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Gerges S, Hallit S, Malaeb D, Laghi F, Obeid S. Drunkorexia Among a Sample of Lebanese Adults: The Role of Early Maladaptive Schemas. Psychol Rep 2024; 127:1175-1200. [PMID: 36321443 DOI: 10.1177/00332941221137242] [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: 06/16/2023]
Abstract
Background: Drunkorexia is a food and alcohol disturbance described as being a range of disordered and compensatory eating behaviors that co-occur with excessive alcohol consumption. The remarkable correlation, highlighted in the literature, between dysfunctional cognitions and both eating disorders and substance use disorders is able to emphasize that cognitive phenomena can be an intrapersonal factor linked to drunkorexia disorder. The aim of this study was to assess the correlation between early maladaptive schemas (EMSs) and drunkorexia among a sample of Lebanese adults.Method: We conducted a cross-sectional study across all the Lebanese governorates (September-December 2020; N = 258). The Drunkorexia Motives and Behaviors Scales, Drunkorexia Fails Scale, Drunkorexia during an Alcohol Consumption Event Scale, and Post-Drinking Compensation Scale were used to assess drunkorexia, whereas the Young Schema Questionnaire-Short Form three was used to measure EMSs.Results: Emotional deprivation and subjugation were significantly associated with more drunkorexia motives, whereas emotional inhibition was significantly associated with less drunkorexia motives. Failure was significantly associated with more drunkorexia behaviors. Abandonment and mistrust were significantly associated with more drunkorexia fails, whereas unrelenting standards was significantly associated with less drunkorexia fails. Subjugation was significantly associated with more drunkorexia during alcohol consumption on events. Social isolation was significantly associated with more post-drinking compensation, whereas unrelenting standards was significantly associated with less post-drinking compensation.Conclusion: Our findings showed that drunkorexia is positively associated with EMSs, delineating as well the specific relationships between dysfunctional cognitive schemas and drunkorexia's maladaptive behavioral aspects. They support the hypothesis that EMSs might play an important role in drunkorexia's development and perpetuation. This study could therefore serve healthcare professionals for the cognitive approach of patients with concomitant alcohol misuse and eating disorders while emphasizing the value of cognitive-behavioral interventions-namely schema therapy.
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Affiliation(s)
- Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sahar Obeid
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
- Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
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Pompili S, Bianchi D, Di Tata D, Cannoni E, Di Norcia A, Lonigro A, Longobardi E, Laghi F. Social Anxiety and Drunkorexia Behaviors among Adolescents and Young Adults: The Moderating Role of Resilience. Subst Use Misuse 2024; 59:825-831. [PMID: 38263611 DOI: 10.1080/10826084.2024.2305790] [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] [Indexed: 01/25/2024]
Abstract
Background: Existing evidence showed that social anxiety represents a significant factor in eating disorders. However, to our knowledge, no prior study has examined the association between social anxiety and drunkorexia behaviors. Objectives: The present study aimed at exploring the relationship between social anxiety and drunkorexia behaviors, and investigating resilience as a moderator of this relationship. Participants were 333 adolescents and young adults aged 15-24 years (Mage=18.26, SDage= 1.55; 66% females) who completed an online survey. Results: The results indicated that drunkorexia behaviors were positively correlated to three dimensions of social anxiety; however, only fear of negative evaluation had a significant predictive effect. In addition, resilience only moderated the relationship between fear of negative evaluation and drunkorexia behaviors, such that youths reporting high fear of negative evaluation and low resilience showed greater drunkorexia behaviors, whereas youths reporting high resilience showed no correlation between fear of negative evaluation and drunkorexia behaviors. Conclusions: The findings highlight the importance of drunkorexia interventions and preventive measures aimed at strengthening youths' resilience and ability to effectively manage stress and social anxiety (i.e., fear of negative evaluation).
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Affiliation(s)
- Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Daniele Di Tata
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Eleonora Cannoni
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Anna Di Norcia
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Antonia Lonigro
- Department of Education Science, University of Rome Tre, Rome, Italy
| | - Emiddia Longobardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
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3
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Pinna F, Suprani F, Paribello P, Milia P, Sanna L, Manchia M, Boi G, Pes A, Lai L, Deiana V, Lostia di Santa Sofia S, Puddu L, Fatteri F, Ghiani A, Lai A, Carpiniello B. Food and Alcohol Disturbance in High School Adolescents: Prevalence, Characteristics and Association with Problem Drinking and Eating Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:83. [PMID: 38248546 PMCID: PMC10815297 DOI: 10.3390/ijerph21010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/30/2023] [Accepted: 01/10/2024] [Indexed: 01/23/2024]
Abstract
Food and alcohol disturbance (FAD) is characterized by the association of alcohol use with compensatory behaviors such as restricting calories, physical activity and purging. Despite not being part of the current nosography, research has grown in the past 10 years, mostly on college students' samples. In this study, we aim to describe the prevalence, characteristics and association of FAD with problem drinking (PD) and eating disorder risk (EDR) in a sample of Italian high school students. Participants were 900 high school students (53.6% males; mean age = 16.22) that were administered standardized questionnaires. Students who screened positive for PD, EDR and both were, respectively, 17.3%, 5.9% and 1.3%. Approximately one out four students reported FAD behaviors, mostly to control weight and by restricting calories, with higher prevalence and severity among those who screened positive for PD. Purging behaviors were rare overall (15.5%), but significantly more frequent in participants who screened positive for both PD and EDR (41.7%). FAD was more strongly associated with alcohol use severity than with ED symptom severity across all subgroups. FAD behaviors appear to be common in the Italian high school population and more strongly associated with PD. Future studies should investigate FAD's impact on adolescents' functioning and possible early interventions.
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Affiliation(s)
- Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Paola Milia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Lucia Sanna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Graziella Boi
- Department of Mental Health and Addictions, ASL Cagliari, 09127 Cagliari, Italy; (G.B.); (A.P.)
| | - Annadele Pes
- Department of Mental Health and Addictions, ASL Cagliari, 09127 Cagliari, Italy; (G.B.); (A.P.)
| | - Lorena Lai
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Valeria Deiana
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Silvia Lostia di Santa Sofia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Laura Puddu
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Francesca Fatteri
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Alice Ghiani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Alice Lai
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
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Shepherd CB, Berry KA, Ye X, Li K. Food and alcohol disturbance among US college students: a mixed methods scoping review. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1715-1731. [PMID: 34292851 DOI: 10.1080/07448481.2021.1947300] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 05/05/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Conduct a scoping review of food and alcohol disturbance (FAD) in US college students to overview the literature within this population and identify research opportunities. METHODS Studies (n = 39) were selected using systematic searches of databases and references. Search terms included: drunkorexia, "food and alcohol disturbance," and "compensatory behavior" AND alcohol AND eating. RESULTS Issues with methodological quality were noted. Most studies used quantitative methods and cross-sectional designs with small, biased samples. Terminologies, conceptualizations, and measures varied; however, 30% of studies neglected enhanced intoxication effects. Prevalence ranged from approximately 10-55%, with greater risk for women. Alcohol use and disordered eating were primary predictors. Personality, affective, and social factors are potential correlates. Alcohol-related consequences were higher for those with FAD. CONCLUSIONS While the literature is inconsistent and unclear, FAD appears to be common among college students and associated with negative consequences. Suggestions and considerations for future research are provided.
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Affiliation(s)
- Caitlin B Shepherd
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Katherine A Berry
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Xian Ye
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Kathie Li
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
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5
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Herchenroeder L, Speed S, Ward RM, Yeung EW. Sexual minority status and food and alcohol disturbance among college students: The moderating role of body esteem. Eat Behav 2023; 49:101745. [PMID: 37235994 DOI: 10.1016/j.eatbeh.2023.101745] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
Food and alcohol disturbance (FAD; restricting caloric intake before, during, or after drinking to either offset calories or to increase intoxication) is common among college students and poses a threat to students' health. In conjunction, sexual minority (SM; i.e., not exclusively heterosexual) college students may be at increased risk of engaging in alcohol misuse and disordered eating compared to their heterosexual peers due to exposure to minority stress. However, little research has examined whether engagement in FAD differs by SM status. Body esteem (BE) is an important resilience factor among SMs that may influence SM students' risk of participating in FAD. Therefore, the aim of the present study was to understand the association between SM status and FAD with additional interest in BE as a moderating factor. Participants were 459 college students who engaged in past 30-day binge drinking. Most participants identified as White (66.7 %), female (78.4 %), heterosexual (69.3 %), with a mean age of 19.60 (SD = 1.54) years. Participants completed two surveys (3 weeks apart) over the course of an academic semester. Analyses revealed a significant interaction between SM status and BE, such that SMs with lower BE (T1) reported more engagement in FAD-intoxication (T2), whereas SMs with higher BE (T1) reported less engagement in FAD-calories (T2) and FAD-intoxication (T2) than their heterosexual peers. Stressors associated with body esteem may contribute to increased FAD engagement among SM students. Consequently, BE may be an especially important target for interventions aimed at reducing FAD among SM college students.
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Affiliation(s)
- Luke Herchenroeder
- Department of Psychological and Brain Sciences, George Washington University, United States of America.
| | - Shannon Speed
- NIH IRP, NIDA/NIAAA, Translational Addiction Medicine Branch Lab, Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, United States of America
| | | | - Ellen W Yeung
- Department of Psychological and Brain Sciences, George Washington University, United States of America
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Di Tata D, Bianchi D, Pompili S, Laghi F. The Psychological Impact of the COVID-19 Pandemic on Alcohol Abuse and Drunkorexia Behaviors in Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3466. [PMID: 36834161 PMCID: PMC9967230 DOI: 10.3390/ijerph20043466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 outbreak negatively affected young adults' psychological well-being, increasing their stress levels and symptoms of anxiety and depression, and potentially triggering health-risk behaviors. The present study was aimed at investigating the psychological impact of the COVID-19 pandemic on alcohol abuse and drunkorexia behaviors among young adults living in Italy. Participants were 370 emerging adults (63% women, 37% men; Mage = 21.00, SDage = 2.96, range: 18-30) who were recruited through an online survey between November 2021 and March 2022. Participants completed measures of alcohol abuse, drunkorexia behaviors, negative life experiences, and post-traumatic symptoms related to the COVID-19 outbreak. The results showed that the emotional impact and negative life experiences associated with the pandemic predicted both alcohol abuse and drunkorexia behaviors, albeit in different ways. Specifically, the number of negative life experiences during the pandemic and the tendency to avoid COVID-19-related negative thoughts positively predicted alcohol abuse; and the presence of intrusive thoughts associated with the pandemic significantly predicted the frequency of drunkorexia behaviors. Implications for research and clinical practice are discussed.
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Affiliation(s)
- Daniele Di Tata
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy
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Hahn SL, Burnette CB, Borton KA, Carpenter LM, Sonneville KR, Bailey B. Eating disorder risk in rural US adolescents: What do we know and where do we go? Int J Eat Disord 2023; 56:366-371. [PMID: 36305331 PMCID: PMC9951233 DOI: 10.1002/eat.23843] [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: 08/19/2022] [Revised: 10/14/2022] [Accepted: 10/14/2022] [Indexed: 02/03/2023]
Abstract
Adolescence is a vulnerable period for the development of eating disorders, but there are disparities in eating disorder risk among adolescents. One population that may be at increased risk but is vastly understudied, is adolescents residing in rural regions within the United States. Rural communities face many mental and physical health disparities; however, the literature on rural adolescent eating disorder risk is nearly nonexistent. In this paper we summarize the scant literature on disordered eating and eating disorder risk and prevalence among rural US adolescents. We also detail eating disorder risk factors that may have unique influence in this population, including socioeconomic status, food insecurity, healthcare access, body image, and weight stigma. Given the presence of numerous eating disorder risk factors, we speculate that rural adolescents may be a particularly vulnerable population for eating disorders and we propose critical next steps in research for understanding eating disorder risk among the understudied population of rural adolescents. PUBLIC SIGNIFICANCE: Rural adolescents may be at increased risk for eating disorders due to disproportionate burden of known risk factors, though this relationship remains understudied. We present a summary of the literature on prevalence and unique risk factors, proposing that this may be a high-risk population. We detail next steps for research to understand eating disorder risk in this population to inform future prevention, identification, and treatment efforts needed in this community.
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Affiliation(s)
- Samantha L. Hahn
- Central Michigan University College of Medicine, Mount Pleasant, Michigan, USA
| | - C. Blair Burnette
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Kelley A. Borton
- Oakland University School of Health Sciences, Rochester, Michigan, USA
- Center of Hope Counseling, Mount Pleasant, Michigan, USA
| | | | | | - Beth Bailey
- Central Michigan University College of Medicine, Mount Pleasant, Michigan, USA
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Azzi V, Bianchi D, Pompili S, Laghi F, Gerges S, Akel M, Malaeb D, Obeid S, Hallit S. Emotion regulation and drunkorexia behaviors among Lebanese adults: the indirect effects of positive and negative metacognition. BMC Psychiatry 2022; 22:391. [PMID: 35689196 PMCID: PMC9185707 DOI: 10.1186/s12888-022-04030-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although metacognition processes are a core feature of restrictive eating and alcohol cravings and entail an individual to control both of his/her emotions and thoughts, yet, to our knowledge, a scarcity of research has examined their potential role in drunkorexia as cognitive and emotional predictors. The following study investigates the different associations between two emotion regulation strategies (i.e. emotional suppression and cognitive reappraisal) and drunkorexia behaviors in a sample of Lebanese adults, exploring the possible indirect effects of positive and negative alcohol-related metacognitions. METHODS This was a cross-sectional study that enrolled 335 participants (March-July 2021). RESULTS Higher problematic alcohol use (beta = 5.56), higher physical activity index (beta = 0.08), higher expressive suppression (beta = 0.23), higher negative metacognitive beliefs about cognitive harm due to drinking (beta = 0.75) and higher cognitive reappraisal (beta = 0.20) were significantly associated with more drunkorexic behaviors. The positive metacognitive beliefs about cognitive self-regulation significantly mediated the association between cognitive reappraisal and drunkorexia behaviors. Both the positive metacognitive beliefs about cognitive self-regulation and the negative metacognitive beliefs about the uncontrollability of drinking significantly mediated the association between expressive suppression and drunkorexia behaviors. CONCLUSION This study demonstrated that emotional and metacognitive processes are associated with drunkorexia, addressing as well the mediating effect between deficient emotional regulation and risky behavioral patterns. Overall, our results would speculate that the lack of emotional and cognitive assets might enhance internal distress perceived out of control, leading individuals to indulge in maladaptive behavioral patterns for managing the underlying impairment.
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Affiliation(s)
- Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- School of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
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Drunkorexia behaviors and motives, eating attitudes and mental health in Lebanese alcohol drinkers: a path analysis model. Eat Weight Disord 2022; 27:1787-1797. [PMID: 34713408 PMCID: PMC8553592 DOI: 10.1007/s40519-021-01321-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Drunkorexia refers to limited intake of high-calorie food to avert gaining weight and the need to increase in alcohol excessive consumption. The present study aimed to check for an association between depression, anxiety, and stress with drunkorexia behaviors/motives among Lebanese adults, while evaluating the mediating role of inappropriate eating attitude in those associations. METHODS Two hundred and fifty-eight participants enrolled in this cross-sectional study, who filled an online survey (September-December 2020). RESULTS Drunkorexia behaviors were considered as the dependent variable; the path coefficients from stress to anxiety, from anxiety to eating attitudes, from eating attitudes to drunkorexia behaviors and from anxiety to drunkorexia behaviors were all significant. The indirect relationships showed that eating attitudes mediated the association between anxiety and drunkorexia behaviors. When taking the drunkorexia motives as the dependent variable, the path coefficients from stress to anxiety, from anxiety to eating attitudes, from eating attitudes to drunkorexia motives, and from anxiety to drunkorexia motives were all significant. The indirect relationships showed that eating attitudes mediated the association between anxiety and drunkorexia motives. CONCLUSION This study highlighted that individuals with more psychological problems (depression, anxiety, and stress) and inappropriate eating habits exhibit more drunkorexic motivations and behaviors. LEVEL OF EVIDENCE Level V, Cross-sectional study.
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10
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Exploring risk factors of food and alcohol disturbance (FAD) in U.S. college students. Eat Weight Disord 2022; 27:1739-1749. [PMID: 34622393 DOI: 10.1007/s40519-021-01313-2] [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: 04/25/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Current research examining mental health and history of childhood trauma as risk factors of food and alcohol disturbance (FAD) is limited. College students may be at greater risk to engage in FAD behaviors because of the common co-occurrence of alcohol misuse and disordered eating behaviors within college populations. Therefore, the current study examined anxiety, depression, and adverse childhood experiences as possible risk factors of FAD behaviors in a college student sample. METHODS Two-hundred and seven undergraduate students from a large Midwest university completed a cross-sectional survey assessing history of adverse childhood experiences, depressive symptoms, anxiety symptoms, FAD behaviors, and frequency of alcohol use. RESULTS Current symptoms of generalized anxiety were significantly associated with engagement in FAD behaviors (Alcohol Effects subscale, β = 0.13, F(1, 204) = 4.10, p = 0.04; Bulimia subscale, β = 0.17, F(1, 204) = 6.19, p = 0.01; Diet and Exercise subscale, β = 0.19, F(1, 204) = 9.05, p < 0.01). Adverse childhood experiences were associated with engagement in FAD behaviors (Alcohol Effects subscale, β = 0.14, F(1, 204) = 4.27, p = 0.04). Current depressive symptoms were not significantly associated with FAD behaviors. CONCLUSIONS Study findings suggest that students who experience greater current symptoms of anxiety are at a greater risk to engage in FAD behaviors. Further understanding the role of anxiety in the development and maintenance of FAD behaviors may provide clinically useful information for the prevention and treatment of FAD behaviors. These findings highlight the need for further research to examine psychological distress as a risk factor for engagement in FAD behaviors longitudinally, in a larger, more diverse study sample. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Pompili S, Di Tata D, Bianchi D, Lonigro A, Zammuto M, Baiocco R, Longobardi E, Laghi F. Food and alcohol disturbance among young adults during the COVID-19 lockdown in Italy: risk and protective factors. Eat Weight Disord 2022; 27:769-780. [PMID: 34052989 PMCID: PMC8164478 DOI: 10.1007/s40519-021-01220-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/20/2021] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The COVID-19 lockdown measures have had a significant impact on risk behaviors as alcohol use and disordered eating. However, little is known about a serious health-risk-behavior named "food and alcohol disturbance" (FAD), characterized by engaging in dysfunctional eating on days of planned alcohol consumption. The aim of the present study was to investigate potential factors that may have put young adults at risk or protected against FAD during the COVID-19 lockdown. METHODS A sample of 447 young adults (280 females, 167 males; range 18-26) completed an online survey during the country's nationwide lockdown composed of self-reported measures assessing FAD behaviors, alcohol consumption, compensatory behaviors, eating and weight concerns, social support, emotion regulation strategies, and living arrangement. RESULTS Our findings showed that FAD was significantly and positively correlated to alcohol consumption, use of laxatives, self-induced vomiting, eating and weight concerns, and expressive suppression, and negatively correlated to social support and living with family. Hierarchical regression analysis revealed that alcohol consumption, eating concern, and expression suppression positively predicted FAD, while social support and living with family were negative predictors. CONCLUSIONS Our results suggest that during the COVID-19 lockdown, preoccupation with eating and the use of expressive suppression may have increased vulnerability to FAD; conversely, perceived social support and living with family may have been a source of protection against this dysfunctional behavior. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- Sara Pompili
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Daniele Di Tata
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Dora Bianchi
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Antonia Lonigro
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Marta Zammuto
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Roberto Baiocco
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Emiddia Longobardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy.
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12
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The Relationship between Psychological Distress during the Second Wave Lockdown of COVID-19 and Emotional Eating in Italian Young Adults: The Mediating Role of Emotional Dysregulation. J Pers Med 2021; 11:jpm11060569. [PMID: 34204480 PMCID: PMC8235082 DOI: 10.3390/jpm11060569] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 12/16/2022] Open
Abstract
This cross-sectional study aims to investigate the impact of psychological distress experienced during the second wave of the COVID-19 pandemic on emotional eating and to assess the mediating role of emotional dysregulation in a sample of Italian young adults (20-35). A total of 437 participants provided demographical data and were assessed using the Depression Anxiety Stress Scale, the Difficulties in Emotion Regulation Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire. Correlational analyses were performed to assess the relationship between continuous variables, while ANOVA was conducted to detect differences between males and females for emotional eating. To assess whether demographic and clinical data predicted emotional eating, hierarchical linear regression was performed. Then, a mediation analysis was conducted to assess whether emotional dysregulation was a mediator between psychological distress and emotional eating. Emotional eating was associated with psychological distress and emotional dysregulation. Moreover, higher levels of emotional eating were found in females than in males. Predictors of emotional eating were sex, psychological distress, and emotional dysregulation. Mediation analyses showed that the indirect effect of psychological distress on emotional eating through emotional dysregulation was significant (b = 0.0069; SE = 0.0024; CI = 0.0024-0.0118), confirming that the relationship between psychological distress and emotional eating was mediated by emotional dysregulation, controlling for sex. The model explained 26.8% (R2 = 0.2680) of the variance. These findings may help to plan and develop psychological interventions aimed at addressing emotional eating in young adults by targeting emotional dysregulation.
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Azzi V, Hallit S, Malaeb D, Obeid S, Brytek-Matera A. Drunkorexia and Emotion Regulation and Emotion Regulation Difficulties: The Mediating Effect of Disordered Eating Attitudes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052690. [PMID: 33800011 PMCID: PMC7967414 DOI: 10.3390/ijerph18052690] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 01/22/2023]
Abstract
Drunorexia refers to food calorie intake restriction to prevent weight gain and the desire to enhance the more extensive intoxicating effects of alcohol. The present study aimed to investigate the association of drunkorexia with emotion regulation as well as emotion regulation difficulties across the Lebanese population, and assess disordered eating attitudes as a potential mediator of these relationships. The cross-sectional study enrolled participants (n = 258) from all Lebanese districts. The study was performed through an online survey based on a self-designed and structured questionnaire. The Drunkorexia Motives and Behaviors Scales (DMBS), the College Life Alcohol Salience Scale (CLASS), the Difficulties in Emotion Regulation Scale (DERS-16), the Emotion Regulation Questionnaire (ERQ) and the Eating Attitudes Test (EAT-26) were used in the present study. The results showed that higher EAT-26 total scores (more disordered eating attitudes) (B = 0.16) and higher DERS-16 total score (B = 0.30) were significantly associated with more drunkorexia motives. Also, higher EAT-26 total scores (B = 0.09) and higher DERS-16 total score (B = 0.17) were significantly associated with more drunkorexia behaviors. In addition, higher EAT-26 total scores (B = 0.10) and higher DERS-26 total score (B = 0.36) were significantly associated with more drunkorexia fails. Furthermore, higher EAT-26 total scores (B = 0.07), and higher DERS-16 total score (B = 0.37) were significantly associated with more drunkorexia during an alcohol consumption event. Higher EAT-26 total scores (B = 0.09), and higher DERS-16 total score (B = 0.22) were significantly associated with more post-drinking compensation. Higher EAT-26 total scores (B = 0.21), higher DERS-16 total scores (B = 0.65) and higher emotion regulation (B = 0.33) were significantly associated with higher CLASS scores. The results showed that EAT-26 total scores partially mediated the association between DERS-16 total score and drunkorexia motives (25.20%), between DERS-16 total score and drunkorexia behaviors (25.16%), between DERS-16 total score and drunkorexia fails (106.87%), between DERS-16 total score and drunkorexia during an alcohol consumption event (11.84%), between DERS-16 total score and post-drinking compensation (22.55%), between ERQ total score and college life alcohol salience (8.35%) and between DERS-16 total score and college life alcohol salience (20.14%). This study highlighted that only emotional regulation difficulties were associated with drunkorexia, whereas emotional regulation was not significantly associated with such behavior.
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Affiliation(s)
- Vanessa Azzi
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon;
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon;
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut 6573-14, Lebanon;
- Correspondence: (S.H.); (A.B.-M.)
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut 1083, Lebanon;
| | - Sahar Obeid
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut 6573-14, Lebanon;
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon
| | - Anna Brytek-Matera
- Institute of Psychology, University of Wroclaw, Dawida 1, 50-527 Wroclaw, Poland
- Correspondence: (S.H.); (A.B.-M.)
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14
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Laghi F, Pompili S, Bianchi D, Lonigro A, Baiocco R. Drunkorexia: An Examination of the Role of Theory of Mind and Emotional Awareness among Adolescents. Dev Neuropsychol 2020; 46:70-81. [PMID: 33372552 DOI: 10.1080/87565641.2020.1869743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to investigate Theory of Mind (ToM) and emotional awareness in drunkorexia, an emerging behavior characterized by calorie restriction when drinking alcohol is planned. A sample of 246 adolescents (148 females, 98 males; range 17-20) completed self-reported measures assessing drunkorexia, ToM and lack of emotional awareness. Drunkorexia was negatively correlated with ToM abilities, with reading neutral emotions, and positively with lack of emotional awareness. ToM and lack of emotional awareness were also found to predict drunkorexia. Findings highlighted that adolescents who engage in drunkorexia may have difficulties in reading others' mental states and being aware of their emotions.
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Affiliation(s)
- Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Antonia Lonigro
- Department of Human Sciences, European University of Rome , Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
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Janiri D, Kotzalidis GD, Giuseppin G, Molinaro M, Modica M, Montanari S, Terenzi B, Carfì A, Landi F, Sani G. Psychological Distress After Covid-19 Recovery: Reciprocal Effects With Temperament and Emotional Dysregulation. An Exploratory Study of Patients Over 60 Years of Age Assessed in a Post-acute Care Service. Front Psychiatry 2020; 11:590135. [PMID: 33304286 PMCID: PMC7693440 DOI: 10.3389/fpsyt.2020.590135] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/13/2020] [Indexed: 01/24/2023] Open
Abstract
To study the long-term psychological effects of Covid-19 disease, we recruited 61 patients older than 60 years of age and administered the Kessler questionnaire K10 to assess psychological distress and classify them according to mental health risk groups. Patients' affective temperaments were assessed with the 39-item form of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-A-39) and emotional dysregulation with the Difficulties in Emotion Regulation Scale (DERS). Patients were divided in two samples according to their scores on the K10, i.e., a high likelihood of psychological distress group (N = 18) and a low likelihood of psychological distress group (N = 43). The two groups differed on their gender composition, in that more women (N = 11) were in the former and more men in the latter (N = 29) (χ2 = 4.28; p = 0.039). The high likelihood of psychological distress group scored higher on the Cyclothymic (3.39 ± 3.45 vs. 0.93 ± 1.08, p < 0.001) and the Depressive (2.28 ± 2.82 vs. 0.65 ± 1.09, p = 0.01) affective temperaments of the TEMPS and on the lack of Impulse control (12.67 ± 4.04 vs. 9.63 ± 3.14, p = 0.003) and lack of Clarity (15.00 ± 5.56 vs. 9.85 ± 4.67, p = 0.004) scales of the DERS. Our results show that having had Covid-19 may be related with high likelihood for psychological distress in advanced-age people and this may in turn be associated with impaired emotional regulation and higher scores on depressive and cyclothymic temperaments.
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Affiliation(s)
- Delfina Janiri
- Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy.,Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Georgios D Kotzalidis
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Giulia Giuseppin
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marzia Molinaro
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Modica
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Silvia Montanari
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Beatrice Terenzi
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Carfì
- Geriatrics Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Francesco Landi
- Geriatrics Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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