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Guzman S, Melara RD. Effects of Covid-19-related anxiety on overeating and weight gain in a diverse college sample. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38579128 DOI: 10.1080/07448481.2024.2337009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
The outbreak of the Covid-19 pandemic has been linked with caloric overeating and weight gain. We employed a mediation analysis to determine whether pandemic-associated overeating was a direct effect of Covid-19-related anxiety (affect regulation theory) or mediated by a coping mechanism of escape eating (escape theory). A diverse pool of college students participated in a repeated cross-sectional study during three separate waves: May 2021 (wave 1, n = 349), December 2021 (wave 2, n = 253), and March 2022 (wave 3, n = 132). The results revealed a significant indirect effect of Covid-19-related anxiety on high-caloric overeating mediated by escape eating, but no direct path between Covid-19-related anxiety and caloric overeating. Analysis of racial/ethnic status uncovered significantly greater Covid-weight gain in Hispanic participants compared with White, Black, and Asian participants. Our results suggest that Covid-19 weight gain is a byproduct of a mediated escape mechanism differentially affecting racial/ethnic groups.
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Peschel SKV, Fürtjes S, Sigrist C, Voss C, Berwanger J, Ollmann TM, Kische H, Rückert F, Koenig J, Pieper L, Beesdo-Baum K. Tension and disordered eating behaviors in the daily lives of adolescents and young adults from the general population: Associations and moderating role of trait emotion regulation. Scand J Psychol 2024; 65:252-263. [PMID: 37850537 DOI: 10.1111/sjop.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/10/2023] [Accepted: 09/15/2023] [Indexed: 10/19/2023]
Abstract
Experiences of tension and difficulties in emotion regulation have been linked to eating pathology in clinical samples and are targeted in respective treatment approaches. The present study aimed to investigate the impact of tension on engagement in disordered eating behaviors (DEBs) and potential moderating effects of trait emotion regulation in young people from the general population. A subsample of 971 adolescents and young adults from an epidemiological cohort study reported on levels of tension and four different DEBs (skipping eating, restrained eating, eating large amounts of food, loss-of-control-eating) via ecological momentary assessment (EMA), as well as on trait emotion regulation via questionnaire. In multilevel models, momentary tension did not predict levels of subsequent DEBs. However, higher average levels of tension across the EMA period predicted higher levels of all DEBs. No interactions with emotion regulation emerged. Individuals experiencing overall higher levels of tension appear to be more prone to engaging in DEBs.
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Affiliation(s)
- Stephanie K V Peschel
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sophia Fürtjes
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christine Sigrist
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Johanna Berwanger
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Theresa M Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Lo Coco G, Brugnera A, Salerno L, Compare A, Tasca GA, Kivlighan DM. Group member attachment style interacts with actor and partner helping alliance to predict decreasing binge eating episodes. Psychother Res 2024:1-15. [PMID: 38451851 DOI: 10.1080/10503307.2024.2325509] [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: 11/30/2023] [Accepted: 02/26/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE An individual's attachment style may impact how they interact with their therapy group. This study examined the moderating role of a group member's attachment on the dynamic relationships between that group member's (actor) and other group members' (partner) therapeutic alliances and symptom outcomes. Method: This is a secondary analysis of data from a trial testing the outcome of emotionally-focused group therapy for binge-eating disorder. The sample consisted of 2,360 sessions nested within 118 group members who attended a 20-session treatment. Patients recorded binge eating episodes (BEE), their body weight and an alliance measure session-by-session. RESULTS Dynamic structural equation modelling showed decreases in BEE and weight over the therapy. When attachment style was not included in the model, higher-than-average partner's alliance scores in the previous session were related to decreases in BEE in the current session. Attachment style moderated these actor and partner effects. For patients with preoccupied attachments, higher-than-average actor alliance in the previous session was related to subsequent decreases in BEE. For patients with dismissing or disorganized attachments, higher partner alliance in the previous session was related to subsequent decreases in BEE. CONCLUSION Group members' attachment characteristics can play a role in the development of alliance-outcome patterns in group therapy.
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Arexis M, Feron G, Brindisi MC, Billot PÉ, Chambaron S. A scoping review of emotion regulation and inhibition in emotional eating and binge-eating disorder: what about a continuum? J Eat Disord 2023; 11:197. [PMID: 37950264 PMCID: PMC10636978 DOI: 10.1186/s40337-023-00916-7] [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: 02/24/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Emotional eating is defined as a nonpathological eating behavior, whereas binge-eating disorder (BED) is defined as a pathological eating behavior. While different, both share some striking similarities, such as deficits in emotion regulation and inhibition. Previous research has suggested the existence of an "eating continuum" that might reflect the increased severity of overeating behaviors, that is, from nonpathological overeating to BED. The main aims of this scoping review were to explore in the literature the idea of a continuum between emotional eating and BED and to observe whether deficits in emotion regulation and inhibition follow this continuum in terms of severity. The other aims were to hopefully clarify the ill-defined concept of overeating, to question the potential role of positive emotions and to identify potential knowledge gaps. METHOD A systematic scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Two databases (PubMed/Medline and PsycINFO) were examined in complete accordance with the beforehand sharply defined eligibility and exclusion criteria. The main criteria included adults (≥ 18) with emotional eating, BED or overeating and emotion regulation and inhibition as exposure criteria. RESULTS Thirty-two studies were included in this scoping review. If the results showed a link between emotional eating and BED, with the presence of inhibition and emotion regulation deficits in both eating behaviors, no mention of a continuum between emotional eating and BED was found. CONCLUSION In the absence of research directly comparing emotional eating and BED in the same studies and testing the potential increase in severity of emotion regulation and inhibition deficits along this continuum, there is currently no certainty that a continuum exists between emotional eating and BED. In the end, the idea of a continuum in terms of increased severity of overeating and in terms of emotion regulation and inhibition deficits between emotional eating and BED appears to be a gap in knowledge in the literature. This scoping review highlights the need for further research to identify knowledge gaps.
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Affiliation(s)
- Mahé Arexis
- Centre Des Sciences du Goût Et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, 21000, Dijon, France
- Université de Franche-Comté, LINC, 25000, Besançon, France
| | - Gilles Feron
- Centre Des Sciences du Goût Et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, 21000, Dijon, France
| | - Marie-Claude Brindisi
- Centre Des Sciences du Goût Et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, 21000, Dijon, France
- Centre Spécialisé de L'Obésité Bourgogne, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | | | - Stéphanie Chambaron
- Centre Des Sciences du Goût Et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, 21000, Dijon, France
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Tanis J, Martijn C, Vroling MS, Maas J, Keijsers GPJ. Reducing binge eating through behavioral-focused versus emotion-focused implementation intentions in patients with binge eating disorder or bulimia nervosa: An experimental approach. Behav Res Ther 2023; 169:104399. [PMID: 37672830 DOI: 10.1016/j.brat.2023.104399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
Binge eating disorder (BED) and bulimia nervosa (BN) are characterized by recurrent binge eating, episodes of consuming large amounts of food in a discrete period of time associated with a loss of control. Implementation intentions are explicit if-then plans that engender goal-directed action, and rely less on cognitive control than standard treatment options. In a sample with BED and BN, we compared two implementation intention conditions to a control condition. In the behavior-focused condition, implementation intentions targeted binge eating behaviors. In the emotion-focused condition, implementation intentions targeted negative affect preceding binge eating. In the control condition, only goal intentions were set. Each condition comprised three sessions. Participants kept food diaries for four weeks. Compared to the control condition both implementation intention conditions showed significant and large reductions of binge eating that persisted for six months. Effects did not differ between the behavior-focused and emotion-focused implementation intention conditions. These results demonstrate that three sessions on implementation intention formation can lead to long-term reductions in binge eating in patients with BED or BN. Learning how to form implementation intentions seems a recommendable addition to the current standard treatment. Future research could investigate the added value of fully personalized implementation intentions. CLINICAL TRIAL REGISTRATION NUMBER: NL52600.068.15.
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Affiliation(s)
- Jorg Tanis
- Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands.
| | - Carolien Martijn
- Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands
| | - Maartje S Vroling
- GGNet Amarum, Expert Centre for Eating Disorders, Nijmegen, the Netherlands; Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Joyce Maas
- GGZ Oost-Brabant, Center for Eating Disorders, Helmond, the Netherlands
| | - Ger P J Keijsers
- Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands; Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
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O'Loghlen E, Galligan R, Grant S. Childhood maltreatment, shame, psychological distress, and binge eating: testing a serial mediational model. J Eat Disord 2023; 11:96. [PMID: 37312168 PMCID: PMC10265894 DOI: 10.1186/s40337-023-00819-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/04/2023] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVE Despite evidence of causal relationships between childhood maltreatment and the development of binge eating disorder (BED), research on mediating mechanisms is lacking. The present study sought to understand the childhood maltreatment-binge eating relationship more fully by examining three types of shame (internal, external, body) and psychological distress as mediators in this relationship. There is evidence that shame and psychological distress are associated with both childhood maltreatment and binge eating pathology. It was hypothesised that shame stemming from childhood maltreatment would contribute to psychological distress, and to binge eating as a dysfunctional emotion regulation strategy, in a serial mediational model. METHOD Five hundred and thirty adults with self-reported binge eating symptoms completed an online survey, which included measures of childhood maltreatment, internal shame, external shame, body shame, psychological distress, and binge eating and other eating disorder symptoms. RESULTS Path analyses showed three specific relationships: (1) a relationship between childhood emotional maltreatment and binge eating, which was serially mediated by internal shame and psychological distress; (2) a relationship between childhood sexual abuse and binge eating, which was mediated by body shame; and (3) a relationship between childhood physical maltreatment and binge eating, which was mediated by psychological distress. We also found a feedback loop, whereby binge eating might lead to increased overvaluation of body shape and weight (possibly due to increased weight) and then to an increase in internal shame and body shame. The final model showed excellent fit for the data. DISCUSSION Findings extend our understanding of the link between childhood maltreatment and BED. Future intervention research should focus on examining the efficacy of interventions for different forms of childhood maltreatment, based on the key mediating factors.
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Affiliation(s)
- Elyse O'Loghlen
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
| | - Roslyn Galligan
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia
| | - Sharon Grant
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia
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Flynn RL, Massion TA, Kosmas JA, Smith SR, Mastronardi CN, Graham AK. Positive affect dysregulation and its relation to binge eating size and frequency. Front Psychol 2023; 14:1146549. [PMID: 37284471 PMCID: PMC10239925 DOI: 10.3389/fpsyg.2023.1146549] [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: 01/17/2023] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
Negative affect is an established predictor of binge eating, yet less is known about positive affect. Low positive affect has been theorized to increase binge eating, but a better understanding is needed on the relationship between positive affect and binge eating frequency and size. Participants were 182 treatment-seeking adults (76% self-identified as female; 45% self-identified their race as Black and 40% as White; and 25% self-identified their ethnicity as Hispanic/Latino) with self-reported recurrent binge eating (≥12 binge episodes in the past 3 months). Participants completed the positive and negative affect schedule (PANAS) survey and the eating disorder examination to assess frequency of objective binge episodes (OBEs) and subjective binge episodes (SBEs) over the past 3 months. OBEs and SBEs also were combined to yield total binge episodes over the past 3 months. Independent t-tests and linear regression analyses were used to test associations between positive affect scores and binge episode size and frequencies, and to compare low versus higher positive affect on binge frequency. Additional exploratory models were conducted controlling for negative affect, identity characteristics, and socio-demographic variables. Lower positive affect was significantly associated with more frequent total binge episodes, but not OBEs and SBEs when assessed independently. Findings remained consistent when controlling for covariates and when comparing individuals with the lowest versus higher positive affect levels. Overall, results lend support to the theory that low positive affect is associated with binge eating. Increasing positive affect may be an important treatment consideration for those with recurrent binge eating.
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Affiliation(s)
- Rebecca L. Flynn
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Thomas A. Massion
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jacqueline A. Kosmas
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Shannon R. Smith
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Carli N. Mastronardi
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Andrea K. Graham
- Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Felonis CR, Boyajian L, Fan S, Drexler S, Fitzpatrick B, Payne-Reichert A, Manasse SM, Juarascio AS. Changes in affect from non-eating activity engagement as predictors of loss of control eating: an ecological momentary assessment study. Eat Weight Disord 2022; 27:2229-2235. [PMID: 34846722 PMCID: PMC8631266 DOI: 10.1007/s40519-021-01337-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/19/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Loss of control eating (LOCE) is supported as a maladaptive regulation strategy for high negative affect (NA) and low positive affect (PA). Yet, little is known about the day-to-day activities outside of eating that may precipitate such changes in affect and impact risk for LOCE. The current ecological momentary assessment study sought to examine whether (1) low NA and high PA at a given survey would prospectively predict lower likelihood of a LOCE episode at the next survey, and (2) having recently engaged in various non-eating activities would be associated with changes in average NA and PA levels at the same survey. METHODS Data collected from 66 participants with LOCE over 7-14 days were analyzed using generalized estimating equations. RESULTS High NA but not low PA at a given survey prospectively predicted lower likelihood of a LOCE episode at the next survey. Having recently engaged in outdoor recreation and socializing was associated with lower than one's usual NA and higher than one's usual PA at the same survey, social media was associated with higher than one's usual NA and lower than one's usual PA, self-care was associated with higher than one's usual PA, and napping was associated with lower than one's usual PA. CONCLUSION Individuals may benefit from increasing the frequency of daily non-eating activities that reduce NA, since it appears to be a more salient predictor of LOCE than PA. Further research is needed to elucidate this LOCE maintenance model, particularly in regard to the role of PA. LEVEL OF EVIDENCE Level IV, multiple time series without intervention.
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Affiliation(s)
- Christina R Felonis
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA.
- Department of Psychology, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA.
- Drexel University, Stratton Hall Room 273, 3141 Chestnut St., Philadelphia, PA, 19104, USA.
| | - Laura Boyajian
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
- Department of Psychology, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
| | - Stephanie Fan
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
- Department of Psychology, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
| | - Sarah Drexler
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
- Department of Psychology, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
| | - Brighid Fitzpatrick
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
- Department of Psychology, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
| | - Adam Payne-Reichert
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
- Department of Psychology, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
| | - Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
- Department of Psychology, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
| | - Adrienne S Juarascio
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
- Department of Psychology, Drexel University, 3201 Chestnut St., Philadelphia, PA, 19104, USA
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Chao AM, Abene J, Allison KC, Pearl RL, Wadden TA, Williams NN, Tronieri JS. Binge eating disorder and eating self-efficacy in adults seeking bariatric surgery. Clin Obes 2022; 12:e12531. [PMID: 35606940 PMCID: PMC9624241 DOI: 10.1111/cob.12531] [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: 01/27/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022]
Abstract
This study assessed the relationships between binge eating disorder (BED) and eating self-efficacy in a sample of patients prior to bariatric surgery. The study also examined the extent that BED status accounted for variance in self-efficacy after controlling for demographic factors (age, sex and race), physical variables (comorbidities and body mass index [BMI]) and depressive symptoms. This was a cross-sectional study of pre-surgical data from patients seeking bariatric surgery at a university-based healthcare system (N = 98; mean ± SD age of 46.2 ± 12.5 years; BMI of 45.4 ± 7.2 kg/m2 ; 86.7% female; and 60.2% of patients self-identified as White). Patients completed the Weight and Lifestyle Inventory (WALI), Beck Depression Inventory-II (BDI-II) and Weight Efficacy Lifestyle Questionnaire. Of the total sample, 15.3% met criteria for BED, 33.7% had subthreshold BED and 51.0% were free of this disorder. In adjusted analyses, total self-efficacy was significantly lower in patients with subthreshold BED (B ± SE = -15.88 ± 7.23, p = .03) and individuals with BED (B ± SE = -35.07 ± 10.23, p = .001) than in those without BED. Patients with BED, compared to those without, had significantly worse scores (in adjusted analyses) on the self-efficacy subscales of negative emotions (p = .003), availability of food (p < .001), social pressure (p = .004) and positive activities (p = .03). In patients seeking bariatric surgery, total self-efficacy scores were significantly lower in patients with BED and subthreshold BED than those without BED. The results suggest that eating self-efficacy may be an important factor to target in patients with BED who seek bariatric surgery.
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Affiliation(s)
- Ariana M Chao
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jessica Abene
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Kelly C Allison
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rebecca L Pearl
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Thomas A Wadden
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Noel N Williams
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jena S Tronieri
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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10
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Egbert AH, Smith KE, Ranzenhofer LM, Goldschmidt AB, Hilbert A. The Role of Affective Instability in Loss of Control Eating in Youth with Overweight/Obesity Across Development: Findings from Two EMA Studies. Res Child Adolesc Psychopathol 2022; 50:945-957. [PMID: 35039971 PMCID: PMC10375484 DOI: 10.1007/s10802-021-00886-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 11/26/2022]
Abstract
Affective instability is common during adolescence, but at high levels it is associated with a variety of internalizing and externalizing disorders, including eating disorders. Although most models focus on affective intensity as a mechanism for explaining eating disorders in adults, affective instability may be more developmentally relevant at predicting eating behaviors in youth. Using ecological momentary assessment, this manuscript explored the association between loss of control over eating (LOC), a key component of dysregulated eating in youth, and affective instability in youth with overweight/obesity in two separate studies, one with youth in middle childhood and early adolescence (Study 1: ages eight to 13) and one in youth in early through middle adolescence (Study 2: ages 12-17). Overall, there was no association between affective instability and LOC in Study 1, but in Study 2, age moderated the association between positive affective instability and LOC, such that greater between-person positive affective instability (i.e., relative to peers) was associated with lower average LOC for youth earlier in adolescence and higher average LOC for those later in adolescence. Negative affective instability was also associated with LOC in Study 2, such that on days when youth reported less within-person negative affective instability (i.e., relative to their own average), they also reported greater average LOC. Findings across the two studies indicate that the association between affective instability and LOC may not emerge until adolescence, and when it does, both positive and negative affective instability may be important to consider.
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Affiliation(s)
- Amy H Egbert
- Department of Psychiatry and Human Behavior, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI, USA.
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lisa M Ranzenhofer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, University of Leipzig Medical Center, Leipzig, Germany
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11
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Tanis J, Vroling MS, Martijn C, van Heijningen LA, Maas J, Keijsers GPJ. Effects of implementation intentions on subthreshold binge eating. Eat Disord 2022; 30:370-384. [PMID: 33395366 DOI: 10.1080/10640266.2020.1868650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Binge eating disorder (BED) and bulimia nervosa (BN) are characterized by binge eating. Frequently related to negative affect, binge eating is considered unwanted eating behavior. It is often preceded by a shift away from the goal of a healthy eating pattern. Implementation intentions are 'if-then' plans that may prevent such shifts in goals. In a students' sample with subthreshold binge eating, two implementation intention conditions were compared to a control condition in which only goals were formed. In the behavior-focused condition, implementation intentions targeted binge eating; in the emotion-focused condition, implementation intentions targeted negative affect preceding binge eating. All participants received three sessions and kept food diaries for four weeks, followed by a post-test and a one-month, three-months, and six-months follow-up. Compared to the control condition, both implementation intention conditions showed significant and large reductions in binge eating lasting for six months. Effects did not differ between both implementation intention conditions. Three implementation intention sessions reduced subthreshold binge eating. This continued for six months after the final session. Contrary to expectations, behavior-focused and emotion-focused implementation intentions were equally effective, possibly due to other triggers than negative affect. Future research should address their usefulness in BED and BN.
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Affiliation(s)
- Jorg Tanis
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Maartje S Vroling
- GGNet Amarum, Expert Centre for Eating Disorders, Nijmegen, The Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Carolien Martijn
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | | | - Joyce Maas
- Department of Work and Organizational Psychology, Radboud University, Nijmegen, The Netherlands
| | - Ger P J Keijsers
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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12
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Berking M, Eichler E, Naumann E, Svaldi J. The efficacy of a transdiagnostic emotion regulation skills training in the treatment of binge-eating disorder-Results from a randomized controlled trial. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:998-1018. [PMID: 35567309 DOI: 10.1111/bjc.12371] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/29/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Deficits in emotion regulation (ER) have been shown to be associated with binge-eating disorder (BED). To further clarify the causal nature of this association, we tested whether systematically enhancing ER skills would reduce symptoms of BED. METHODS We randomly allocated N = 101 individuals meeting the criteria for BED to a transdiagnostic ER skills training or to a waitlist control condition (WLC). Primary outcome was the reduction in binges during the treatment-vs.-waiting period as assessed with the Eating Disorder Examination (EDE) interview. RESULTS Mixed-model ANOVAs indicated that the average pre-to-post decrease in binges assessed with the EDE was significantly greater in the ER skills training condition than in the WLC (d = 0.66). These effects were stable over the 6-month follow-up period (d = 0.72). Remission rates at post/follow-up were 34.4/45.0% in the skills training and 7.5/20.0% in the WLC. Additionally, we found a greater reduction in general eating disorder psychopathology, of food consumption in a bogus taste test and of depression in the ER skills training condition. Moreover, the greater reduction in binge-eating episodes in the training condition was (partially) mediated by a greater increase in ER skills. CONCLUSIONS The findings provide further support for the assumed importance of deficits in ER as a maintaining factor and, hence, as a target in the treatment of BED. As ER skills trainings have been shown to also reduce other kinds of psychopathology, they might be considered a promising transdiagnostic add-on component to disorder-specific interventions.
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Affiliation(s)
| | - Eva Eichler
- University of Erlangen-Nuremberg, Erlangen, Germany
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13
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Binge eating among young adults: association with sociodemographic factors, nutritional intake, dietary n-6: n-3 ratio and impulsivity. Br J Nutr 2021; 126:1431-1440. [PMID: 33441196 DOI: 10.1017/s0007114521000118] [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: 11/07/2022]
Abstract
Binge eating behaviour (BE) is the major symptom of binge eating disorder (BED). This study aimed to compare the nutritional intake in the presence or absence of BE, with a particular focus on dietary n-6:n-3 ratio, to assess the association between BE and impulsivity and the mediating effect of BMI on this association. A total of 450 university students (age 18-28 years) participated. The self-administered questionnaires were a semi-quantitative FFQ and the UPPS-P Impulsive Behavior Scale and the binge eating scale. The average BE score was 11·6 (se 7·388), and 20 % of the total participants scored above the cut-off of 17, thus presenting BE with 95 % CI of 16·3, 23·7 %. Our study revealed that greater BMI, higher total energy intake, greater negative urgency and positive urgency scores were significantly associated with BE. Participants with high value of dietary n-6:n-3 ratio were 1·335 more at risk to present a BE compared with those with a lower value of this ratio (P = 0·017). The relationship between BE score and UPPS domains score was not mediated by the BMI. This is the first study reporting a link between high dietary n-6:n-3 ratio and BE as well as the fact that BE was linked to both, negative and positive urgencies, and that the association between BE and impulsivity was not mediated by BMI. These findings can help to deal more efficiently with people suffering from BE, a symptom that can precede the development of BED.
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14
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Walenda A, Kostecka B, Santangelo PS, Kucharska K. Examining emotion regulation in binge-eating disorder. Borderline Personal Disord Emot Dysregul 2021; 8:25. [PMID: 34629115 PMCID: PMC8504023 DOI: 10.1186/s40479-021-00166-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Inefficient mechanisms of emotional regulation appear essential in understanding the development and maintenance of binge-eating disorder (BED). Previous research focused mainly on a very limited emotion regulation strategies in BED, such as rumination, suppression, and positive reappraisal. Therefore, the aim of the study was to assess a wider range of emotional regulation strategies (i.e. acceptance, refocusing on planning, positive refocusing, positive reappraisal, putting into perspective, self-blame, other-blame, rumination, and catastrophizing), as well as associations between those strategies and binge-eating-related beliefs (negative, positive, and permissive), and clinical variables (eating disorders symptoms, both anxiety, depressive symptoms, and alexithymia). METHODS Women diagnosed with BED (n = 35) according to the DSM-5 criteria and healthy women (n = 41) aged 22-60 years were assessed using: the Eating Attitudes Test-26, the Eating Beliefs Questionnaire-18, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20, the Cognitive Emotion Regulation Questionnaire, and the Difficulties in Emotion Regulation Scale. Statistical analyses included: Student t - tests or Mann-Whitney U tests for testing group differences between BED and HC group, and Pearson's r coefficient or Spearman's rho for exploring associations between the emotion regulation difficulties and strategies, and clinical variables and binge-eating-related beliefs in both groups. RESULTS The BED group presented with a significantly higher level of emotion regulation difficulties such as: nonacceptance of emotional responses, lack of emotional clarity, difficulties engaging in goal-directed behavior, impulse control difficulties, and limited access to emotion regulation strategies compared to the healthy controls. Moreover, patients with BED were significantly more likely to use maladaptive strategies (rumination and self-blame) and less likely to use adaptive strategies (positive refocusing and putting into perspective). In the clinical group, various difficulties in emotion regulation difficulties occurred to be positively correlated with the level of alexithymia, and anxiety and depressive symptoms. Regarding emotion regulation strategies, self-blame and catastrophizing were positively related to anxiety symptoms, but solely catastrophizing was related to the severity of eating disorder psychopathology. CONCLUSIONS Our results indicate an essential and still insufficiently understood role of emotional dysregulation in BED. An especially important construct in this context seems to be alexithymia, which was strongly related to the majority of emotion regulation difficulties. Therefore, it might be beneficial to pay special attention to this construct when planning therapeutic interventions, as well as to the maladaptive emotion regulation strategies self-blame and catastrophizing, which were significantly related to BED psychopathology.
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Affiliation(s)
- Anna Walenda
- The Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Barbara Kostecka
- II Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.
| | | | - Katarzyna Kucharska
- The Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland
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15
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Negative Mood and Food Craving Strength Among Women with Overweight: Implications for Targeting Mechanisms Using a Mindful Eating Intervention. Mindfulness (N Y) 2021; 12:2997-3010. [PMID: 34584574 PMCID: PMC8460847 DOI: 10.1007/s12671-021-01760-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 12/20/2022]
Abstract
Objectives When experiencing negative mood, people often eat to improve their mood. A learned association between mood and eating may cultivate frequent food cravings, detracting from health goals. Training in mindful eating may target this cycle of emotion-craving-eating by teaching individuals to manage urges when experiencing negative mood. We examined the impact of a mobile mindful eating intervention on the link between negative mood and food cravings among overweight women. Methods In a single-arm trial, participants (n = 64, M age = 46.1 years, M BMI = 31.5 kg/m2) completed ecological momentary assessments of negative mood and food cravings 3 times/day for 3 days pre- and post-intervention, as well as 1-month post-intervention. Using multilevel linear regression, we compared associations between negative mood and food craving strength at pre- vs. post-intervention (model 1) and post-intervention vs. 1-month follow-up (model 2). Results In model 1, negative mood interacted with time point (β = − .20, SE = .09, p = .02, 95% CI [− .38, − .03]) to predict craving strength, indicating that the within-person association between negative mood and craving strength was significantly weaker at post-intervention (β = 0.18) relative to pre-intervention (β = 0.38). In model 2, negative mood did not interact with time point to predict craving strength (β = .13, SE = .09, p = .10, 95% CI − .03, .31]); the association did not significantly differ between post-intervention and 1-month follow-up. Conclusions Training in mindful eating weakened the mood-craving association from pre- to post-intervention. The weakened association remained at follow-up. Our findings highlight the mood-craving link as a target-worthy mechanism of mindful eating that should be assessed in clinical trials. Trial Registration NCT02694731 Supplementary Information The online version contains supplementary material available at 10.1007/s12671-021-01760-z.
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Miranda-Olivos R, Steward T, Martínez-Zalacaín I, Mestre-Bach G, Juaneda-Seguí A, Jiménez-Murcia S, Fernández-Formoso JA, Vilarrasa N, Veciana de las Heras M, Custal N, Virgili N, Lopez-Urdiales R, Menchón JM, Granero R, Soriano-Mas C, Fernandez-Aranda F. The neural correlates of delay discounting in obesity and binge eating disorder. J Behav Addict 2021; 10:498-507. [PMID: 33950859 PMCID: PMC8997223 DOI: 10.1556/2006.2021.00023] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/30/2020] [Accepted: 03/23/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND AIMS Increased delay discounting is associated with obesity and binge eating disorder (BED). Although BED and obesity frequently co-occur, the neural mechanisms underlying delay discounting in these conditions remain poorly understood. METHODS Thirtyfive women with obesity, including 10 participants with obesity and BED and 31 controls completed a monetary delay discounting task during functional magnetic resonance imaging. RESULTS We identified that increased discounting rates were associated with decreased activity in the left anterior insula in participants with obesity compared to controls when choosing immediate rewards over delayed rewards (PFWE < 0.05). An exploratory analysis comparing the BED subsample to the other groups did not detect significant differences. DISCUSSION AND CONCLUSIONS Our findings suggest decreased activity in the anterior insula may underlie heightened delay discounting in individuals with obesity, contributing the probability of choosing immediate rewards over delayed rewards based on emotional states. Future studies including larger, more diverse samples are required to confirm these effects.
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Affiliation(s)
- Romina Miranda-Olivos
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | - Trevor Steward
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Ignacio Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | | | - Asier Juaneda-Seguí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Salud Mental (CIBERSAM), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | - José A. Fernández-Formoso
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
| | - Nuria Vilarrasa
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
| | | | - Nuria Custal
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | - Nuria Virgili
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | - Rafael Lopez-Urdiales
- Department of Endocrinology and Nutrition, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Salud Mental (CIBERSAM), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona,08193, Barcelona, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Salud Mental (CIBERSAM), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona,08193, Barcelona, Spain
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, 08907, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, 28029Madrid, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, 08907, Barcelona, Spain
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Chami R, Reichenberger J, Cardi V, Lawrence N, Treasure J, Blechert J. Characterising binge eating over the course of a feasibility trial among individuals with binge eating disorder and bulimia nervosa. Appetite 2021; 164:105248. [PMID: 33819528 DOI: 10.1016/j.appet.2021.105248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/10/2021] [Accepted: 03/28/2021] [Indexed: 01/01/2023]
Abstract
Binge eating disorder and bulimia nervosa are eating disorders that are characterized by recurrent binge eating episodes. The highly contextualized nature of binge eating makes naturalistic research a particularly suitable means of understanding the context within which binge eating occurs. The present study aimed to characterise binge eating days with regards to the frequency and probability of negative affect, food craving, meal skipping, and dietary restriction. In addition, it aimed to examine whether a combined intervention that targets the experience of 'loss of control' over eating can decrease these potential maintenance factors that often precede binge eating episodes. Seventy-eight participants with bulimia nervosa (N = 40) or binge eating disorder (n = 38), who were randomly allocated to a food-specific or general intervention combining inhibitory control training and implementation intentions, completed mood and food diaries over four weeks. Results suggest that negative affect and food craving were elevated on binge eating days, but that dietary restraint and meal skipping did not characterise binge eating days. Moreover, meal skipping, binge eating, restriction, and compensation decreased throughout the intervention period, while negative affect and food craving did not. This suggests that some interventions may successfully reduce binge eating frequency without necessarily decreasing negative affect or food craving, thus pointing to the different routes to targeting binge eating and providing implications for future interventions.
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Affiliation(s)
- Rayane Chami
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Julia Reichenberger
- Centre for Cognitive Neuroscience, Department of Psychology, Paris-Lodron University of Salzburg, Salzburg, Austria.
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of General Psychology, University of Padova, Italy
| | | | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jens Blechert
- Centre for Cognitive Neuroscience, Department of Psychology, Paris-Lodron University of Salzburg, Salzburg, Austria
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Mikhail ME. Affect Dysregulation in Context: Implications and Future Directions of Experience Sampling Research on Affect Regulation Models of Loss of Control Eating. Front Psychiatry 2021; 12:747854. [PMID: 34646178 PMCID: PMC8502879 DOI: 10.3389/fpsyt.2021.747854] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/01/2021] [Indexed: 01/04/2023] Open
Abstract
Loss of control eating is a core, transdiagnostic eating disorder symptom associated with psychological distress, functional impairment, and reduced quality of life. However, the factors that contribute to persistent loss of control eating despite negative consequences are not fully understood. Understanding the mechanisms that maintain loss of control eating is crucial to advance treatments that interrupt these processes. Affect regulation models of loss of control eating hypothesize that negative emotions trigger loss of control eating, and that loss of control eating is negatively reinforced because it temporarily decreases negative affect. Several variations on this basic affect regulation model have been proposed, including theories suggesting that negative affect decreases during loss of control eating rather than afterwards (escape theory), and that loss of control eating replaces one negative emotion with another that is less aversive (trade-off theory). Experience sampling designs that measure negative affect and eating behavior multiple times per day are optimally suited to examining the nuanced predictions of these affect regulation models in people's everyday lives. This paper critically reviews experience sampling studies examining associations between negative affect and loss of control eating, and discusses the implications for different affect regulation models of loss of control eating. The review concludes by proposing an expanded affect-focused model of loss of control eating that incorporates trait-level individual differences and momentary biological and environmental variables to guide future research. Clinical implications and recommendations are discussed.
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Affiliation(s)
- Megan E Mikhail
- Department of Psychology, Michigan State University, East Lansing, MI, United States
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19
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Kukk K, Akkermann K. Emotion regulation difficulties and dietary restraint independently predict binge eating among men. Eat Weight Disord 2020; 25:1553-1560. [PMID: 31621002 DOI: 10.1007/s40519-019-00791-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/30/2019] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Research on eating disorder symptoms among men is growing, but there still are few specific models of disordered eating. The aim of the current study is to expand the literature on male eating behavior by investigating how negative affect can lead to binge eating and overeating through possible mediators, i.e., emotion regulation difficulties and dietary restraint, both separately and together in an integrative model. METHODS Altogether 104 men (mean age 27.3, SD = 8.02; BMI 24.2, SD = 2.92) participated in the study using ecological momentary assessment to collect data on negative affect, the urge to restrict, and the occurrence of binge eating and overeating episodes. Self-report questionnaires were used to measure emotion regulation difficulties and eating disorder symptoms. RESULTS We found that both emotion regulation difficulties and the urge to restrict mediated the effect of negative affect on binge eating in separate models as well as in an integrated model. However, emotion regulation difficulties did not predict the urge to restrict in the joint model. These models did not predict overeating, indicating the pathological nature of binge eating. CONCLUSIONS Our data suggest that negative emotions themselves do not lead to binge eating, but manifest through emotion regulation difficulties and dietary restraint. The results indicate that emotion regulation and restraint play a role in precipitating binge eating among men. However, the emotion regulation and restraint pathways seem to operate independently from one another. Our study also supports the differentiation of overeating and binge eating, as these seem to have different etiologies. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Katrin Kukk
- Institute of Psychology, University of Tartu, Näituse 2, 50409, Tartu, Estonia.
| | - Kirsti Akkermann
- Institute of Psychology, University of Tartu, Näituse 2, 50409, Tartu, Estonia
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20
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Mousavi Asl E, Mahaki B, Gharraee B, Asgharnejad Farid AA, Shahverdi-Shahraki A. Beliefs about binge eating: The psychometric properties of the Persian version of the eating beliefs questionnaire. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:73. [PMID: 33088310 PMCID: PMC7554542 DOI: 10.4103/jrms.jrms_623_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/26/2019] [Accepted: 03/23/2020] [Indexed: 12/12/2022]
Abstract
Background Metacognitive beliefs play an essential role in the maintenance of binge eating behavior. Examining the psychometric properties of tools in societies with different cultures than western societies can help with examining the external validity of those tools. This research aimed at standardization and validation of the Eating Beliefs Questionnaire (EBQ-18) in Iran. Materials and Methods Persian version of the EBQ-18 was produced through forward translation, reconciliation, and back translation. A total of 302 non-WEIRD nonclinical students were selected through convenience sampling method and completed a set of questionnaires, including the EBQ-18, Eating Attitude Test-16 (EAT-16), Difficulties in Emotion Regulation Scale-16 (DERS-16), Weight Efficacy Lifestyle Questionnaire-Short Form (SF), self-esteem scale, and self-compassion scale (SCS) short-form. The construct validity of the EBQ-18 was assessed using confirmatory factor analysis and divergent and convergent validity. Internal consistency and test-retest reliability (2 weeks' interval) were used to evaluate the reliability. Data analysis was performed using LISREL (version 8.8) and SSPS (version 22) softwares. Results EBQ-18 and subscales were found to be valid and reliable measures, with high test-retest reliability and good internal consistency in the nonclinical sample. Cronbrash's Alpha coefficient, for the whole of scale, negative beliefs scale, Permissive Beliefs scale, and Positive Beliefs scale were gained. 96.,89.,90, and. 94 respectively. Intraclass correlations coefficient, for the whole of scale, negative beliefs scale, Permissive Beliefs scale, and Positive Beliefs scale were gained. 84.,78.,75, and. 87, respectively. In terms of convergent validity, EBQ-18 and subscales showed a significant positive correlation with selfreport measures of EAT-16 and DERS-16 (P < 0.01). EBQ-18 and subscales showed a negative correlation with self-compassion, self-esteem, and eating self-efficacy, thus demonstrated divergent validity with these constructs (P < 0.01). The results showed that three factors of negative beliefs, positive beliefs, and permissive beliefs had the goodness of fit indices (root mean square error of approximation = 0.08, normed fit index = 0.97, nonnormed fit index = 0.98, comparative fit index = 0.98, and standardized root mean square residual = 0.04). The results of this study support the EBQ-18 three-factor model. Conclusion These findings indicate that the EBQ-18 is a reliable measure of eating beliefs in the Iranian population. In addition, the study supplements the literature on the cross-cultural validity of this measure.
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Affiliation(s)
- Esmaeil Mousavi Asl
- Student Research Committee , School of Behavioral Sciences and Mental Health(Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.,Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Behzad Mahaki
- Department of Biostatistics, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Banafsheh Gharraee
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Asgharnejad Farid
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
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Emotional eating in healthy individuals and patients with an eating disorder: evidence from psychometric, experimental and naturalistic studies. Proc Nutr Soc 2020; 79:290-299. [PMID: 32398186 PMCID: PMC7663318 DOI: 10.1017/s0029665120007004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Emotional eating has traditionally been defined as (over)eating in response to negative emotions. Such overeating can impact general health because of excess energy intake and mental health, due to the risks of developing binge eating. Yet, there is still significant controversy on the validity of the emotional eating concept and several theories compete in explaining its mechanisms. The present paper examines the emotional eating construct by reviewing and integrating recent evidence from psychometric, experimental and naturalistic research. Several psychometric questionnaires are available and some suggest that emotions differ fundamentally in how they affect eating (i.e. overeating, undereating). However, the general validity of such questionnaires in predicting actual food intake in experimental studies is questioned and other eating styles such as restrained eating seem to be better predictors of increased food intake under negative emotions. Also, naturalistic studies, involving the repeated assessment of momentary emotions and eating behaviour in daily life, are split between studies supporting and studies contradicting emotional eating in healthy individuals. Individuals with clinical forms of overeating (i.e. binge eating) consistently show positive relationships between negative emotions and eating in daily life. We will conclude with a summary of the controversies around the emotional eating construct and provide recommendations for future research and treatment development.
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Echeverri-Alvarado B, Pickett S, Gildner D. A model of post-traumatic stress symptoms on binge eating through emotion regulation difficulties and emotional eating. Appetite 2020; 150:104659. [PMID: 32173568 DOI: 10.1016/j.appet.2020.104659] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
Abstract
Individuals who struggle with binge eating often report a history of trauma and post-traumatic stress symptoms (PTSS), but there is still a paucity of studies on the relationship between PTSS (as opposed to trauma exposure) and binge eating specifically. The current study aimed to contribute to a small body of literature surrounding the link between PTSS and binge eating. Binge eating may be a behavioral coping mechanism against negative affect; however, it has been proposed that additional psychological mechanisms (e.g. emotion regulation difficulties and emotional eating) may explain the link between PTSS and binge eating. It was hypothesized that increased PTSS severity would predict greater emotion regulation difficulties, leading to greater emotional eating, and ultimately predict more severe binge eating in a trauma-exposed sample. Cross-sectional data were collected from 360 U.S. based MTurk workers (i.e. convenience sample) who reported trauma-exposure. Demographic and relevant covariates were included in the hypothesized serial mediation model and the results suggest a significant effect of PTSS severity on binge eating problems through emotion regulation difficulties and emotional eating. When both mediators were included in the model, the direct effect of PTSS on binge eating severity was no longer significant; thus, the association between PTSS and binge eating was partly explained by emotion regulation difficulties and emotional eating. This study expands the understanding of the mechanisms underlying PTSS and binge eating and provides support for complementing therapy approaches for PTSS with methods that target emotion regulation and acceptance.
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Affiliation(s)
| | - Scott Pickett
- Florida State University College of Medicine, Center for Translational Behavioral Science, Tallahassee, FL, USA
| | - Daniel Gildner
- Oakland University, Department of Psychology, Rochester, MI, USA; Florida State University College of Medicine, Center for Translational Behavioral Science, Tallahassee, FL, USA
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Xiang Y, Tang Y, Li J, Li D. How Is the Sexual Function of Premenopausal Chinese Women Without Hyperlipidemia? Sex Med 2019; 8:65-75. [PMID: 31837966 PMCID: PMC7042168 DOI: 10.1016/j.esxm.2019.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/05/2019] [Accepted: 10/26/2019] [Indexed: 01/23/2023] Open
Abstract
Introduction Most premenopausal women in China have normal lipid profiles while the sexual function among them was scarcely demonstrated. Aim To find out the characteristics of the sexual function in premenopausal Chinese women without hyperlipidemia using the Female Sexual Function Index (FSFI) and the Golombok Rust Inventory of Sexual Satisfaction (GRISS). Methods This cross-sectional study was performed to find out the characteristics of sexual function in premenopausal Chinese women without hyperlipidemia. Between January 2019 and March 2019, we recruited 216 women, 25–49 years of age. Data from questionnaires and health checkups were collected and analyzed. Main Outcome Measure We report the prevalence of and factors related to female sexual dysfunction (FSD) in premenopausal Chinese women without hyperlipidemia in accordance with the FSFI and the GRISS. Results The prevalence of FSD in our study was 46.2%. The mean age was 38.07 ± 6.94 years. More highly educated women suffered from FSD than those in the control group (61.1% vs 35.2%, P < .05). Binge eating was significantly different between the groups (P = .023). Multiple logistic regression analyses demonstrated that total cholesterol level was positively associated with low desire (OR, 2.13; 95% CI, 1.10–4.13; P = .025) and so was the low-density lipoprotein level (OR, 2.18; 95% CI, 1.03–4.62; P = .0.041). The high-density lipoprotein level was inversely associated with infrequency (OR, 0.18; 95% CI, 0.06–0.59; P = .004). More women with FSD had orgasm disorder than those in the control group, for 83.3% vs 35.2% in the FSFI (P < .001), 88.9% vs 54.3% in the GRISS (P < .001), respectively. Dissatisfaction remained the most common issue for the control group in both the FSFI and the GRISS (90.50% and 58.10%, respectively). Conclusions FSD is frequent in premenopausal Chinese women without hyperlipidemia. Dissatisfaction as the common problem influenced over half of them and orgasm disorder is a severe sexual issue for women with FSD. Xiang Y, Tang Y, Li J, et al. How Is the Sexual Function of Premenopausal Chinese Women Without Hyperlipidemia. J Sex Med 2019;8:65–75.
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Affiliation(s)
- Yali Xiang
- Health Management Center, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
| | - Yuxin Tang
- Department of Urology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, P.R. China
| | - Jiaqun Li
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R. China.
| | - Dongjie Li
- Department of Geriatric Urology, Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, P.R. China; National Clinical Research Center for Geriatric Disorders, Changsha, P.R. China.
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Cella S, Cipriano A, Giardiello C, Cotrufo P. Relationships Between Self-Esteem, Interoceptive Awareness, Impulse Regulation, and Binge Eating. Path Analysis in Bariatric Surgery Candidates. CLINICAL NEUROPSYCHIATRY 2019; 16:213-220. [PMID: 34908958 PMCID: PMC8650187 DOI: 10.36131/clinicalnpsych2019050604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The current study investigates the hypothesis that the effect of low self-esteem on binge eating in bariatric candidates was mediated by both difficulties in the perception of bodily signals and impulse regulation after accounting for gender, age, and body mass index. METHOD 59 preoperative patients (both male and female) were screened by means of self-report measures of self-esteem, interoceptive deficits, impulse dysregulation, and severity of binge eating. Results: Results indicated that all direct effects were significant, except for the self-esteem on impulse dysregulation and the interoceptive deficits on binge eating. Self-esteem had a significant indirect effect on impulse dysregulation mediated by interoceptive deficits. Impulse dysregulation, in turn, mediates the effect of interoceptive deficits on binge eating. Moreover, the path starting from self-esteem, going first to interoceptive deficits, then going via impulse regulation difficulties to binge eating was significant. RESULTS AND CONCLUSIONS A potential underlying mechanism through which self-esteem is linked to binge eating has been suggested. Obese individuals who perceived themselves as inadequate may carry a stronger burden by the confusion and mistrust related to bodily functioning and, consequently, may act more impulsively, through binge eating.
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Affiliation(s)
- Stefania Cella
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, Viale Ellittico, 31-81100, Caserta, Italy
| | - Annarosa Cipriano
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, Viale Ellittico, 31-81100, Caserta, Italy
| | | | - Paolo Cotrufo
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, Viale Ellittico, 31-81100, Caserta, Italy
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To eat or not to eat: Reward delay impulsivity in children with loss of control eating, attention deficit / hyperactivity disorder, a double diagnosis, and healthy children. PLoS One 2019; 14:e0221814. [PMID: 31525207 PMCID: PMC6746378 DOI: 10.1371/journal.pone.0221814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/15/2019] [Indexed: 11/21/2022] Open
Abstract
Reward delay impulsivity is a feature of attention deficit/hyperactivity disorder (ADHD) and a likely feature of loss of control eating (LOC-E), which might explain the higher risk of children with ADHD or LOC-E to become obese. The goal of this study was to investigate reward delay impulsivity in children with LOC-E, ADHD, or a double diagnosis, in contrast to healthy children. Children (8 to 13 years) with LOC-E (n = 24), ADHD (n = 33), a double diagnosis (n = 9), and healthy children (n = 34) performed a computer game (door opening task [DOT]) and the delay of gratification task (DoGT) to assess food related facets of reward delay impulsivity. In addition, children reported whether they worried to lose control over eating during the DoGT. There were no group differences in the DOT. However, children with ADHD or a double diagnosis had a significantly higher risk to eat prematurely during the DoGT than children with LOC-E, who were not significantly different from healthy children. Children with a double diagnosis were most likely to worry about losing control over eating during the DoGT, followed by children with LOC-E, and both had a significantly higher probability to worry than healthy children. For children with a double diagnosis the probability to worry was significantly higher than for children with ADHD. If replicated, these findings point to a special relevance of reward delay impulsivity in children with ADHD or a double diagnosis, compared to children with LOC-E. ADHD should be regularly assessed in children with LOC-E.
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Svaldi J, Werle D, Naumann E, Eichler E, Berking M. Prospective associations of negative mood and emotion regulation in the occurrence of binge eating in binge eating disorder. J Psychiatr Res 2019; 115:61-68. [PMID: 31121393 DOI: 10.1016/j.jpsychires.2019.05.005] [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: 02/27/2019] [Revised: 04/12/2019] [Accepted: 05/02/2019] [Indexed: 11/27/2022]
Abstract
Retrospective and experimental data demonstrate the importance of emotion regulation (ER) in the maintenance of binge episodes in binge eating disorder (BED). The current study tested whether mood and ER prospectively influence binge episodes in individuals with BED via ecological momentary assessment (EMA). Individuals with BED (n = 79) completed two weeks of EMA. Each sampling point consisted of a series of questions pertaining to participants' mood, ER, and eating behaviour. Successful application of adaptive ER strategies predicted subsequent abstinence, while rumination predicted subsequent binge episodes. However, neither successful application of adaptive ER, nor maladaptive ER, moderated the association between negative mood and probability of binge episodes. This naturalistic study emphasizes the importance of promoting the successful application of adaptive ER skills and cessation of rumination in treatment interventions designed to decrease the occurrence of binge episodes in BED.
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Affiliation(s)
- Jennifer Svaldi
- University of Tübingen, Department of Clinical Psychology and Psychotherapy, Germany.
| | - Dustin Werle
- University of Tübingen, Department of Clinical Psychology and Psychotherapy, Germany
| | - Eva Naumann
- University of Tübingen, Department of Clinical Psychology and Psychotherapy, Germany
| | - Eva Eichler
- University of Erlangen, Department of Clinical Psychology and Psychotherapy, Germany
| | - Matthias Berking
- University of Erlangen, Department of Clinical Psychology and Psychotherapy, Germany
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Lee AY, Reynolds KD, Stacy A, Niu Z, Xie B. Family functioning, moods, and binge eating among urban adolescents. J Behav Med 2019; 42:511-521. [PMID: 30554301 PMCID: PMC10411965 DOI: 10.1007/s10865-018-9994-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 11/19/2018] [Indexed: 11/26/2022]
Abstract
This study builds upon prior research on associations between moods, family functioning, and binge eating, using ecological momentary assessment to examine moderating effects of family functioning on associations between moods and binge eating. This study was conducted among a nonclinical sample of urban adolescents. Family functioning was assessed using five constructs adopted from the FACES-IV measure: 'family cohesion,' 'family flexibility' 'family communication,' 'family satisfaction,' and 'family balance.' Mood data was gathered using 13 items from a daily affect scale. Binge eating was assessed using two subscales from the Eating Disorder Diagnostic Scale-binge eating associated with 'embarrassment' (BE1), and binge eating associated with a sense of 'loss of control' (BE2). A multilevel modeling approach was employed to examine how associations between momentary moods and binge eating behaviors were moderated by family functioning. Results indicated that measures of negative affect, stress/frustration, and tiredness/boredom were significantly and positively associated with two measures of binge eating (BE1 and BE2; p values ≤ 0.05), and that multiple factors of family functioning buffered the positive predictive effects of moods on binge eating. Findings indicate the importance of inclusion of family functioning in the development of eating behavior interventions for adolescents.
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Affiliation(s)
- Anna Yu Lee
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd., Ste. 310, Claremont, CA, 91711, USA.
| | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd., Ste. 310, Claremont, CA, 91711, USA
| | - Alan Stacy
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd., Ste. 310, Claremont, CA, 91711, USA
| | - Zhongzheng Niu
- University at Buffalo, The State University of New York, New York, USA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd., Ste. 310, Claremont, CA, 91711, USA
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Moskovich AA, Dmitrieva NO, Babyak MA, Smith PJ, Honeycutt LK, Mooney J, Merwin RM. Real-time predictors and consequences of binge eating among adults with type 1 diabetes. J Eat Disord 2019; 7:7. [PMID: 30923613 PMCID: PMC6421642 DOI: 10.1186/s40337-019-0237-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/20/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Objective binge eating (OBE) is common among individuals with type 1 diabetes (T1D) and may have negative consequences for glycemic control. Recent studies have suggested that diabetes distress (i.e., emotional distress specific to diabetes and living with the burden of management) is a distinct emotional experience among individuals with diabetes. Preliminary studies have found diabetes distress is associated with eating disorder symptoms and poor glycemic control. The aim of the current study was to examine real-time emotional precursors and consequences of OBE in adults with T1D (i.e., general negative affect, specific emotional states and diabetes distress) using ecological momentary assessment methods. We also explore the impact of OBE on 2-h postprandial glycemic control relative to non-OBE eating episodes. METHODS Adults with T1D (N = 83) completed 3-days of ecological momentary assessment assessing mood and eating behavior using a telephone-based survey system. Participants were prompted to rate momentary affect, including level diabetes distress, at random intervals and reported on eating episodes. Participants also wore continuous glucose monitors allowing for ongoing assessment of glycemic control. Multi-level modeling was used to examine between- and within-person effects of momentary increases in emotions prior to eating on the likelihood of OBE and the impact of OBE on postprandial blood glucose. Generalized linear mixed models examined whether change in post-meal affect differed between OBE and non-OBE episodes. RESULTS Participants were predominately middle-aged (Mean = 42; SD = 12.43) Caucasian (87%) females (88%) reporting clinically significant eating disorder symptoms (76%). Nearly half of the sample (43%) reported OBE during the 3-day study period. The between-person effect for negative affect was significant (OR = 1.93, p < .05), indicating a 93% increased risk of OBE among individuals with higher negative affect compared to individuals with average negative affect. Between-person effects were also significant for guilt, frustration and diabetes distress (OR = 1.48-1.77, ps < .05). Analyses indicated that mean change in post-meal negative affect was significantly greater for OBE relative to non-OBE episodes (B = 0.44, p < .001). Blood glucose at 120 min postprandial was also higher for OBE than for non-OBE episodes (p = .03). CONCLUSIONS Findings indicate that individuals who tend to experience negative affect and diabetes distress before eating are at increased risk of OBE at the upcoming meal. Results also suggest that engaging in binge eating may result in greater subsequent negative affect, including diabetes distress, and lead to elevated postprandial blood glucose levels. These findings add to a growing literature suggesting diabetes distress is related to eating disordered behaviors among individuals with T1D.
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Affiliation(s)
| | | | - Michael A Babyak
- 1Duke University Medical Center, DUMC Box 3842, Durham, NC 27712 USA
| | - Patrick J Smith
- 1Duke University Medical Center, DUMC Box 3842, Durham, NC 27712 USA
| | - Lisa K Honeycutt
- 1Duke University Medical Center, DUMC Box 3842, Durham, NC 27712 USA
| | - Jan Mooney
- 1Duke University Medical Center, DUMC Box 3842, Durham, NC 27712 USA
| | - Rhonda M Merwin
- 1Duke University Medical Center, DUMC Box 3842, Durham, NC 27712 USA
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Burton AL, Abbott MJ. Processes and pathways to binge eating: development of an integrated cognitive and behavioural model of binge eating. J Eat Disord 2019; 7:18. [PMID: 31183111 PMCID: PMC6554957 DOI: 10.1186/s40337-019-0248-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/12/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There are a number of factors commonly believed to be important to the development and maintenance of binge eating that have been identified across multiple models and theories in the psychological literature. In the present study, we sought to develop and test a psychological model for binge eating that incorporated the main variables identified in the literature to drive binge eating behaviour; specifically, core low self-esteem, negative affect, difficulty with emotional regulation, restricted eating and beliefs about eating. METHODS Questionnaire data was collected from 760 unselected participants. The proposed model of binge eating was developed, bivariate relationships between the included variables were assessed, and the goodness-of-fit of this new model was evaluated using structural equations modelling. RESULT The results identified significant bivariate relationships between all the included variables. While the originally proposed model did not provide a good fit to the data, the revised version of the model provided a good fit to the data. CONCLUSIONS Supporting, integrating and building upon the current existing psychological models of binge eating, this study presents a new integrated cognitive and behavioural model of binge eating. The dual-pathway to binge eating identified in the new model provides a different way to understand transdiagnostic binge eating.
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Affiliation(s)
- Amy L Burton
- School of Psychology, The University of Sydney, Camperdown, NSW Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Camperdown, NSW Australia
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Flayelle M, Canale N, Vögele C, Karila L, Maurage P, Billieux J. Assessing binge-watching behaviors: Development and validation of the “Watching TV Series Motives” and “Binge-watching Engagement and Symptoms” questionnaires. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2018.08.022] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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The use of a positive mood induction video-clip to target eating behaviour in people with bulimia nervosa or binge eating disorder: An experimental study. Appetite 2018; 133:400-404. [PMID: 30529607 DOI: 10.1016/j.appet.2018.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/29/2018] [Accepted: 12/05/2018] [Indexed: 12/11/2022]
Abstract
Recent theoretical models and empirical research have indicated that momentary negative affect increases the likelihood of binge eating episodes for individuals with bulimia nervosa and binge eating disorder. However, relatively little research has explored the potential for positive mood to serve a protective effect in reducing the likelihood of overeating behaviour in bulimia nervosa and binge eating disorder. The current study included 30 women with bulimia nervosa or binge eating disorder in a within-subjects crossover design. Following exposure to a video designed to induce food craving, we found that a positive mood vodcast was associated with significantly lower levels of negative mood and food consumption in a taste test meal, when compared to a neutral vodcast (p = 0.002). These findings support a role for decreasing negative mood in reducing the likelihood of binge eating behaviour in women with bulimia nervosa and binge eating disorder.
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Potential psychological & neural mechanisms in binge eating disorder: Implications for treatment. Clin Psychol Rev 2018; 60:32-44. [DOI: 10.1016/j.cpr.2017.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 12/13/2017] [Accepted: 12/20/2017] [Indexed: 02/08/2023]
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Racine SE, Horvath SA. Emotion dysregulation across the spectrum of pathological eating: Comparisons among women with binge eating, overeating, and loss of control eating. Eat Disord 2018; 26:13-25. [PMID: 29384463 DOI: 10.1080/10640266.2018.1418381] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Emotion regulation difficulties influence the etiology and maintenance of binge eating and eating disorders, but differential associations between emotion dysregulation and objective binge eating (OBE) components have not been examined. We compared emotion dysregulation dimensions in women with OBEs (n = 27), overeating only (n = 25), loss of control (LOC) only (n = 32), or no pathological eating (n = 137). Women with OBEs had significantly more difficulty with overall emotion dysregulation, access to strategies, and impulse control when upset than other groups. Women with OBEs and women with overeating did not differ on poor emotional clarity, whereas women with OBEs and women with LOC did not differ on non-acceptance of emotions. The combination of overeating and LOC eating is associated with the greatest emotion dysregulation, but certain emotion regulation facets may differentially relate to overeating and LOC. Identifying emotion-related treatment targets for core eating disorder symptoms is important.
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Affiliation(s)
- Sarah E Racine
- a Department of Psychology, Ohio University , Athens, Ohio, United States.,b Department of Psychology, McGill University , Montréal, Québec, Canada
| | - Sarah A Horvath
- a Department of Psychology, Ohio University , Athens, Ohio, United States
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Escandón-Nagel N, Peró M, Grau A, Soriano J, Feixas G. Emotional eating and cognitive conflicts as predictors of binge eating disorder in patients with obesity. Int J Clin Health Psychol 2018; 18:52-59. [PMID: 30487910 PMCID: PMC6220906 DOI: 10.1016/j.ijchp.2017.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/18/2017] [Indexed: 12/24/2022] Open
Abstract
Background/Objectives: Binge Eating Disorder (BED) is often associated with obesity. In order to identify the variables that allow to better detect the presence of BED, people with overnutrition were compared with and without BED in the presence of cognitive conflicts, eating symptoms and anxious-depressive symptoms. The inclusion of cognitive conflicts had been relevant in bulimia studies but had not been investigated with respect to BED. Method: Two groups with obesity were evaluated, one without BED (OB, n = 54) and the other with BED (OB-BED, n = 48), using a social-demographic questionnaire as well as a semi-structured interview to assess BED, questionnaires (DASS-21, EDE-Q, EEQ) and the Repertory Grid Technique. Results: Overall, the OB-BED group presented more conflicts and more symptoms. The model that best differentiated between the groups included emotional eating and level of cognitive conflicts, correctly classifying 91.4% of the sample. Conclusion: These results highlight the role played by cognitive conflicts and emotional eating as differentiating elements between OB and OB-BED, with a high level of predictive accuracy.
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Affiliation(s)
| | - Maribel Peró
- Universitat de Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Spain
| | | | | | - Guillem Feixas
- Universitat de Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Spain
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Flayelle M, Maurage P, Billieux J. Toward a qualitative understanding of binge-watching behaviors: A focus group approach. J Behav Addict 2017; 6:457-471. [PMID: 29025269 PMCID: PMC6034945 DOI: 10.1556/2006.6.2017.060] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background and aims Binge-watching (i.e., seeing multiple episodes of the same TV series in a row) now constitutes a widespread phenomenon. However, little is known about the psychological factors underlying this behavior, as reflected by the paucity of available studies, most merely focusing on its potential harmfulness by applying the classic criteria used for other addictive disorders without exploring the uniqueness of binge-watching. This study thus aimed to take the opposite approach as a first step toward a genuine understanding of binge-watching behaviors through a qualitative analysis of the phenomenological characteristics of TV series watching. Methods A focus group of regular TV series viewers (N = 7) was established to explore a wide range of aspects related to TV series watching (e.g., motives, viewing practices, and related behaviors). Results A content analysis identified binge-watching features across three dimensions: TV series watching motivations, TV series watching engagement, and structural characteristics of TV shows. Most participants acknowledged that TV series watching can become addictive, but they all agreed having trouble recognizing themselves as truly being an "addict." Although obvious connections could be established with substance addiction criteria and symptoms, such parallelism appeared to be insufficient, as several distinctive facets emerged (e.g., positive view, transient overinvolvement, context dependency, and low everyday life impact). Discussion and conclusion The research should go beyond the classic biomedical and psychological models of addictive behaviors to account for binge-watching in order to explore its specificities and generate the first steps toward an adequate theoretical rationale for these emerging problematic behaviors.
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Affiliation(s)
- Maèva Flayelle
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg,Corresponding author: Maèva Flayelle; Maison des Sciences Humaines, University of Luxembourg, 11, Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg; Phone: +352 46 66 44 5332; Fax: +352 46 66 44 35332; E-mail:
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology (LEP), Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg,Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
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Lewer M, Bauer A, Hartmann AS, Vocks S. Different Facets of Body Image Disturbance in Binge Eating Disorder: A Review. Nutrients 2017; 9:nu9121294. [PMID: 29182531 PMCID: PMC5748745 DOI: 10.3390/nu9121294] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 11/11/2017] [Accepted: 11/20/2017] [Indexed: 01/22/2023] Open
Abstract
The goal of the present review is to give an overview of the current findings on various facets of body image disturbance in Binge Eating Disorder such as body dissatisfaction, overconcern with weight and shape, body-related checking and avoidance behavior, misperception of body size, and body-related cognitive bias. In addition, treatments for a disturbed body image in BED and evidence of body image disturbance in youth with binge eating are reviewed. The results show that a disturbed body image in BED is present in the form of overconcern with weight and shape. Furthermore, there are hints that body dissatisfaction, as well as body-related checking and avoidance behavior, are also impaired. Research concerning misperception of body size in BED has been neglected so far, but first findings show that individuals with BED rate their own body shape rather accurately. Furthermore, there are first hints that body-related cognitive biases are present in individuals with BED. Moreover, in children and adolescents, there are first hints that body dissatisfaction, as well as shape and weight concerns, seem to be associated with loss of control and binge eating. Treatments aimed directly at the convertibility of a disturbed body image in BED have revealed encouraging outcomes. In conclusion, body image disturbance seems to occur in BED, and first studies show that it can be treated effectively.
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Affiliation(s)
- Merle Lewer
- Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Mental Health Research and Treatment Center, Massenbergstr, 9-13, D-44787 Bochum, Germany.
| | - Anika Bauer
- Department of Clinical Psychology and Psychotherapy, Universität Osnabrück, Knollstr. 52, D-49069 Osnabrück, Germany.
| | - Andrea S Hartmann
- Department of Clinical Psychology and Psychotherapy, Universität Osnabrück, Knollstr. 52, D-49069 Osnabrück, Germany.
| | - Silja Vocks
- Department of Clinical Psychology and Psychotherapy, Universität Osnabrück, Knollstr. 52, D-49069 Osnabrück, Germany.
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Emotion Regulation in Binge Eating Disorder: A Review. Nutrients 2017; 9:nu9111274. [PMID: 29165348 PMCID: PMC5707746 DOI: 10.3390/nu9111274] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/10/2017] [Accepted: 11/18/2017] [Indexed: 01/19/2023] Open
Abstract
The purpose of the present review is to provide a summary of the research findings on emotion regulation in Binge Eating Disorder (BED). Negative emotions and maladaptive emotion regulation strategies play a role in the onset and maintenance of binge eating in BED. Anger and sadness, along with negative emotions related to interpersonal experiences (i.e., disappointment, being hurt or loneliness), seem to be particularly relevant. Individuals with BED have a tendency to suppress and ruminate on their unwanted emotions, which leads to increased psychopathological thoughts and symptoms. Compared to healthy controls, they use adaptive strategies, such as reappraisal, less frequently. Evidence concerning the causal relation between negative affect and binge eating is inconclusive and still very limited. While experimental studies in a laboratory setting lack ecological validity, ecological momentary assessment studies offer more promise at unraveling the causal relationship between emotions and binge eating. Increases in negative affect are found to be antecedents of binge eating in BED. However, there seems to be less support for the possibility that binge eating serves as a means to alleviate negative affect. Finally, BED seems to be related to other forms of maladaptive emotion regulation strategies, such as substance abuse and self-harm.
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Neurobiological evidence for attention bias to food, emotional dysregulation, disinhibition and deficient somatosensory awareness in obesity with binge eating disorder. Physiol Behav 2017; 184:122-128. [PMID: 29128522 DOI: 10.1016/j.physbeh.2017.11.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/11/2017] [Accepted: 11/05/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To refine the biobehavioral markers of binge eating disorder (BED). METHODS We conducted fMRI brain scans using images of high energy processed food (HEPF), low energy unprocessed food (LEUF), or non-foods (NF) in 42 adults (obese with BED [obese -BED; n=13] and obese with no BED [obese non-BED; n=29]) selected via ads. Two blood oxygenated level dependent (BOLD) signal contrast maps were examined: food versus nonfood, and HEPF versus LEUF. In addition, score differences on the disinhibition scale were correlated with BOLD signals. RESULTS food versus nonfood showed greater BOLD activity for BED in emotional, motivational and somatosensory brain areas: insula, anterior cingulate cortex (ACC), Brodmann areas (BA) 19 & 32, inferior parietal lobule (IPL), posterior cingulate cortex (PCC), and lingual, postcentral, middle temporal and cuneate gyri (p≤0.005; k≥88). HEPF versus LEUF showed greater BOLD activity for BED in inhibitory brain regions: BA 6, middle and superior frontal gyri (p<0.01; k≥119). The groups also differed in the relationships between disinhibition and BOLD activity in the postcentral gyrus (PCG; p=0.04) and ACC-BA 32 (p=0.02). For all participants jointly, PCG BOLD amplitude predicted greater disinhibition (p=0.04). DISCUSSION Food images elicited neural activity indicating attention bias (cuneate & PCG), emotion dysregulation (BA 19 & 32), and disinhibition (MFG, BA6 & SFG) in obese with BED. These may help tailor a treatment for the obesity with BED phenotype.
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Kenny TE, Singleton C, Carter JC. Testing predictions of the emotion regulation model of binge-eating disorder. Int J Eat Disord 2017; 50:1297-1305. [PMID: 29052240 DOI: 10.1002/eat.22787] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/24/2017] [Accepted: 09/24/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The emotion regulation (ER) model of binge eating posits that individuals with binge-eating disorder (BED) experience more intense emotions and greater difficulties in ER than individuals without BED, leading them to binge eat as a means of regulating emotions. According to this model, individuals with BED should report greater difficulties in ER than their non-BED counterparts, the severity of these difficulties should be positively associated with BED symptoms, and this association should be stronger when individuals experience persistent negative emotions (i.e., depression). Studies examining these hypotheses, however, have been limited. METHOD Data were collected from adults meeting the DSM 5 criteria for BED (n = 71; 93% female) and no history of an eating disorder (NED; n = 79; 83.5% female). Participants completed self-report measures of difficulties in ER, eating disorder (ED) psychopathology, and depression. RESULTS Individuals with BED reported greater difficulties in ER compared to those with NED. Moreover, difficulties in ER predicted unique variance in binge frequency and ED psychopathology in BED. Depression moderated the association between ER difficulties and binge frequency such that emotion dysregulation and binge frequency were positively associated in those reporting high, but not low, depression levels. DISCUSSION The association between difficulties in ER and ED pathology in BED suggests that treatments focusing on improving ER skills may be effective in treating this ED; however, the moderating effect of depression underscores the need for research on individual differences and treatment moderators. These findings suggest the importance of ER in understanding and treating BED.
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Affiliation(s)
- Therese E Kenny
- Department of Psychology, Memorial University of Newfoundland, St. John's, A1B 3X9, Canada
| | - Christopher Singleton
- Department of Psychology, Memorial University of Newfoundland, St. John's, A1B 3X9, Canada
| | - Jacqueline C Carter
- Department of Psychology, Memorial University of Newfoundland, St. John's, A1B 3X9, Canada
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Preuss H, Pinnow M, Schnicker K, Legenbauer T. Improving Inhibitory Control Abilities (ImpulsE)-A Promising Approach to Treat Impulsive Eating? EUROPEAN EATING DISORDERS REVIEW 2017; 25:533-543. [DOI: 10.1002/erv.2544] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 07/24/2017] [Accepted: 08/09/2017] [Indexed: 01/16/2023]
Affiliation(s)
- Hanna Preuss
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology; Johannes Gutenberg University Mainz; Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center; Johannes Gutenberg University Mainz; Germany
| | - Marlies Pinnow
- Motivation Lab, Institute of Cognitive Neurosciences; Ruhr-University Bochum; Germany
| | - Katja Schnicker
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology; Johannes Gutenberg University Mainz; Germany
| | - Tanja Legenbauer
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology; Johannes Gutenberg University Mainz; Germany
- Department of Research and Diagnostics, Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine; LWL-University Hospital; Germany
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Abstract
Binge eating is a distressing symptom common to bulimia nervosa (BN), anorexia nervosa binge/purge subtype (AN-BP) and binge-eating disorder (BED). Over the last 40 years, many attempts have been made to conceptualise this symptom in terms of its antecedents, function, triggers, consequences, and maintaining factors. Cognitive theories of binge eating have evolved as new evidence has emerged. This literature review summarises the main and most influential cognitive models of binge eating across different eating disorder presentations. Many theories have examined binge eating in the context of restriction or compensatory behaviours, as is often observed in cases of BN. Few theories have examined binge eating as it occurs in BED specifically. The long-term efficacy of cognitive behavioural therapy (CBT) treatment based on these models leaves much to be desired, and indicates that there may be maintaining factors of binge eating not addressed in the typical CBT treatment for eating disorders. More recent cognitive models of binge eating propose possible maintaining beliefs, but further study is required to validate these models. Suggestions for future research are presented.
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Cerniglia L, Muratori P, Milone A, Paciello M, Ruglioni L, Cimino S, Levantini V, Tambelli R. Paternal psychopathological risk and psychological functioning in children with eating disorders and Disruptive Behavior Disorder. Psychiatry Res 2017; 254:60-66. [PMID: 28456023 DOI: 10.1016/j.psychres.2017.04.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/12/2017] [Accepted: 04/22/2017] [Indexed: 10/19/2022]
Abstract
Several studies demonstrated that maternal psychopathological risk is related to child's maladjustment, but until recently research has relatively neglected fathers. Disruptive Behavior Disorder (DBD) and Eating disorders (ED) have a large prevalence during childhood but a few studies have focused on their association with paternal psychopathological risk. One-hundred and thirty-nine children and their fathers were recruited from pediatric hospitals and outpatient clinics and paired with a healthy control group (CG). Fathers were administered the SCL-90/R and the CBCL 6-18 to assess: 1) psychopathological risk of fathers of children with DBD, ED and CG; 2) significant differences between ED and DBD fathers' psychopathological profiles; and 3) associations between specific fathers' psychopathological symptoms and children's emotional-behavioral problems. Fathers of children with ED showed a higher psychopathological risk than fathers of DBD offspring. Children with DBD showed higher externalizing symptoms. Paternal hostility was associated with internalizing problems in children with DBD. Paternal hostility showed a non-significant but clinically interesting association with internalizing problems in DBD children; interpersonal sensitivity was associated with internalizing problems in ED children. This study can constitute a contribution to a better understanding of the clinical characteristics of fathers of children with DBD and ED.
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Affiliation(s)
- Luca Cerniglia
- International Telematic University Uninettuno, Psychology Faculty, Department of Psychology, Corso Vittorio Emanuele II, 39 - 00100, Rome, Italy.
| | - Pietro Muratori
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331, Calambrone, Pisa, Italy.
| | - Annarita Milone
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331, Calambrone, Pisa, Italy.
| | - Marinella Paciello
- International Telematic University Uninettuno, Psychology Faculty, Department of Psychology, Corso Vittorio Emanuele II, 39 - 00100, Rome, Italy.
| | - Laura Ruglioni
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331, Calambrone, Pisa, Italy.
| | - Silvia Cimino
- Sapienza, University of Rome, Psychology and Medicine Faculty, Department of Dynamic and Clinical Psychology, Via dei Marsi, 78 - 00186, Rome, Italy.
| | - Valentina Levantini
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno, 331, Calambrone, Pisa, Italy.
| | - Renata Tambelli
- Sapienza, University of Rome, Psychology and Medicine Faculty, Department of Dynamic and Clinical Psychology, Via dei Marsi, 78 - 00186, Rome, Italy.
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Pompili S, Laghi F. Binge eating and binge drinking among adolescents: The role of drinking and eating motives. J Health Psychol 2017; 24:1505-1516. [DOI: 10.1177/1359105317713359] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to investigate the motivations underlying binge eating and binge drinking in a sample of 302 adolescents. Our findings showed that binge eating was significantly correlated with gender, environmental, emotional, and social eating. Hierarchical multiple regression analysis indicated that emotional and environmental eating were significant positive predictors of binge eating, whereas binge drinking was significantly correlated with enhancement, social, and coping motives. Only enhancement motives were significant predictors of binge drinking. Our results support the argument that the reasons underlying binge eating and binge drinking in adolescents may be similar and may perform the same function.
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Razzoli M, Pearson C, Crow S, Bartolomucci A. Stress, overeating, and obesity: Insights from human studies and preclinical models. Neurosci Biobehav Rev 2017; 76:154-162. [PMID: 28292531 PMCID: PMC5403578 DOI: 10.1016/j.neubiorev.2017.01.026] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 01/06/2017] [Accepted: 01/21/2017] [Indexed: 12/22/2022]
Abstract
Eating disorders and obesity have become predominant in human society. Their association to modern lifestyle, encompassing calorie-rich diets, psychological stress, and comorbidity with major diseases are well documented. Unfortunately the biological basis remains elusive and the pharmacological treatment inadequate, in part due to the limited availability of valid animal models. Human research on binge eating disorder (BED) proves a strong link between stress exposure and bingeing: state-levels of stress and negative affect are linked to binge eating in individuals with BED both in laboratory settings and the natural environment. Similarly, classical animal models of BED reveal an association between acute exposure to stressors and binging but they are often associated with unchanged or decreased body weight, thus reflecting a negative energy balance, which is uncommon in humans where most commonly BED is associated with excessive or unstable body weight gain. Recent mouse models of subordination stress induce spontaneous binging and hyperphagia, altogether more closely mimicking the behavioral and metabolic features of human BED. Therefore the translational relevance of subordination stress models could facilitate the identification of the neurobiological basis of BED and obesity-associated disease and inform on the development of innovative therapies.
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Affiliation(s)
- Maria Razzoli
- Department of Integrative Biology and Physiology, University of Minnesota, 2231 6th Street SE, Minneapolis, MN 55455, USA
| | - Carolyn Pearson
- Department of Psychiatry, University of Minnesota, 2450 Riverside Avenue, Minneapolis, MN 55454, USA
| | - Scott Crow
- Department of Psychiatry, University of Minnesota, 2450 Riverside Avenue, Minneapolis, MN 55454, USA; The Emily Program, 2265 Como Avenue, St. Paul, MN 55108, USA
| | - Alessandro Bartolomucci
- Department of Integrative Biology and Physiology, University of Minnesota, 2231 6th Street SE, Minneapolis, MN 55455, USA.
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Juarascio AS, Manasse SM, Espel HM, Schumacher LM, Kerrigan S, Forman EM. A Pilot Study of an Acceptance-based Behavioral Treatment for Binge Eating Disorder. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017; 6:1-7. [PMID: 28966910 PMCID: PMC5618713 DOI: 10.1016/j.jcbs.2016.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
While existing treatments produce remission in a relatively large percentage of individuals with binge eating disorder (BED), room for improvement remains. Interventions designed to increase emotion regulation skills and clarify one's chosen values may be well-suited to address factors known to maintain BED. The current study examined the preliminary efficacy of a group-based treatment, Acceptance-based Behavioral Therapy (ABBT), in a small open trial (n=19), as well as the relationship between changes in hypothesized mechanisms of action and outcomes. ABBT includes the behavioral components of cognitive behavioral treatment for BED and emotion-focused strategies from acceptance and commitment therapy and dialectical behavioral therapy. Results from generalized linear multilevel modeling revealed significant fixed linear effects of time on depression, quality of life, global eating pathology, and binge frequency (all ps < .05). Global eating disorder symptoms appeared to improve rapidly from pre- to mid-treatment, and continued to improve toward post-treatment and follow-up, but at a slower rate. Binge frequency decreased rapidly from pre- to mid-treatment, followed by a slight increase at post-treatment and a reduction again by follow-up. Improvements in experiential acceptance were strongly and consistently related to decreases in overall eating pathology across several measures (rs = .35-.54). Additionally, greater access to emotion regulation strategies was strongly related to decreases in overall eating pathology (r= .67). Preliminary results support the efficacy of this novel treatment approach and indicate that additional research on ABBT for BED is warranted.
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Affiliation(s)
| | | | - Hallie M Espel
- Drexel University, Department of Psychology, Philadelphia PA
| | | | | | - Evan M Forman
- Drexel University, Department of Psychology, Philadelphia PA
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Kukk K, Akkermann K. Fluctuations in negative emotions predict binge eating both in women and men: An experience sampling study. Eat Disord 2017; 25:65-79. [PMID: 27775488 DOI: 10.1080/10640266.2016.1241058] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study investigated the associations between emotional fluctuations and emotion regulation difficulties in predicting binge eating and overeating episodes using the experience sampling method among 97 women and 61 men. Among women, fluctuations in negative emotion, emotion regulation difficulties, restrained eating, and the interaction of negative emotion fluctuations and emotion regulation difficulties predicted binge eating. Among men, trait impulsivity and fluctuations in negative emotion predicted binge eating. However, overeating did not associate with aforementioned aspects. Results suggest that fluctuations in negative emotions should be studied in the context of emotion regulation difficulties.
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Affiliation(s)
- Katrin Kukk
- a Institute of Psychology , University of Tartu , Tartu , Estonia
| | - Kirsti Akkermann
- a Institute of Psychology , University of Tartu , Tartu , Estonia
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Eichen DM, Chen E, Boutelle KN, McCloskey MS. Behavioral evidence of emotion dysregulation in binge eaters. Appetite 2016; 111:1-6. [PMID: 27989564 DOI: 10.1016/j.appet.2016.12.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 11/07/2016] [Accepted: 12/14/2016] [Indexed: 11/18/2022]
Abstract
Binge eating is the most common disordered eating symptom and can lead to the development of obesity. Previous self-report research has supported the hypothesis that individuals who binge eat report greater levels of general emotion dysregulation, which may facilitate binge-eating behavior. However, to date, no study has experimentally tested the relation between binge eating history and in-vivo emotion dysregulation. To do this, a sample of female college students who either endorsed binge eating (n = 40) or denied the presence of any eating pathology (n = 47) completed the Difficulties with Emotion Regulation Scale (DERS) and a behavioral distress tolerance task (the Paced Auditory Serial Addition Task-Computer: PASAT-C) known to induce negative affect and distress. The binge eating group was 2.96 times more likely to quit the PASAT-C early (χ2 = 5.04, p = 0.025) and reported greater irritability (F(1,84) = 7.09 p = 0.009) and frustration (F(1,84) = 5.00, p = 0.028) after completing the PASAT-C than controls, controlling for initial levels of these emotions. Furthermore, across the entire sample, quitting early was associated with greater emotion dysregulation on the DERS (rpb = 0.342, p < 0.01). This study is the first to demonstrate that individuals who binge eat show in-vivo emotional dysregulation on a laboratory task. Future studies should examine the PASAT-C to determine its potential clinical utility for individuals with or at risk of developing binge eating.
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Affiliation(s)
- Dawn M Eichen
- Temple University, Department of Psychology, 1701 N. 13th St., Philadelphia, PA 19122, United States
| | - Eunice Chen
- Temple University, Department of Psychology, 1701 N. 13th St., Philadelphia, PA 19122, United States
| | - Kerri N Boutelle
- University of California, San Diego Department of Pediatrics, 9500 Gilman Drive, MC #0874, La Jolla, CA 92093, United States
| | - Michael S McCloskey
- Temple University, Department of Psychology, 1701 N. 13th St., Philadelphia, PA 19122, United States
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Luca C, Silvia C, Giulia B, Renata T. Do parental traumatic experiences have a role in the psychological functioning of early adolescents with binge eating disorder? Eat Weight Disord 2016; 21:635-644. [PMID: 27438789 DOI: 10.1007/s40519-016-0303-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 07/11/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Few studies have addressed the psychological characteristics of adolescents with binge eating disorder (BED). No research has focused on the psychological functioning of these adolescents' parents or on the prevalence of traumatic experiences among them. METHODS In this study, 202 adolescents aged 11-13 and their parents were recruited from mental health clinics to complete the youth self-report (YSR), the response evaluation measure for youth (REM-71), the Toronto Alexithymia Scale (TAS-20), the Symptom Check-List (SCL-90-R), and the traumatic experience checklist (TEC). RESULTS Female adolescents scored higher than males on withdrawal, internalizing problems, dissociation, and somatization subscales. Boys scored higher than girls on externalizing problems and acting out subscales. Maternal depression predicted withdrawal and dissociation in female adolescents. Maternal sexual abuse predicted social problems in males and self-destructive behaviors in females. Paternal physical abuse predicted delinquent behavior and acting out in males. CONCLUSIONS Our data suggest that parental traumatic experiences play a role in their offspring's mental health; the data also showed different psychopathological configurations in male and female adolescents with BED and their parents, suggesting the development of prevention and treatment polices specific to gender.
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Affiliation(s)
- Cerniglia Luca
- Uninettuno International Telematic University, Corso Vittorio Emanuele II, 39, Rome, Italy.
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Mustelin L, Bulik CM, Kaprio J, Keski-Rahkonen A. Prevalence and correlates of binge eating disorder related features in the community. Appetite 2016; 109:165-171. [PMID: 27899295 DOI: 10.1016/j.appet.2016.11.032] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 11/19/2016] [Accepted: 11/23/2016] [Indexed: 10/20/2022]
Abstract
Binge eating disorder (BED) is associated with high levels of obesity and psychological suffering, but little is known about 1) the distribution of features of BED in the general population and 2) their consequences for weight development and psychological distress in young adulthood. We investigated the prevalence of features of BED and their association with body mass index (BMI) and psychological distress among men (n = 2423) and women (n = 2825) from the longitudinal community-based FinnTwin16 cohort (born 1975-1979). Seven eating-related cognitions and behaviors similar to the defining features of BED were extracted from the Eating Disorder Inventory-2 and were assessed at a mean age of 24. BMI and psychological distress, measured with the General Health Questionnaire, were assessed at ages 24 and 34. We assessed prevalence of the features and their association with BMI and psychological distress cross-sectionally and prospectively. More than half of our participants reported at least one feature of BED; clustering of several features in one individual was less common, particularly among men. The most frequently reported feature was 'stuffing oneself with food', whereas the least common was 'eating or drinking in secrecy'. All individual features of BED and their clustering particularly were associated with higher BMI and more psychological distress cross-sectionally. Prospectively, the clustering of features of BED predicted increase in psychological distress but not additional weight gain when baseline BMI was accounted for. In summary, although some features of BED were common, the clustering of several features in one individual was not. The features were cumulatively associated with BMI and psychological distress and predicted further increase in psychological distress over ten years of follow-up.
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Affiliation(s)
- Linda Mustelin
- Department of Public Health, University of Helsinki, Finland; Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland.
| | - Cynthia M Bulik
- Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Finland; Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
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Lavagnino L, Arnone D, Cao B, Soares JC, Selvaraj S. Inhibitory control in obesity and binge eating disorder: A systematic review and meta-analysis of neurocognitive and neuroimaging studies. Neurosci Biobehav Rev 2016; 68:714-726. [DOI: 10.1016/j.neubiorev.2016.06.041] [Citation(s) in RCA: 137] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 12/12/2022]
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