a secondary data analysis of a randomized controlled trial (RCT) to examine changes in depressive symptoms and eating-related cognitions in teens who participated in a nonclinic-based adolescent behavioral weight control treatment delivered by YMCA coaches. Differences in intervention effects were also examined by sex. METHODS Adolescents (N = 66; 13-17 years; 60.6% girls) with overweight (10.6%) or obesity (53.0% with severe obesity) participated in an RCT comparing 2 versions of an evidence-based intervention. Adolescents completed measures of eating-related cognitions (Eating Disorder Examination Questionnaire) and depressive symptoms (Children's Depressive Inventory-2) at baseline and end of active treatment (16 weeks). RESULTS There were no significant effects of group, time, or group by time interaction for depressive symptoms, global eating-related cognitions, dietary restraint, or eating concerns (ps > 0.05). Shape concerns (p = 0.04) and weight concerns (p = 0.02) significantly decreased over the intervention. Significant interactions between sex and time on global eating-related cognitions (p < 0.001), eating (p = 0.002), shape (p = 0.02), and weight concerns (p = 0.004) were detected such that female participants' scores decreased over the course of the treatment, but male participants' scores did not. CONCLUSION The results demonstrate some positive and no detrimental effects of a nonclinic-based behavioral weight control intervention on adolescents' eating-related cognitions and depressive symptoms. The findings may mitigate concerns that dissemination of structured, nonclinic-based weight management programs for adolescents will produce negative eating and mood outcomes; however, replication of results in larger trials is needed.
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Affiliation(s)
- Katherine E. Darling
- Weight Control and Diabetes Research Center, The Miriam Hospital; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | | | - E. Whitney Evans
- Weight Control and Diabetes Research Center, The Miriam Hospital; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Lisa M. Ranzenhofer
- Department of Psychiatry, Columbia University Irving Medical Center & New York State Psychiatric Institute
| | - Elissa Jelalian
- Weight Control and Diabetes Research Center, The Miriam Hospital; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
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10
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Development and validation of the Croatian version of the Eating Disorder Examination Questionnaire in a community sample. Eat Weight Disord 2021; 26:859-868. [PMID: 32430884 DOI: 10.1007/s40519-020-00915-6] [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: 09/18/2019] [Accepted: 05/02/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE The Eating Disorder Examination Questionnaire (EDE-Q) is one of the most commonly used tools for identification of eating disorder (ED) symptoms. The purpose of this study was to develop and validate the Croatian version of the EDE-Q 6.0. METHODS Participants were 279 individuals from a community sample (215 females; 64 males) with an average age of 24.61 ± 5.68 years. The Eating Attitudes Test-26 and Body Image Satisfaction Scale were used to determine the convergent validity of the EDE-Q. Four-, three-, two-, and single-factor models were tested, together with a brief 8-item version of the EDE-Q. RESULTS Confirmatory factor analysis yielded a better fit of the original four-factor model when compared to other models, although the best model-data fit was obtained when testing subscales individually with correlations between factors ranging from 0.30 to 0.99. However, item 10 had to be excluded from the shape concern subscale to reach an acceptable fit. Correlation analyses showed that the EDE-Q has good convergent validity, but additional calculations discovered its tendency to overestimate ED symptomatology. CONCLUSIONS This study is the first to show satisfactory psychometric properties of the Croatian version of the EDE-Q with minor modifications of the original questionnaire. The Croatian translation and validation of the EDE-Q enables researchers and clinicians in Croatia to employ the most widely and commonly used instrument for the assessment of core ED features. LEVEL OF EVIDENCE Descriptive cross-sectional study, Level V.
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11
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Examining the ecological validity of the Power of Food Scale. Eat Weight Disord 2021; 26:717-721. [PMID: 32107744 PMCID: PMC8667200 DOI: 10.1007/s40519-020-00871-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/11/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Appetite for palatable foods may impact eating-related behaviors in everyday life. The present study evaluated the real-world predictive validity of the Power of Food Scale (PFS) using ecological momentary assessment (EMA). METHODS 30 women who reported binge eating completed the PFS and related measures. Subsequently, during a 14-day assessment period, participants completed five daily EMA surveys of appetite and binge eating via text message and web. RESULTS Results of generalized estimating equations showed that higher PFS scores were associated with higher momentary levels of hunger, eagerness to eat, and urge to eat but were unrelated to fullness, preoccupation with thoughts of food, and binge eating. CONCLUSION This study supported the ecological validity of the PFS by demonstrating its association with momentary measures of appetite in everyday life using EMA. Although the PFS may not be predictive of binge eating, future research should investigate PFS as a dispositional moderator, and explore associations between the PFS and overeating (i.e., binge eating without the loss of control component) and loss of control eating in non-clinical samples. LEVEL OF EVIDENCE Level IV, multiple time series.
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12
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Panza E, Olson K, Selby EA, Wing RR. State versus trait weight, shape, and eating concerns: Disentangling influence on eating behaviors among sexual minority women. Body Image 2021; 36:107-116. [PMID: 33279785 PMCID: PMC7987775 DOI: 10.1016/j.bodyim.2020.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 10/22/2020] [Accepted: 10/28/2020] [Indexed: 01/20/2023]
Abstract
This study examined the relative influence of trait and state weight, shape, and eating concerns on dysregulated eating in the daily lives of sexual minority women with overweight and obesity. This study is a secondary analysis of data from an Ecological Momentary Assessment (EMA) study of 55 sexual minority women with overweight/obesity. Trait shape, weight, and eating concerns were assessed at baseline. For the following five days, participants used a smartphone to report state weight/shape concerns, overeating, and binge eating five times daily. Women who endorsed higher levels of trait weight, shape, and eating concerns at baseline reported more frequent state weight/shape concerns in daily life. Trait eating concerns were associated with higher odds of binge eating during EMA, but trait weight/shape concerns were unrelated to future dysregulated eating. In daily life, state weight/shape concerns was associated with greater risk for over/binge eating at the concurrent EMA prompt, the subsequent EMA prompt, and over the course of a full day, independent of trait concerns. State weight and shape concerns may play an important role in predicting dysregulated eating in daily life among sexual minority women of higher body weight.
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Affiliation(s)
- Emily Panza
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI, USA; Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
| | - KayLoni Olson
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI, USA; Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Edward A Selby
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Rena R Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI, USA; Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
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13
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Validation of the 12-item Short Form of the Eating Disorder Examination Questionnaire in the Chinese context: confirmatory factor analysis and Rasch analysis. Eat Weight Disord 2021; 26:201-209. [PMID: 31898240 DOI: 10.1007/s40519-019-00840-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/17/2019] [Indexed: 12/22/2022] Open
Abstract
PURPOSE As a 12-item Short Form of the Eating Disorder Examination Questionnaire (EDE-QS), the EDE-QS was developed based on Rasch modeling to address certain weaknesses of the EDE-Q, and it has been demonstrated to be a psychometrically sound measure. Thus, the current study aimed to obtain a Chinese version of the EDE-QS and validate its psychometric properties in the Chinese context. METHODS According to standard procedures, the Chinese version of the EDE-QS (C-EDE-QS) was obtained. A total of 1068 Chinese college students finished the survey. The psychometric properties of the C-EDE-QS were examined under the frameworks of both classic test theory and Rasch modeling. RESULTS The one-factor structure of the C-EDE-QS was confirmed in confirmatory factor analysis; the C-EDE-QS showed good reliability with a Cronbach's α of 0.89; and the total scores of the C-EDE-QS were significantly correlated with eating disturbances and psychological distress in expected magnitudes and directions. Rasch analysis supported the unidimensional construct of the C-EDE-QS and the four-point rating scale structure. However, results revealed differential item functioning (DIF) across gender groups. CONCLUSIONS The findings suggest that the C-EDE-QS could be a useful tool to assess key attitudes and behavioral features of eating disorder psychopathologies in the Chinese context. LEVEL OF EVIDENCE V, descriptive (cross-sectional) study.
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Smith KE, Mason TB, Juarascio A, Schaefer LM, Crosby RD, Engel SG, Wonderlich SA. Moving beyond self-report data collection in the natural environment: A review of the past and future directions for ambulatory assessment in eating disorders. Int J Eat Disord 2019; 52:1157-1175. [PMID: 31313348 PMCID: PMC6942694 DOI: 10.1002/eat.23124] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/31/2019] [Accepted: 06/04/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE In recent years, ecological momentary assessment (EMA) has been used to repeatedly assess eating disorder (ED) symptoms in naturalistic settings, which has allowed for increased understanding of temporal processes that potentiate ED behaviors. However, there remain notable limitations of self-report EMA, and with the rapid proliferation of technology there are ever-increasing possibilities to improve ambulatory assessment methods to further the understanding and treatment of EDs. Therefore, the purpose of this review was to (a) systematically review the studies in EDs that have utilized ambulatory assessment methods other than self-report, and (b) provide directions for future research and clinical applications. METHOD A systematic literature search of electronic databases was conducted, and data regarding study characteristics and methodological quality were extracted. RESULTS The search identified 17 studies that used ambulatory assessment methods to gather objective data, and focused primarily on autonomic functioning, physical activity, and cognitive processes in ED and control groups. DISCUSSION Together the literature demonstrates the promise of using a range of ecologically valid ambulatory assessment approaches in EDs, though there remains limited research that has utilized methods other than self-report (e.g., wearable sensors), particularly in recent years. Going forward, there are several technology-enhanced momentary assessment methods that have potential to improve the understanding and treatment of EDs.
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Affiliation(s)
- Kathryn E Smith
- Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | | | - Lauren M Schaefer
- Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota
| | - Ross D Crosby
- Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Scott G Engel
- Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Stephen A Wonderlich
- Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
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Smith KE, Juarascio A. From Ecological Momentary Assessment (EMA) to Ecological Momentary Intervention (EMI): Past and Future Directions for Ambulatory Assessment and Interventions in Eating Disorders. Curr Psychiatry Rep 2019; 21:53. [PMID: 31161276 DOI: 10.1007/s11920-019-1046-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Ambulatory assessment methods, including ecological momentary assessment (EMA), have often been used in eating disorders (EDs) to assess the type, frequency, and temporal sequencing of ED symptoms occurring in naturalistic environments. Relatedly, growing research in EDs has explored the utility of ecological momentary interventions (EMIs) to target ED symptoms. The aims of the present review were to (1) synthesize recent literature pertaining to ambulatory assessment/EMA and EMI in EDs, and (2) identify relevant limitations and future directions in these domains. RECENT FINDINGS With respect to ambulatory assessment and EMA, there has been substantial growth in the expansion of constructs assessed with EMA, the exploration of state- vs. trait-level processes, integration of objective and passive assessment approaches, and consideration of methodological issues. The EMI literature in EDs also continues to grow, though most of the recent research focuses on mobile health (mHealth) technologies with relatively minimal EMI components that adapt to momentary contextual information. Despite these encouraging advances, there remain several promising areas of ambulatory assessment research and clinical applications in EDs going forward. These include integration of passive data collection, use of EMA in treatment evaluation and design, evaluation of dynamic system processes, inclusion of diverse samples, and development and evaluation of adaptive, tailored EMIs such as just-in-time adaptive interventions. While much remains to be learned in each of these domains, the continual growth in mobile technology has potential to facilitate and refine our understanding of the nature of ED psychopathology and ultimately improve intervention approaches.
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Affiliation(s)
- Kathryn E Smith
- Center for Bio-behavioral Research, Sanford Research, Fargo, ND, USA. .,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA.
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Smith KE, Mason TB, Crosby RD, Engel SG, Crow SJ, Wonderlich SA, Peterson CB. State and trait positive and negative affectivity in relation to restraint intention and binge eating among adults with obesity. Appetite 2018; 120:327-334. [PMID: 28943474 PMCID: PMC5969992 DOI: 10.1016/j.appet.2017.09.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/16/2017] [Accepted: 09/20/2017] [Indexed: 02/05/2023]
Abstract
Restraint and binge eating are cognitive and behavioral processes that are particularly important in the context of obesity. While extensive research has focused on negative affect (NA) in relation to binge eating, it is unclear whether affective valence (i.e., positive versus negative) and stability (i.e., state versus trait) differentially predict binge eating and restraint among individuals with obesity. Distinguishing between valence and stability helps elucidate under which affective contexts, and among which individuals, restraint and binge eating are likely to occur. Therefore, the present study examined relationships between trait and state levels of NA and positive affect (PA), binge eating, and restraint intention among 50 adults with obesity (BMI ≥ 30). Participants completed baseline assessments followed by a two-week ecological momentary assessment (EMA) protocol. Structural equation modeling assessed a trait model of person-level measures of affect in relation to overall levels of binge eating and restraint intention, while general estimating equations (GEEs) assessed state models examining relationships between momentary affect and subsequent binge eating and restraint. The trait model indicated higher overall NA was related to more binge eating episodes, but was unrelated to overall restraint intention. Higher overall PA was related to higher overall restraint intention, but was unrelated to binge eating. State models indicated momentary NA was associated with a greater likelihood of subsequent binge eating and lower restraint intention. Momentary PA was unrelated to subsequent binge eating or restraint intention. Together, findings demonstrate important distinctions between the valence and stability of affect in relationship to binge eating and restraint intention among individuals with obesity. While NA is a more salient predictor of binge eating than PA, both overall PA and momentary NA are predictors of restraint intention.
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Affiliation(s)
- Kathryn E Smith
- Neuropsychiatric Research Institute, Fargo, ND, United States; University of North Dakota School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Science, Fargo, ND, United States.
| | - Tyler B Mason
- Department of Preventative Medicine, University of Southern California, United States
| | - Ross D Crosby
- Neuropsychiatric Research Institute, Fargo, ND, United States; University of North Dakota School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Science, Fargo, ND, United States
| | - Scott G Engel
- Neuropsychiatric Research Institute, Fargo, ND, United States; University of North Dakota School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Science, Fargo, ND, United States
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Stephen A Wonderlich
- Neuropsychiatric Research Institute, Fargo, ND, United States; University of North Dakota School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Science, Fargo, ND, United States
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
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