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Pinna F, Suprani F, Paribello P, Milia P, Sanna L, Manchia M, Boi G, Pes A, Lai L, Deiana V, Lostia di Santa Sofia S, Puddu L, Fatteri F, Ghiani A, Lai A, Carpiniello B. Food and Alcohol Disturbance in High School Adolescents: Prevalence, Characteristics and Association with Problem Drinking and Eating Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:83. [PMID: 38248546 PMCID: PMC10815297 DOI: 10.3390/ijerph21010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/30/2023] [Accepted: 01/10/2024] [Indexed: 01/23/2024]
Abstract
Food and alcohol disturbance (FAD) is characterized by the association of alcohol use with compensatory behaviors such as restricting calories, physical activity and purging. Despite not being part of the current nosography, research has grown in the past 10 years, mostly on college students' samples. In this study, we aim to describe the prevalence, characteristics and association of FAD with problem drinking (PD) and eating disorder risk (EDR) in a sample of Italian high school students. Participants were 900 high school students (53.6% males; mean age = 16.22) that were administered standardized questionnaires. Students who screened positive for PD, EDR and both were, respectively, 17.3%, 5.9% and 1.3%. Approximately one out four students reported FAD behaviors, mostly to control weight and by restricting calories, with higher prevalence and severity among those who screened positive for PD. Purging behaviors were rare overall (15.5%), but significantly more frequent in participants who screened positive for both PD and EDR (41.7%). FAD was more strongly associated with alcohol use severity than with ED symptom severity across all subgroups. FAD behaviors appear to be common in the Italian high school population and more strongly associated with PD. Future studies should investigate FAD's impact on adolescents' functioning and possible early interventions.
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Affiliation(s)
- Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Paola Milia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Lucia Sanna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Graziella Boi
- Department of Mental Health and Addictions, ASL Cagliari, 09127 Cagliari, Italy; (G.B.); (A.P.)
| | - Annadele Pes
- Department of Mental Health and Addictions, ASL Cagliari, 09127 Cagliari, Italy; (G.B.); (A.P.)
| | - Lorena Lai
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Valeria Deiana
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Silvia Lostia di Santa Sofia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Laura Puddu
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Francesca Fatteri
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Alice Ghiani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Alice Lai
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
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Ritz L, Mauny N, Leconte P, Margas N. French validation of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS) in a university student sample. Eat Weight Disord 2023; 28:95. [PMID: 37947957 PMCID: PMC10638208 DOI: 10.1007/s40519-023-01622-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023] Open
Abstract
PURPOSE Food and Alcohol Disturbance (FAD) is characterized by the combination of problematic alcohol use and eating disorder symptoms to offset caloric intake associated with alcohol drinking and/or to enhance intoxication. The Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS) is a proven tool for measuring FAD, validated in English and Italian populations but never in the French population. The present study aims at validating a French version of the CEBRACS in a representative sample of university students and to determine its validity and reliability. METHODS 2267 university students completed the CEBRACS and measures of eating disorders, alcohol consumption and exercise. RESULTS An exploratory factor analysis revealed a 4-factor structure: enhancement of the effects of alcohol, dietary restraint and exercise, purging and vomiting and extreme fasting. The internal consistency for these subscales ranged from good to excellent. Correlations between the CEBRACS and eating disorders, alcohol and exercise measures revealed a good concurrent validity. No gender differences were found in the CEBRACS scores. Participants with a CEBRACS total score > 21 points were at higher risk for developing eating disorders and alcohol-related problems. CONCLUSIONS These findings highlight the reliability and validity of the French version of the CEBRACS. The distinct factors identified in the CEBRACS allow to distinguish between participants with different motives for engaging FAD behaviour and thus to prevent future development of eating and/or alcohol use disorders. The CEBRACS seems to be a relevant scale to capture FAD behaviors and thus to prevent negative and deleterious consequences. LEVEL OF EVIDENCE Level III, evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Ludivine Ritz
- UNICAEN, Laboratoire de Psychologie Caen Normandie (LPCN, UR 7452), Pôle Santé, Maladies, Handicaps-MRSH (USR 3486, CNRS-UNICAEN), Normandie Univ, 14000, Caen, France.
- UFR de Psychologie, Bâtiment L, Esplanade de La Paix, 14032, Caen Cedex 5, France.
| | - Nicolas Mauny
- UNICAEN, Laboratoire de Psychologie Caen Normandie (LPCN, UR 7452), Pôle Santé, Maladies, Handicaps-MRSH (USR 3486, CNRS-UNICAEN), Normandie Univ, 14000, Caen, France
| | - Pascale Leconte
- UMR-S 1075 Inserm/Unicaen COMETE-Mobilités: Vieillissement, Pathologies, Santé, Caen, France
| | - Nicolas Margas
- Institut Des Sciences du Sport, Université de Lausanne, Lausanne, Switzerland
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Meinerding M, Weinstock J, Vander Wal J, Weaver TL. Failure to confirm the factor structure of the CEBRACS: An assessment of food and alcohol disturbance. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-11. [PMID: 36084273 DOI: 10.1080/07448481.2022.2119401] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 07/19/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Objectives: Food and Alcohol Disturbance (FAD) is the phenomenon in which individuals exhibit co-occurring hazardous alcohol and eating behaviors to either negate caloric intake associated with alcohol and/or maximize intoxication. While the Compensatory Eating and Behaviors in Response to Alcohol Scale (CEBRACS) is the most widely used measure to assess FAD to date, its factor-structure has yet to be confirmed. Methods: The current study utilized confirmatory factor analysis (CFA) to examine the CEBRACS' four factor subscales as well as recently proposed alternative scoring structures. Participants: Participants (N = 582) were American college students from seven universities (18-24 years; 67% cisgender women; 70% non-Hispanic White). Results: The CFA failed to provide optimal fit for all models tested. Results of invariance testing found no measurement variance by sex, suggesting the failure of the four-factor solution was not due to noninvariance. Conclusions: Overall, findings do not support continued use of the original 21-item CEBRACS.
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Affiliation(s)
- Maria Meinerding
- Department of Psychology, Saint Louis University, Saint Louis, Missouri, USA
| | - Jeremiah Weinstock
- Department of Psychology, Saint Louis University, Saint Louis, Missouri, USA
| | - Jillon Vander Wal
- Department of Psychology, Saint Louis University, Saint Louis, Missouri, USA
| | - Terri L Weaver
- Department of Psychology, Saint Louis University, Saint Louis, Missouri, USA
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Speed S, Ward RM, Haus L, Branscum P, Barrios V, Budd KM, Lemons K, Humenay E. A Systematic Review of Common Drunkorexia Measures: Examining Gender Differences across Scales. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2100846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Pompili S, Di Tata D, Bianchi D, Lonigro A, Zammuto M, Baiocco R, Longobardi E, Laghi F. Food and alcohol disturbance among young adults during the COVID-19 lockdown in Italy: risk and protective factors. Eat Weight Disord 2022; 27:769-780. [PMID: 34052989 PMCID: PMC8164478 DOI: 10.1007/s40519-021-01220-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/20/2021] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The COVID-19 lockdown measures have had a significant impact on risk behaviors as alcohol use and disordered eating. However, little is known about a serious health-risk-behavior named "food and alcohol disturbance" (FAD), characterized by engaging in dysfunctional eating on days of planned alcohol consumption. The aim of the present study was to investigate potential factors that may have put young adults at risk or protected against FAD during the COVID-19 lockdown. METHODS A sample of 447 young adults (280 females, 167 males; range 18-26) completed an online survey during the country's nationwide lockdown composed of self-reported measures assessing FAD behaviors, alcohol consumption, compensatory behaviors, eating and weight concerns, social support, emotion regulation strategies, and living arrangement. RESULTS Our findings showed that FAD was significantly and positively correlated to alcohol consumption, use of laxatives, self-induced vomiting, eating and weight concerns, and expressive suppression, and negatively correlated to social support and living with family. Hierarchical regression analysis revealed that alcohol consumption, eating concern, and expression suppression positively predicted FAD, while social support and living with family were negative predictors. CONCLUSIONS Our results suggest that during the COVID-19 lockdown, preoccupation with eating and the use of expressive suppression may have increased vulnerability to FAD; conversely, perceived social support and living with family may have been a source of protection against this dysfunctional behavior. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- Sara Pompili
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Daniele Di Tata
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Dora Bianchi
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Antonia Lonigro
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Marta Zammuto
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Roberto Baiocco
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Emiddia Longobardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy.
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Joshi D, Dodge T. Compensatory physical activity: Impact on type of physical activity and physical activity habits among female young adults. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:39-48. [PMID: 32045337 DOI: 10.1080/07448481.2020.1719113] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 12/12/2019] [Accepted: 01/16/2020] [Indexed: 06/10/2023]
Abstract
Engaging in physical activity (PA) to compensate for drinking-related calories is common among female college students. The objective was to test whether frequency of compensatory PA was associated with type of PA (Study 1) and PA habit strength (Study 2). Study 1 utilized a cross-sectional design. Female undergraduates (N = 198) completed questionnaires assessing frequency of compensatory PA and PA types. In Study 2, female undergraduates (N = 280) were assessed on frequency of compensatory PA at Time 1 and PA habit strength at Time 2, 4-weeks later. Study 1 revealed that frequency of compensatory PA was significantly related to high intensity PA but was unrelated to low or moderate intensity PA. Study 2 revealed that frequency of compensatory PA at Time 1 was a significant predictor of PA habit strength at Time 2. The studies advance our understanding of the immediate and long-lasting impact of compensatory PA on behaviors and habits.
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Affiliation(s)
- Deepti Joshi
- Department of Psychology, George Washington University, Washington, DC, USA
| | - Tonya Dodge
- Department of Psychology, George Washington University, Washington, DC, USA
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Hill EM, Ruark R. An examination of the role of social comparison orientation and social norms in drunkorexia engagement. Addict Behav 2022; 124:107107. [PMID: 34530208 DOI: 10.1016/j.addbeh.2021.107107] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/06/2021] [Accepted: 08/29/2021] [Indexed: 11/30/2022]
Abstract
Drunkorexia is a behavior pattern marked by calorie restriction and/or compensation in relation to alcohol consumption. The aim of the present study was to examine the role of social norms (descriptive, injunctive) and social comparison orientation (SCO; global, alcohol-specific, eating disorder-related) in drunkorexia engagement. Specifically, our research aimed to examine a possible interaction between norms and SCO; we hypothesized that the relationship between social norms and drunkorexia would be moderated by SCO in that the relationship would be stronger among those elevated on SCO. Data were collected from an undergraduate sample (n = 501); participants completed the consent form and questions/questionnaires via Qualtrics. The results indicated that the predictor variables examined were correlated with overall drunkorexia engagement. In the regression models, in terms of main effects, eating disorder-related SCO emerged as the strongest predictor of the drunkorexia dimensions as well as overall drunkorexia engagement. Descriptive norms emerged as the second strongest predictor in the models. Only one interaction was identified; eating disorder-related SCO moderated the relationship between descriptive norms and the bulimia drunkorexia dimension. The simple slopes analysis indicated that descriptive norms was positively predictive of the bulimia drunkorexia dimension only among individuals with average or elevated eating disorder-related SCO. Social comparisons made regarding one's body, eating, or exercise (eating disorder-related) and social norms are potentially important targets for drunkorexia prevention and/or intervention programs. Further research is needed to better understand risk factors for drunkorexia engagement in the college population.
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Affiliation(s)
- Erin M Hill
- Department of Psychology, West Chester University, West Chester, PA 19383, USA.
| | - Robert Ruark
- Department of Psychology, West Chester University, West Chester, PA 19383, USA
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Hill EM, Nolan MT. Examining eating disorder-related social comparison orientation and body dissatisfaction in the relationship between fit ideal internalization and drunkorexia engagement. Eat Behav 2021; 41:101480. [PMID: 33631489 DOI: 10.1016/j.eatbeh.2021.101480] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 01/31/2021] [Accepted: 02/05/2021] [Indexed: 01/04/2023]
Abstract
The aim of the present study was to examine the relationship between fit ideal internalization and drunkorexia engagement in women. Specifically, in line with the Tripartite Influence Model, we examined the indirect effect of fit ideal internalization on drunkorexia through eating disorder-related social comparison orientation and body dissatisfaction. Data were collected from two samples of women-college undergraduate students (n = 198) and women recruited through Amazon Mechanical Turk (n = 324)-in order to test the model across the two groups. All participants completed the consent forms and then questionnaires via Qualtrics between March and June 2020. The results suggest that fit ideal internalization, body dissatisfaction, and eating disorder-related social comparison orientation are linked to drunkorexia. More specifically, multigroup path analyses indicated that there was an indirect effect of fit ideal internalization on drunkorexia via eating disorder-related social comparison orientation but not through body dissatisfaction. In examining the role of different types of eating disorder-related social comparison orientation (body, eating, exercise) in the model, more nuanced patterns emerged across the samples. Future research examining potential mediators and moderators of the relationship between eating disorder-related social comparison orientation and drunkorexia would be beneficial in expanding this area of study.
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Affiliation(s)
- Erin M Hill
- Department of Psychology, West Chester University, West Chester, PA 19383, United States of America.
| | - Megan T Nolan
- Department of Psychology, West Chester University, West Chester, PA 19383, United States of America
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Laghi F, Pompili S, Bianchi D, Lonigro A, Baiocco R. Drunkorexia: An Examination of the Role of Theory of Mind and Emotional Awareness among Adolescents. Dev Neuropsychol 2020; 46:70-81. [PMID: 33372552 DOI: 10.1080/87565641.2020.1869743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to investigate Theory of Mind (ToM) and emotional awareness in drunkorexia, an emerging behavior characterized by calorie restriction when drinking alcohol is planned. A sample of 246 adolescents (148 females, 98 males; range 17-20) completed self-reported measures assessing drunkorexia, ToM and lack of emotional awareness. Drunkorexia was negatively correlated with ToM abilities, with reading neutral emotions, and positively with lack of emotional awareness. ToM and lack of emotional awareness were also found to predict drunkorexia. Findings highlighted that adolescents who engage in drunkorexia may have difficulties in reading others' mental states and being aware of their emotions.
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Affiliation(s)
- Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Antonia Lonigro
- Department of Human Sciences, European University of Rome , Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
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Examining the role of body esteem and sensation seeking in drunkorexia behaviors. Eat Weight Disord 2020; 25:1507-1513. [PMID: 31587177 DOI: 10.1007/s40519-019-00784-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/21/2019] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The purpose of the present study was to examine the role of body esteem (BE), sensation seeking (SS), and their interaction in drunkorexia, a behavior pattern marked by calorie restriction/compensation in the context of alcohol consumption. While previous research on drunkorexia has focused on a range of variables, the present study examined two novel variables and their potential interaction: body esteem (weight, appearance) and sensation seeking. METHODS A sample of college students (n =488) completed the Body Esteem Scale for Adolescents and Adults, the Brief Sensation Seeking Scale, and the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale, which measures overall drunkorexia engagement as well as four dimensions: alcohol effects, bulimia, dietary restraint and exercise, and restriction. RESULTS Moderated linear regression analyses indicated that SS and BE (weight, appearance) did not interact in predicting drunkorexia. Rather, only main effects were observed; SS, weight esteem (WE), and appearance esteem (AE) were significant in predicting overall drunkorexia engagement. In terms of the drunkorexia dimensions, AE was a significant predictor in the alcohol effects, dietary restraint and exercise, and restriction models. WE was significant in the dietary restraint and exercise model as well as the restriction model. SS was a significant predictor across all drunkorexia dimensions. CONCLUSIONS Our findings suggest that both elevated SS and lowered BE are associated with drunkorexia engagement. Implications for practice are discussed. Drunkorexia is a complex and multifaceted behavior pattern; therefore, further research is needed in this area of study. LEVEL OF EVIDENCE Level V (descriptive study).
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Reexamination of the psychometric properties of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS) and exploration of alternative scoring. Eat Behav 2020; 38:101410. [PMID: 32736310 DOI: 10.1016/j.eatbeh.2020.101410] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 06/17/2020] [Accepted: 07/02/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The primary aims of this paper were to reexamine the factor structure of the 21-item Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS), a measure of Food and Alcohol Disturbance (FAD), and investigate an alternative scoring structure. FAD is the use of disordered eating behaviors within an alcohol use episode to compensate for alcohol-related calories and/or increase effects of alcohol. The new scoring approach captures FAD behaviors based on whether they occurred before, during, or after alcohol use. METHOD Participants were 586 young adults (18-30 years; 77.6% female; 55.8% non-Hispanic White) who completed online questionnaires on alcohol use, disordered eating behaviors, and FAD. RESULTS Confirmatory factor analyses did not provide unequivocal evidence for any previously proposed factor structures of the CEBRACS. Exploratory factor analysis suggested items capturing FAD "Before" drinking had a two-factor structure (i.e., Alcohol Effects and Compensatory Behaviors), items capturing FAD "During" drinking had a three-factor structure (i.e., Alcohol Effects, Diet & Exercise, and Extreme Weight Control Behaviors [EWCB]), and items capturing FAD "After" drinking had a two-factor structure (i.e., Diet & Exercise & EWCB). DISCUSSION The CEBRACS factor structure is not consistent across samples; however, despite suboptimal fit, the original structure remains the best approach to capture FAD behaviors. The alternative scoring reflects FAD behaviors based on when they occur relative to alcohol use. The two scoring approaches provide researchers and clinicians flexibility to describe FAD behaviors in multiple ways using the CEBRACS.
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Emotion dysregulation as a correlate of food and alcohol disturbance in undergraduate students. Eat Behav 2020; 38:101409. [PMID: 32585563 DOI: 10.1016/j.eatbeh.2020.101409] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/29/2020] [Accepted: 06/16/2020] [Indexed: 01/01/2023]
Abstract
Disordered eating behaviors (e.g., binge eating, food restriction, self-induced vomiting, and laxative use) as well as alcohol use and related issues are prevalent in undergraduate students and are often comorbid with one another. Recently, the unique combination of these behaviors, termed food and alcohol disturbance (FAD), has received empirical attention. FAD involves compensatory behaviors performed in preparation for, or in response to, alcohol use in order to counteract calories consumed from alcohol and/or to increase intoxication. Research on FAD is sparse; in particular, there is a lack of consensus regarding potential gender differences in FAD and a lack of knowledge concerning psychological correlates of these behaviors. Emotion dysregulation is a transdiagnostic correlate of psychopathology, including disordered eating and alcohol use, and therefore may relate to FAD. The present study used a cross-sectional design to examine associations between emotion dysregulation and FAD, as well as gender differences in this relationship, in a sample of male and female undergraduate students (N = 417; 51.8% female). There were no gender differences in FAD, and the associations between emotion dysregulation and FAD did not vary among men and women. FAD was positively associated with emotion dysregulation at the bivariate level, but emotion dysregulation was not uniquely associated with FAD after accounting for disordered eating, alcohol use and problems, and body mass index. Future research should extend the current findings by examining temporal associations between emotions, emotion dysregulation, and FAD.
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Psychological characteristics and eating attitudes in adolescents with drunkorexia behavior: an exploratory study. Eat Weight Disord 2020; 25:709-718. [PMID: 30888609 DOI: 10.1007/s40519-019-00675-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/13/2019] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Drunkorexia represents an emerging phenomenon that is still understudied especially among adolescents. The present study aimed to investigate the relation between drunkorexia and psychological characteristics relevant and commonly associated with existing forms of eating disorders. METHODS The sample was composed of 849 adolescents (513 boys, 334 girls, 2 unknown; range 14-22) who completed a survey composed of Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale and Psychological scales of the Eating Disorders Inventory-3. RESULTS Our findings highlighted that drunkorexia was associated with low self-esteem, personal alienation, interoceptive deficits, emotional dysregulation, and asceticism. Hierarchical multiple regression analysis indicated that difficulties with emotion regulation and ascetic tendencies were significant predictors of drunkorexia among adolescents. CONCLUSIONS Our findings suggest the importance for programs preventing drunkorexia to be focused on training adolescents in using more adaptive strategies to manage emotions and accepting both emotional and physical signals without feeling guilty or threatened. LEVEL OF EVIDENCE Level V, descriptive study.
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Laghi F, Pompili S, Bianchi D, Lonigro A, Baiocco R. Dysfunctional metacognition processes as risk factors for drunkorexia during adolescence. J Addict Dis 2020; 38:291-300. [DOI: 10.1080/10550887.2020.1756709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Antonia Lonigro
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
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College students’ engagement in drunkorexia: Examining the role of sociocultural attitudes toward appearance, narcissism, and Greek affiliation. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00382-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Choquette EM, Ordaz DL, Melioli T, Delage B, Chabrol H, Rodgers R, Thompson JK. Food and Alcohol Disturbance (FAD) in the U.S. and France: Nationality and gender effects and relations to drive for thinness and alcohol use. Eat Behav 2018; 31:113-119. [PMID: 30245363 DOI: 10.1016/j.eatbeh.2018.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Food and Alcohol Disturbance (FAD), colloquially coined "drunkorexia," is a set of behaviors that encompasses restriction of calories, over-exercise, and other compensatory behaviors before, during, or after alcohol use to offset caloric intake or maximize intoxication. To date, this phenomenon has not been compared in a cross-cultural sample. METHOD The Compensatory Eating and Behaviors Related to Alcohol Consumption Scale (CEBRACS), Eating Disorder Inventory - Drive for Thinness Subscale (EDI-DT) and Alcohol Use Disorders Identification Test of Consumption (AUDIT-C) were completed by 502 American (73% female) and 365 French (68% female) college students. RESULTS Just over half (56.70%) of French and American (55.83%) participants engaged in FAD. Nationality was found to be a significant moderator of the relationship between alcohol use and FAD for both compensatory (p = .013) and intoxication (p = .01) purposes, such that Americans who drank more engaged in more FAD. Further, nationality moderated the relationship between drive for thinness and FAD for compensatory purposes (p = .005), but not for intoxication purposes (p = .10). At higher levels of drive for thinness French participants were more likely to engage in FAD for compenatory purposes. DISCUSSION There is growing concern around how maladaptive eating and drinking behaviors intersect within the college population. These findings suggest that FAD is present cross-culturally, but that the relationships between predictors vary across culture. Thus, culture should be taken into consideration in the development of interventions for FAD.
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Affiliation(s)
- Emily M Choquette
- Department of Psychology, University of South Florida, 4202 E Folwer Ave, PCD 4118G, Tampa, FL 33625, United States of America.
| | - D Luis Ordaz
- Department of Psychology, University of South Florida, 4202 E Folwer Ave, PCD 4118G, Tampa, FL 33625, United States of America
| | - Tiffany Melioli
- Department of Psychology, Université of Toulouse - Jean Jaurès, Pavillion de la recherche, R41, 5 allées Antonio Machado, 31058 Toulouse Cedex 9, Toulouse, France
| | - Beatrice Delage
- Department of Psychology, Université of Toulouse - Jean Jaurès, Pavillion de la recherche, R41, 5 allées Antonio Machado, 31058 Toulouse Cedex 9, Toulouse, France
| | - Henri Chabrol
- Department of Psychology, Université of Toulouse - Jean Jaurès, Pavillion de la recherche, R41, 5 allées Antonio Machado, 31058 Toulouse Cedex 9, Toulouse, France
| | - Rachel Rodgers
- Northeastern University, 360 Huntington Ave., Boston, MA 02115, United States of America; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU 191 Av. du Doyen Gaston Giraud, 34090 Montpellier, France
| | - J Kevin Thompson
- Department of Psychology, University of South Florida, 4202 E Folwer Ave, PCD 4118G, Tampa, FL 33625, United States of America
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Pompili S, Laghi F. Drunkorexia: Disordered eating behaviors and risky alcohol consumption among adolescents. J Health Psychol 2018; 25:2222-2232. [PMID: 30073869 DOI: 10.1177/1359105318791229] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The first goal of our study was to examine the differences on disordered eating and alcohol consumption among heavy, occasional restrictors, and non-restrictors in a sample of 823 adolescents. The second goal was to analyze the relation of drunkorexia between unhealthy eating and alcohol use. Our results showed that heavy restrictors reported more eating disorder symptoms and alcohol use than occasional restrictors and non-restrictors. Similarly, occasional restrictors showed more unhealthy eating and drinking behaviors than non-restrictors. Both disordered eating and alcohol use were significant predictors of drunkorexia, supporting the argument of drunkorexia as an overlapping of dysfunctional eating and drinking patterns.
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Peralta RL, Barr PB. Gender orientation and alcohol-related weight control behavior among male and female college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2017; 65:229-242. [PMID: 27982766 DOI: 10.1080/07448481.2016.1271802] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE We examine weight control behavior used to (a) compensate for caloric content of heavy alcohol use; and (b) enhance the psychoactive effects of alcohol among college students. We evaluate the role of gender orientation and sex. PARTICIPANTS Participants completed an online survey (N = 651; 59.9% women; 40.1% men). METHOD Weight control behavior was assessed via the Compensatory-Eating-and-Behaviors-in Response-to-Alcohol-Consumption-Scale. Control variables included sex, race/ethnicity, age, and depressive symptoms. Gender orientation was measured by the Bem Sex Role Inventory. The prevalence and probability of alcohol-related weight control behavior using ordinal logistic regression are reported. RESULTS Men and women do not significantly differ in compensatory-weight-control-behavior. However, regression models suggest that recent binge drinking, other substance use, and masculine orientation are positively associated with alcohol-related weight control behavior. CONCLUSIONS Sex was not a robust predictor of weight control behavior. Masculine orientation should be considered a possible risk factor for these behaviors and considered when designing prevention and intervention strategies.
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Affiliation(s)
- Robert L Peralta
- a Department of Sociology , The University of Akron , Akron , Ohio , USA
| | - Peter B Barr
- b Department of Psychology , Virginia Commonwealth University , Richmond , VA , USA
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