A multimodal, naturalistic investigation of relationships between behavioral impulsivity, affect, and binge eating

Trajectories of negative affect prior to and following disordered eating behaviors among women with eating disorder pathology: An examination of the role of state-interoception

OBJECTIVE

Affect regulation theories of eating disorders (ED) posit that negative affect increases in the hours before and decreases following disordered eating behaviors (DEBs) in daily life, yet findings from studies assessing affective changes post-DEBs are mixed. This inconsistency may be due to the previously unassessed role of other transdiagnostic processes in these associations, such as interoception (the ability to sense and integrate information from bodily sensations). To address this research gap, the present study examined whether different interoception dimensions moderated negative affect trajectories surrounding DEBs in the natural environment.

METHOD

150 women with ED pathology (Mage = 21.0, SD = 4.1) completed 4 surveys targeting affect and DEBs each day for a 10-day ecological momentary assessment period. Polynomial multilevel models examined negative affect trajectories pre- and post-DEBs (dietary restriction, overeating, loss of control eating), and whether these trajectories varied based on daily interoception dimensions (not distracting, self-regulation, body listening and trust).

RESULTS

Negative affect increased prior to loss of control eating-but not dietary restriction or overeating-and decreased following all DEBs. Further, the magnitude of the decrease in negative affect that emerged post-dietary restriction decreased in strength as daily "not distracting" interoception increased. The other interoception dimensions did not moderate negative affect trajectories surrounding DEBs.

CONCLUSIONS

Allowing oneself to experience (vs. distract from) uncomfortable bodily sensations may weaken affect dysregulation processes that follow dietary restriction in daily life and are theorized to maintain DEBs. These results provide insight that may strengthen EDs theories, research, and inform interoception-focused interventions.

Mechanisms underlying food devaluation after response inhibition to food

Multiple studies reveal that a requirement to stop a response to appetitive food stimuli causes devaluation of these stimuli. However, the mechanism underlying food devaluation after stopping is still under debate. The immediate-affect theory suggests that an increase in negative affect after stopping a response is the driving force for food devaluation. A competing value-updating theory presumes that food devaluation after stopping occurs through the need to align behavior with goals. The current study assessed how food devaluation after response inhibition is influenced by negative emotional reactivity and behavior-goal alignment on a trial-by-trial basis. The study included 60 healthy participants who completed a Food-Stop-Signal-Emotion task. Participants categorized high vs. low-calorie food stimuli and stopped their response upon encountering a stop signal. Subsequently, participants made subjective negativity ratings of negative- or neutral-valenced emotional images, and rated their desire to eat the previously depicted food. In contrast to predictions made by the immediate-affect account, food devaluation after stopping was not mediated nor moderated via changes in negative emotional reactivity after stopping. In support of the value-updating account, food devaluation was modulated by behavior-goal alignment, indicated by larger food devaluation after successful vs. failed stopping. In agreement with this theory, the findings indicate that devaluation occurs more strongly when performance aligns with the task requirement. This study sheds light on the mechanism that likely underlies food devaluation after stopping. Implications regarding applied use of food-inhibition trainings are discussed.

Daily Relationship Functioning and Disordered Eating Behaviors Among Sexual Minority Women in Same-Sex Relationships

BACKGROUND AND PURPOSE

The present study aimed to examine associations between different types of relationship functioning and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships-an at-risk population that has not been assessed in this context.

METHODS

Participants included 321 young sexual minority women (Mage = 27.56, SD = 3.67) in same-sex relationships who completed surveys assessing their daily relationship functioning and DEB use each day for a 14-day daily diary period. Multilevel structural equation modeling was used to examine daily-, person-, and couple-level associations among women's daily relationship functioning (general relationship functioning, positive and negative relational behaviors they and, separately, their partners engaged in) and DEBs (overeating, loss of control eating, emotional eating, and dietary restriction).

RESULTS

Results generally indicated that more positive and less negative daily relationship functioning across all assessed constructs was associated with less same-day emotional eating. In contrast, associations between all daily relationship functioning constructs and loss of control eating were not significant, nor were any relationship functioning-DEB associations at the couple level. More circumscribed patterns of association were identified for associations between the relationship functioning constructs, and overeating and dietary restriction.

CONCLUSIONS

Collectively, these findings provide insight into how aspects of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term, and directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence-base and care for this historically overlooked and underserved population.

Neuronal activity and reward processing in relation to binge eating

PURPOSE OF REVIEW

Studies increasingly show the importance of reward processing in binge eating and provide evidence of associated changes in the neurobiological reward system. This review gives an up-to-date overview of the neurobiological substrates of reward processing subconstructs in binge eating. Neural findings are linked to different behavioral theories and the clinical relevance is discussed.

RECENT FINDINGS

Increased neural responses in the orbitofrontal cortex, anterior cingulate cortex as well as striatum during anticipation and receipt of food rewards are found in association to binge eating. Increased model-free learning is also found and associated with altered brain reward reactivity. Data in rest report reduced striatal dopamine release and lower frontostriatal connectivity. Mechanisms of onset of binge eating are less clear, but specific personality traits, related to frontostriatal dysconnectivity, probably increase the risk of binge eating onset.

SUMMARY

Both structural and task-based imaging studies show differences in the neurobiological reward system in binge eating. These changes are linked to specific reward processing, such as altered reward responsiveness to food cues, reinforcement learning, and habitual behavior. Findings are lined with different behavioral theories of binge eating, and a staging model is described, from onset to full illness development. Understanding the specific underlying aberrant reward mechanism in binge eating, associated with different stages of the illness, enables caregivers to focus their treatment more precisely.

Dysfunctional decision-making in binge-eating disorder: A meta-analysis and systematic review

Binge-Eating Disorder (BED) involves anticipatory craving and urges, subjective loss-of-control during binge-eating episodes, and post-feeding psychological distress and guilt. Evidence indicates neurocognitive dysfunctions contribute to BED onset, maintenance, and treatment response. However, an integrated understanding of how cognitive processes underpin BED symptomology is lacking. We utilised a multi-stage decision-making model defining ten cognitive processes underpinning Preference Formation, Choice Implementation, Feedback Processing, and Flexibility/Shifting, to comprehensively review research published since 2013. We used preregistered PICOS criteria to assess 1966 articles identified from PubMed, PsycInfo, and Scopus database searches. This yielded 50 studies reporting behavioural cognitive tasks outcomes, comparing individuals with BED to controls with normal and higher weight. Meta-analyses revealed a unique profile of cognitive dysfunctions that spanned all decision-making stages. Significant deficits were evident in Uncertainty Evaluation, Attentional Inhibition, Choice Consistency, and Cognitive Flexibility/Set-shifting. We propose a novel model of dysfunctional decision-making processes in BED and describe their role in binge-eating behaviour. We further highlight the potential for cognitive interventions to target these processes and address the significant treatment gap in BED.

Positive affect dysregulation and its relation to binge eating size and frequency

Negative affect is an established predictor of binge eating, yet less is known about positive affect. Low positive affect has been theorized to increase binge eating, but a better understanding is needed on the relationship between positive affect and binge eating frequency and size. Participants were 182 treatment-seeking adults (76% self-identified as female; 45% self-identified their race as Black and 40% as White; and 25% self-identified their ethnicity as Hispanic/Latino) with self-reported recurrent binge eating (≥12 binge episodes in the past 3  months). Participants completed the positive and negative affect schedule (PANAS) survey and the eating disorder examination to assess frequency of objective binge episodes (OBEs) and subjective binge episodes (SBEs) over the past 3  months. OBEs and SBEs also were combined to yield total binge episodes over the past 3  months. Independent t-tests and linear regression analyses were used to test associations between positive affect scores and binge episode size and frequencies, and to compare low versus higher positive affect on binge frequency. Additional exploratory models were conducted controlling for negative affect, identity characteristics, and socio-demographic variables. Lower positive affect was significantly associated with more frequent total binge episodes, but not OBEs and SBEs when assessed independently. Findings remained consistent when controlling for covariates and when comparing individuals with the lowest versus higher positive affect levels. Overall, results lend support to the theory that low positive affect is associated with binge eating. Increasing positive affect may be an important treatment consideration for those with recurrent binge eating.

Bi-Directional Associations of Affective States and Diet among Low-Income Hispanic Pregnant Women Using Ecological Momentary Assessment

Affective states play a role in dietary behaviors. Yet, little research has studied within-subjects associations between affect and diet during pregnancy. We examined the acute bidirectional relationships between affect and food intake and moderation by pre-pregnancy body mass index (BMI) in low-income, Hispanic pregnant women using ecological momentary assessment (EMA). Women (N = 57) completed four days of EMA during their first trimester. Women responded to five random prompts per day about their current affect and past two-hour food intake. Higher positive affect (PA) or lower negative affect (NA) predicted greater likelihood of fruit/vegetable consumption in the next two hours in women with lower pre-pregnancy BMI and lower likelihood in women with higher pre-pregnancy BMI. Higher PA predicted less likelihood of fast food consumption in the next two hours in women with lower pre-pregnancy BMI and slightly higher likelihood in women with higher pre-pregnancy BMI. Women with lower pre-pregnancy BMI had higher PA when they reported consuming chips/fries in the past two hours, and women with higher pre-pregnancy BMI had lower PA when they reported consumption of chips/fries in the past two hours. Results showed differential relationships between affect and food intake as a function of pre-pregnancy BMI.

Associations among affect, diet, and activity and binge-eating severity using ecological momentary assessment in a non-clinical sample of middle-aged fathers

PURPOSE

Knowledge of within-day factors associated with binge-eating severity among middle-aged fathers is limited. The purpose of the current report was to examine within-day associations of affect, diet, and activity in relation to binge-eating severity using ecological momentary assessment (EMA) in men.

METHODS

Twenty-three middle-aged fathers completed 8 days of EMA and wore accelerometers to objectively assess activity. Generalized estimating equations assessed relationships among affect, diet, and activity and binge-eating severity.

RESULTS

When positive affect was above average, men reported greater binge-eating severity in the next 2 h. Oppositely, when negative affect was above average, men reported less binge-eating severity in the next 2 h. At times when men reported consumption of sweets and fast food, they reported higher binge-eating severity during the same 2-h window. Men with greater average levels of light activity reported less overall binge-eating severity.

CONCLUSIONS

Findings show that affect, unhealthy food intake, and light activity could be targeted among middle-aged fathers to reduce binge-eating severity and prevent eating disorders.

LEVEL OF EVIDENCE

Level III: Evidence obtained from cohort or case-control analytic studies.

Associations among weight-based teasing distress, impulsive emotion regulation, and loss of control eating in racially and ethnically diverse young men

According to affect regulation models, distress associated with weight-based teasing may be related to loss of control (LOC) eating. Maladaptive coping strategies may further exacerbate this association, but such hypotheses have not been evaluated in men. The purpose of the current study was to examine the association between distress from weight-based teasing and LOC eating in racially and ethnically diverse young men. The degree to which men engage in impulsive behavior when distressed was investigated as a moderating variable. Exploratory analyses examined the proposed associations within racial/ethnic identity groups. The current study included 1011 young men (18-30 years, M_age = 23.9 ± 3.6 y, 28.3% non-Hispanic White; 23.4% African American; 24.3% Hispanic/Latino; 23.8% Asian/Asian American). Participants completed an online survey with measures of weight-based teasing, LOC eating frequency, engagement in impulsive behavior when distressed, and demographics. After adjusting for age, race/ethnicity, and body mass index, there was a positive association between distress from weight-based teasing and LOC eating frequency (p < .001). In the full sample, the tendency to engage in impulsive behavior when distressed exacerbated this link (p < .01). Exploratory analyses revealed the moderating effect of impulsive coping on distress from teasing was significant in non-Hispanic White men, but was not significant for all others. These findings suggest that men are not immune to the negative correlates of weight-based teasing. LOC eating may function as a maladaptive coping mechanism, or may be an artifact of the disordered eating symptoms that can emerge during extreme efforts to obtain a thinner physique.

Multi-state modeling of thought-shape fusion using ecological momentary assessment

Body dissatisfaction (BD) and preoccupation with thoughts of food (PTF) are intertwined and are components of thought-shape fusion. Thought-shape fusion describes the process by which PTF lead to beliefs about weight and shape. To study thought-shape fusion in daily life and explore various transitions between BD and PTF, 30 women with binge eating completed ecological momentary assessment for 14 days. BD and PTF were assessed using continuous rating scales at each prompt. Multi-state modeling, which analyzes micro-temporal transitions between discrete states, was used to examine transitions among four states created with BD and PTF ratings. The four states included low BD/low PTF, low BD/high PTF, high BD/low PTF, and high BD/high PTF. Affect and disordered eating were examined as covariates of state transitions. Results showed high BD states were self-perpetrating, such that when in high BD states, transition to low BD states were less likely. Regarding covariates, positive affect buffered against maladaptive transitions whereas negative affect and disordered eating increased risk. Findings highlighted high BD states as influential, and negative affect and disordered eating as risk factors and positive affect as preventive. This study enhances theory of thought-shape fusion and implicates transitions from BD to PTF as possible underlying transitions.

A review of effort-based decision-making in eating and weight disorders

Effort-based decision-making provides a framework to understand the mental computations estimating the amount of work ("effort") required to obtain a reward. The aim of the current review is to systematically synthesize the available literature on effort-based decision-making across the spectrum of eating and weight disorders. More specifically, the current review summarises the literature examining whether 1) individuals with eating disorders and overweight/obesity are willing to expend more effort for rewards compared to healthy controls, 2) if particular components of effort-based decision-making (i.e. risk, discounting) relate to specific binge eating conditions, and 3) how individual differences in effort and reward -processing measures relate to eating pathology and treatment measures. A total of 96 studies were included in our review, following PRISMA guidelines. The review suggests that individuals with binge eating behaviours 1) are more likely to expend greater effort for food rewards, but not monetary rewards, 2) demonstrate greater decision-making impairments under risk and uncertainty, 3) prefer sooner rather than delayed rewards for both food and money, and 4) demonstrate increased implicit 'wanting' for high fat sweet foods. Finally, individual differences in effort and reward -processing measures relating to eating pathology and treatment measures are also discussed.

Descriptives and baseline ecological momentary assessed predictors of weight change over the course of psychological treatments for binge eating disorder

OBJECTIVE

The objectives were to examine individual variability in weight change across psychological treatments for binge-eating disorder (BED) and to examine baseline predictors (i.e., BED symptoms, affect, and appetite) of weight change using ecological momentary assessment (EMA).

METHOD

Adults with BED (N = 110) enrolled in a randomized clinical trial in which they received one of two psychological treatments for BED. At baseline, participants completed a 7-day EMA protocol measuring BED symptoms, affect, and appetite. Height and weight were measured at baseline, mid-treatment, end-of-treatment, and follow-up, and body mass index (BMI) was calculated.

RESULTS

On average, participants evidenced a 2% increase in BMI at end-of-treatment and a 1% increase between end-of-treatment and 6-month follow-up assessments. Although results showed that BMI increased over time, the quadratic term reflected a deceleration in this effect. There were interactions between positive affect and the linear trajectory across time predicting BMI, indicating that individuals reporting higher positive affect at baseline evidenced a flatter trajectory of weight gain. There was a main effect of overeating as assessed by EMA and interactions between overeating and linear and quadratic trajectories across time predicting BMI. Individuals who reported greater overeating at baseline had higher BMI across time. However, the BMI of individuals with lower overeating increased linearly, and increases in BMI among those with average or high rates of overeating appeared to stabilize over time.

CONCLUSION

Despite the variability in weight change, baseline positive affect and overeating may be ecological targets for improving weight outcomes in psychological treatments for BED.

Latent profile analysis of impulsivity and perfectionism dimensions and associations with psychiatric symptoms

BACKGROUND

Impulsivity and perfectionism are transdiagnostic personality factors that have been studied extensively and shown to relate to externalizing and internalizing pathology respectively. Typically, these personality factors are antithesized, with impulsivity characterized by lack of control and perfectionism characterized by rigid overcontrol.

METHODS

The current study (N = 1,353 undergraduate students) used latent profile analysis to identify subgroups based on impulsivity and perfectionism dimensions and tested the relations of these subgroups with the symptomatology of ten prevalent types of psychopathology (depression, worry, social anxiety, attention-deficit hyperactivity disorder inattentive subtype, attention-deficit hyperactivity disorder impulsive-hyperactive subtype, alcohol use, obsessive-compulsive disorder, posttraumatic stress disorder, restrictive eating pathology, and binge eating pathology).

RESULTS

The latent profile analysis identified four meaningful subgroups: high perfectionism, high impulsivity, combined impulsivity and perfectionism, and low impulsivity and perfectionism. The combined group was the most prevalent, comprising almost half of the sample. Further, the perfectionism group had the highest scores for obsessive-compulsive disorder, worry, and restrictive eating pathology, the impulsivity group had the highest scores for alcohol use disorder, and the combined group had the highest or second-highest scores across all types of psychopathology.

LIMITATIONS

Limitations include the undergraduate sample, self-report, cross-sectional study design, and high bivariate residuals.

CONCLUSIONS

These findings suggest impulsivity and perfectionism can co-occur. Further, the co-occurrence of these personality traits may heighten risk for psychopathology and help explain comorbidity across internalizing and externalizing disorders. Future research should continue to investigate the presentation, prevalence, and treatment for individuals high in both perfectionism and impulsivity.

Anhedonia, positive affect dysregulation, and risk and maintenance of binge-eating disorder

Low positive affect has been identified as an antecedent of binge-eating episodes among individuals with binge-eating disorder (BED), yet positive affect has received far less attention in eating disorders research than its counterpart, negative affect. In this article, we argue that the low levels of positive affect which occur with anhedonia (i.e., loss of interest or pleasure in activities) may contribute to the onset and maintenance of BED. We introduce a theoretical model in which anhedonia increases the risk for BED through its interrelationships with dysregulated eating and weight gain, and we describe potential direct (e.g., reward-related processes) as well as indirect (e.g., influences on depressive symptoms and physical activity) pathways by which anhedonia may lead to adverse eating- and weight-related outcomes. We also propose a momentary maintenance model in which low positive affect and positive affect dysregulation occurring with anhedonia maintain binge eating directly and indirectly through maladaptive health behaviors, such as decreased physical activity, less healthy eating, and fewer social interactions, which in turn maintain anhedonia. We draw upon outside literature to present evidence that aligns with the proposed risk and maintenance models and conclude by outlining avenues for future research-including methodological/measurement, theoretical, and clinical research directions.

Affect Dysregulation in Context: Implications and Future Directions of Experience Sampling Research on Affect Regulation Models of Loss of Control Eating

Loss of control eating is a core, transdiagnostic eating disorder symptom associated with psychological distress, functional impairment, and reduced quality of life. However, the factors that contribute to persistent loss of control eating despite negative consequences are not fully understood. Understanding the mechanisms that maintain loss of control eating is crucial to advance treatments that interrupt these processes. Affect regulation models of loss of control eating hypothesize that negative emotions trigger loss of control eating, and that loss of control eating is negatively reinforced because it temporarily decreases negative affect. Several variations on this basic affect regulation model have been proposed, including theories suggesting that negative affect decreases during loss of control eating rather than afterwards (escape theory), and that loss of control eating replaces one negative emotion with another that is less aversive (trade-off theory). Experience sampling designs that measure negative affect and eating behavior multiple times per day are optimally suited to examining the nuanced predictions of these affect regulation models in people's everyday lives. This paper critically reviews experience sampling studies examining associations between negative affect and loss of control eating, and discusses the implications for different affect regulation models of loss of control eating. The review concludes by proposing an expanded affect-focused model of loss of control eating that incorporates trait-level individual differences and momentary biological and environmental variables to guide future research. Clinical implications and recommendations are discussed.

Inhibitory control and negative affect in relation to food intake among youth

Negative affect and poor inhibitory control are related to disinhibited eating behaviors in youth and may contribute to the development and/or maintenance of obesity. Although few studies have jointly examined these constructs in youth, it has been theorized that poor inhibitory control may be driven by negative affect. If supported, impaired inhibitory control, driven by negative affect, could represent a modifiable neurocognitive treatment target for disinhibited eating. The current study examined whether inhibitory control mediates the relationship between negative affect and eating among youth. Youth (8-17 years) participated in a Food Go/No-Go neurocognitive task to measure inhibitory control as the percentage of commission errors. A composite negative affect score was created from self-report measures of anxiety and depression. A laboratory buffet meal modeled to simulate disinhibited eating was used to measure total and snack food intake. Cross-sectional mediation models with bias-corrected bootstrap confidence intervals (CI) were conducted using negative affect as the independent variable, inhibitory control as the mediator, and intake patterns as dependent variables. One-hundred-eighty-one youths (13.2 ± 2.7y; 55% female; BMIz 0.6 ± 1.0) were studied. Total Go/No-Go commission errors mediated the relationship between negative affect and total intake (95%CI = [0.3, 31.6]), but not snack intake (95%CI = [-2.5, 7.3]). Commission errors for Food-Go blocks significantly mediated the relationship between negative affect and total intake (95%CI = [7.7, 44.4]), but not snack intake (95%CI = [-3.4, 9.5]). Commission errors on Neutral-Go blocks did not significantly mediate any of these relationships. Negative affect may lead to poorer inhibitory control as well as a stronger approach tendency toward food, increasing the likelihood of engaging in disinhibited eating. Future research should determine if, in combination with approaches to reduce negative affect, improved inhibitory control could help prevent overeating in youths with depressive or anxiety symptoms.

Emotion regulation difficulties interact with negative, not positive, emotional eating to strengthen relationships with disordered eating: An exploratory study

Disordered eating includes core eating disorder symptoms present in diverse populations. The extant literature has focused on associations between negative emotional eating and disordered eating to the exclusion of positive emotional eating. Emotion regulation may help explain relationships between emotional eating and disordered eating. Emotion regulation difficulties was examined as a moderator of relationships between negative and positive emotional eating and disordered eating including dietary restraint, eating, weight, and shape concerns, and global scores of disordered eating, a general index of disordered eating. A cross-sectional study was employed using a university student population in the United States. Participants completed surveys assessing negative (Dutch Eating Behavior Questionnaire; Emotional Appetite Questionnaire) and positive (Emotional Appetite Questionnaire) emotional eating, emotion regulation (Difficulties in Emotion Regulation Scale), and disordered eating (Eating Disorder Examination Questionnaire). Moderation analyses were calculated with emotion regulation difficulties as the moderator of relationships between negative and positive emotional eating and disordered eating. Across two separate measures of negative emotional eating, higher negative emotional eating was associated with higher weight concerns and global scores of disordered eating when emotion regulation difficulties was average and increased (+1 SD above average). Higher positive emotional eating was associated with lower dietary restraint and global scores of disordered eating when emotion regulation difficulties was decreased (-1 SD below average). Emotion regulation difficulties strengthened relationships between negative, not positive, emotional eating and disordered eating. Research and clinical implications for the contribution of emotional eating and emotion regulation on disordered eating were discussed.

Dysregulated Sexuality in Women with Eating Disorders: The Role of Childhood Traumatic Experiences

The present study explored the psychopathological, behavioral, and putative biological underpinnings of dysregulated sexuality in eating disorders (EDs), focusing on the role of childhood trauma - evaluated with the Childhood Trauma Questionnaire (CTQ). The comparison between Binge-Purging and Restricting patients outlined the predominance of markers of dysregulated sexuality in the first subgroup. In the clinical sample, hypersexuality - measured through the Hypersexual Behavior Inventory (HBI) - was associated with severe psychopathology, emotion dysregulation, childhood trauma, adverse consequences, and higher ghrelin levels. Moderation analyses showed that hypersexuality was associated with emotion dysregulation and psychopathology only in those patients reporting childhood traumatic experiences.

Emotional eating in healthy individuals and patients with an eating disorder: evidence from psychometric, experimental and naturalistic studies

Emotional eating has traditionally been defined as (over)eating in response to negative emotions. Such overeating can impact general health because of excess energy intake and mental health, due to the risks of developing binge eating. Yet, there is still significant controversy on the validity of the emotional eating concept and several theories compete in explaining its mechanisms. The present paper examines the emotional eating construct by reviewing and integrating recent evidence from psychometric, experimental and naturalistic research. Several psychometric questionnaires are available and some suggest that emotions differ fundamentally in how they affect eating (i.e. overeating, undereating). However, the general validity of such questionnaires in predicting actual food intake in experimental studies is questioned and other eating styles such as restrained eating seem to be better predictors of increased food intake under negative emotions. Also, naturalistic studies, involving the repeated assessment of momentary emotions and eating behaviour in daily life, are split between studies supporting and studies contradicting emotional eating in healthy individuals. Individuals with clinical forms of overeating (i.e. binge eating) consistently show positive relationships between negative emotions and eating in daily life. We will conclude with a summary of the controversies around the emotional eating construct and provide recommendations for future research and treatment development.

Examining associations between emotion-based rash action and dysregulated eating symptoms in men and women

Negative urgency (NU: tendency to act rashly when distressed) is the facet of impulsive personality that has been most predictive of binge eating, but less is known about the relative role of positive urgency (PU: tendency to act rashly in response to positive emotions). In addition, most studies have exclusively focused on women and the examination of pathological eating outcomes, using a dimensional symptom approach, has been somewhat limited. This study aimed to replicate and extend upon prior work. We examined the extent to which NU and/or PU are uniquely associated with dysregulated eating, using a latent factor comprised of dimensional symptoms, and directly tested whether effects differ by sex. Two independent cross-sectional samples of women and men were used (Sample 1: Midwestern university, 437 females, 348 males; Sample 2: Southwestern university, 301 females, 236 males). NU and PU were assessed with the UPPS-P Impulsive Behavior Scale, and dysregulated eating symptoms (i.e., binge eating, loss of control eating, eating concerns) were assessed with well-validated self-report questionnaires. Although both NU and PU showed significant positive associations with dysregulated eating, NU showed the strongest unique relationship with dysregulated eating in both samples. The relative role of PU was weakened in Sample 1 and completely attenuated in Sample 2 once its shared variance with NU was accounted for. All results were similar in men and women. Overall, findings continue to suggest that NU is the form of impulsivity that is most relevant to dysregulated eating in both men and women.

Examining intra-individual variability in food-related inhibitory control and negative affect as predictors of binge eating using ecological momentary assessment

Binge eating presents in the context of several eating disorders (EDs) and has been shown to be associated with negative affectivity and inhibitory control deficits. While considerable ecological momentary assessment (EMA) work in EDs has demonstrated the importance of intra-individual variability in affect in predicting binge episodes, no research has considered how fluctuations in inhibitory control and negative affect together influence binge eating, or the extent to which these relationships may differ across ED diagnoses. Therefore, the present EMA study assessed the extent to which daily inhibitory control moderated momentary associations between negative affect and binge eating, and whether the presence of regular compensatory behaviors influenced these associations. Participants were 40 women reporting regular binge eating (anorexia nervosa binge-purge type [AN-BP], bulimia nervosa [BN], binge-eating disorder [BED]/subthreshold BED) who completed a 10-day EMA protocol that included measures of affect, eating, and a daily ambulatory Go/No-go task that included palatable food and neutral stimuli. Results of generalized estimating equations indicated greater between-person food-related inhibitory control deficits were associated with greater binge likelihood, and there was a three-way interaction between momentary negative affect, daily food-related inhibitory control, and compensatory behavior group. For individuals with BN or AN-BP, the relationship between momentary negative affect and subsequent binge eating was stronger on days characterized by reduced inhibitory control, whereas no main or interactive effects of negative affect or inhibitory control were observed for those with BED/subthreshold BED. Together these results demonstrate the importance of intra-individual variability in executive functioning and affective processes that underlie binge eating, as well as meaningful individual differences in these momentary associations.

The interplay between self-regulation and affectivity in binge eating among adolescents

Binge eating among adolescents is associated with negative developmental outcomes. From a cognitive perspective, the role of impaired self-regulation is increasingly emphasized as an underlying factor in binge eating, whereas the affect regulation model proposes that affectivity is a key factor in explaining binge eating. Studies combining both perspectives are scarce, but necessary to add to the understanding of this pathological eating behavior. Therefore, the aim of the current study was to investigate unique and joint contributions of both factors in understanding binge eating among adolescents. Participants were 301 adolescents (10-17 years; 67.2% girls; M_age = 13.46 years; SD = 1.99) from the general community. Adolescents self-reported on different types of binge eating episodes (loss of control over eating in general, objective and subjective binge eating in particular), self-regulation (general self-regulation and inhibitory control) and affectivity (positive and negative). The parents were questioned about their children's self-regulatory capacities. Results revealed main effects of self-regulatory capacities (adolescent report) and negative affectivity in predicting objective binge eating. In addition, negative affectivity interacted with self-regulation (parent report) to predict objective binge eating, whereas positive affectivity interacted with self-regulation (adolescent report) to predict subjective binge eating. No significant effects were found for loss of control over eating specifically. Both self-regulation and affectivity each make unique as well as joint contributions to binge eating among adolescents, with results differing across types of binge eating episodes and informants. Theoretical and practical implications are discussed.

From Ecological Momentary Assessment (EMA) to Ecological Momentary Intervention (EMI): Past and Future Directions for Ambulatory Assessment and Interventions in Eating Disorders

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.