Perceived hunger mediates the relationship between attachment anxiety and emotional eating

Attachment, Feeding Practices, Family Routines and Childhood Obesity: A Systematic Review of the Literature

Childhood obesity is considered a major public health problem. To help prevention and intervention programs targeting families with obese children, this paper is aimed at synthesizing multifactorial and transactional data resulting from studies and reviews assessing relational factors between the child and his or her parents and the child's obesity risk, including the child's and CG's attachment quality, parental feeding practices, and family routines. It is also aimed at assessing the mediation of these links by specific self-regulatory capacities across different developmental periods (0-2, 2-8, and 8-18 years old). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were applied in the review methodology. Ten papers were analyzed, including seven empirical studies and three reviews proposing etiological models of childhood obesity. The quality of empirical studies was assessed, and a synthetical model of the results was proposed. This literature review showed that the caregiver's (CG) and the child's attachment quality, along with controlling or permissive feeding practices, and few family routines are mostly mediated by appetite dysregulation and emotional regulation strategies with the development of child obesity. New research topics are proposed to understand other facets of childhood obesity, as well as how to better prevent and treat it.

Attachment, rumination, and disordered eating among adolescent girls: The moderating role of stress

PURPOSE

Disordered eating behaviors are prevalent and problematic in adolescent girls. Given that disordered eating has been linked to attachment insecurity and emotion dysregulation, the current study used an emotion regulation model of attachment theory to investigate pathways to disordered eating among adolescent girls. While past research has examined attachment and eating, an emotion regulation perspective is rarely used. Additionally, limited studies have investigated specific types of eating or mediators or moderators. To address these research gaps, this study examined whether rumination mediates the relationship between attachment anxiety and avoidance and three types of disordered eating and whether stress moderates this mediation.

METHODS

100 adolescent girls (M_age = 14.35 years, SD = 2.29) completed online surveys including the Relationship Structures Questionnaire, Dutch Eating Behaviour Questionnaire, Rumination Questionnaire, and Perceived Stress Scale.

RESULTS

The interaction between stress and attachment anxiety on rumination was significant (b = .09, SE = .04, p < .05), and stress and attachment anxiety predicted emotional eating through rumination (b = .50, SE = .15, p < .05). Rumination also predicted external eating (b = .32, SE = .11, p < .05). The mediation was not significant for restrained eating. Attachment avoidance did not significantly predict eating behaviors.

CONCLUSION

The emotion regulation model of attachment theory provides a suitable framework for studying disordered eating in adolescent girls. Future research may continue the use of this framework to examine related topics. Clinicians treating girls experiencing disordered eating may use interventions to promote healthy emotion regulation strategies.

LEVEL OF EVIDENCE

Level V: cross-sectional descriptive study.

Predictors of Anxiety-Induced Sleep Disturbance among in-School Adolescents in Ghana: Evidence from the 2012 Global School-Based Health Survey

(1) Background: Psychological problems of adolescents have become a global health and safety concern. Empirical evidence has shown that adolescents experience diverse mental health conditions (e.g., anxiety, depression, and emotional disorders). However, research on anxiety-induced sleep disturbance among in-school adolescents has received less attention, particularly in low- and middle-income countries. This study's central focus was to examine factors associated with t anxiety-induced sleep disturbance among in-school adolescents in Ghana. (2) Methods: Analysis was performed using the 2012 Global School-based Health Survey (GSHS). A sample of 1342 in-school adolescents was included in the analysis. The outcome variable was anxiety-induced sleep disturbance reported during the past 12 months. Frequencies, percentages, chi-square, and multivariable logistic regression analyses were conducted. Results from the multivariable logistic regression analysis were presented as crude and adjusted odds ratios at 95% confidence intervals (CIs) and with a statistical significance declared at p < 0.05. (3) Results: Adolescents who went hungry were more likely to report anxiety-induced sleep disturbance compared to their counterparts who did not report hunger (aOR = 1.68, CI = 1.10, 2.57). The odds of anxiety-induced sleep disturbance were higher among adolescents who felt lonely compared to those that never felt lonely (aOR = 2.82, CI = 1.98, 4.01). Adolescents who had sustained injury were more likely to have anxiety-induced sleep disturbance (aOR = 1.49, CI = 1.03, 2.14) compared to those who had no injury. Compared to adolescents who never had suicidal ideations, those who reported experiencing suicidal ideations had higher odds of anxiety-induced sleep disturbance (aOR = 1.68, CI = 1.05, 2.71). (4) Conclusions: Anxiety-induced sleep disturbance among in-school adolescents were significantly influenced by the psychosocial determinants such as hunger, loneliness, injury, and suicidal ideation in this study. The findings can help design appropriate interventions through effective strategies (e.g., early school-based screening, cognitive-behavioral therapy, face-face counseling services) to reduce psychosocial problems among in-school adolescents in Ghana.

The Effect of Hunger and Satiety on Mood-Related Food Craving

In addition to hunger, which results from food deprivation, fasting, or restrained eating, food craving is thought to be one of the major factors influencing eating behavior. Although food craving occurs in healthy humans with normal eating behavior, research suggests pronounced food craving to be a risk factor for binging food, which in turn might cause weight gain and obesity. In addition, negative mood seems to induce binge eating, although the underlying processes are not clearly understood. To examine these effects on momentary food craving more closely, we implemented a food cue-reactivity paradigm in 33 normal-weight females (mean age = 25.1 years, mean BMI = 21.6). Mood (negative vs. neutral) and state of food deprivation (hunger vs. satiety) were varied systematically. Self-rated craving was significantly higher in hungry compared to sated states. Moreover, in neutral mood, high-caloric foods modulated craving, i.e., hungry and sated participants preferred savory food and sweet food, respectively. In negative mood, this differential effect of savory and sweet items was absent. In summary, the state of hunger has a huge impact on food craving, which is further modulated by emotional state. Future research should consider hunger to be of high relevance for effects investigated in food-related paradigms. Our findings in healthy women of normal weight support etiological models of disturbed eating behavior and are in line with common interventions targeting eating schedules and mood regulation.

How food brings us together: The ties between attachment and food behaviors

Interpersonal food behaviors, such as food sharing and food offering, are associated with closeness between people and thought to facilitate the formation and strengthening of social bonds. Despite the importance of food and food-related behavior in general and for social bonding specifically, there is relatively little research about the psychological underpinnings of food-related behavior within relationship science. To fill this gap, we conducted three studies focusing on food behaviors and attachment style. In Study 1, we found attachment avoidance to be negatively associated with engagement in food sharing behaviors, and with a lower likelihood of dating a potential partner due to the partner's food preferences. In Study 2, we found that enhancing attachment security increased the tendency to offer one's food to a fellow participant. In Study 3, we found that the tendency to accept food from a fellow participant was positively associated with attachment anxiety, but security priming did not affect this tendency. Implications for attachment, close relationships, and food sciences are discussed.

Attachment, Parenting, and Obesogenic Behavior: A Dyadic Perspective

Pediatric obesity is a growing health concern afflicting the United States. The treatment for pediatric obesity, as a health epidemic, costs billions of dollars to our nation, leaving providers and researchers searching for effective and sustainable ways to better manage the biological, psychological, and social health of individuals and families. While many assessments and interventions continue to emerge, researchers have predominately focused on intra-individual concerns among white non-Hispanic populations. This quantitative study was grounded in a relational theory (attachment theory), with a dyadic and primarily Hispanic sample. Evidence from our study supported that child attachment predicted child obesogenic behavior and that this relationship was mediated by child self-regulation. Children with insecure attachments had more obesogenic behaviors and lower self-regulation of eating than those with secure attachments. Family therapists should be on the frontlines of relational research and clinical interventions that interface with biopsychosocial health across diverse cultures and families.

Care vs Food as an Emotional Regulation Strategy in Elementary School Children: The Role of the Attachment Style

According to attachment theory, potentially threatening stimuli tend to activate the attachment system for the search of the protective figure. In secure attachments, the experience of responsive relationships increases the probability of resorting to available figures as a strategy for regulating emotions in stressful situations. The aim of the research was to verify whether, in conditions of mild threat, children's attachment styles affect the choice between caring relationships and food as a form of emotion regulation. We used a mixed experimental design to perform this research. Here, we presented children (N = 65; M_age= 9.4) with threatening and neutral images and, afterwards, asked them to select from images of caring relationship or images of food. The results indicate that securely and ambivalently attached but not avoidantly attached children under both the neutral and threatening image conditions chose the care pictures over the food pictures. Second, only the securely attached increased their choice of care over food images in the threatening condition, and third, this difference was significant when compared with the avoidant children. In conclusion, the results show that although in general the choice of care is primary with respect to food, children with insecure attachments differ from secure children between the two options of emotional regulation.

Sensitivity to CT-optimal, Affective Touch Depends on Adult Attachment Style

Affective touch supports affiliative bonds and social cognition. In particular, gentle, stroking touch, which has recently been associated with the C Tactile (CT) system, is typically perceived as pleasant and prosocial. However, it remains unknown whether pre-existing models of social relating influence the perception of CT-optimal touch. In this study (N = 44 adults), we examined how individual differences in attachment styles relate to the perception of CT-optimal touch, as well as to a different modality of interoception, namely heartbeat perception. Using the gold-standard assessment of attachment (Adult Attachment Interview), we found that insecure attachment was associated with reduced pleasantness discrimination between CT-optimal vs. non-CT optimal touch. Acknowledging the different traditions in measuring attachment, we also used a well-validated self-report questionnaire that pertains to explicit representations of current close relationships. Using this measure, we found that higher scores in attachment anxiety (but not attachment avoidance) were associated with reduced pleasantness discrimination between CT-optimal vs. non-CT optimal touch. Attachment patterns (in both measures) were not related to cardiac perception accuracy. These results corroborate and extend previous literature on CT-optimal touch and its relation with affiliative bonds and social cognition. Given that attachment was not related to perceived cardiac accuracy, these findings point to the specificity of the relationship between CT-optimal touch and attachment.

Attachment anxiety is associated with a fear of becoming fat, which is mediated by binge eating

Background

Previous work demonstrated that individuals with higher levels of attachment anxiety are prone to increased binge eating (Alexander & Siegel, 2013). Given that our society rejects obese individuals and individuals with higher levels of attachment anxiety tend to be highly sensitive to rejection (Downey & Feldman, 1996), it follows that those with increased attachment anxiety may be especially fearful of becoming fat.

Methods

Undergraduate psychology students (n = 148) completed surveys measuring attachment, binge eating, and fear of becoming fat.

Results

The data demonstrate that attachment anxiety is positively associated with a fear of becoming fat (β = .30, p < .001) and binge eating mediates this relationship. In other words, binge eating underlies the fear of becoming fat.

Discussion

These findings contribute to a more refined understanding of binge eating which may create pathways for professionals to develop targeted interventions.

Parental attachment insecurity predicts child and adult high-caloric food consumption

Eating habits are established early and are difficult to change once formed. This study investigated the role of caregiver-child attachment quality and its associations with high-caloric food consumption in a sample of middle socio-economic status children and adults, respectively. Survey data were collected from an online questionnaire administered separately to 213 (143 girls) children and 216 parents (adult sample; 180 women). Two studies showed that an insecure parental attachment, whether actual (Study 1; children) or recalled (Study 2; adults), significantly and positively predicted high-caloric food consumption in both samples. The present findings highlight the importance of parental attachment and its association with unhealthy eating patterns in children and adults.

Gender differences in couple attachment behaviors as predictors of dietary habits and physical activity levels

This study used an Actor-Partner Interdependence Model to examine the relationship between attachment behaviors and health practices, as measured by physical activity levels and dietary habits. The sample included 1031 married couples, the majority of which is Caucasian (83.8%). Results suggest that women's attachment behaviors significantly influenced their own health practices (p = .038), such that for every unit increase in poor attachment behaviors, women were 199.8 percent more likely to have poor diet and low physical activity levels (exp(1.098) = 2.998). Men's attachment behaviors were not significantly related to their own health practices. There were also no significant partner paths. Implications for treating women who present with health problems are discussed, as are directions for future research.