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Robillard CL, Merrin GJ, Legg NK, Ames ME, Turner BJ. Different self-damaging behaviours, similar motives? Testing measurement invariance of motives for nonsuicidal self-injury, disordered eating and substance misuse. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024. [PMID: 38623602 DOI: 10.1111/bjc.12467] [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: 11/09/2023] [Revised: 02/29/2024] [Accepted: 03/25/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES Theory and research suggest that distinct self-damaging behaviours (SDBs; e.g., nonsuicidal self-injury [NSSI], restrictive eating, binge eating, drug misuse, alcohol misuse) share similar motives. However, few studies have used a common self-report inventory to investigate the shared relevance and relative salience of motives for SDBs. Accordingly, the present study: (1) examined whether self-report scales assessing intrapersonal motives (i.e., relieving negative emotions, enhancing positive emotions, punishing oneself) and interpersonal motives (i.e., bonding with others, conforming with others, communicating distress, communicating strength, reducing demands) have invariant factor structures across SDBs; and (2) compared the salience of these motives across SDBs. METHODS 1018 adults (54.6% men, Mage = 35.41 years) with a history of SDBs were allocated to the following groups: NSSI (n = 213), restrictive eating (n = 200), binge eating (n = 200), drug misuse (n = 200) or alcohol misuse (n = 205). Participants reported on their motives for engaging in their allocated SDB. Measurement invariance analyses compared the factor structures and latent means of the motive scales across SDBs. RESULTS The motive scales had comparable factor structures across SDBs. Intrapersonal motives were most strongly endorsed for NSSI and drug misuse. Interpersonal motives were most strongly endorsed for drug and alcohol misuse. All motives were least salient to restrictive eating. CONCLUSIONS Results suggest that common motives underlie distinct SDBs and that they can be adequately assessed using a single self-report inventory. However, certain motives are more relevant to some SDBs than others, with restrictive eating being the most motivationally distinct SDB. This knowledge can inform transdiagnostic models and interventions for SDBs.
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Affiliation(s)
- Christina L Robillard
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Gabriel J Merrin
- Human Development and Family Science, Syracuse University, Syracuse, New York, USA
| | - Nicole K Legg
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Megan E Ames
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
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Meier M, Summers BJ, Buhlmann U. Which Symptoms Bridge Symptoms of Depression and Symptoms of Eating Disorders?: A Network Analysis. J Nerv Ment Dis 2024; 212:61-67. [PMID: 38166183 DOI: 10.1097/nmd.0000000000001715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
ABSTRACT Depression is a common comorbid mental illness in eating disorders (EDs). Network theory focuses on interactions between symptoms, but findings from network analyses of EDs and depression need to be replicated to make reliable claims about the nature of symptomatic interplay. We used cross-sectional data of 366 online-recruited participants with clinically elevated ED symptomatology and constructed a regularized partial correlation network with ED and depression symptoms. To determine each symptom's influence, we calculated expected influence (EI) and bridge EI to identify symptoms that bridged symptoms of depression and ED. Concerns that others see one eat, fear of weight gain, and fear of loss of control over eating were especially important among the ED symptoms. Loss of interest and feeling sad were the key depression symptoms. Eating in secret and low self-esteem emerged as potential bridge symptoms between clusters. These findings regarding bridge symptoms partially overlap with prior network analyses in nonclinical and clinical samples. Future studies that investigate symptom interplay via a longitudinal design to deduce causality are needed.
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Affiliation(s)
- Marieke Meier
- Department of Psychology, University of Münster, Münster, Germany
| | - Berta J Summers
- Massachusetts General Hospital, Department of Psychiatry, Boston, Massachusetts
| | - Ulrike Buhlmann
- Department of Psychology, University of Münster, Münster, Germany
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Kim AJ, Stewart SH, Sherry SB, McGrath DS, Mushquash CJ, Olthuis JV, Mushquash AR. Clarifying the pathway from anxiety sensitivity to binge eating: The mediating role of depressive symptoms in a 3-week, 3-wave longitudinal study of undergraduates. Eat Behav 2024; 52:101843. [PMID: 38217932 DOI: 10.1016/j.eatbeh.2024.101843] [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: 08/15/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
Anxiety sensitivity (AS) - characterized by a persistent fear that arousal-related bodily sensations will lead to serious cognitive, physical, and/or social consequences - is associated with various psychopathologies, including depressive symptoms and binge eating. This 3-week, 3-wave longitudinal study examined the relation between AS (including its global AS factor and lower-order AS cognitive, physical, and social concern dimensions), depressive symptoms, and binge eating among 410 undergraduates from two universities. Using generalized estimating equation models, we found that global AS, AS social concerns, and depressive symptoms predicted binge eating during any given week. Mediation analyses showed that global AS (as a latent variable with its lower-order AS dimensions as indicators), AS cognitive concerns, and AS physical concerns at Wave 1 predicted subsequent increases in depressive symptoms at Wave 2, which, in turn, led to increases in binge eating at Wave 3. Findings contribute to a better understanding of the interplay between AS, depressive symptoms, and binge eating, highlighting the role of binge eating as a potential coping mechanism for individuals with high AS, particularly in managing depressive symptoms. This study underscores the importance of AS-targeted intervention and prevention efforts in addressing depressive symptoms and binge eating.
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Affiliation(s)
- Andy J Kim
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada.
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada; Department of Psychiatry, Dalhousie University, B3H2E2, Canada.
| | - Simon B Sherry
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada; Department of Psychiatry, Dalhousie University, B3H2E2, Canada.
| | - Daniel S McGrath
- Department of Psychology, University of Calgary, T2N1N4, Canada.
| | | | - Janine V Olthuis
- Department of Psychology, University of New Brunswick, E3B5A3, Canada.
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Dougherty EN, Bottera AR, Haedt-Matt AA, Wildes JE. Reconceptualizing emotion regulation and coping strategy usage in eating disorders research: The utility of a regulatory flexibility framework. Int J Eat Disord 2023; 56:1835-1841. [PMID: 37465948 PMCID: PMC10592414 DOI: 10.1002/eat.24027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023]
Abstract
Emotion regulation and coping strategies are often conceptualized in eating disorder (ED) research as inherently adaptive or maladaptive, and successful regulation is often defined as greater overall use of adaptive strategies. However, recent empirical work outside of the field of EDs challenges this categorical conceptualization of strategies, demonstrating that adaptiveness is determined by the ability to flexibly implement and adjust strategies based on contextual demands (i.e., regulatory flexibility). Despite evidence that emotion regulation and coping strategies are best conceptualized in terms of flexibility in the broader literature, few ED studies have adopted this model. We review the current conceptual framework of emotion regulation and coping strategies used in ED research and present regulatory flexibility as an alternative approach to conceptualizing these strategies. The lack of research on regulatory flexibility among individuals with EDs limits our understanding of the role of emotion regulation and coping difficulties in ED risk and maintenance. Adopting a regulatory flexibility model of strategies in EDs may extend knowledge of the role of emotion regulation difficulties in the development and maintenance of EDs. We highlight the potential utility of investigating regulatory flexibility and present recommendations for future research on regulatory flexibility in EDs. PUBLIC SIGNIFICANCE STATEMENT: Research on emotion regulation and coping strategy usage in eating disorders often view regulatory strategies as inherently adaptive or maladaptive. However, recent studies support defining strategies in terms of flexibility. Adopting a regulatory flexibility model of strategies in eating disorders research may advance knowledge of the role of emotion regulation difficulties in the development and maintenance of eating disorders, ultimately enhancing prevention and treatment efforts.
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Affiliation(s)
- Elizabeth N Dougherty
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois, USA
| | - Angeline R Bottera
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois, USA
| | - Alissa A Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois, USA
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Zelkowitz RL, Kehle-Forbes SM, Smith BN, Vogt DS, Mitchell KS. Associations between DSM-5 posttraumatic stress disorder Criterion E2 endorsement and selected self-destructive behaviors in recent-era veterans: A focus on disordered eating. J Trauma Stress 2023; 36:1001-1009. [PMID: 37485630 DOI: 10.1002/jts.22960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 07/25/2023]
Abstract
Revisions to the posttraumatic stress disorder (PTSD) criteria in the DSM-5 included a new criterion in the alterations in arousal and reactivity cluster (i.e., engagement in reckless and self-destructive behaviors; Criterion E2). Despite its clinical significance, little is known about how this symptom corresponds to engagement in specific direct and indirect self-harm behaviors. We examined associations between E2 and self-reported recent engagement in direct and indirect self-harm behaviors, including disordered eating, which is not included in the prototypical E2 symptom scope, in a trauma-exposed sample of 1,010 recent-era veterans (61.5% self-identified women, 38.5% self-identified men). We also tested whether gender moderated these associations. We repeated analyses in a subsample of participants with clinically elevated PTSD symptoms. Participants self-reported past-month PTSD symptoms (PCL-5) as well as past-month nonsuicidal self-injury, suicidal ideation, suicide planning, fasting, purging, binge eating, compulsive exercise, and problematic alcohol and drug use. We found no evidence for moderation by gender for any of the behaviors examined in the main sample. However, after controlling for gender and demographic covariates, weighted logistic regressions showed small, significant associations between E2 score and direct self-harm behaviors, substance use, purging, and binge eating, aORs = 1.30-1.91. Criterion E2 was linked to behaviors included in the typical symptom scope (self-directed violence, substance use) and those that are not (disordered eating behaviors). Comprehensive screening for self-destructive behaviors, including disordered eating, among veteran men and women who endorse Criterion E2 is indicated.
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Affiliation(s)
- Rachel L Zelkowitz
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Shannon M Kehle-Forbes
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Brian N Smith
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Dawne S Vogt
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Karen S Mitchell
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
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Kinnear A, Siegel JA, Masson PC, Bodell LP. Functions of disordered eating behaviors: a qualitative analysis of the lived experience and clinician perspectives. J Eat Disord 2023; 11:141. [PMID: 37605248 PMCID: PMC10440936 DOI: 10.1186/s40337-023-00854-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/28/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND One method to improve treatment outcomes for individuals with eating disorders (EDs) may be understanding and targeting individuals' motives for engaging in DE behaviors-or the functions of DE behaviors. The goal of this study was to investigate and categorize the various functions of DE behaviors from the perspectives of adults who engage in DE behaviors and clinicians who treat EDs. METHODS Individuals who engage in DE behaviors (n = 16) and clinicians who treat EDs (n = 14) were interviewed, and a thematic analysis was conducted to determine key functions of DE behaviors. RESULTS Four main functions of DE behaviors were identified by the authors: (1) alleviating shape, weight, and eating concerns; (2) regulating emotions; (3) regulating one's self-concept; and (4) regulating interpersonal relationships/communicating with others. CONCLUSIONS Differences in participant responses, particularly regarding the relevance of alleviating shape and weight concerns as an DE behavior function, highlight the importance of individualized conceptualizations of DE behavior functions for any given client.
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Affiliation(s)
- Abbigail Kinnear
- Department of Psychology, University of Western Ontario, London, ON Canada
| | - Jaclyn A. Siegel
- Department of Psychology, University of Western Ontario, London, ON Canada
- Department of Psychology, San Diego State University, San Diego, CA USA
| | - Philip C. Masson
- Department of Psychology, University of Western Ontario, London, ON Canada
| | - Lindsay P. Bodell
- Department of Psychology, University of Western Ontario, London, ON Canada
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Presseller EK, Lampe EW, Zhang F, Gable PA, Guetterman TC, Forman EM, Juarascio AS. Using Wearable Passive Sensing to Predict Binge Eating in Response to Negative Affect Among Individuals With Transdiagnostic Binge Eating: Protocol for an Observational Study. JMIR Res Protoc 2023; 12:e47098. [PMID: 37410522 PMCID: PMC10360009 DOI: 10.2196/47098] [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: 03/07/2023] [Revised: 05/02/2023] [Accepted: 05/05/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Binge eating (BE), characterized by eating a large amount of food accompanied by a sense of loss of control over eating, is a public health crisis. Negative affect is a well-established antecedent for BE. The affect regulation model of BE posits that elevated negative affect increases momentary risk for BE, as engaging in BE alleviates negative affect and reinforces the behavior. The eating disorder field's capacity to identify moments of elevated negative affect, and thus BE risk, has exclusively relied on ecological momentary assessment (EMA). EMA involves the completion of surveys in real time on one's smartphone to report behavioral, cognitive, and emotional symptoms throughout the day. Although EMA provides ecologically valid information, EMA surveys are often delivered only 5-6 times per day, involve self-report of affect intensity only, and are unable to assess affect-related physiological arousal. Wearable, psychophysiological sensors that measure markers of affect arousal including heart rate, heart rate variability, and electrodermal activity may augment EMA surveys to improve accurate real-time prediction of BE. These sensors can objectively and continuously measure biomarkers of nervous system arousal that coincide with affect, thus allowing them to measure affective trajectories on a continuous timescale, detect changes in negative affect before the individual is consciously aware of them, and reduce user burden to improve data completeness. However, it is unknown whether sensor features can distinguish between positive and negative affect states, given that physiological arousal may occur during both negative and positive affect states. OBJECTIVE The aims of this study are (1) to test the hypothesis that sensor features will distinguish positive and negative affect states in individuals with BE with >60% accuracy and (2) test the hypothesis that a machine learning algorithm using sensor data and EMA-reported negative affect to predict the occurrence of BE will predict BE with greater accuracy than an algorithm using EMA-reported negative affect alone. METHODS This study will recruit 30 individuals with BE who will wear Fitbit Sense 2 wristbands to passively measure heart rate and electrodermal activity and report affect and BE on EMA surveys for 4 weeks. Machine learning algorithms will be developed using sensor data to distinguish instances of high positive and high negative affect (aim 1) and to predict engagement in BE (aim 2). RESULTS This project will be funded from November 2022 to October 2024. Recruitment efforts will be conducted from January 2023 through March 2024. Data collection is anticipated to be completed in May 2024. CONCLUSIONS This study is anticipated to provide new insight into the relationship between negative affect and BE by integrating wearable sensor data to measure affective arousal. The findings from this study may set the stage for future development of more effective digital ecological momentary interventions for BE. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47098.
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Affiliation(s)
- Emily K Presseller
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, United States
| | - Elizabeth W Lampe
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, United States
| | - Fengqing Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Philip A Gable
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
| | - Timothy C Guetterman
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Evan M Forman
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, United States
| | - Adrienne S Juarascio
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, United States
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Gilmartin T, Gurvich C, Dipnall JF, Sharp G. One size does not fit all: Exploring how the five-factor model facets predict disordered eating behaviours among adolescent and young adult males and females. Br J Psychol 2023; 114:132-158. [PMID: 36183174 PMCID: PMC10092835 DOI: 10.1111/bjop.12601] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 09/14/2022] [Indexed: 01/11/2023]
Abstract
There is a wealth of research that has highlighted the relationship between personality and eating disorders. It has been suggested that understanding how subclinical disordered eating behaviours are uniquely associated with personality can help to improve the conceptualization of individuals with eating disorders. This study aimed to explore how the facets of the Five-Factor Model (FFM) predicted restrictive eating, binge eating, purging, chewing and spitting, excessive exercising and muscle building among males and females. An online survey assessing disordered eating behaviours, FFM and general psychopathology was completed by 394 females and 167 males aged between 16 and 30 years. Simultaneous equations path models were systematically generated for each disordered eating behaviour to identify how the FFM facets, body dissatisfaction and age predicted behaviour. The results indicated that each of the six disordered behaviours were predicted by a unique pattern of thinking, feeling and behaving. Considerable differences between males and females were found for each path model, suggesting differences between males and females in the personality traits that drive disordered eating behaviours. It was concluded that it is important to take personality into account when treating males and females who engage in disordered eating behaviours.
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Affiliation(s)
- Tanya Gilmartin
- Monash Alfred Psychiatry Research Centre, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
| | - Joanna F Dipnall
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Gemma Sharp
- Monash Alfred Psychiatry Research Centre, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
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Huisman SD, Hendrieckx C, Bot M, Pouwer F, Nefs G. Prevalence, associations and health outcomes of binge eating in adults with type 1 or type 2 diabetes: Results from Diabetes MILES - The Netherlands. Diabet Med 2023; 40:e14953. [PMID: 36084309 PMCID: PMC10087813 DOI: 10.1111/dme.14953] [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: 11/09/2021] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022]
Abstract
AIMS To examine the prevalence and health risks of binge eating in people with diabetes. METHODS Self-report data were analysed from a subsample (n = 582 type 1 diabetes/735 type 2 diabetes) of Diabetes MILES - the Netherlands, an online survey. Prevalence of binge eating was compared across diabetes type and treatment and between participants with and without binges for eating styles, diabetes treatment and outcomes, weight, BMI and psychological comorbidity. Associations between binge eating, HbA1c , BMI, diabetes distress were assessed using hierarchical linear regression analyses. RESULTS 23% (n = 308) of participants reported eating binges, with 16% at least monthly, and 6% at least weekly. Prevalence and frequency of binges did not differ across diabetes type or treatment. People reporting binges scored higher on dietary restraint, emotional and external eating and reported higher weight and BMI than those without binges. Only people with type 1 diabetes and eating binges had a higher HbA1c . Hierarchical regression analyses demonstrated that binge eating was independently associated with higher HbA1c (β = 0.12, p=0.001), BMI (β = 0.13, p < 0.001) but not with diabetes distress. CONCLUSIONS This study found binge eating to be associated with eating styles, BMI and HbA1c . However, our cross-sectional data do not allow for conclusions on causality. Future studies could further examine the directions of these associations and their clinical implications.
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Affiliation(s)
- Sasja D Huisman
- Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Mariska Bot
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - François Pouwer
- School of Psychology, Deakin University, Geelong, Australia
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense, Denmark
| | - Giesje Nefs
- Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg, The Netherlands
- Diabeter, National Treatment and Research Center for Children, Adolescents and Adults with Type 1 Diabetes, Rotterdam, The Netherlands
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Zelkowitz RL, Cole DA, Sterba SK, Liu Q, Lau AS, Trung LT, Weiss B. Latent profile analyses of disordered eating behaviors and nonsuicidal self-injury among Vietnamese adolescents. Int J Eat Disord 2022; 55:1721-1732. [PMID: 36165444 DOI: 10.1002/eat.23813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Comorbidity of disordered eating (DE) behaviors and nonsuicidal self-injury (NSSI) is linked to increased functional impairment. The present study identified subtypes of DE and NSSI comorbidity in a non-Western, low- and middle-income country where there has been particularly little research in this area. METHOD Latent profile analyses (LPA) were conducted to identify patterns of subgroup comorbidity in self-reported DE behaviors and NSSI behaviors, in a sample of Vietnamese high-school students (N = 1451, 51% female). Parallel-process LPA was used to predict NSSI subgroup membership from DE subgroup membership. RESULTS A seven-class LPA model was identified for DE: (1) Low frequencies of all DE behaviors; (2) Frequent levels of all DE behaviors; (3) Frequent fasting and purging behaviors; (4) Frequent binge eating only; (5) Moderate binge eating; (6) Moderate fasting and purging behaviors; (7) Exercise and fasting. A two-class (high versus low) model was identified for NSSI. Odds of membership in the high-NSSI class were significantly increased for all DE classes except the class characterized by moderate binge eating. Odds of belonging to the high-NSSI class were highest for those in DE classes involving purging behaviors. Males predominated in classes characterized by high behavior dysregulation. DISCUSSION DE and NSSI represent important clinical concerns among Vietnamese youth in urban contexts, and males may show particular vulnerability for certain risk behaviors. The association of classes of DE behaviors to NSSI was particularly strong for classes that involved purging, highlighting the importance of this specific behavior for understanding comorbidity of DE and NSSI. PUBLIC SIGNIFICANCE Disordered eating and nonsuicidal self-injury (NSSI; hurting oneself without intending to die) commonly co-occur. There has been less research on disordered eating and NSSI among individuals from non-Western or low/middle-income countries. We examined patterns of these behaviors in a school-based sample of Vietnamese adolescents. We found that patterns of disordered eating distinguished by purging showed particular links to NSSI, which could have implications for screening and treatment.
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Affiliation(s)
- Rachel L Zelkowitz
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - David A Cole
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA
| | - Sonya K Sterba
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA
| | - Qimin Liu
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA
| | - Anna S Lau
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Lam T Trung
- Danang Psychiatric Hospital, Da Nang, Vietnam
| | - Bahr Weiss
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, Tennessee, USA
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Hennigan KM, Olson KR, Baker JH, Munn-Chernoff MA. Associations between eating disorder symptoms and smoking and vaping use and motives in college students. Eat Behav 2022; 46:101652. [PMID: 35839570 PMCID: PMC9679963 DOI: 10.1016/j.eatbeh.2022.101652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/16/2022] [Accepted: 06/28/2022] [Indexed: 11/18/2022]
Abstract
A positive association between eating disorder (ED) symptoms and cigarette use exists. However, little is known about the association between ED symptoms and e-cigarette use, as well as how these symptoms are related to motives for using cigarettes and e-cigarettes. In this study, 716 college students (M age = 19.23, SD = 1.65; 61 % female) completed an online survey that included the Eating Pathology Symptoms Inventory, smoking and vaping questionnaires, and the Drinking Motives Questionnaire-Revised, which was modified for smoking and vaping. We examined mean differences in ED symptoms in lifetime (and past-month) cigarette and e-cigarette users versus non-users, and investigated correlations between ED symptoms and smoking and vaping motives. Finally, we evaluated whether biological sex influenced the results. Overall, 30.4 % of students reported lifetime smoking, 10.5 % reported past-month smoking, 23 % reported lifetime vaping, and 9.5 % reported past-month vaping. With the exception of higher mean scores for negative attitudes toward obesity in students reporting lifetime smoking versus never smoking after adjusting for sex (M = 5.97 vs. M = 4.52, t[713] = -3.76, q = 0.004), no significant mean differences emerged between those who used nicotine and those who did not, which reflected small to moderate effect sizes. Few associations were observed between ED symptoms and nicotine use motives. These findings suggest that the comorbidity between ED symptoms and smoking and vaping in a non-clinical sample is minimal, although additional research with larger sample sizes of males and females is needed.
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Affiliation(s)
- Kathrin M Hennigan
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathleen R Olson
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Melissa A Munn-Chernoff
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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12
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Forbes CN, Tull MT, Lavender JM, Dixon-Gordon KL, Gratz KL. Development and Initial Validation of the Body-focused Self-damaging Behavior Expectancies Questionnaire. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-021-09906-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Zinchuk M, Lavrishcheva A, Menshikova A, Voinova N, Artemieva M, Guekht A. Nonsuicidal self-injury in eating disorders. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:70-78. [DOI: 10.17116/jnevro202212209170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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14
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Bicaker E, Racine SE. Protection versus risk? The relative roles of compassionate and uncompassionate self-responding for eating disorder behaviors. Eat Behav 2022; 44:101592. [PMID: 34920209 DOI: 10.1016/j.eatbeh.2021.101592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/14/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022]
Abstract
Research demonstrates the protective role of self-compassion for eating disorder symptoms. However, studies investigating self-compassion most often use the Self-Compassion Scale, which aggregates the distinct but related constructs of compassionate and uncompassionate self-responding. This study examined differential associations of compassionate and uncompassionate self-responding with positive and negative affect and with a range of eating disorder behaviors (i.e., binge eating, purging, dietary restriction, and excessive exercise). Participants were 547 undergraduate students (59% women, Mage = 20.49, SDage = 1.83) who completed measures of self-compassion, trait affect, and eating disorder behaviors. Compassionate and uncompassionate self-responding were moderately negatively correlated (rs = -0.41 and -0.33, among women and men, respectively). Compassionate self-responding was more strongly related to positive affect, and uncompassionate self-responding was more strongly related to negative affect. Among women, uncompassionate self-responding was related to all eating disorder behaviors controlling for compassionate self-responding, whereas compassionate self-responding was not uniquely related to any eating disorder behavior. Among men, a similar pattern emerged, except that only compassionate self-responding related uniquely to excessive exercise. Results are consistent with studies showing that the presence of uncompassionate self-responding might outweigh the absence of compassionate self-responding in explaining psychopathology. Findings highlight the potential importance of primarily targeting uncompassionate self-responding in eating disorder interventions.
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Affiliation(s)
- Ege Bicaker
- Department of Psychology, McGill University, Montreal, Canada
| | - Sarah E Racine
- Department of Psychology, McGill University, Montreal, Canada.
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15
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Schaumberg K, Peters D, Ahrenholtz R, Crombie KM, Zhang R, Gorrell S. Registered report: A pilot investigation of acute exercise response among girls and young women with and without eating disorders. Int J Eat Disord 2021; 54:2057-2065. [PMID: 34323294 PMCID: PMC8595629 DOI: 10.1002/eat.23587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Driven exercise (DEx) is a serious and common feature of eating disorders (EDs), but current understanding of factors that give rise to and maintain DEx is limited. DEx may be reinforced through its effects on the threat reduction and reward systems. The current protocol is designed to evaluate acute psychobiological response to exercise among female participants (age 16-22) with and without EDs. METHOD Twenty medically-stable participants with restrictive-spectrum EDs and 20 healthy control (HC) participants will complete study screening and three task visits which will include two 30-minute bouts of aerobic exercise. RESULTS We aim to validate and demonstrate feasibility of two tasks capturing exercise response in this sample. Further, we will estimate the degree to which a bout of exercise impacts state body image, affect, and circulating concentrations of biological markers among participants, and we will examine whether the impact of exercise on psychological outcomes may differ across ED and HC groups. DISCUSSION Completion of this project will contribute to the conceptualization of DEx and how individuals' acute biological and affective responses to exercise contribute to risk for and maintenance of DEx.
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Affiliation(s)
- Katherine Schaumberg
- University of Wisconsin - Madison, Department of Psychiatry, 6001 Research Park Boulevard, Madison, Wisconsin, United States of America, 53719-1176
| | - Danielle Peters
- University of Wisconsin - Madison, Department of Psychiatry, 6001 Research Park Boulevard, Madison, Wisconsin, United States of America, 53719-1176
| | - Rachel Ahrenholtz
- University of Wisconsin - Madison, Department of Psychiatry, 6001 Research Park Boulevard, Madison, Wisconsin, United States of America, 53719-1176
| | - Kevin M. Crombie
- University of Wisconsin - Madison, Department of Psychiatry, 6001 Research Park Boulevard, Madison, Wisconsin, United States of America, 53719-1176
| | - Ruisu Zhang
- University of Wisconsin - Madison, Department of Psychiatry, 6001 Research Park Boulevard, Madison, Wisconsin, United States of America, 53719-1176
| | - Sasha Gorrell
- University of California - San Francisco, Department of Psychiatry and Behavioral Sciences, 401 Parnassus Avenue, San Francisco, California, United States of America, 94143
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16
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Wang SB, Fox KR, Boccagno C, Hooley JM, Mair P, Nock MK, Haynos AF. Functional assessment of restrictive eating: A three-study clinically heterogeneous and transdiagnostic investigation. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:761-774. [PMID: 34780230 PMCID: PMC8597895 DOI: 10.1037/abn0000700] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Restrictive eating is common and associated with negative psychological outcomes across the life span and eating disorder (ED) severity levels. Little is known about functional processes that maintain restriction, especially outside of narrow diagnostic categories (e.g., anorexia nervosa). Here, we extend research on operant four-function models (identifying automatic negative, automatic positive, social negative, and social positive reinforcement functions) that have previously been applied to nonsuicidal self-injury (NSSI), binge eating, and purging to restricting. We assessed restrictive eating functions in three samples: clinically heterogeneous adolescents (Study 1: N = 457), transdiagnostic adults (Study 2: N = 145), and adults with acute or recently weight-restored anorexia nervosa (Study 3: N = 45). Study 1 indicated the four-function model was a good fit for restricting (root mean square error of approximation [RMSEA] = .06, Tucker-Lewis index [TLI] = .88). This factor structure replicated in Study 2 (comparative fit index [CFI] = .97, RMSEA = .07, TLI = .97, standardized root mean square residual [SRMR] = .09). Unlike NSSI, binge eating, and purging, which have been found to primarily serve automatic negative reinforcement functions, all three present studies found automatic positive reinforcement was most highly endorsed (by up to 85% of participants). In Studies 1 and 3, automatic functions were associated with poorer emotion regulation (ps < .05). In Study 1, social functions were associated with less social support (ps < .001). Across studies, automatic functions were associated with greater restriction ps < .05). Functions varied slightly by ED diagnosis. Across ED presentation, severity, and developmental stage, restrictive eating may be largely maintained by automatic positive reinforcement, with some variability across presentations. Continued examination of restrictive eating functions will establish processes that maintain restriction, allowing more precise treatment targeting for these problematic behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Kathryn R. Fox
- Department of Psychology, University of Denver, Denver, CO
| | | | - Jill M. Hooley
- Department of Psychology, Harvard University, Cambridge, MA
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA
| | | | - Ann F. Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
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17
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Abstract
BACKGROUND The nature and significance of impulse-control difficulties in binge-eating disorder (BED) are uncertain. Most emerging research has focused on food-specific rather than general impulsivity. The current study examines the clinical presentation of patients with BED categorized with and without clinical levels of general impulsivity. METHOD A total of 343 consecutive treatment-seeking patients with BED were categorized as having BED with general impulsivity (GI+; N = 73) or BED without general impulsivity (GI-: N = 270) based on structured diagnostic and clinical interviews. The groups were compared on demographic, developmental, and psychological features, and on rates of psychiatric and personality comorbidity. RESULTS Individuals with BED and general impulsivity (GI+) reported greater severity of eating-disorder psychopathology, greater depressive symptoms, and greater rates of comorbidity than those without general impulsivity (GI-). CONCLUSIONS A subtype of individuals with BED and general impulsivity may signal a more severe presentation of BED characterized by heightened and broader psychopathology. Future work should investigate whether these impulse-control difficulties relate to treatment outcomes.
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18
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Nitturi V, Chen TA, Zvolensky MJ, McNeill LH, Obasi EM, Reitzel LR. Anxiety Sensitivity and Fast-Food Ordering Habits Among Black Adults. HEALTH BEHAVIOR RESEARCH 2021; 4. [PMID: 34541461 DOI: 10.4148/2572-1836.1086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Black adults experience high rates of overweight/obesity, which is linked to chronic diseases and is exacerbated by fast-food consumption. Anxiety sensitivity, a relative stable fear of anxiety-related sensations, has been linked to high caloric intake. Here, we examine whether anxiety sensitivity is associated with fast-food ordering habits within a convenience sample of Black adults. Methods Of 124 adults (79.4% women; Mage=49.3±11.6; 84.8% overweight/obese), 107 (86.3%) reported eating from a fast-food restaurant in the last month. Participants completed the Anxiety Sensitivity-Index 3, which has a total score and physical, cognitive, and social concerns subscales. Investigator-generated items queried frequency of ordering "supersized" quantities of fast-food (e.g., cheeseburgers, fries), and healthy items (e.g., salads, oatmeal, yogurt), respectively, from "never" to "always." Covariate-adjusted ordinal logistic regression models were used to assess relations between measures of interest. Results Anxiety sensitivity (total and physical concerns) was associated with greater odds of more frequently ordering supersized unhealthy fast-food; and anxiety sensitivity (total and cognitive concerns) was associated with lower odds of more frequently ordering healthy items from fast-food restaurants. Conclusions Results suggest that adults with greater anxiety sensitivity may engage in fast-food ordering habits that can contribute to the overweight/obesity epidemic. Future studies should replicate results and determine the potential for anxiety sensitivity-reduction interventions to affect dietary choices that contribute to overweight/obesity.
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Affiliation(s)
- Vijay Nitturi
- The University of Houston, Department of Psychological, Health, and Learning Sciences, and the University of Houston, HEALTH Research Institute, Houston, Texas
| | - Tzu-An Chen
- The University of Houston, Department of Psychological, Health, and Learning Sciences, and the University of Houston, HEALTH Research Institute, Houston, Texas
| | - Michael J Zvolensky
- The University of Houston, HEALTH Research Institute, The University of Houston, College of Liberal Arts and Social Sciences, Department of Psychology, and The University of Texas MD Anderson Cancer Center, Department of Behavioral Sciences, Houston, Texas
| | - Lorna H McNeill
- The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX
| | - Ezemenari M Obasi
- The University of Houston, Department of Psychological, Health, and Learning Sciences, and the University of Houston, HEALTH Research Institute, Houston, Texas
| | - Lorraine R Reitzel
- The University of Houston, Department of Psychological, Health, and Learning Sciences, and the University of Houston, HEALTH Research Institute, Houston, Texas
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19
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Barney JL, Barrett TS, Lensegrav-Benson T, Quakenbush B, Twohig MP. Confirmatory factor analysis and measurement invariance of the Cognitive Fusion Questionnaire-Body Image in a clinical eating disorder sample. Body Image 2021; 38:262-269. [PMID: 34000498 DOI: 10.1016/j.bodyim.2021.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 11/25/2022]
Abstract
Individuals with eating disorders (EDs) may be particularly susceptible to body image related cognitive fusion (i.e., excessive entanglement with one's body image related thoughts such that they unduly influence on behavior). The Cognitive Fusion Questionnaire-Body Image (CFQ-BI) is the only existing measure of this construct, yet its psychometric properties have not been examined within a clinically diagnosed ED sample. The current study used confirmatory factor analysis and explored measurement invariance, construct validity, and incremental validity of the CFQ-BI when used with adolescent (n = 75) and adult (n = 100) females admitting to residential ED treatment. A modified version of the single-factor structure of the CFQ-BI best fit the data and configural, metric, and scalar invariance were supported across age groups (i.e., adolescents or adults) and ED behavioral presentations (i.e., restrictive behaviors or binge/purge behaviors). Adults' and individuals with binge/purge behavioral presentations reported significantly more body image related fusion compared to adolescents and adults, respectively. Body image related psychological flexibility and ED severity were both significantly correlated CFQ-BI scores in expected directions. These findings suggest the CFQ-BI is a valid measure for assessing body image related fusion among adolescent and adult females with varying ED behavioral presentations. Implications and future research directions are discussed.
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Affiliation(s)
- Jennifer L Barney
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT, 84322, USA.
| | - Tyson S Barrett
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT, 84322, USA
| | | | - Benita Quakenbush
- Avalon Hills Eating Disorder Specialists, 175 E 100 N, Logan, UT, 84321, USA
| | - Michael P Twohig
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT, 84322, USA
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20
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Simons RM, Hansen JM, Simons JS, Hovrud L, Hahn AM. Drunkorexia: Normative behavior or gateway to alcohol and eating pathology? Addict Behav 2021; 112:106577. [PMID: 32861988 DOI: 10.1016/j.addbeh.2020.106577] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/06/2020] [Accepted: 07/25/2020] [Indexed: 12/14/2022]
Abstract
Drunkorexia is characterized by a group of behaviors designed to minimize caloric intake while maximizing levels of alcohol intoxication. Individuals plan and modify their diet, via skipping meals, exercising, or purging, to save calories for a night of alcohol consumption. Minimal research has examined risk factors related to drunkorexia, and little is known regarding associated problems. We used structural equation modeling to test associations between coping and enhancement motives, drive for thinness, body dissatisfaction, and disordered eating (i.e., bulimia behaviors) and drinking among an at-risk college population (N = 364). Drive for thinness and alcohol coping motives were positively associated with drunkorexia. Notably, drunkorexia was associated with alcohol-related outcomes, but not bulimia. While common risk factors are shared with eating pathology, drunkorexia appears to be a unique construct apart from bulimia behaviors. Results indicate drunkorexia behaviors may extend past normative drinking and place individuals at increased risk of alcohol-related problems. The current study contributes to greater understanding of functional models and maladaptive outcomes related to drunkorexia behaviors.
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21
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Bottera AR, Kambanis PE, De Young KP. The differential associations of shame and guilt with eating disorder behaviors. Eat Behav 2020; 39:101427. [PMID: 32896681 DOI: 10.1016/j.eatbeh.2020.101427] [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: 03/04/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 02/07/2023]
Abstract
Negative affect increases in the hours prior to binge eating (BE), suggesting individuals may use BE to attempt to alleviate experiences of aversive self-awareness, such as shame and guilt. Guilt involves feeling bad about ones behavior and may elicit reparative actions; shame involves feeling bad about oneself and is generally associated with maladaptive behavior. Distinguishing how shame and guilt differentially relate to specific eating disorder (ED) behaviors may inform our understanding of emotional antecedents of ED behaviors and lead to refined treatment and prevention targets. We aimed to distinguish shame and guilt as they relate to BE and self-induced vomiting (SIV). We hypothesized that: (a) shame-proneness and state shame would be uniquely associated with BE, as BE may be used to escape from experiences of shame, and (b) guilt-proneness and state guilt would be positively associated with SIV among individuals who binge eat, as SIV may be used as a reparative action for BE. Participants (N = 347) completed self-report measures assessing guilt, shame, and ED behaviors. Shame-proneness and state shame were uniquely associated with BE and the urge to binge eat, while guilt-proneness and state guilt were not. Contrary to our hypothesis, guilt-proneness and state guilt were not associated with SIV among those who binge eat or endorsed urges to binge eat. These findings suggest that shame and guilt are differentially related to ED behaviors and identify shame specifically as an emotion that may elicit BE. Future research is needed to identify temporal relations between shame and ED behaviors.
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Affiliation(s)
- Angeline R Bottera
- Department of Psychology, University of Wyoming, United States of America.
| | - P Evelyna Kambanis
- Department of Psychology, University of Wyoming, United States of America
| | - Kyle P De Young
- Department of Psychology, University of Wyoming, United States of America
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22
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Edwards ER, Liu Y, Ruiz D, Brosowsky NP, Wupperman P. Maladaptive Emotional Schemas and Emotional Functioning: Evaluation of an Integrated Model Across Two Independent Samples. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2020. [DOI: 10.1007/s10942-020-00379-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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23
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Tosyali AF, Harma M. The role of co-regulation of stress in the relationship between perceived partner responsiveness and binge eating: A dyadic analysis. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2020; 56:435-443. [PMID: 32959904 DOI: 10.1002/ijop.12712] [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: 09/17/2019] [Accepted: 07/17/2020] [Indexed: 11/06/2022]
Abstract
The main aim of this study is to investigate whether there are relationships between perceived partner responsiveness (PPR), co-regulation of negative affect between romantic partners and binge eating. Data were collected from 148 opposite-sex romantic partners (18-61 years old) with the mean relationship duration being 8.04 years. Dyadic data were analysed through the actor-partner interdependence model framework. We proposed a model where co-regulation between partners has indirect effects on the relationship between PPR and binge eating. Results showed that there was no direct association between PPR and binge eating scores of the participants. However, significant direct associations were found regarding both actor and partner effects of PPR on co-regulation between romantic partners. In addition, there were four significant indirect effects: Women's co-regulation had an indirect effect on the link between PPR and women's binge eating scores. Similarly, women's co-regulation had also a significant indirect effect on the link between PPR and men's binge eating. These findings are the first to illustrate a relationship between PPR and binge eating. This study is the first attempt to examine binge eating in terms of co-regulation processes.
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Affiliation(s)
| | - Mehmet Harma
- Department of Psychology, Kadir Has University, Istanbul, Turkey
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24
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Morawetz C, Steyrl D, Berboth S, Heekeren HR, Bode S. Emotion Regulation Modulates Dietary Decision-Making via Activity in the Prefrontal-Striatal Valuation System. Cereb Cortex 2020; 30:5731-5749. [PMID: 32567667 PMCID: PMC7899064 DOI: 10.1093/cercor/bhaa147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/31/2020] [Accepted: 05/07/2020] [Indexed: 01/03/2023] Open
Abstract
The consumption of indulgent, carbohydrate- and fat-rich foods is often used as a strategy to cope with negative affect because they provide immediate self-reward. Such dietary choices, however, can severely affect people's health. One countermeasure could be to improve one's emotion regulation ability. We used functional magnetic resonance imaging to examine the neural activity underlying the downregulation of incidental emotions and its effect on subsequent food choices. We investigated whether emotion regulation leads to healthier food choices and how emotion regulation interacts with the brain's valuation and decision-making circuitry. We found that 1) the downregulation of incidental negative emotions was associated with a subsequent selective increase in decisions for tasty but also for healthy foods, 2) food preferences were predicted by palatability but also by the current emotional state, and 3) emotion regulation modulated decision-related activation in the ventromedial prefrontal cortex and ventral striatum. These results indicate that emotional states are indeed important for food choice and that the process of emotion regulation might boost the subsequent processing of health attributes, possibly via neural reward circuits. In consequence, our findings suggest that increasing emotion regulation ability could effectively modulate food choices by stimulating an incidental upvaluation of health attributes.
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Affiliation(s)
- Carmen Morawetz
- Department of Education and Psychology, Freie Universität Berlin, Berlin 14195, Germany.,Center for Cognitive Neuroscience Berlin, Freie Universität Berlin, Berlin 14195, Germany.,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna 1090, Austria
| | - David Steyrl
- Department of Basic Psychological Research and Research Methods, University of Vienna, Vienna 1010, Austria.,Psychiatric University Hospital, University of Zürich, Zurich 8091, Switzerland
| | - Stella Berboth
- Department of Education and Psychology, Freie Universität Berlin, Berlin 14195, Germany.,Center for Cognitive Neuroscience Berlin, Freie Universität Berlin, Berlin 14195, Germany
| | - Hauke R Heekeren
- Department of Education and Psychology, Freie Universität Berlin, Berlin 14195, Germany.,Center for Cognitive Neuroscience Berlin, Freie Universität Berlin, Berlin 14195, Germany
| | - Stefan Bode
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne 3010, VIC, Australia.,Department of Psychology, University of Cologne, Cologne 50923, Germany
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25
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Liebman RE, Coniglio KA, Becker KR, Tabri N, Keshishian AC, Wons O, Keel PK, Eddy KT, Thomas JJ. Behavioral inhibition moderates the association between overvaluation of shape and weight and noncompensatory purging in eating disorders. Int J Eat Disord 2020; 53:143-148. [PMID: 31758819 DOI: 10.1002/eat.23195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/19/2019] [Accepted: 10/07/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The cognitive-behavioral therapy (CBT) model of eating disorders suggests that compensatory purging behaviors (e.g., self-induced vomiting, inappropriate laxative use) are primarily driven by binge eating. However, many individuals endorse purging in the absence of binge eating (i.e., noncompensatory purging [NCP]). Research is needed to understand why some individuals purge in the absence of objective or subjective binge-eating episodes. METHOD Given the importance of overvaluation of shape/weight in the CBT model, and the existing evidence linking temperamental characteristics like behavioral inhibition (i.e., the tendency to withdraw in response to threat cues) with purging in general, we tested whether behavioral inhibition moderated the relationship between overvaluation of shape/weight and NCP in a sample of individuals in a residential eating disorder treatment center (N = 143). RESULTS Overvaluation was more strongly related to NCP in individuals with high (relative to low) levels of behavioral inhibition. Among individuals low in behavioral inhibition, overvaluation predicted engagement in NCP to a much weaker extent. DISCUSSION For those high (relative to low) in behavioral inhibition, both emotional avoidance and overvaluation may be important targets in the treatment of NCP, particularly in the absence of binge eating.
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Affiliation(s)
- Rachel E Liebman
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | | | - Kendra R Becker
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Nassim Tabri
- Department of Psychology, Carleton University, Ottawa, Ontario
| | - Ani C Keshishian
- Department of Psychology, University of Louisville, Louisville, KY
| | - Olivia Wons
- Department of Psychology, Drexel University, Philadelphia, PA
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, FL
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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26
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Davis HA, Smith GT, Keel PK. An examination of negative urgency and other impulsigenic traits in purging disorder. Eat Behav 2020; 36:101365. [PMID: 32018192 PMCID: PMC7044031 DOI: 10.1016/j.eatbeh.2020.101365] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 11/25/2022]
Abstract
There is extensive evidence for the clinical significance of Purging Disorder (PD), an eating disorder characterized by recurrent purging behavior (self-induced vomiting, laxative use, and diuretic use) in the absence of binge eating and low weight (Smith, Crowther, & Lavender, 2017). Research on the personality profile of PD is still developing but evidence supports an association with impulsivity (Brown, Haedt-Matt, & Keel, 2011). The personality underpinnings of impulsive behavior include several different impulsigenic traits. To investigate personality contributors to impulsive behavior among women with PD, we compared 31 women with PD to 57 women with bulimia nervosa (BN) and 31 healthy control women on four impulsigenic traits: negative urgency, lack of premeditation, lack of perseverance, and sensation seeking. Compared to healthy controls, women with PD reported significantly greater levels of negative urgency, but no significant differences on the other traits. Compared to BN, PD was associated with significantly lower levels of negative urgency, but no other significant differences. Compared with controls, women in the BN group had significantly higher scores on lack of premeditation and lack of perseverance, but no significant difference on sensation seeking. Findings indicate negative urgency is a potentially important personality trait for distinguishing those with PD.
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Affiliation(s)
- Heather A. Davis
- Department of Psychology, University of Kentucky, Lexington, KY, United States
| | - Gregory T. Smith
- Department of Psychology, University of Kentucky, Lexington, KY, United States
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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27
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Zelkowitz RL, Cole DA. Self-Criticism as a Transdiagnostic Process in Nonsuicidal Self-Injury and Disordered Eating: Systematic Review and Meta-Analysis. Suicide Life Threat Behav 2019; 49:310-327. [PMID: 29504147 PMCID: PMC6123292 DOI: 10.1111/sltb.12436] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 09/21/2017] [Indexed: 12/14/2022]
Abstract
Nonsuicidal self-injury (NSSI) and disordered eating (DE) are highly comorbid and may be regarded as belonging to a spectrum of self-harm behaviors. We investigated self-criticism as a transdiagnostic correlate of these behaviors, in keeping with etiological theories of both NSSI and DE. We reviewed the literature and meta-analyzed the relation of self-criticism to both NSSI (15 studies; 17 effect sizes) and DE (24 studies; 29 effect sizes). Results showed equivalent, moderate-to-large effects for the relation of self-criticism to NSSI (r = .38; CI: .29-.46) and DE (r = .40; CI: .34-.45). The relation of NSSI to self-criticism generalized across multiple potential moderators. DE behavior type moderated the relation of self-criticism to DE, with a stronger relation emerging for purging than restriction. Findings support self-criticism as a possible candidate for transdiagnostic pathways to self-harm.
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Affiliation(s)
- Rachel L. Zelkowitz
- Department of Psychology and Human Development; Vanderbilt University; Nashville TN USA
| | - David A. Cole
- Department of Psychology and Human Development; Vanderbilt University; Nashville TN USA
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Jonsson LS, Svedin CG, Priebe G, Fredlund C, Wadsby M, Zetterqvist M. Similarities and Differences in the Functions of Nonsuicidal Self-Injury (NSSI) and Sex as Self-Injury (SASI). Suicide Life Threat Behav 2019; 49:120-136. [PMID: 29073344 DOI: 10.1111/sltb.12417] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 08/16/2017] [Indexed: 11/27/2022]
Abstract
Differences and similarities were studied in the functions of two different self-injurious behaviors (SIB): nonsuicidal self-injury (NSSI) and sex as self-injury (SASI). Based on type of SIB reported, adolescents were classified in one of three groups: NSSI only (n = 910), SASI only (n = 41), and both NSSI and SASI (n = 76). There was support for functional equivalence in the two forms of SIB, with automatic functions being most commonly endorsed in all three groups. There were also functional differences, with adolescents in the SASI only group reporting more social influence functions than those with NSSI only. Adolescents reporting both NSSI and SASI endorsed the highest number of functions for both behaviors. Clinical implications are discussed, emphasizing the need for emotion regulation skills.
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Affiliation(s)
- Linda Sofia Jonsson
- Barnafrid, Department of Child and Adolescent Psychiatry and Clinical and Experimental Medicine, Child and Adolescent Psychiatry, Linköping University, Linköping, Sweden
| | - Carl Göran Svedin
- Barnafrid, Department of Child and Adolescent Psychiatry and Clinical and Experimental Medicine, Child and Adolescent Psychiatry, Linköping University, Linköping, Sweden
| | - Gisela Priebe
- Department of Psychology, IKV, Lund University, Lund, Sweden
| | - Cecilia Fredlund
- Department of Child and Adolscent Psychiatry and, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Marie Wadsby
- Department of Child and Adolscent Psychiatry and, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Maria Zetterqvist
- Department of Child and Adolscent Psychiatry and, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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Muehlenkamp JJ, Suzuki T, Brausch AM, Peyerl N. Behavioral functions underlying NSSI and eating disorder behaviors. J Clin Psychol 2019; 75:1219-1232. [PMID: 30672588 DOI: 10.1002/jclp.22745] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/13/2018] [Accepted: 12/27/2019] [Indexed: 11/11/2022]
Affiliation(s)
| | - Takakuni Suzuki
- Department of Psychiatry and Human BehaviorUniversity of Mississippi Medical CenterJackson Mississippi
- Department of Psychological SciencesPurdue University Indiana
| | - Amy M. Brausch
- Department of Psychological ScienceWestern Kentucky UniversityBowling Green Kentucky
| | - Naomi Peyerl
- Department of PsychologyUniversity of North DakotaGrand Forks North Dakota
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30
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Black EB, Garratt M, Beccaria G, Mildred H, Kwan M. Body image as a predictor of nonsuicidal self-injury in women: A longitudinal study. Compr Psychiatry 2019; 88:83-89. [PMID: 30529911 DOI: 10.1016/j.comppsych.2018.11.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/19/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVES To determine whether Body Image Dissatisfaction (BID) predicted NonSuicidal Self-Injury (NSSI) cross-sectionally and longitudinally, independent of comorbidity between NSSI and Disordered Eating (DE). Another aim was to determine whether BID could predict number of NSSI methods present. METHOD Adult females completed measures of NSSI and DE (n = 283); and a longitudinal sample (n = 106) completed these measures again one year later. RESULTS BID was a small yet significant predictor of NSSI both cross-sectionally and longitudinally. Poorer BID significantly explained a greater number of NSSI methods cross-sectionally and longitudinally. CONCLUSIONS BID explains unique variance in NSSI (including increased number of methods), and is not a function of comorbidity with DE. This has the potential to influence theory, as well as inform early intervention initiatives for BID in females. Further research is required to determine other variables implicated in this relationship, as well as whether these findings are applicable to other groups such as adolescents and males.
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Affiliation(s)
- Emma B Black
- The University of Queensland, Australia; Deakin University, Australia.
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Abstract
Stress and negative emotions pose a major threat to public health, by increasing the risk of obesity. Since the management process for emotions (emotion regulation; ER) is developed in childhood, we present a novel conceptual framework model for the role of ER in the prevention and treatment of childhood obesity. A narrative review of the literature by electronic database search (MEDLINE, Web of Knowledge and Scopus) was conducted of observational and interventional/experimental literature on ER and obesity and the underlying concepts. We also present an overview of ER intervention techniques. Our model indicates that childhood ER is a link between stress and obesity. Stress along with ineffective ER leads to abnormal cortisol patterns, emotional eating, sedentary lifestyle, reduction of physical activity, and sleep problems. Simultaneously, a healthy lifestyle could show benefits on ER and in developing adaptive ER strategies. In the development of obesity and ER, parents also play a role. By contrast, effective ER skills decrease obesity-related unhealthy behaviour and enhance protective factors, which boost health. The literature contains some observational studies of children but very few intervention studies, most of which are pilot or on-going studies. In conclusion, encouraging effective ER could be a useful new approach for combating and treating childhood obesity. Future ER intervention studies are needed to confirm the validity of this model in children.
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32
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Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders. Eat Weight Disord 2016; 21:205-10. [PMID: 26511501 PMCID: PMC4848163 DOI: 10.1007/s40519-015-0235-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/15/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. METHODS Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. RESULTS Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. CONCLUSIONS Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted.
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Riley EN, Davis HA, Combs JL, Jordan CE, Smith GT. Nonsuicidal Self-injury as a Risk Factor for Purging Onset: Negatively Reinforced Behaviours that Reduce Emotional Distress. EUROPEAN EATING DISORDERS REVIEW 2016; 24:78-82. [PMID: 26373703 PMCID: PMC4681665 DOI: 10.1002/erv.2407] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/21/2015] [Accepted: 08/24/2015] [Indexed: 11/07/2022]
Abstract
Both nonsuicidal self-injury (NSSI) and purging behaviour are thought to involve harm to the self. The acquired capability for self-harm model holds that engaging in one self-harming behaviour increases the capability to tolerate harm to the self, thus increasing risk for engaging on other such behaviours. In addition, both behaviours are thought to serve the similar function of relief from distress. We thus tested whether engagement in one of these behaviours predicts the subsequent onset of the other. In a longitudinal design, 1158 first-year college women were assessed for purging and NSSI at two time points. Engagement in NSSI at time 1 predicted the college onset of purging behaviour 9 months later (OR = 2.20, p < .04, CI = 1.07-4.19) beyond prediction from time 1 binge behaviour, and purging behaviour at time 1 predicted the subsequent onset of NSSI (OR = 6.54, p < .01, CI = 1.71-25.04). These findings are consistent with the acquired capability for harm model and with the possibility that the two behaviours serve a similar function.
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Affiliation(s)
- Elizabeth N. Riley
- The University of Kentucky Department of Psychology 125 Kastle Hall Lexington, KY 40506-0044
| | - Heather A. Davis
- The University of Kentucky Department of Psychology 125 Kastle Hall Lexington, KY 40506-0044
| | - Jessica L. Combs
- The University of Kentucky Department of Psychology 125 Kastle Hall Lexington, KY 40506-0044
| | - Carol E. Jordan
- The University of Kentucky Department of Psychology 125 Kastle Hall Lexington, KY 40506-0044
| | - Gregory T. Smith
- The University of Kentucky Department of Psychology 125 Kastle Hall Lexington, KY 40506-0044
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34
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Hammelstein P. Kritische Funktionalität - Darstellung des Konzeptes und der therapeutischen Implikationen in der kognitiven Verhaltenstherapie. VERHALTENSTHERAPIE 2015. [DOI: 10.1159/000441637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Crockett AC, Myhre SK, Rokke PD. Boredom proneness and emotion regulation predict emotional eating. J Health Psychol 2015; 20:670-80. [DOI: 10.1177/1359105315573439] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Emotional eating is considered a risk factor for eating disorders and an important contributor to obesity and its associated health problems. It has been suggested that boredom may be an important contributor to overeating, but has received relatively little attention. A sample of 552 college students was surveyed. Linear regression analyses found that proneness to boredom and difficulties in emotion regulation simultaneously predicted inappropriate eating behavior, including eating in response to boredom, other negative emotions, and external cues. The unique contributions of these variables to emotional eating were discussed. These findings help to further identify which individuals could be at risk for emotional eating and potentially for unhealthy weight gain.
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36
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Moore M, Masuda A, Hill ML, Goodnight BL. Body image flexibility moderates the association between disordered eating cognition and disordered eating behavior in a non-clinical sample of women: a cross-sectional investigation. Eat Behav 2014; 15:664-9. [PMID: 25289446 DOI: 10.1016/j.eatbeh.2014.08.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 05/21/2014] [Accepted: 08/21/2014] [Indexed: 11/15/2022]
Abstract
Body image flexibility, a regulation process of openly and freely experiencing disordered eating thoughts and body dissatisfaction, has been found to be a buffering factor against disordered eating symptomatology. The present cross-sectional study investigates whether body image flexibility accounts for disordered eating behavior above and beyond disordered eating cognition, mindfulness, and psychological inflexibility in a sample of nonclinical women, and whether body image flexibility moderates the associations between these correlates and disordered eating behavior. Participants were 421 women, age 21±5.3 years old on average, who completed a web-based survey that included the self-report measures of interest. Results demonstrate the incremental effects of body image flexibility on disordered eating behavior above and beyond disordered eating cognition, mindfulness, and psychological inflexibility. Women with greater body image flexibility endorse disordered eating behavior less so than those with lower body image flexibility. Body image flexibility moderates the association between disordered eating cognition and disordered eating behavior; for women with greater body image flexibility, disordered eating cognition is not positively associated with disordered eating behavior.
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Affiliation(s)
- Makeda Moore
- Department of Psychology, Georgia State University, USA
| | - Akihiko Masuda
- Department of Psychology, Georgia State University, USA.
| | - Mary L Hill
- Department of Psychology, Georgia State University, USA
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37
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O'Reilly GA, Cook L, Spruijt-Metz D, Black DS. Mindfulness-based interventions for obesity-related eating behaviours: a literature review. Obes Rev 2014; 15:453-61. [PMID: 24636206 PMCID: PMC4046117 DOI: 10.1111/obr.12156] [Citation(s) in RCA: 269] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 01/01/2014] [Accepted: 01/02/2014] [Indexed: 01/01/2023]
Abstract
Mindfulness-based interventions (MBIs) targeting eating behaviours have gained popularity in recent years. A literature review was conducted to determine the effectiveness of MBIs for treating obesity-related eating behaviours, such as binge eating, emotional eating and external eating. A search protocol was conducted using the online databases Google Scholar, PubMed, PsycINFO and Ovid Healthstar. Papers were required to meet the following criteria to be included in this review: (i) describe a MBI or the use of mindfulness exercises as part of an intervention; (ii) include at least one obesity-related eating behaviour as an outcome; (iii) include quantitative outcomes; and (iv) be published in English in a peer-reviewed journal. A total of N = 21 papers were included in this review. Interventions used a variety of approaches to implement mindfulness training, including combined mindfulness and cognitive behavioural therapies, mindfulness-based stress reduction, acceptance-based therapies, mindful eating programmes, and combinations of mindfulness exercises. Targeted eating behaviour outcomes included binge eating, emotional eating, external eating and dietary intake. Eighteen (86%) of the reviewed studies reported improvements in the targeted eating behaviours. Overall, the results of this first review on the topic support the efficacy of MBIs for changing obesity-related eating behaviours, specifically binge eating, emotional eating and external eating.
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Affiliation(s)
- G A O'Reilly
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
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38
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Møhl B, la Cour P, Skandsen A. Non-Suicidal Self-Injury and Indirect Self-Harm Among Danish High School Students. Scand J Child Adolesc Psychiatr Psychol 2014. [DOI: 10.21307/sjcapp-2014-003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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39
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Ditch SM, Tosh AK. A college student with muscle cramps and weakness. Diagnosis: Bulimia nervosa, purging subtype, complicated by rhabdomyolysis and acute renal failure. Clin Pediatr (Phila) 2013; 52:770-3. [PMID: 23671269 DOI: 10.1177/0009922813488657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sarah M Ditch
- University of Missouri School of Medicine, Columbia, MO 65212, USA
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40
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Abstract
Functional behavior analytic approaches have been demonstrated to be widely applicable and efficacious. While interventions have typically focused on children and individuals with intellectual or developmental disabilities, behavior analytic principles have a great deal to offer to conceptualizations of psychopathology in other populations. This manuscript describes a case of an adolescent with oppositional symptoms treated using a functional behavior analytic intervention. Following an 8-week course of treatment, the client experienced improvements in the areas of academic and social functioning. Findings suggest that a functional behavior analytic perspective may have a great deal to offer to treatment of adolescents.
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41
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Farmer RF, Kosty DB, Seeley JR, Olino TM, Lewinsohn PM. Aggregation of lifetime Axis I psychiatric disorders through age 30: incidence, predictors, and associated psychosocial outcomes. JOURNAL OF ABNORMAL PSYCHOLOGY 2013; 122:573-86. [PMID: 23421525 PMCID: PMC3667968 DOI: 10.1037/a0031429] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Longitudinal data from representative birth cohorts on the aggregation of psychiatric disorders, or the cumulative number of unique diagnosed disorders experienced by persons within a circumscribed period, are limited. As a consequence, risk factors for and psychosocial implications of lifetime disorder aggregation in the general population remain largely unknown. This research evaluates the incidence, predictors, and psychosocial sequela of lifetime disorder aggregation from childhood through age 30. Over a 14-year period, participants in the Oregon Adolescent Depression Project (probands; N = 816) were repeatedly evaluated for psychiatric disorders and assessed with multiple measures of psychosocial functioning. First-degree relatives of probands (N = 2,414) were also interviewed to establish their lifetime psychiatric history. The cumulative prevalence of common lifetime psychiatric disorders for the proband sample was 71%. Three-quarters of all proband psychiatric disorders occurred among 37% of the sample, and 82% of all disorder diagnoses were made among persons who met criteria for at least one other lifetime disorder. Lifetime disorder aggregation in probands was predicted by lifetime psychiatric disorder densities among first-degree relatives and was related to heterotypic comorbidity patterns that included disorders from both internalizing and externalizing domains, most notably major depressive and alcohol use disorders. By age 30, disorder aggregation was significantly associated with mental health care service utilization and predictive of personality disorder pathology and numerous indicators of poor psychosocial functioning. Possible implications of disorder aggregation on the conceptualization of lifetime psychiatric disorder comorbidity are discussed.
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42
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Lee S, Fowler D, Yuan J. Characteristics of Healthy Foods as Perceived by College Students Utilizing University Foodservice. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/15378020.2013.782239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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43
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DeBoer LB, Tart CD, Presnell KE, Powers MB, Baldwin AS, Smits JAJ. Physical activity as a moderator of the association between anxiety sensitivity and binge eating. Eat Behav 2012; 13:194-201. [PMID: 22664396 PMCID: PMC3614415 DOI: 10.1016/j.eatbeh.2012.01.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 12/16/2011] [Accepted: 01/17/2012] [Indexed: 10/14/2022]
Abstract
Individuals with elevated anxiety sensitivity (AS; i.e., fear of somatic arousal) may binge eat to reduce emotional distress. Because physical activity reduces stress reactivity, we predicted that: (1) the relation between AS and binge eating would be moderated by physical activity and (2) coping motives for eating would mediate the association between AS and binge eating such that the relation would be stronger for those low in physical activity. Participants (N=167) completed online self-report measures. Regression analyses revealed that moderate-intensity physical activity (MPA) moderated the relation between AS and binge eating such that AS was not related to binge eating among those who frequently engaged in MPA but was related to binge eating among those who did not report engaging in MPA. Vigorous-intensity physical activity (VPA) moderated in the opposite direction such that the relation between AS and binge eating was significant among persons reporting high levels of VPA but less strong among persons reporting low levels of VPA. The mediation model was also significant, but was not moderated by MPA or VPA. Theoretical and clinical implications are discussed.
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Affiliation(s)
| | | | | | | | | | - Jasper A. J. Smits
- Southern Methodist University, United States,Corresponding author at: Department of Psychology, Southern Methodist University, Dedman College, PO Box 750442, Dallas, TX 75275, United States. Tel.: +1 214 768 4125; fax: +1 214 768 4191.
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44
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Haedt-Matt AA, Keel PK. Revisiting the affect regulation model of binge eating: a meta-analysis of studies using ecological momentary assessment. Psychol Bull 2011; 137:660-681. [PMID: 21574678 DOI: 10.1037/a0023660] [Citation(s) in RCA: 497] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The affect regulation model of binge eating, which posits that patients binge eat to reduce negative affect (NA), has received support from cross-sectional and laboratory-based studies. Ecological momentary assessment (EMA) involves momentary ratings and repeated assessments over time and is ideally suited to identify temporal antecedents and consequences of binge eating. This meta-analytic review includes EMA studies of affect and binge eating. Electronic database and manual searches produced 36 EMA studies with N = 968 participants (89% Caucasian women). Meta-analyses examined changes in affect before and after binge eating using within-subjects standardized mean gain effect sizes (ESs). Results supported greater NA preceding binge eating relative to average affect (ES = 0.63) and affect before regular eating (ES = 0.68). However, NA increased further following binge episodes (ES = 0.50). Preliminary findings suggested that NA decreased following purging in bulimia nervosa (ES = -0.46). Moderators included diagnosis (with significantly greater elevations of NA prior to bingeing in binge eating disorder compared to bulimia nervosa) and binge definition (with significantly smaller elevations of NA before binge vs. regular eating episodes for the Diagnostic and Statistical Manual of Mental Disorders definition compared to lay definitions of binge eating). Overall, results fail to support the affect regulation model of binge eating and challenge reductions in NA as a maintenance factor for binge eating. However, limitations of this literature include unidimensional analyses of NA and inadequate examination of affect during binge eating, as binge eating may regulate only specific facets of affect or may reduce NA only during the episode.
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45
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Harrison A, Treasure J, Smillie LD. Approach and avoidance motivation in eating disorders. Psychiatry Res 2011; 188:396-401. [PMID: 21645929 DOI: 10.1016/j.psychres.2011.04.022] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 04/12/2011] [Accepted: 04/20/2011] [Indexed: 10/18/2022]
Abstract
It has been proposed that approach and avoidance processes may be critically involved in the development and maintenance of eating disorders (EDs), including anorexia nervosa (AN) and bulimia nervosa (BN). The Behavioural Inhibition System and Behavioural Activation System Scales (BIS/BAS) and Appetitive Motivation Scale (AMS) questionnaires were administered to 286 participants: 91 healthy controls (HCs), 121 participants with a current ED, either AN (restrictive and binge purge subtypes), or BN and 74 participants recovered from an ED. Individuals with EDs had higher levels of sensitivity to punishment and lower levels of reward reactivity than controls. Individuals in recovery from an ED scored the same as those in the acute group, with the exception of BAS fun seeking, for which they scored significantly higher than those with restricting AN. Discriminant analysis revealed that HCs were maximally separated from those in the acute and recovered ED groups along a dimension reflecting high punishment sensitivity and low reward sensitivity. Classification analysis demonstrated that ED and HC group membership was predicted from reward and punishment sensitivity measures; however recovered participants tended to be misclassified as ED. This study suggests high punishment sensitivity and low reward reactivity/sensitivity might form a personality cluster associated with the risk of developing an ED.
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Affiliation(s)
- Amy Harrison
- Kings College London, Institute of Psychiatry, Section of Eating Disorders, London, UK.
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46
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Abstract
People have engaged in self-injury-defined as direct and deliberate bodily harm in the absence of suicidal intent-for thousands of years; however, systematic research on this behavior has been lacking. Recent theoretical and empirical work on self-injury has significantly advanced the understanding of this perplexing behavior. Self-injury is most prevalent among adolescents and young adults, typically involves cutting or carving the skin, and has a consistent presentation cross-nationally. Behavioral, physiological, and self-report data suggest that the behavior serves both an intrapersonal function (i.e., decreases aversive affective/cognitive states or increases desired states) and an interpersonal function (i.e., increases social support or removes undesired social demands). There currently are no evidence-based psychological or pharmacological treatments for self-injury. This review presents an integrated theoretical model of the development and maintenance of self-injury that synthesizes prior empirical findings and proposes several testable hypotheses for future research.
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Affiliation(s)
- Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, Massachusetts 02138, USA.
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