The role of negative reinforcement eating expectancies in the relation between experiential avoidance and disinhibition

Black Young Adult Superwomen in the Face of Gendered Racial Microaggressions: Contextualizing Challenges With Acceptance and Avoidance and Emotional Eating

BACKGROUND

Black young adult women (ages 18-35) are at disproportionate risk for obesity and emotional eating. Emotional eating interventions target psychological flexibility, such as reducing experiential avoidance and increasing acceptance of food-related thoughts. Yet Black women face gendered racism, and some endorse roles that reduce psychological flexibility, such as the superwoman schema role. Culturally centered stress and coping has often been overlooked, leading to an incomplete understanding of processes that engender emotional eating and the implications for appropriate and effective interventions for Black young adult women.

PURPOSE

We investigated direct and indirect pathways of associations between stress from gendered racial microaggressions to emotional eating through the endorsement of superwoman schema and two aspects of psychological flexibility.

METHODS

Black young adult women (N = 504; Mage = 24.72; 75.2% African American; 98.4% cisgender) participated in an online survey wherein they reported demographics, stress from gendered racial microaggressions, superwoman schema, experiential avoidance, acceptance of food-related thoughts, and emotional eating. Path analysis was conducted to examine direct and indirect effects.

RESULTS

Results provided evidence for indirect associations between more stress from gendered racial microaggressions and more emotional eating. More stress was associated with greater endorsement of the superwoman schema which was associated with more experiential avoidance and less acceptance of food-related thoughts, which were each associated with more emotional eating.

CONCLUSIONS

Endorsement of superwoman schema and concomitant avoidance and less acceptance may be one way that gendered racial stress propels emotional eating. Future research could test intervention components that disrupt this path.

Greater negative affect reduction expectancies moderate the interactive relationship between emotion regulation difficulties and distress tolerance in predicting loss-of-control eating

OBJECTIVES

Loss-of-control eating (LOCE) is often conceptualized as a negative reinforcement mechanism. However, LOCE does not consistently reduce negative affect (NA). One explanation for continued LOCE, despite a lack of NA reduction, may be expectations of NA reduction. Emotion regulation difficulties and low distress tolerance often predict LOCE, but have not been examined in the context of NA reduction expectancies.

DESIGN

This study examined the main and interactive relationships between emotion regulation difficulties, distress tolerance and NA reduction expectancies on LOCE in US adults (n = 3331).

METHOD

This study consisted of a battery of surveys administered to a national sample of US adults.

RESULTS

Results indicate NA reduction expectancies are robust, eclipsing the predictive effects of other emotion regulation variables. Distress tolerance was only able to attenuate the relationship between emotion regulation difficulties and LOCE when NA reduction expectancies were low.

CONCLUSIONS

These findings identify NA reduction expectancies as having a strong relationship with LOCE, such that the protective factor of distress tolerance is only relevant when such expectancies are low. Clinical implications suggest that targeting NA reduction expectancies in eating interventions that bolster emotion regulation difficulties and distress tolerance may improve the effectiveness of said interventions. Additionally, stand-alone expectancy interventions should be assessed for the purpose of LOCE reduction. Directions for future research are discussed.

The role of eating expectancies and eating motives in the association between mood and loss-of-control eating: A national sample daily diary study

Loss-of-control eating (LOCE, the subjective inability to refrain from eating or cease eating), is highly mood-driven. Mood-related eating motives and eating expectancies have been identified as contributors to binge eating. However, little is known about how these factors relate to LOCE, much less their relationship with daily-level LOCE. This study assessed the impact of trait eating expectancies and daily eating motives on the relationship between daily affective states and LOCE. United States adults (n = 109) reporting recent LOCE participated in a ten-day diary study, completing two surveys per day regarding eating behaviors, mood, and motives. Data were analyzed at the within- and between-subject levels utilizing a Bayesian approach to examine pathways from mood to LOCE, mediated by eating motives and accounting for a moderating impact of baseline eating expectancies on the path leg between mood and motives. Negative mood was associated with LOCE at both the within- and between-subjects level by way of coping motives, and directly at the within-subjects level. Negative affect (NA) reduction expectancies did not moderate the indirect pathway. Positive mood was only associated with LOCE at the within-subjects level, via pleasure motives. This relationship was potentiated via reward expectancies. Therefore, although negative mood appears be a robust predictor of LOCE regardless of trait NA reduction expectancies, positive mood appears to have a specific set of conditions under which individuals are at increased likelihood of LOCE at the within-subjects level. These findings suggest that eating expectancies and motives for eating may be meaningful targets in LOCE interventions.

The Mediating Role of Psychological Inflexibility in the Relationship Between Anxiety, Depression, and Emotional Eating in Adult Individuals With Obesity

The aim of this cross-sectional study is to investigate the role of psychological inflexibility in the relationship between anxiety and depression and emotional eating in a sample of 123 inpatient Italian adult individuals with obesity. Participants completed the Anxiety and Depression subscales of the Psychological General Well-Being Inventory, the Acceptance and Action Questionnaire, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire to assess anxiety and depression, psychological inflexibility, and emotional eating, respectively. Results showed that the indirect effect of PGWBI-A on DEBQ-EE through AAQ-II was significant [b = -0.0155; SE = 0.076; 95% BC-CI (-0.0320 to -0.023)]. Similarly, the indirect effect of PGWBI-D on DEBQ-EE through AAQ-II was significant [b = -0.0383; SE = 0.0207; 95% BC-CI (-0.0810 to -0.0002)]. These findings may help to plan and develop specific psychological interventions aimed at addressing emotional eating through targeting psychological inflexibility to be included in obesity treatment programs.

Validation of the food craving Acceptance and action questionnaire (FAAQ) in a weight loss-seeking sample

OBJECTIVE

The Food Craving Acceptance and Action Questionnaire (FAAQ) was developed to measure psychological flexibility around food-related internal experiences (e.g., thoughts, feelings, urges) and has two subscales, acceptance and willingness. However, the FAAQ factor structure has not yet been systematically validated with a clinically relevant sample.

METHODS

Two weight-loss treatment seeking samples (total N = 462; 80.4% female) ages 18 to 70 (M = 52.6, SD = 9.8) completed the FAAQ before and after group-based treatment of overweight or obesity.

RESULTS

Confirmatory factor analysis on the FAAQ's previously observed two-factor model produced poor model fit. An alternative 7-item model removing specific items that contributed to poor fit and were conceptually relevant to remove provided good model fit. The resulting revised 7-item FAAQ (items 1,3,6 removed) had adequate internal consistency and significant predictive validity for the Total score and subscales, and showed initial construct validity for the Total score.

CONCLUSIONS

Results from this study suggest researchers and clinicians should now use the 7-item FAAQ-II, which retains the Willingness and Acceptance subscales. Future research is needed with other relevant samples to confirm the FAAQ-II's factor structure and psychometric properties.

Depressive symptoms, psychological flexibility, and binge eating in individuals seeking behavioral weight loss treatment

Depressive symptoms and binge eating are both prevalent in weight management populations and may be associated with reduced benefit from behavioral weight loss, including higher attrition, more perceived barriers, lower weight loss, and increased weight regain. These two potential risk factors for poor behavioral weight loss outcomes may also be associated with each other as depressive symptoms may trigger binge eating, and binge eating-related distress could increase depressive symptoms. The depressive symptom-binge eating link has not been well studied in weight management samples, and psychological processes involved in this relationship have not yet been elucidated. Psychological flexibility, an individual's ability to be connected with and conscious of the present moment and to engage in values-consistent behavior even in the presence of difficult internal experiences, may be one psychological process that changes the depressive symptom-binge eating relationship. High psychological flexibility may be a protective factor in the association of depressive symptoms with binge eating. This study examined the relationship between depressive symptom and binge eating and a potential interactive role of psychological flexibility. Participants (N = 468, 76% female) completed self-report questionnaires of binge eating, depressive symptoms, and psychological flexibility at baseline prior to initiating behavioral weight loss. Depressive symptoms were positively associated with binge eating (B = 1.00, p < 0.001). Psychological flexibility had an interactive role (B = -0.03, p = 0.005). Among participants with minimal to mild depressive symptoms, those with higher psychological flexibility had less severe binge eating. Findings suggest that psychological flexibility may be a protective factor in the association between depressive symptoms and binge eating in the majority of individuals initiating behavioral weight loss. Psychological flexibility is a psychological process to consider targeting for enhancing efficacy of weight loss treatment, especially among individuals with minimal to mild depressive symptoms and binge eating behavior.

Eating expectancies before bariatric surgery: assessment and associations with weight loss trajectories

BACKGROUND

While presurgical eating behaviors have demonstrated limited prognostic value, cognitions regarding the effects of eating may serve as important predictors of weight loss outcomes after bariatric surgery. The Eating Expectancies Inventory (EEI) is a commonly used, self-report measure of expected consequences of eating; however, its psychometric and predictive properties have not yet been evaluated among bariatric surgery patients.

OBJECTIVES

This study sought to examine the factor structure and internal consistency of the EEI among bariatric surgery candidates, to examine relationships between EEI factors and measures of eating psychopathology, and to explore the effects of eating expectancies on postsurgical weight loss.

SETTING

Data originated from an interdisciplinary bariatric surgery center in the Midwest United States.

METHODS

Two hundred sixty-two women completed self-report questionnaires before bariatric surgery. Presurgical data and available postsurgical weights (at 6, 12, and 18 mo) were obtained from medical records.

RESULTS

Analyses indicated that the original 5-factor model was a good-to-excellent fit for the EEI data. All EEI factors demonstrated good reliability and were significantly associated with eating disorder symptoms and behaviors at baseline. Higher scores on EEI Factor 1 (negative affect) and Factor 5 (alleviates boredom) predicted poorer weight loss at 18 months postsurgery (n = 132).

CONCLUSIONS

Findings support the reliability and validity of the EEI among female bariatric candidates. Presurgical eating expectancies were linked to pathologic eating patterns and also predicted postsurgical weight loss trajectories, suggesting that eating expectancies may have prognostic value as predictors of bariatric surgery outcomes.

The Association Between Eating-Compensatory Behaviors and Affective Temperament in a Brazilian Population

Eating-compensatory behaviors are associated with biological and psychological complications, with high rates of morbidity and mortality. Different elements may contribute to the development of eating-compensatory behaviors, such as genetic, physiological, environmental, and temperamental factors. Therefore, the aim of this study was to examine the association between affective temperaments and eating-compensatory behaviors. A sample of 27,501 volunteers, between 18 and 55 years old, mean age 28.9 ± 8.7 years (69.6% women), were assessed by the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). The results showed that eating-compensatory behaviors were associated with distinctive affective temperaments. Cyclothymic types were more associated with eating-compensatory behaviors. The avoidant and irritable types presented lower percentages of eating-compensatory behaviors in women and men, respectively. In conclusion, this study highlighted that participants who adopted frequent eating-compensatory behaviors are more likely to have dysfunctional affective traits. Consequently, the affective temperaments should be considered as a strategy to build capacity for prevention, treatment, and care of eating-compensatory behaviors.

Characteristics of adults with overweight/obesity and high internal disinhibition: do they fit with targets for acceptance-based interventions?

OBJECTIVE

Adults with overweight/obesity reporting high levels of internal disinhibition (ID) tend to do poorly in standard behavioural weight loss programmes. The current study sought to compare a sample of individuals with overweight/obesity selected on the basis of high ID with an unselected treatment-seeking sample of adults with overweight/obesity on characteristics that might make acceptance-based treatments particularly appropriate for those with high ID.

METHODS

Sample 1 included 162 treatment-seeking adults with overweight/obesity who were selected for high ID; sample 2 included 194 unselected treatment-seeking adults with overweight/obesity. First, the two samples were compared on levels of general and weight-related experiential avoidance, and values-consistent behaviour, both of which are targeted in acceptance-based treatments, and on other general psychological characteristics. Next, the unselected sample was split into two groups, those meeting criteria for high (N = 105; sample 2/high ID) vs. low (N = 89; sample 2/low ID) ID, and the three groups were compared on the same characteristics.

RESULTS

Sample 1 reported higher levels of both general and weight-related experiential avoidance as well as less values-consistent behaviour than sample 2. They reported greater psychological impairment in quality of life, depression and anxiety. Within sample 2, 54% met the criteria for high ID. Both sample 1 and sample 2/high ID reported higher levels of experiential avoidance and less values-consistent behaviour than did the sample 2/low ID. The two high ID samples also reported greater psychological impairment in quality of life, depression and anxiety than sample 2/low ID.

CONCLUSIONS

Adults with overweight/obesity who report high levels of ID were characterized by higher levels of experiential avoidance, lower levels of values-consistent behaviour, and more psychosocial impairment as compared with other adults with overweight/obesity. As these are important targets of acceptance-based approaches, this subgroup may benefit from the integration of such approaches into behavioural weight loss programmes.