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Wonderlich JA, Forester G, Crosby RD, Engel SG, Crow SJ, Peterson CB, Wonderlich SA. An examination of state and trait urgency in individuals with binge-eating disorder. EUROPEAN EATING DISORDERS REVIEW 2024; 32:869-879. [PMID: 38602883 PMCID: PMC11298304 DOI: 10.1002/erv.3096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 03/30/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE Negative urgency (i.e., acting rashly when experiencing negative affect; NU), is a theorised maintenance factor in binge-eating type eating disorders. This study examined the association between trait NU and eating disorder severity, momentary changes in state NU surrounding episodes of binge eating, and the momentary mechanistic link between affect, rash action, and binge-eating risk. METHODS Participants were 112 individuals with binge-eating disorder (BED). Baseline measures included the UPPS-P Impulsive Behaviour Scale to assess trait NU and the Eating Disorders Examination to assess binge-eating frequency and global eating disorder severity. Ecological momentary assessment captured real-time data on binge eating, negative affect, and state NU. RESULTS Multiple regression analysis revealed a strong association between trait NU and eating disorder severity. Generalised estimating equations showed that state NU increased before and decreased after binge-eating episodes, and that this pattern was not moderated by trait-level NU. Finally, a multilevel structural equation model indicated that increases in rash action mediated the momentary relationship between states of high negative affect and episodes of binge eating. CONCLUSION These findings underscore the importance of both trait and state NU in binge-eating type eating disorders, and suggest NU as a potential key target for intervention.
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Affiliation(s)
- Joseph A Wonderlich
- Sanford Research, Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - Glen Forester
- Sanford Research, Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - Ross D Crosby
- Sanford Research, Center for Biobehavioral Research, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Scott G Engel
- Sanford Research, Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
- Accanto Health, St. Paul, Minnesota, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
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Horvath SA, Keel PK, Forney KJ. Examining negative urgency as a predictor of eating disorder maintenance in purging syndromes. J Clin Psychol 2024. [PMID: 38554059 DOI: 10.1002/jclp.23683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/21/2023] [Accepted: 03/20/2024] [Indexed: 04/01/2024]
Abstract
OBJECTIVES Negative urgency is associated with short-term maintenance of binge eating and purging in unselected samples. The current study used an eating disorder sample to test the hypothesis that negative urgency maintains bulimia nervosa (BN) and purging disorder (PD) at long-term follow-up. It was also hypothesized that baseline differences in negative urgency between BN and PD would remain at follow-up. METHODS Secondary analyses were conducted on a sample of women who engaged in recurrent self-induced vomiting (n = 68; 52.9% BN; 47.1% PD). Women completed diagnostic interviews and questionnaires at baseline and at a mean (SD) of 5.95 (1.58) years follow-up (range = 2.51-9.62; retention rate = 75%). RESULTS Negative urgency did not predict eating disorder diagnostic status, recovery status, or global eating pathology at follow-up (p's = .06-.83). There were no significant differences in negative urgency across women with BN and PD at follow-up (p = .16). However, post hoc analyses indicated that negative urgency was not stable across time (ICC = .102). Increases in negative urgency from baseline to follow-up were associated with greater global eating pathology at follow-up (p = .002). CONCLUSION Results suggest negative urgency does not predict long-term eating disorder maintenance. Negative urgency may not be a stable personality trait but rather an indicator of overall poor emotion regulation. Future research should confirm that changes in negative urgency predict chronic eating pathology over long durations of follow-up in women who have increasing negative urgency across time.
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Affiliation(s)
- Sarah A Horvath
- Department of Psychology, Ohio University, Athens, Ohio, USA
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - K Jean Forney
- Department of Psychology, Ohio University, Athens, Ohio, USA
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Davis HA, Smith ZR, Smith GT. Longitudinal transactions between negative urgency and fasting predict binge eating. Appetite 2024; 192:107113. [PMID: 37924849 DOI: 10.1016/j.appet.2023.107113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/11/2023] [Accepted: 11/01/2023] [Indexed: 11/06/2023]
Abstract
Fasting and negative urgency (the disposition to act rashly when distressed) are risk factors for binge eating. It may be that each influences the other over time to predict binge eating. OBJECTIVE This study tested whether (1) fasting predicts binge eating through negative urgency, and (2) negative urgency predicts binge eating through fasting. METHOD Path analysis and mediation tests were used to investigate objectives in n = 302 college women assessed three times over eight months. We controlled for each variable at the previous time point, and concurrent negative affect and body mass index at each time point. RESULTS Time 1 (T1) fasting predicted elevated negative urgency three months later at Time 2 (T2) and T2 negative urgency predicted increases in binge eating five months later at Time 3 (T3). T2 negative urgency mediated the relationship between T1 fasting and T3 binge eating. T1 negative urgency predicted increases in T2 fasting, which then predicted increases in T3 binge eating. T2 fasting mediated the relationship between T1 negative urgency and T3 binge eating. DISCUSSION Findings suggest fasting and negative urgency transact to predict binge eating among college women. Interventions targeting negative urgency may prevent or reduce both fasting and binge eating.
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Affiliation(s)
- Heather A Davis
- Department of Psychology, Virginia Polytechnic Institute and State University, USA.
| | - Zoe R Smith
- Department of Psychology, Loyola University Chicago, USA
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4
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Gonçalves SF, Izquierdo AM, Bates RA, Acharya A, Matto H, Sikdar S. Negative Urgency Linked to Craving and Substance Use Among Adults on Buprenorphine or Methadone. J Behav Health Serv Res 2024; 51:114-122. [PMID: 37414999 PMCID: PMC11002981 DOI: 10.1007/s11414-023-09845-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/08/2023]
Abstract
Despite the effectiveness of medication-assisted treatment (MAT), adults receiving MAT experience opioid cravings and engage in non-opioid illicit substance use that increases the risk of relapse and overdose. The current study examines whether negative urgency, defined as the tendency to act impulsively in response to intense negative emotion, is a risk factor for opioid cravings and non-opioid illicit substance use. Fifty-eight adults (predominately White cis-gender females) receiving MAT (with buprenorphine or methadone) were recruited from online substance use forums and asked to complete self-report questionnaires on negative urgency (UPPS-P Impulsive Behavior Scale), past 3-month opioid cravings (ASSIST-Alcohol, Smoking, and Substance Involvement Screening Test), and non-opioid illicit substance use (e.g., amphetamines, cocaine, benzodiazepines). Results revealed that negative urgency was associated with past 3-month opioid cravings, as well as past month illicit stimulant use (not benzodiazepine use). These results may indicate that individuals high in negative urgency would benefit from receiving extra intervention during MAT.
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Affiliation(s)
| | - Alyssa M Izquierdo
- Department of Psychology, George Mason University, Fairfax, VA, 22030, USA
| | - Rebecca A Bates
- Department of Psychology, George Mason University, Fairfax, VA, 22030, USA
| | - Angeela Acharya
- Department of Psychology, George Mason University, Fairfax, VA, 22030, USA
| | - Holly Matto
- Department of Psychology, George Mason University, Fairfax, VA, 22030, USA
| | - Siddhartha Sikdar
- Department of Psychology, George Mason University, Fairfax, VA, 22030, USA
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Hall NT, Hallquist MN. Dissociation of basolateral and central amygdala effective connectivity predicts the stability of emotion-related impulsivity in adolescents and emerging adults with borderline personality symptoms: a resting-state fMRI study. Psychol Med 2023; 53:3533-3547. [PMID: 35225192 DOI: 10.1017/s0033291722000101] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Borderline personality disorder (BPD) is associated with altered activity in the prefrontal cortex (PFC) and amygdala, yet no studies have examined fronto-limbic circuitry in borderline adolescents and emerging adults. Here, we examined the contribution of fronto-limbic effective connectivity (EC) to the longitudinal stability of emotion-related impulsivity, a key feature of BPD, in symptomatic adolescents and young adults. METHODS We compared resting-state EC in 82 adolescents and emerging adults with and without clinically significant borderline symptoms (n BPD = 40, ages 13-30). Group-specific directed networks were estimated amongst fronto-limbic nodes including PFC, ventral striatum (VS), central amygdala (CeN), and basolateral amygdala (BLA). We examined the association of directed centrality metrics with initial levels and rates of change in emotion-related impulsivity symptoms over a one-year follow-up using latent growth curve models (LGCMs). RESULTS In controls, ventromedial prefrontal cortex (vmPFC) and dorsal ACC had a directed influence on CeN and VS, respectively. In the BPD group, bilateral BLA had a directed influence on CeN, whereas in the healthy group CeN influenced BLA. LGCMs indicated that emotion-related impulsivity was stable across a one-year follow-up in the BPD group. Further, higher EC of R CeN to other regions in controls was associated with stronger within-person decreases in emotion-related impulsivity. CONCLUSIONS Functional inputs from BLA and vmPFC appear to play competing roles in influencing CeN activity. In borderline adolescents and young adults, BLA may predominate over CeN activity, while in controls the ability of CeN to influence BLA activity predicted more rapid reductions in emotion-related impulsivity.
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Affiliation(s)
- Nathan T Hall
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Michael N Hallquist
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Barrios L, Stamatovich SN, Simons RM, Simons JS. Reinforcement sensitivity and bulimia symptoms: the role of emotion regulation. Eat Weight Disord 2022; 27:1593-1602. [PMID: 34546555 DOI: 10.1007/s40519-021-01275-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/20/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Reinforcement Sensitivity Theory (RST) provides a theoretical foundation associated with various approach and avoidance behaviors and individual personality differences. Sensitivity to reward and punishment, two neural systems within the RST have been significantly associated with bingeing and purging behaviors. However, inconsistent findings are observed and specific factors mediating these relationships are not well understood. Deficits in emotion regulation may account for these relationships, as both negative urgency and distress tolerance have been independently associated with bulimia behaviors. Thus, this is an area that requires further investigation. METHOD The current study utilized various self-report inventories, including the Eating Disorder Inventory-3rd Edition to measure bulimia symptoms, as well as measures of negative affect, sensitivity to reward and punishment, distress tolerance, and negative urgency. These measures were used to assess whether distress tolerance and negative urgency mediated associations between sensitivity to reward and punishment and bulimia symptoms in a community sample of 394 young adults ranging from the ages of 18 to 25. RESULTS As expected, sensitivity to reward and punishment were significantly associated with decreased distress tolerance. Distress tolerance was also directly associated with greater negative urgency, which was significantly associated with increased bulimia symptoms. Consistent with hypotheses, indirect associations between sensitivity to reward and sensitivity to punishment to bulimia symptoms via distress tolerance and negative urgency were observed, controlling for gender and negative affect. DISCUSSION Results contribute to understanding specific contributions of risk factors within the relationship of sensitivity to reward and punishment and bulimia symptoms, measured by the EDI-3. Novel to existing literature, results indicate that reinforcement sensitivity significantly contributes to emotion regulation deficits. Thus, these findings may have important implications for understanding the development and treatment of bulimia symptoms. LEVEL OF EVIDENCE Level V, based on descriptive, cross-sectional data.
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Affiliation(s)
- Lindsey Barrios
- Department of Psychology, University of South Dakota, Vermillion, SD, USA.
| | | | - Raluca M Simons
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
| | - Jeffrey S Simons
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
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Cheng D, Wei M. Modified Dual Pathway Model for Binge Eating: The Role of Emotion Dysregulation. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000221077936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We tested a modification of the dual pathway model using two sequential mediators between body dissatisfaction and binge eating: restricted eating and difficulties in emotion regulation replacing negative affect. A total of 435 college students completed an online survey. Results from path analyses indicated that the relationship between body dissatisfaction and binge eating was not mediated by restricted eating for neither women nor men. However, this relationship was mediated first by restricted eating and then by difficulties in emotion regulation for women only. Moreover, this relationship was mediated by difficulties in emotion regulation for both women and men. A post hoc analysis indicated that the above mediation results were still significant after adding negative affect into the model. No mediations through negative affect were significant. Clinical implications include the conceptualization and intervention of eating concerns within an emotion dysregulation framework.
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Affiliation(s)
- Davelle Cheng
- Department of Psychology, Iowa State University, Ames, IA, USA
| | - Meifen Wei
- Department of Psychology, Iowa State University, Ames, IA, USA
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Tie B, Chen G, He J. Validation of the inflexible eating questionnaire in a large sample of Chinese adolescents: psychometric properties and gender-related differential item functioning. Eat Weight Disord 2022; 27:1029-1037. [PMID: 34137005 DOI: 10.1007/s40519-021-01239-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/08/2021] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The aim of this study was to provide preliminary psychometric evidence for the Chinese version of the Inflexible Eating Questionnaire (C-IEQ) among a large sample of Chinese adolescents. METHODS For testing the psychometric properties of the C-IEQ, a total of 2241 (Mage = 13.91 years; 46.4% boys) adolescents from mainland China responded to the survey. Confirmatory factor analysis (CFA) was used to examine the factor structure of the C-IEQ. Measurement invariance by gender was examined by both multi-group CFA and differential item functioning (DIF). Convergent validity of the C-IEQ was assessed via examining the correlations between the C-IEQ scores and theoretically related constructs (e.g., orthorexia nervosa symptomatology, eating disorder symptomatology, and body image inflexibility). RESULTS The unidimensional structure with correlated errors of the C-IEQ showed good model fit (χ2 = 1674.05, df = 44, p < 0.001; CFI = 0.93; TLI = 0.91; RMSEA = 0.13; SRMR = 0.06). The C-IEQ had an adequate internal consistency (α = 0.89) and demonstrated strong measurement invariance across genders. Moreover, the scores of the C-IEQ showed significant correlations with theoretically correlated constructs: orthorexia nervosa symptomatology (girls; r = 0.53 p < 0.001, boys; r = 0.45 p < 0.001), eating disorder symptomatology (girls; r = 0.32 p < 0.001, boys; r = 0.25 p < 0.001) body image inflexibility (girls; r = 0.41 p < 0.001, boys; r = 0.36 p < 0.001), suggesting good convergent validity of the C-IEQ. CONCLUSION The C-IEQ showed good psychometric properties in a sample of Chinese adolescents and can be used in future studies to assess eating-specific psychological inflexibility among Chinese adolescents. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Bijie Tie
- School of Education, Zhengzhou University, Zhengzhou, Henan, China
| | - Gui Chen
- College of Educational Science, Hengyang Normal University, Hengyang, Hunan, China
| | - Jinbo He
- School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, 518172, Guangdong, China.
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A Preliminary Exploration of Behaviours Associated with Negative Urgency in Individuals High and Low in Chronic Worry. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractWhile chronic worry is typically associated with cautious and harm-avoidant behaviours, there is evidence that people high in chronic worry are characterised by negative urgency (NU), that is, the propensity to act rashly when experiencing negative affect. The present study was a preliminary examination of how rash action and impulsive decision-making manifest for chronic worriers compared to individuals low in worry. In total, 93 participants who endorsed high and low worry and NU responded to open-ended questions about their experience of NU on Amazon Mechanical Turk. Themes were identified using a data-driven approach. Participants high in chronic worry endorsed significantly greater NU compared to those low in worry. However, the types of NU behaviours were similar across participants, with a majority of responses involving initiating interpersonal conflict. Other themes included spending money, excessive eating, alcohol use, and aggressive behaviours. The manifestations of NU were largely consistent with those described in the model of NU. Although individuals higher in chronic worry engaged in NU behaviours to a greater extent, the types of behaviours were similar to those reported by people lower in worry. More research is needed to understand the characteristics of NU-motivated behaviour in individuals high in chronic worry.
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Associations of self-reported eating disorder behaviors and personality in a college-educated sample. Appetite 2020; 151:104669. [PMID: 32179014 DOI: 10.1016/j.appet.2020.104669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 01/28/2020] [Accepted: 03/11/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In order to better understand factors motivating eating disorder (ED) behaviors and better identify persons at-risk for these behaviors, we sought to identify which personality domains and facets were associated with behaviors for weight control. METHODS ED behavior information was gathered from the University of North Carolina Alumni Heart Study using the question, "have you ever used any of the following to lose weight?" Respondents endorsed any combination of the following: "Vomiting," "Fasting," "Laxatives," "Excessive physical exercise." Personality was measured using the Revised NEO Personality Inventory (NEO-PI-R). One-way ANOVAs were performed comparing personality domains and facets to reported ED behaviors, computed both as separate behaviors and the number of cumulative behaviors. RESULTS Of 3496 respondents, 9.41% endorsed ever having used at least one ED behavior, with the majority endorsing only a single ED behavior. For both sexes, endorsing greater numbers of ED behaviors was associated with higher scores on Neuroticism and Openness. For women, the strongest associations for behaviors with personality were: excessive exercise with high Impulsiveness; fasting with high Impulsiveness and low Gregariousness; laxative use/purging with high scores on Activity and Feelings. For men, the strongest associations were: excessive exercise with high Impulsiveness; fasting with high Ideas; laxative use/purging with low Modesty. DISCUSSION Data collected from this sample showed a sex-modulated pattern of association between personality domains and facets with ED behaviors. Our findings support that obtaining personality profiles of individuals exhibiting subclinical eating behaviors will enhance our understanding of who is at risk of developing an ED diagnosis.
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Yiu A, Christensen K, Arlt JM, Chen EY. Distress tolerance across self-report, behavioral and psychophysiological domains in women with eating disorders, and healthy controls. J Behav Ther Exp Psychiatry 2018; 61:24-31. [PMID: 29885596 DOI: 10.1016/j.jbtep.2018.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 05/19/2018] [Accepted: 05/28/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVES The tendency to engage in impulsive behaviors when distressed is linked to disordered eating. The current study comprehensively examines emotional responses to a distress tolerance task by utilizing self-report, psychophysiological measures (respiratory sinus arrhythmia [RSA], skin conductance responses [SCRs] and tonic skin conductance levels [SCLs]), and behavioral measures (i.e., termination of task, latency to quit task). METHODS 26 healthy controls (HCs) and a sample of treatment-seeking women with Bulimia Nervosa (BN), Binge Eating Disorder (BED) and Anorexia Nervosa (AN) (N = 106) completed the Paced Auditory Serial Addition Task- Computerized (PASAT-C). Psychophysiological measurements were collected during baseline, PASAT-C, and recovery, then averaged for each time period. Self-reported emotions were collected at baseline, post-PASAT-C and post-recovery. RESULTS Overall, we found an effect of Time, with all participants reporting greater negative emotions, less happiness, lower RSA, more SCRs and higher tonic SCLs after completion of the PASAT-C relative to baseline. There were no differences in PASAT-C performance between groups. There was an effect of Group for negative emotions, with women with BN, BED and AN reporting overall higher levels of negative emotions relative to HCs. Furthermore, we found an effect of Group for greater urges to binge eat and lower RSA values among BED, relative to individuals with BN, AN and HCs. LIMITATIONS This study is cross-sectional and lacked an overweight healthy control group. CONCLUSION During the PASAT-C, individuals with eating disorders (EDs) compared to HCs report higher levels of negative emotions, despite similar physiological and behavioral manifestations of distress.
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Affiliation(s)
- Angelina Yiu
- TEDp (Temple Eating Disorders program), Department of Psychology, Temple University, 1701 North 13th Street, Philadelphia, PA, 19122, United States
| | - Kara Christensen
- Cognition and Emotion Lab, Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, United States
| | - Jean M Arlt
- TEDp (Temple Eating Disorders program), Department of Psychology, Temple University, 1701 North 13th Street, Philadelphia, PA, 19122, United States
| | - Eunice Y Chen
- TEDp (Temple Eating Disorders program), Department of Psychology, Temple University, 1701 North 13th Street, Philadelphia, PA, 19122, United States.
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Puccio F, Fuller-Tyszkiewicz M, Buck K, Krug I. Negative urgency and the dual pathway model of bulimic symptoms: A longitudinal analysis. EUROPEAN EATING DISORDERS REVIEW 2018; 27:34-48. [PMID: 30318838 DOI: 10.1002/erv.2647] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/29/2018] [Accepted: 09/16/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study extends the dual pathway model (DPM) of bulimic symptoms by considering the bidirectional effects amongst symptoms of depression, dietary restraint, and bulimia. We also assessed the influence of negative urgency, a personality construct associated with bulimic symptoms, on the DPM. METHOD Participants were 244 females (Mage = 23.77 years) from the general community. Variables pertinent to the DPM as well as negative urgency were assessed at baseline, and symptoms of depression, dietary restraint, and bulimia were reassessed at 1-month follow-up. RESULTS Excellent model fit was obtained once modifications were made to the DPM and the extended model that included negative urgency. Cross-sectional paths replicated the DPM as hypothesized, with the exception that time 1 (T1) body mass index failed to predict T1 body dissatisfaction. Although no bidirectional effects were observed, T1 depression predicted dietary restraint at time 2 (T2). Negative urgency was shown to provide incremental predictive utility of T1 pressure to be thin, T1 body dissatisfaction, and T1 and T2 depression. CONCLUSION Findings lend support to the DPM and suggest that depression might be a risk factor for later dietary restraint. The results are also consistent with the notion that negative urgency may be an independent risk factor for symptoms of bulimia. However, short-term longitudinal effects of these putative risk factors require further evaluation.
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Affiliation(s)
- Francis Puccio
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, Victoria, Australia.,Center for Social and Early Emotional Development, Deakin University, Geelong, Victoria, Australia
| | - Kimberly Buck
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.,Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Peters JR, Eisenlohr-Moul TA, Walsh EC, Derefinko KJ. Exploring the pathophysiology of emotion-based impulsivity: The roles of the sympathetic nervous system and hostile reactivity. Psychiatry Res 2018; 267:368-375. [PMID: 29957555 PMCID: PMC6309543 DOI: 10.1016/j.psychres.2018.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 06/07/2018] [Accepted: 06/07/2018] [Indexed: 11/22/2022]
Abstract
The tendency to engage in impulsive behavior in the context of negative affect, known as negative urgency, has emerged as a powerful transdiagnostic predictor of behavioral dysregulation. Although general vulnerability to negative affect (neuroticism) correlates with negative urgency, not all neurotic individuals engage in urgent behavior. Given prior experimental evidence that sympathetic nervous system (SNS) activation may promote emotion-related impulsivity, the present study examines tonic SNS activity as a moderator of the link between neuroticism and negative urgency. Participants (N = 194) completed measures of neuroticism and negative urgency, as well as a stress task. They also underwent assessment of tonic SNS activity (cardiac pre-ejection period). The link between neuroticism and negative urgency was strengthened for individuals with higher tonic SNS activity; however, this was not the case for behavioral performance on the task. A similar pattern was demonstrated for hostile reactivity to the stress task; increased hostile response partially explained the interaction between SNS activation and neuroticism on negative urgency. These findings suggest a potential facilitative role of the SNS in hostile reactivity and emotion-driven impulsivity among more neurotic individuals.
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Affiliation(s)
- Jessica R Peters
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
| | | | - Erin C Walsh
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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14
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Racine SE, VanHuysse JL, Keel PK, Burt SA, Neale MC, Boker S, Klump KL. Eating disorder-specific risk factors moderate the relationship between negative urgency and binge eating: A behavioral genetic investigation. JOURNAL OF ABNORMAL PSYCHOLOGY 2018; 126:481-494. [PMID: 28691840 DOI: 10.1037/abn0000204] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Theoretical models of binge eating and eating disorders include both transdiagnostic and eating disorder-specific risk factors. Negative urgency (i.e., the tendency to act impulsively when distressed) is a critical transdiagnostic risk factor for binge eating, but limited research has examined interactions between negative urgency and disorder-specific variables. Investigating these interactions can help identify the circumstances under which negative urgency is most strongly associated with binge eating. We examined whether prominent risk factors (i.e., appearance pressures, thin-ideal internalization, body dissatisfaction, dietary restraint) specified in well-established etiologic models of eating disorders moderate negative urgency-binge eating associations. Further, we investigated whether phenotypic moderation effects were due to genetic and/or environmental associations between negative urgency and binge eating. Participants were 988 female twins aged 11-25 years from the Michigan State University Twin Registry. Appearance pressures, thin-ideal internalization, and body dissatisfaction, but not dietary restraint, significantly moderated negative urgency-binge eating associations, with high levels of these risk factors and high negative urgency associated with the greatest binge eating. Twin moderation models revealed that genetic, but not environmental, sharing between negative urgency and binge eating was enhanced at higher levels of these eating disorder-specific variables. Future longitudinal research should investigate whether eating disorder risk factors shape genetic influences on negative urgency into manifesting as binge eating. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | - Michael C Neale
- Departments of Psychiatry, Human Genetics, and Psychology, Virginia Commonwealth University
| | - Steven Boker
- Department of Psychology, University of Virginia
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Bardone-Cone AM, Butler RM, Balk MR, Koller KA. Dimensions of impulsivity in relation to eating disorder recovery. Int J Eat Disord 2016; 49:1027-1031. [PMID: 27404963 PMCID: PMC5121027 DOI: 10.1002/eat.22579] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2016] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Impulsivity is associated with eating pathology, but different dimensions of impulsivity have not been extensively studied in the eating disorders. The current study examined the relationship between four facets of impulsivity and eating disorder recovery status. METHOD Females formerly seen for an eating disorder were categorized as having an eating disorder (n = 53), partially recovered (n = 15), or fully recovered (n = 20) based on a diagnostic interview and physical, behavioral, and psychological indices. These groups and non-eating disorder controls were compared on impulsivity facets from the UPPS Impulsive Behavior Scale (UPPS): Urgency (negative urgency), Premeditation (lack of), Perseverance (lack of), and Sensation Seeking. RESULTS Negative urgency (the tendency to engage in impulsive behavior to alleviate negative affect) was related to recovery. The fully recovered group and controls experienced significantly less negative urgency than those with a current eating disorder; the partially recovered group did not differ from the eating disorder group. DISCUSSION Findings suggest that negative urgency may be a particularly important facet of impulsivity to target in therapeutic intervention for eating disorders, especially among those with a history of binge eating and/or purging. Future longitudinal work is needed to test a potential causal relationship between negative urgency and eating disorder recovery. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1027-1031).
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Affiliation(s)
- Anna M. Bardone-Cone
- Correspondence to: Dr. Anna M. Bardone-Cone, Department of Psychology and Neuroscience, CB #3270 Davie Hall, University of North Carolina, Chapel Hill, NC 27599.
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Exploring divergent trajectories: Disorder-specific moderators of the association between negative urgency and dysregulated eating. Appetite 2016; 103:45-53. [DOI: 10.1016/j.appet.2016.03.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 03/15/2016] [Accepted: 03/24/2016] [Indexed: 11/21/2022]
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Hoptman MJ, Ahmed AO. Neural Foundations of Mood-Induced Impulsivity and Impulsive Aggression in Schizophrenia. Curr Behav Neurosci Rep 2016. [DOI: 10.1007/s40473-016-0081-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pennesi JL, Wade TD. A systematic review of the existing models of disordered eating: Do they inform the development of effective interventions? Clin Psychol Rev 2016; 43:175-92. [PMID: 26781985 DOI: 10.1016/j.cpr.2015.12.004] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 11/09/2015] [Accepted: 12/20/2015] [Indexed: 12/21/2022]
Abstract
Despite significant advances in the development of prevention and treatment interventions for eating disorders and disordered eating over the last decade, there still remains a pressing need to develop more effective interventions. In line with the 2008 Medical Research Council (MRC) evaluation framework from the United Kingdom for the development and evaluation of complex interventions to improve health, the development of sound theory is a necessary precursor to the development of effective interventions. The aim of the current review was to identify the existing models for disordered eating and to identify those models which have helped inform the development of interventions for disordered eating. In addition, we examine the variables that most commonly appear across these models, in terms of future implications for the development of interventions for disordered eating. While an extensive range of theoretical models for the development of disordered eating were identified (N=54), only ten (18.5%) had progressed beyond mere description and to the development of interventions that have been evaluated. It is recommended that future work examines whether interventions in eating disorders increase in efficacy when developed in line with theoretical considerations, that initiation of new models gives way to further development of existing models, and that there be greater utilisation of intervention studies to inform the development of theory.
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Giner-Bartolomé C, Fagundo AB, Sánchez I, Jiménez-Murcia S, Santamaría JJ, Ladouceur R, Menchón JM, Fernández-Aranda F. Can an intervention based on a serious videogame prior to cognitive behavioral therapy be helpful in bulimia nervosa? A clinical case study. Front Psychol 2015; 6:982. [PMID: 26236261 PMCID: PMC4500862 DOI: 10.3389/fpsyg.2015.00982] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/29/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Several studies have highlighted the implications of impulsivity and novelty seeking for both the maintenance and the process of recovery from bulimia nervosa (BN). Cognitive behavioral therapy (CBT) is the treatment of choice for BN, but for some cases, this treatment alone might not be sufficient for reducing the high levels of impulsivity. The paper presents a case report of a patient with BN, examining the effectiveness of using a videogame (VG; Playmancer) as an additional intervention designed to address impulsivity. DESIGN Psychometric and neuropsychological measures were collected at baseline. After this assessment, Playmancer was applied prior to CBT, following an "A-B-A-C-A" single case experimental design. Impulsivity levels were assessed with the Conner's Continuous Performance Test II (CPT-II). After the Playmancer treatment, the patient started CBT, and the levels of impulsivity were recorded again. Finally, psychometric and neuropsychological measures were collected after treatment. Weekly frequency of binges and vomiting were also recorded during the entire procedure. RESULTS After the VG intervention, psychometric measures such as anxiety levels, impulsivity and novelty seeking decreased. Regarding the neuropsychological measures, impulsivity levels (measured with the CPT-II) progressively decreased throughout the intervention, and an improvement in decision making capacities was observed. Furthermore, the frequency of binges also decreased during and after the VG intervention. DISCUSSION This case report suggests that using the Playmancer VG to reduce impulsivity prior to CBT may enhance the final results of the treatment for BN.
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Affiliation(s)
- Cristina Giner-Bartolomé
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Ciber Fisiopatologia Obesidad y Nutrición, Instituto de Salud Carlos III , Barcelona, Spain
| | - Ana B Fagundo
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Ciber Fisiopatologia Obesidad y Nutrición, Instituto de Salud Carlos III , Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Ciber Fisiopatologia Obesidad y Nutrición, Instituto de Salud Carlos III , Barcelona, Spain ; Clinical Sciences Department, School of Medicine, University of Barcelona , Barcelona, Spain
| | - Juan J Santamaría
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Ciber Fisiopatologia Obesidad y Nutrición, Instituto de Salud Carlos III , Barcelona, Spain
| | | | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Clinical Sciences Department, School of Medicine, University of Barcelona , Barcelona, Spain ; Ciber Salud Mental, Instituto de Salud Carlos III , Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Ciber Fisiopatologia Obesidad y Nutrición, Instituto de Salud Carlos III , Barcelona, Spain ; Clinical Sciences Department, School of Medicine, University of Barcelona , Barcelona, Spain
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Vainik U, Neseliler S, Konstabel K, Fellows LK, Dagher A. Eating traits questionnaires as a continuum of a single concept. Uncontrolled eating. Appetite 2015; 90:229-39. [DOI: 10.1016/j.appet.2015.03.004] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 02/17/2015] [Accepted: 03/05/2015] [Indexed: 11/17/2022]
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Lavender JM, Green D, Anestis MD, Tull MT, Gratz KL. Negative Affect, Negative Urgency, Thought Suppression, and Bulimic Symptoms: A Moderated Mediation Analysis in a Sample at-Risk for Bulimic Symptoms. EUROPEAN EATING DISORDERS REVIEW 2015; 23:246-50. [DOI: 10.1002/erv.2351] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 01/27/2015] [Accepted: 02/08/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Jason M. Lavender
- Neuropsychiatric Research Institute; Fargo North Dakota USA
- The University of North Dakota School of Medicine and Health Sciences; Fargo North Dakota USA
| | - Daniel Green
- Neuropsychiatric Research Institute; Fargo North Dakota USA
| | | | | | - Kim L. Gratz
- University of Mississippi Medical Center; Jackson MS USA
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