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Maroney TL, Keech JJ. Feasibility and acceptability of a theory-based online tool for reducing stress-induced eating. Appetite 2024; 200:107558. [PMID: 38880281 DOI: 10.1016/j.appet.2024.107558] [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: 03/07/2024] [Revised: 06/07/2024] [Accepted: 06/12/2024] [Indexed: 06/18/2024]
Abstract
Stress-induced eating is associated with various health risks like obesity and cardiovascular disease, exacerbated by the overconsumption of unhealthy foods. This study sought to investigate replacement coping strategies for stress-induced eating that participants can seek to implement using behaviour change techniques like implementation intentions. The study adopted a feasibility and acceptability design, with 258 participants (88.37% female) aged 17-75 years old who self-reported stress-induced eating. Participants were asked to identify cues for their stress-induced eating and evaluate the acceptability of eight potential replacement coping strategies. After selecting their preferred strategy, participants formed implementation intentions, linking the strategy with their previously identified cues. There were six themes of cues for stress-induced eating as identified by participants, including a range of external and internal stressors. Themes regarding the acceptability of the replacement coping strategies were organised based on constructs from integrated social cognition theories. Participant responses reflected cognitive and affective attitudes, and control and normative beliefs behind engagement in coping behaviour; further, automatic and volitional processes were described by participants as playing a role in whether a coping strategy was deemed as useful. Plans formulated by participants commonly detailed specific situations and strategies to utilise, though few described start times or durations of their plan. Action planning was found to significantly increase following formation of implementation intentions, and participants' descriptions supported the feasibility and acceptability of utilising implementation intentions to adopt alternative coping strategies to stress-induced eating. Future research should conduct a randomised controlled trial to assess the efficacy of the implementation intentions intervention in promoting uptake of replacement coping strategies to reduce stress-induced eating.
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Affiliation(s)
- Tenelle L Maroney
- School of Applied Psychology, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, Australia; School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Jacob J Keech
- School of Applied Psychology, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, Australia; School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.
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2
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Murray MF, Pearl ES, Zelenak L, Hamann A, Sehgal M, Braciszewski JM, Carlin AM, Miller-Matero LR. COVID-19-Related Increases in Depressive and Anxious Symptoms Are Associated with Maladaptive Eating Among Patients up to 4 years Post-bariatric Surgery. Obes Surg 2024; 34:2580-2586. [PMID: 38839635 DOI: 10.1007/s11695-024-07326-x] [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: 11/03/2023] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION Depressive and anxious symptoms and maladaptive eating behaviors fluctuate with stressful events for patients seeking bariatric surgery. These associations are less clear for patients postoperatively. Using the COVID-19 pandemic as a frame, we examined associations between changes in depressive and anxious symptoms and maladaptive eating behaviors between up to four years postoperatively. METHODS Participants (N = 703) who underwent surgery between 2018 and 2021 completed web-based questionnaires between 2021 and 2022. Demographic and surgical data were obtained from electronic health records. Participants reported whether depressive and anxious symptoms increased or were stable/decreased during the COVID-19 pandemic, and completed eating behavior measures. RESULTS Many participants reported increased depressive (27.5%) and anxious (33.7%) symptoms during the COVID-19 pandemic. Compared to those who reported stable or decreased symptoms, these participants were as follows: (1) more likely to endorse presence of binge, loss-of-control, graze, and night eating; (2) reported higher emotional eating in response to anger and frustration, depression, and anxiety; and (3) reported higher driven and compulsive eating behaviors. Frequency of binge, loss-of-control, graze, and night eating episodes did not differ between groups (e.g., increased vs. stable/decreased anxious symptoms) among participants who endorsed any episodes. CONCLUSION A large portion of the sample reported increased depressive and anxious symptoms during the COVID-19 pandemic, and these increases were associated with maladaptive eating behaviors. Depressive and anxious symptoms and eating behaviors should be assessed postoperatively as significant stressors may be associated with increased distress and maladaptive eating behaviors that can affect postoperative outcomes. Postoperative interventions may be useful at simultaneously targeting these concerns.
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Affiliation(s)
- Matthew F Murray
- Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA.
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 S Maryland Ave MC3077, Chicago, IL, 60637, USA.
| | - Elise S Pearl
- Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA
| | - Logan Zelenak
- Center for Health Policy and Health Services Research, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA
| | - Aaron Hamann
- Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA
- Department of Surgery, Henry Ford Health, 2799 W Grand Blvd, Detroit, MI, 48202, USA
| | - Monica Sehgal
- Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA
| | - Jordan M Braciszewski
- Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA
- Center for Health Policy and Health Services Research, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA
| | - Arthur M Carlin
- Department of Surgery, Henry Ford Health, 2799 W Grand Blvd, Detroit, MI, 48202, USA
| | - Lisa R Miller-Matero
- Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA
- Center for Health Policy and Health Services Research, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA
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Klatzkin RR, Nadel T, Lallo B, Mosby E, Perkins D, Qureshi H, McKay NJ, Slavich GM. Lifetime stressor exposure is associated with greater rewarding effects of stress-related eating. Physiol Behav 2024:114610. [PMID: 38866298 DOI: 10.1016/j.physbeh.2024.114610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 05/23/2024] [Accepted: 06/09/2024] [Indexed: 06/14/2024]
Abstract
Acute stressors tend to shift preferences toward comfort foods, yet they do not ubiquitously increase the amount of food consumed. Moreover, although many individuals eat more under stress, others eat less or show no change. Although the precise mechanisms explaining this variability in stress-related eating are unknown, they may be driven by individual differences in the rewarding effects of comfort eating, which are enhanced by greater lifetime stressor exposure. To investigate this possibility, we examined whether differences in lifetime stressor exposure predicted reductions in negative affect following snacking (i.e., negative reinforcement) and if this effect was specific to stress-related snacking or snacking in general. Participants were 26 women (23% non-White) between 20 and 45 years old (M = 31), with a mean body mass index of 26, who completed three laboratory visits. Participants completed an assessment of lifetime stressor exposure (i.e., STRAIN) on the first visit and, on two subsequent laboratory visits in counterbalanced order, were given snacks after an acute social stress task (i.e., TSST) or rest period. Greater lifetime stressor exposure was related to greater post-ingestive decreases in negative affect following the acute social stressor but not following the rest period. If stress-related eating is more comforting for women with greater lifetime stressors and contributes to a stronger stress-eating association, then this may inform obesity-related clinical treatments that target behaviors and cognitions related to reward-based learning.
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Affiliation(s)
| | - Tzvi Nadel
- Department of Psychology, Rhodes College, Memphis, TN, USA
| | - Bella Lallo
- Department of Psychology, Rhodes College, Memphis, TN, USA
| | - Erica Mosby
- Department of Psychology, Rhodes College, Memphis, TN, USA
| | - Dot Perkins
- Department of Psychology, Rhodes College, Memphis, TN, USA
| | | | - Naomi J McKay
- Department of Psychology, SUNY Buffalo State, Buffalo, NY, USA
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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4
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Smith KE, Goldschmidt AB. Treatment of Binge-Eating Disorder Across the Lifespan: An Updated Review of the Literature and Considerations for Future Research. Curr Obes Rep 2024; 13:195-202. [PMID: 38363468 PMCID: PMC11150297 DOI: 10.1007/s13679-024-00553-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE OF REVIEW The present review describes the recent literature on treatment for binge-eating disorder (BED) in adults and youth, with a particular focus on research gaps, emerging treatments, and future research directions. RECENT FINDINGS Evidence supports the efficacy of several treatment modalities in adults, including self-help treatment, clinician-led psychotherapy, and pharmacotherapy; the largest effect sizes have been found for psychotherapies, most of which were cognitive-behavioral in orientation. Adapted psychotherapies for youth also show promise but lack a robust body of evidence. Predictors, moderators, and mediators of treatment outcome remain poorly understood; individuals with BED continue to experience significant barriers to treatment; and research is needed to address suboptimal treatment response. Recent work has highlighted the potential of adaptive interventions and investigation of novel mechanisms to address these gaps. Research on BED treatment continues to grow, though critical questions must be answered to improve treatment efficacy across the lifespan.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar St #2200, Los Angeles, CA, 90033, USA.
| | - Andrea B Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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5
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Linardon J. Identifying factors that predict the onset and persistence of fasting for weight control: Prospective findings. EUROPEAN EATING DISORDERS REVIEW 2024. [PMID: 38809806 DOI: 10.1002/erv.3112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/31/2024] [Accepted: 05/21/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVE Fasting for weight control is an under-studied behaviour implicated in eating disorders. However, little is known about what factors account for its onset and persistence. METHOD This study sought to identify risk and maintenance factors for fasting among 1025 women recruited through an eating disorder self-help platform who completed study measures at baseline and 6 month follow-up. Univariate and multivariate logistic regressions were performed to test which variables at baseline predicted the onset (vs. stably asymptomatic) and persistence (vs. remission) of fasting at follow-up. RESULTS Univariate models showed that higher baseline overvaluation, dissatisfaction, fear of weight gain, generalised and social anxiety, depression, self-esteem deficits and eating disorder symptoms (inflexible eating rules, driven exercise) predicted greater likelihood of fasting onset. Only fear of weight gain and depressive symptoms remained significant in the multivariate model. Higher baseline overvaluation, fear of weight gain, driven exercise, inflexible eating rules, and depression predicted greater likelihood of fasting persistence in univariate models. An adherence to inflexible eating rules and overvaluation remained significant in the multivariate model. CONCLUSION Findings shed new light on factors that may account for the development and maintenance of fasting, which have implications for guiding effective interventions targeting this behaviour.
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Affiliation(s)
- Jake Linardon
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia
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6
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Chester MA, Viranda T, Kaye WH, Berner LA. Evaluating the predictions of an interoceptive inference model of bulimia nervosa. J Eat Disord 2024; 12:57. [PMID: 38741168 DOI: 10.1186/s40337-024-01010-2] [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: 01/17/2024] [Accepted: 04/23/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVE Bulimia nervosa (BN) is associated with loss-of-control (LOC) eating episodes that frequently occur in response to negative emotions. According to recent neurocomputational models, this link could be explained by a failure to accurately update beliefs about the body in states of high arousal. Specifically, these interoceptive inference models suggest that under-relying on signals from one's body about sensory experience ("low sensory precision") and/or over-relying on previously held beliefs ("excessively precise priors") lead to inaccurate perception and maladaptive behaviors. We conducted an initial test of these core predictions of the interoceptive inference model in BN using self-report measures. METHODS We compared women with BN (n = 30) and age-, BMI-, and full-scale IQ-matched controls (n = 31) on trust in sensory information from the body and two types of beliefs about what can be done to regulate high negative affect. Within the BN group, we tested interrelations among these measures and explored their associations with LOC eating frequency. RESULTS Compared with healthy controls, the BN group reported lower levels of trust in sensory information and stronger beliefs that once upset, there is little one can do, apart from eating, to self-regulate. These beliefs were associated with each other and with lower body trust. Beliefs about the uncontrollability of emotion were associated with more frequent subjective binge-eating episodes. CONCLUSIONS Findings provide initial support for the core predictions of an interoceptive inference account of BN: low trust in sensory information ("sensory precision") may promote an overreliance on maladaptive "prior beliefs" about the effects of eating on negative emotions, ultimately interfering with accurate updating of beliefs about other strategies that could regulate emotions and maintain LOC eating. Low body trust, strong expectations about emotions, and their neurocomputational underpinnings could be promising combined treatment targets for BN.
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Affiliation(s)
- Maia A Chester
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Thalia Viranda
- Department of Information Science, Cornell Tech, New York, NY, USA
| | - Walter H Kaye
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Laura A Berner
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Kambanis PE, Mancuso CJ, Becker KR, Eddy KT, Thomas JJ, De Young KP. Course of avoidant/restrictive food intake disorder: Emergence of overvaluation of shape/weight. J Eat Disord 2024; 12:54. [PMID: 38702736 PMCID: PMC11067077 DOI: 10.1186/s40337-024-01001-3] [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: 12/31/2023] [Accepted: 03/23/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Avoidant/restrictive food intake disorder (ARFID) is a feeding/eating disorder characterized by avoidance/restriction of food intake by volume and/or variety. The emergence of shape/weight-related eating disorder symptoms in the longitudinal course of ARFID is an important clinical phenomenon that is neither robustly documented nor well understood. We aimed to characterize the emergence of eating disorder symptoms among adults with an initial diagnosis of ARFID who ultimately developed other eating disorders. METHOD Thirty-five participants (94% female; Mage = 23.17 ± 5.84 years) with a history of ARFID and a later, separate eating disorder completed clinical interviews (i.e., Structured Clinical Interview for DSM-5 - Research Version and Longitudinal Interval Follow-Up Evaluation) assessing the period between ARFID and the later eating disorder. Participants used calendars to aid in recall of symptoms over time. Descriptive statistics characterized the presence, order of, and time to each symptom. Paired samples t-tests compared weeks to emergence between symptoms. RESULTS Most participants (71%) developed restricting eating disorders; the remainder (29%) developed binge-spectrum eating disorders. Cognitive symptoms (e.g., shape/weight concerns) tended to onset initially and were followed by behavioral symptoms. Shape/weight-related food avoidance presented first, objective binge eating, fasting, and excessive exercise occurred next, followed by subjective binge eating and purging. CONCLUSIONS Diagnostic crossover from ARFID to another (typically restricting) eating disorder following the development of shape/weight concerns may represent the natural progression of a singular clinical phenomenon. Findings identify potential pathways from ARFID to the development of another eating disorder, highlighting possible clinical targets for preventing this outcome.
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Affiliation(s)
- P Evelyna Kambanis
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Suite 200, Boston, MA, 02114, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | | | - Kendra R Becker
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Suite 200, Boston, MA, 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Suite 200, Boston, MA, 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Suite 200, Boston, MA, 02114, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kyle P De Young
- Department of Psychology, University of Wyoming, Laramie, WY, USA
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8
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Mikhail ME, Burt SA, Neale MC, Keel PK, Katzman DK, Klump KL. Changes in affect longitudinally mediate associations between emotion regulation strategy use and disordered eating. Int J Eat Disord 2024; 57:1181-1191. [PMID: 38332591 PMCID: PMC11093708 DOI: 10.1002/eat.24162] [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: 11/18/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Trait-level emotion regulation (ER) difficulties are associated with eating disorders (EDs) transdiagnostically. However, little research has examined whether within-person fluctuations in ER longitudinally predict ED behaviors in daily life or the mechanisms of ER effects. Investigating daily ER could help us better understand why people experience ED behaviors at a given time. We examined whether day-to-day changes in adaptive (e.g., cognitive reappraisal) and maladaptive (e.g., rumination) ER longitudinally predicted core ED behaviors (binge eating, purging, dieting) and whether changes in affect mediated effects. METHOD Female participants (N = 688) ages 15-30 from the Michigan State University Twin Registry reported their adaptive and maladaptive ER use, negative affect (NA), positive affect (PA), binge eating, purging, and dieting on 49 consecutive days. Using structural equation modeling, we examined whether within-person fluctuations in ER predicted same- and next-day ED behaviors and whether changes in affect mediated longitudinal ER effects. RESULTS Greater maladaptive ER predicted increased likelihood of same-day binge eating and next-day binge eating and purging. The association between maladaptive ER and next-day binge eating and purging was mediated by increased next-day NA. In contrast, dieting was more closely related to changes in PA. Adaptive ER did not predict reduced likelihood of any ED behavior. CONCLUSIONS Maladaptive ER may longitudinally increase risk for binge eating and purging by amplifying NA. Interventions focused on decreasing maladaptive ER and subsequent NA might help disrupt binge eating-purging cycles. Conversely, results add to evidence that PA fluctuations may play a unique role in maintaining restrictive behaviors. PUBLIC SIGNIFICANCE Little is known about how daily changes in emotion regulation may impact disordered eating. We found that maladaptive emotion regulation (e.g., rumination) was associated with a higher likelihood of binge eating and purging on the next day because it predicted increased next-day negative affect. In contrast, dieting was more closely tied to fluctuations in positive affect. Targeting daily emotion regulation and affective processes may help disrupt cycles of disordered eating.
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Affiliation(s)
| | | | - Michael C. Neale
- Departments of Psychiatry, Human Genetics, and Psychology, Virginia Commonwealth University, USA
| | | | | | - Kelly L. Klump
- Department of Psychology, Michigan State University, USA
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Wilkinson ML, Manasse SM, Juarascio AS. Affect trajectories surrounding binge eating episodes and heavy drinking episodes in adults with binge-spectrum eating disorders. EUROPEAN EATING DISORDERS REVIEW 2024; 32:503-513. [PMID: 38265932 DOI: 10.1002/erv.3067] [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: 10/20/2023] [Revised: 01/05/2024] [Accepted: 01/13/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE The comorbidity of binge eating and heavy drinking (BE + HD) is concerning due to high prevalence and associated consequences. Affective pathways may maintain BE + HD, yet more micro-level research is needed. This study used ecological momentary assessment (EMA) to examine between-person and day-level relationships between positive and negative affect and binge eating or heavy drinking episodes in BE + HD. METHODS Participants (N = 53) were adults with binge-spectrum eating disorders who completed between 7 and 14 days of EMA prior to a treatment for binge eating. RESULTS Anxiety was highest on days with both binge eating and heavy drinking, while excitement and confidence were highest on days with only heavy drinking episodes for BE + HD. Global negative affect was relatively stable surrounding binge eating episodes. Guilt significantly increased prior to binge eating, and sadness significantly decreased following binge eating. Global positive affect significantly decreased prior to and stopped decreasing following heavy drinking episodes. DISCUSSION Results support binge eating being negatively reinforced by specific aspects of negative affect, while heavy drinking may be positively reinforced by global positive affect for individuals with BE + HD. Clinicians should incorporate interventions that focus on specific negative affect dimensions and that promote alternative rewarding activities besides heavy drinking.
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Affiliation(s)
- Megan L Wilkinson
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut St. Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Psychological and Brain Sciences, Drexel University, 3201 Chestnut St. Philadelphia, Philadelphia, Pennsylvania, USA
| | - Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut St. Philadelphia, Philadelphia, Pennsylvania, USA
| | - Adrienne S Juarascio
- Center for Weight, Eating, and Lifestyle Science, Drexel University, 3201 Chestnut St. Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Psychological and Brain Sciences, Drexel University, 3201 Chestnut St. Philadelphia, Philadelphia, Pennsylvania, USA
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Al-Shoaibi AAA, Shao IY, Ganson KT, Lavender JM, Testa A, Kiss O, He J, Glidden DV, Baker FC, Nagata JM. Prospective association of screen time with binge-eating disorder among adolescents in the United States: The mediating role of depression. Int J Eat Disord 2024; 57:1192-1201. [PMID: 38358046 DOI: 10.1002/eat.24169] [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: 11/19/2023] [Revised: 01/13/2024] [Accepted: 02/01/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE Screen time has been reported to be associated with binge-eating disorder (BED) among adolescents in the US; however, potential mediators remain unclear. This study aimed to evaluate depression symptoms as a mediator of the prospective association between screen time and BED. METHOD We utilized data from 9465 children (aged 9-11 years at baseline) from the Adolescent Brain Cognitive Development (ABCD) study (2016-2021). A generalized structural equation model was used to examine the prospective association between average daily screen time at baseline and BED at year 2, adjusting for baseline BED diagnosis, and other potential covariates (e.g., age, sex, and income). Mediation was examined using bias-corrected (BC) 95% confidence intervals for the indirect effect of baseline screen time on year 2 BED through depression symptoms (change from baseline to year 1). RESULTS One hundred and one participants (42.7% male, 49.4% racial/ethnic minority) met the criteria for BED in year 2. Participants were 9.9 years of age on average at baseline, 51.3% identified as male, and 43.1% identified as a racial/ethnic minority. Adjusting for covariates, screen time was prospectively associated with BED (OR = 1.09, 95% CI [1.03, 1.14], p = .005). Depression symptoms (B = .19, BC 95% CI [0.10, 0.28]) partially mediated (9.2%) the prospective association between screen time and BED. DISCUSSION Among US adolescents, higher baseline screen time was prospectively associated with BED diagnosis at year 2, and this relationship was partially mediated by increased depression symptoms. Preventive approaches targeting high screen use may have utility for reducing BED risk among adolescents. PUBLIC SIGNIFICANCE Among U.S. adolescents, higher screen time was prospectively associated with the incidence of BED. This association was partially mediated by the change in depressive symptoms. Preventive approaches targeting high screen use may have utility for reducing BED risk among adolescents.
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Affiliation(s)
- Abubakr A A Al-Shoaibi
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Iris Yuefan Shao
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research Program (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- The Metis Foundation, San Antonio, Texas, USA
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, California, USA
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China
| | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, California, USA
- School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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11
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Dougherty EN, Wildes JE, Haedt-Matt AA. The role of habit in maintaining binge/purge behaviors: An ecological momentary assessment study. Int J Eat Disord 2024; 57:1160-1171. [PMID: 37776547 PMCID: PMC10980597 DOI: 10.1002/eat.24070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE Individuals with eating disorders transdiagnostically engage in binge eating (BE) and/or purging, despite life-threatening consequences. Little is known about factors that contribute to the persistence of these behaviors. This study explored whether habitual control over binge/purge (B/P) spectrum behaviors contributes to symptom persistence and whether negative reinforcement via reductions in negative affect is less influential in maintaining B/P behaviors that are under habitual control and are persistent. METHOD Women with BE and/or purging (N = 81) completed self-report measures assessing habit strength of BE and purging. Then, they completed a 14-day ecological momentary assessment (EMA) protocol during which they completed measures of negative affect, BE, and purging multiple times per day. RESULTS Habitual control over purging was associated with a greater frequency of purging during the EMA period. However, habitual control over BE was not associated with the severity of loss of control eating or the frequency of BE episodes. Habitual control did not moderate temporal relations between negative affect and B/P behaviors during the EMA period. However, exploratory analyses revealed that individuals with a longer duration of BE and greater habitual control over BE showed a less pronounced reduction in negative affect following BE. DISCUSSION Overall, these findings suggest that purging may be maintained by habitual stimulus-response learning. In addition, they support the possibility that reduction in negative affect may play a less prominent role in maintaining BE that is habitual and persistent. PUBLIC SIGNIFICANCE This study investigated whether habit contributes to the persistence of symptoms in women with binge/purge spectrum behaviors and whether negative reinforcement via reductions in negative affect is less influential in maintaining binge/purge behaviors that are under habitual control. The findings suggest that purging may be maintained through habit. This supports the potential utility of habit reversal interventions to decrease habitual purging.
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Affiliation(s)
- Elizabeth N Dougherty
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Alissa A Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
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12
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Dougherty EN, Bottera AR, Haedt-Matt AA. Dysphoric mood may explain the relation between sleep reactivity and binge eating but not purging. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-5. [PMID: 38579122 DOI: 10.1080/07448481.2024.2336998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
Objective: This study investigated whether sleep reactivity (i.e., a propensity to experience sleep disturbances when stressed) relates to eating disorder behavioral symptoms indirectly through dysphoric mood in a sample of college students. Participants: One hundred and ninety-eight college students (51.5% female). Methods: Participants completed self-report measures of dysphoric mood, eating disorder behavioral symptoms, and sleep reactivity. Results: Higher sleep reactivity was associated with greater binge-eating symptoms indirectly through higher dysphoric mood. Higher sleep reactivity was associated with greater purging symptoms; however, this association was not explained by dysphoric mood. Conclusions: Findings support the relevance of sleep reactivity to binge eating and purging and suggest that sleep reactivity relates to binge-eating symptoms indirectly through dysphoric mood. If replicated in prospective data, targeting stress-induced sleep and mood disturbances in college students may reduce risk for binge eating.
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Affiliation(s)
- Elizabeth N Dougherty
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois, USA
| | | | - Alissa A Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
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13
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Pasquale EK, Strong DR, Manzano MA, Eichen DM, Peterson CB, Boutelle KN. Exploring relationships among appetitive traits, negative affect, and binge eating in adults with overweight or obesity. Eat Behav 2024; 53:101871. [PMID: 38518632 PMCID: PMC11144099 DOI: 10.1016/j.eatbeh.2024.101871] [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: 10/10/2023] [Revised: 03/09/2024] [Accepted: 03/13/2024] [Indexed: 03/24/2024]
Abstract
Binge eating (BE) is a significant public health concern due to its prevalence and impact on mental and physical health. While research has suggested both negative affect and appetitive traits are associated with BE, few studies have investigated these constructs concurrently. Structural equation modeling (SEM) evaluated relationships between negative affect, reward-related appetitive traits, and BE among 293 adults with overweight or obesity (OW/OB) seeking treatment for BE, overeating, and weight management (m age = 46.6; m body mass index[BMI] = 34.5; 81.2 % female; 20.1 % Latinx, 60.8 % White non-Latinx). BE was related to negative affect (β = 0.53; p < 0.01) and appetitive traits (β = 1.53; p < 0.001). Negative affect and appetitive traits were related to one another (r = 0.42; p < 0.001), and the full model accounted for 77 % of the variance in BE. In an exploratory follow-up analysis, multigroup SEM evaluated the above relationships in models stratified by sex. Exploratory findings demonstrated both negative affect and appetitive traits were related to BE across sex, particularly when examining BE cognitions and behaviors. However, relationships in men depended upon BE assessment tool. These findings highlight that both negative affect and appetitive traits are related to BE, and jointly may represent significant risk and maintenance factors, particularly in adults with OW/OB. Our findings also highlight the importance of future investigation of sex differences in BE and the potential impact of assessment method.
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Affiliation(s)
- Ellen K Pasquale
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Michael A Manzano
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Dawn M Eichen
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, F282/2A West 2450 Riverside Ave, Minneapolis, MN 55454, USA
| | - Kerri N Boutelle
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
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14
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Biçaker E, Trolio V, Miller AE, Zhu LY, White C, Racine SE. Affective processes underlying restrictive eating in atypical anorexia nervosa: Comparisons to anorexia nervosa and bulimia nervosa using ecological momentary assessment. Int J Eat Disord 2024; 57:879-891. [PMID: 38192012 DOI: 10.1002/eat.24134] [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: 09/15/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE Certain symptom and risk/maintenance factor similarities between individuals with atypical anorexia nervosa (AN) and 'typical' AN have been documented, but few studies have investigated how atypical AN compares to bulimia nervosa (BN). Further, the role of affective mechanisms in maintaining restrictive eating in atypical AN has not been examined. The current study investigated whether atypical AN resembles AN and/or BN on affect-related processes using questionnaires and ecological momentary assessment (EMA). METHOD Women with atypical AN (n = 24), AN-restrictive subtype, (n = 27), AN-binge eating/purging subtype (n = 34), and BN (n = 58) completed questionnaires measuring depressive symptoms and emotion regulation difficulties. They also completed a 14-day EMA protocol during which they reported negative and positive affect and skipped meals five times/day (signal-contingent surveys) and restrictive eating after meals/snacks (event-contingent surveys). RESULTS Diagnostic groups generally did not differ on questionnaire measures nor affective patterns surrounding restrictive eating behaviors. Momentary changes in affect did not predict or follow restriction at meals/snacks, though higher momentary negative affect ratings predicted skipped meals, and higher positive affect was reported after skipped meals. Greater average negative affect and lower average positive affect predicted both restrictive eating behaviors. DISCUSSION Across diagnoses, reductions in food intake do not appear to be influenced by momentary changes in affect, though skipping meals may serve an emotion regulation function. Atypical AN seems to resemble AN and BN on affective processes underlying restrictive eating, raising further questions regarding the unique diagnosis of atypical AN. PUBLIC SIGNIFICANCE Though atypical anorexia appears to strongly resemble anorexia nervosa, it is less clear how this disorder relates to bulimia nervosa. It is further unknown whether affective-related processes underlie restrictive eating in atypical anorexia nervosa, and how these processes compare to those in anorexia nervosa and bulimia nervosa. Results suggest that atypical anorexia does not differ from anorexia nervosa or bulimia nervosa on emotion-related measures, nor in affective patterns surrounding restrictive eating behaviors.
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Affiliation(s)
- Ege Biçaker
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Vittoria Trolio
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Alexia E Miller
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Lisa Y Zhu
- Department of Psychology, University of Western Ontario, Social Science Centre, London, Ontario, Canada
| | - Chloe White
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Sarah E Racine
- Department of Psychology, McGill University, Montreal, Quebec, Canada
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15
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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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16
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Mehak A, Bicaker E, Racine SE. The roles of negative affect and emotion differentiation in the experience of 'feeling fat' among undergraduate students: An ecological momentary assessment study. Body Image 2024; 48:101681. [PMID: 38310706 DOI: 10.1016/j.bodyim.2024.101681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/06/2024]
Abstract
'Feeling fat' is the somatic experience of being overweight not fully explained by objective body mass. According to the body displacement hypothesis, 'feeling fat' occurs when diffuse negative emotions are projected onto the body in lieu of adaptive emotion regulation. Emotion differentiation, the ability to experience and label discrete emotions, is an important skill for adaptively addressing emotion that may reduce 'feeling fat.' We hypothesized that individuals with better negative emotion differentiation would be less likely to report 'feeling fat' when experiencing high negative emotion. We collected ecological momentary assessment data from 198 undergraduate students (52.24% female). Multilevel modeling revealed that both within-person increases in negative emotions and the tendency to experience greater negative emotion were associated with greater 'feeling fat.' Of the specific types of negative emotion, guilt and sadness predicted 'feeling fat.' Contrary to hypotheses, individuals with better emotion differentiation were more likely to report 'feeling fat' after experiencing elevated negative affect. These findings contradict the primary clinical conceptualization of 'feeling fat,' suggesting that factors beyond displacement of negative emotions onto the body may be responsible for 'feeling fat'. Results in a sample with pronounced shape/weight concern may better support the traditional clinical understanding of 'feeling fat.'
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Affiliation(s)
| | - Ege Bicaker
- Department of Psychology, McGill University, Canada
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17
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MacDonald DE, Trottier K, Cao L, Crosby RD, Wonderlich SA, Engel SG, Olmsted MP. Momentary skills use predicts decreased binge eating and purging early in day treatment: An ecological momentary assessment study. Int J Eat Disord 2024; 57:548-557. [PMID: 38189475 DOI: 10.1002/eat.24128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE Emerging research indicates that skills acquisition may be important to behavior change in cognitive behavior therapy (CBT) for eating disorders. This study investigated whether skills use assessed in real time during the initial 4 weeks of CBT-based day treatment was associated with momentary eating disorder behavior change and rapid response to treatment. METHODS Participants with DSM-5 bulimia nervosa or purging disorder (N = 58) completed ecological momentary assessments (EMA) several times daily for the first 28 days of treatment. EMA assessed skills use, the occurrence of binge eating and/or purging, and state negative affect. Rapid response was defined as abstinence from binge eating and/or purging in the first 4 weeks of treatment. RESULTS Greater real-time skills use overall, and use of "planning ahead," "distraction," "social support," and "mechanical eating" skills in particular, were associated with a lower likelihood of engaging in binge eating or purging during the same period. After controlling for baseline group differences in overall difficulties with emotion regulation, rapid and non-rapid responders did not differ in overall skills use, or skills use at times of higher negative affect, during the EMA period. DISCUSSION Momentary use of skills appears to play an important role in preventing binge eating and purging, and certain skills appear to be particularly helpful. These findings contribute to the literature elucidating the processes by which CBT treatments for eating disorders work by providing empirical evidence that skills use helps to prevent binge eating and purging behaviors. PUBLIC SIGNIFICANCE Individuals with eating disorders learn new skills during treatment to help them improve their symptoms. This study shows that for people with eating disorders, using skills helps prevent eating disorder behaviors in the moment. Certain skills may be particularly helpful, including planning ahead, distracting activities, support from others, and focusing on eating meals and snacks regardless of how one is feeling. These findings help us better understand how treatments work.
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Affiliation(s)
- Danielle E MacDonald
- Centre for Mental Health, University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Kathryn Trottier
- Centre for Mental Health, University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Li Cao
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Ross D Crosby
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - Stephen A Wonderlich
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - Scott G Engel
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Marion P Olmsted
- Centre for Mental Health, University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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18
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Bottera AR, Dougherty EN, Forester G, Peterson CB, Crosby RD, Engel SG, Crow SJ, Wildes JE, Wonderlich SA. Changes in evening-shifted loss of control eating severity following treatment for binge-eating disorder. Psychol Med 2024:1-8. [PMID: 38414359 DOI: 10.1017/s003329172400028x] [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] [Indexed: 02/29/2024]
Abstract
BACKGROUND Loss of control eating is more likely to occur in the evening and is uniquely associated with distress. No studies have examined the effect of treatment on within-day timing of loss of control eating severity. We examined whether time of day differentially predicted loss of control eating severity at baseline (i.e. pretreatment), end-of-treatment, and 6-month follow-up for individuals with binge-eating disorder (BED), hypothesizing that loss of control eating severity would increase throughout the day pretreatment and that this pattern would be less pronounced following treatment. We explored differential treatment effects of cognitive-behavioral guided self-help (CBTgsh) and Integrative Cognitive-Affective Therapy (ICAT). METHODS Individuals with BED (N = 112) were randomized to receive CBTgsh or ICAT and completed a 1-week ecological momentary assessment protocol at baseline, end-of-treatment, and 6-month follow-up to assess loss of control eating severity. We used multilevel models to assess within-day slope trajectories of loss of control eating severity across assessment periods and treatment type. RESULTS Within-day increases in loss of control eating severity were reduced at end-of-treatment and 6-month follow-up relative to baseline. Evening acceleration of loss of control eating severity was greater at 6-month follow-up relative to end-of-treatment. Within-day increases in loss of control severity did not differ between treatments at end-of-treatment; however, evening loss of control severity intensified for individuals who received CBTgsh relative to those who received ICAT at 6-month follow-up. CONCLUSIONS Findings suggest that treatment reduces evening-shifted loss of control eating severity, and that this effect may be more durable following ICAT relative to CBTgsh.
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Affiliation(s)
| | - Elizabeth N Dougherty
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | - Glen Forester
- Center for Biobehavioral Research, Sanford Research, Fargo, ND, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Ross D Crosby
- Center for Biobehavioral Research, Sanford Research, Fargo, ND, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Scott G Engel
- Center for Biobehavioral Research, Sanford Research, Fargo, ND, USA
| | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
- Department of Psychiatry, Accanto Health, St. Paul, MN, USA
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | - Stephen A Wonderlich
- Center for Biobehavioral Research, Sanford Research, Fargo, ND, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
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Murayama Y, Ito H, Hamada M, Takayanagi N, Nakajima T, Myogan M, Tsujii M. Longitudinal associations between response-style strategies and abnormal eating behaviors/attitudes in adolescents: a cross-lagged panel model. J Eat Disord 2024; 12:33. [PMID: 38414032 PMCID: PMC10900678 DOI: 10.1186/s40337-024-00991-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/19/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Previous studies have suggested that response-style strategies (rumination, problem-solving, and distraction) can be risk or protective factors for the development of abnormal eating behaviors/attitudes (AEB) during adolescence. However, due to limited empirical data regarding the prospective effects of these strategies on AEB, further research is needed to clarify their role in developing AEB in adolescence. METHODS This study investigated the one-year lagged effects of response-style strategies on AEB in 24,883 fourth- to eighth-grade students in Japan between 2015 and 2019 using a cross-lagged panel model. Depressive symptoms and body mass index (BMI), which are reported to relate to AEB, were also included in the analytic model. The students self-reported their levels of response-style strategies, AEB, and depressive symptoms. We also evaluated BMI based on teachers' reports. RESULTS We found that greater rumination significantly predicted more severe AEB in the following year among students from all grades, with small to moderate effect sizes. In addition, distraction significantly predicted more severe binge eating/purging behaviors, but with very weak small effect sizes. Problem-solving did not predict any level of AEB. Furthermore, we observed significant reciprocal relationships between response-style strategies, AEB, and depressive symptoms. Positive reciprocal associations between BMI and AEB were also found except for some intervals. CONCLUSIONS We concluded that a decrease in rumination is critical to alleviating mental health problems, such as AEB and depressive symptoms, during adolescence. This suggests that interventions to reduce the level of rumination should be conducted in the early stages of adolescence. TRIAL REGISTRATION NUMBER Not Applicable.
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Affiliation(s)
- Yasuo Murayama
- Institute of Human and Social Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan.
| | - Hiroyuki Ito
- Faculty of Core Research Human Science Division, Ochanomizu University, 2-1-1, Otsuka, Bunkyo-ku, Tokyo, 112-8610, Japan
| | - Megumi Hamada
- School of Psychology, Chukyo University, 101-2, Yagoto Honmachi, Showa-ku, Nagoya, Aichi, 466-8666, Japan
| | - Nobuya Takayanagi
- Department of Psychology, Aichi University of Education, 1 Hirosawa, Igaya-Cho, Kariya, Aichi, 448-8542, Japan
| | - Takahiro Nakajima
- School of Human Care Studies, Nagoya University of Arts and Sciences, 57, Takenoyama, Iwasaki-Cho, Nisshin, Aich, 470-0196, Japan
| | - Mitsunori Myogan
- School of Psychology, Chukyo University, 101-2, Yagoto Honmachi, Showa-ku, Nagoya, Aichi, 466-8666, Japan
| | - Masatsugu Tsujii
- School of Contemporary Sociology, Chukyo University, 101, Tokodachi, Kaizu-Cho, Toyota, Aichi, 470-0393, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1, Hadayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan
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Dora J, Kuczynski AM, Schultz ME, Acuff SF, Murphy JG, King KM. An experimental investigation into the effect of negative affect on the behavioral economic demand for alcohol. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:1-7. [PMID: 35201808 PMCID: PMC10759813 DOI: 10.1037/adb0000823] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Influential theoretical models hypothesize that alcohol use is an especially potent reinforcer when used as a strategy to cope with negative affect. Although the evidence for this idea in observational data is weak, some experimental evidence suggests that the behavioral economic demand for alcohol increases immediately following a negative emotional event. Because existing studies testing the effect of negative mood inductions on the demand for alcohol have several methodological limitations and do not take inter- and intraindividual variability into account, we developed an improved experimental design to increase our confidence in any potential within-person effect of negative mood inductions on alcohol demand as well as to test whether this effect exhibits systematic inter- and intraindividual variability. We hypothesize that people will show a higher demand for alcohol following negative compared to neutral mood inductions and that this effect is stronger in heavy compared to light drinkers as well as stronger on days characterized by higher coping motives and negative urgency. Three hundred twenty college students will complete the alcohol purchase task (APT) after being subjected to 100 mood inductions (six negative, six neutral) on 20 separate days. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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21
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Meier M, Summers BJ, Buhlmann U. Which Symptoms Bridge Symptoms of Depression and Symptoms of Eating Disorders?: A Network Analysis. J Nerv Ment Dis 2024; 212:61-67. [PMID: 38166183 DOI: 10.1097/nmd.0000000000001715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
ABSTRACT Depression is a common comorbid mental illness in eating disorders (EDs). Network theory focuses on interactions between symptoms, but findings from network analyses of EDs and depression need to be replicated to make reliable claims about the nature of symptomatic interplay. We used cross-sectional data of 366 online-recruited participants with clinically elevated ED symptomatology and constructed a regularized partial correlation network with ED and depression symptoms. To determine each symptom's influence, we calculated expected influence (EI) and bridge EI to identify symptoms that bridged symptoms of depression and ED. Concerns that others see one eat, fear of weight gain, and fear of loss of control over eating were especially important among the ED symptoms. Loss of interest and feeling sad were the key depression symptoms. Eating in secret and low self-esteem emerged as potential bridge symptoms between clusters. These findings regarding bridge symptoms partially overlap with prior network analyses in nonclinical and clinical samples. Future studies that investigate symptom interplay via a longitudinal design to deduce causality are needed.
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Affiliation(s)
- Marieke Meier
- Department of Psychology, University of Münster, Münster, Germany
| | - Berta J Summers
- Massachusetts General Hospital, Department of Psychiatry, Boston, Massachusetts
| | - Ulrike Buhlmann
- Department of Psychology, University of Münster, Münster, Germany
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22
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Van Malderen E, Goossens L, Claes L, Wilderjans TF, Kemps E, Verbeken S. Self-regulation profiles in addictive behaviors among adolescents: A transdiagnostic approach. Appetite 2024; 192:107128. [PMID: 37984600 DOI: 10.1016/j.appet.2023.107128] [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: 12/16/2022] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023]
Abstract
Dual-pathway models suggest that poor self-regulation (immature regulatory combined with strong reactive processes) is an important factor underlying addictive behaviors among adolescents. This study examined whether there are different self-regulation profiles among community adolescents, and how these profiles are related to the presence, severity and comorbidity of different addictive behaviors. A community sample of 341 adolescents (54.5% female; 13-17 years) was recruited. Participants self-reported on regulatory (inhibitory control) and reactive (reward and punishment sensitivity) processes, as well as on different addictive behaviors (binge eating, tobacco-, cannabis- and alcohol use, gaming, gambling and pathological buying). A model-based clustering analysis found evidence for three meaningful profiles: 'impulsive/under-controlled', 'anxious' and 'protective'. The 'impulsive/under-controlled' profile was characterized by the highest prevalence and severity of cannabis use and the most severe alcohol use. The 'impulsive/under-controlled' and 'protective' profiles demonstrated the highest prevalence and severity of tobacco use, whereas the 'impulsive/under-controlled' and 'anxious' profiles showed the highest binge eating scores. Adolescents who reported more than three types of addictive behaviors generally belonged to the 'impulsive/under-controlled' profile. The profiles did not differ for gaming, gambling and pathological buying. The 'impulsive/under-controlled' profile emerged as the most vulnerable profile in the context of addictive behaviors (especially for binge eating and substance use).
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Affiliation(s)
- Eva Van Malderen
- Ghent University, Department of Developmental, Personality and Social Psychology, Henri Dunantlaan 2, 9000, Ghent, Belgium.
| | - Lien Goossens
- Ghent University, Department of Developmental, Personality and Social Psychology, Henri Dunantlaan 2, 9000, Ghent, Belgium
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Tom F Wilderjans
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Faculty of Social and Behavioral Sciences, Leiden University, Leiden, the Netherlands; Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands; Institute for Brain and Cognition, Leids Universitair Medisch Centrum, the Netherlands
| | - Eva Kemps
- School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Sandra Verbeken
- Ghent University, Department of Developmental, Personality and Social Psychology, Henri Dunantlaan 2, 9000, Ghent, Belgium
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Manasse SM, Russon J, Lampe EW, King A, Abber SR, Trainor C, Gillikin LM, Levy S, Diamond G. Attachment-Based Family Therapy to Improve Family Functioning in Adolescent Binge-Spectrum Eating Disorders: An Initial Evaluation Via Case Series Design. Clin Child Psychol Psychiatry 2024; 29:45-62. [PMID: 37384823 DOI: 10.1177/13591045231187433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Binge-spectrum eating disorders (EDs; bulimia nervosa, binge eating disorder) often develop during adolescence and are associated with serious psychological and physical consequences. Current treatments for adolescents are highly behavioral in nature and while efficacious, many patients do not reach remission indicating that current treatments fail to target a key maintenance factor for EDs. One potential maintenance factor is poor family functioning (FF). In particular, high family conflict (e.g., arguing, critical comments) and low family cohesion (e.g., warmth, support) are known to maintain ED behaviors. Poor FF can (1) cause or exacerbate an adolescent's use of ED behaviors to cope with life stress and/or (2) inhibit parents from being a resource to adolescents during ED treatment. Attachment-Based Family Therapy (ABFT) is specifically designed to improve FF, and thus may be a promising adjunct to behavioral ED intervention strategies. ABFT, however, has not been tested in adolescents with binge-spectrum EDs. Thus, the current study is the first to evaluate a 16-week adapted ABFT treatment for adolescents with EDs (N = 8, Mage = 16.00, 71.43% female, 71.43% White) fusing together behavioral treatment for EDs with ABFT for highest possible impact. Eight families were treated in an open pilot trial to examine treatment feasibility, acceptability, and preliminary efficacy on FF and eating pathology. Overall, findings were promising. ABFT + B treatment was feasible and acceptable and showed preliminary evidence that it could improve FF and ED behaviors. Future research will test this intervention in a larger sample and further examine the role of FF in maintaining ED symptoms.
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Affiliation(s)
- Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
| | - Jody Russon
- Department of Human Development & Family Science, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Elizabeth W Lampe
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Allie King
- Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA
| | - Sophie R Abber
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Claire Trainor
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | | | - Suzanne Levy
- Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA
| | - Guy Diamond
- Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA
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Goldschmidt AB, Goldstein SP, Schmiedek F, Stalvey E, Irizarry B, Thomas JG. State-level working memory and dysregulated eating in children and adolescents: An exploratory ecological momentary assessment study. Int J Eat Disord 2024; 57:93-103. [PMID: 37888341 PMCID: PMC10872824 DOI: 10.1002/eat.24087] [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: 06/07/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Children with loss of control (LOC) eating and overweight/obesity have relative deficiencies in trait-level working memory (WM), which may limit adaptive responding to intra- and extra-personal cues related to eating. Understanding of how WM performance relates to eating behavior in real-time is currently limited. METHODS We studied 32 youth (ages 10-17 years) with LOC eating and overweight/obesity (LOC-OW; n = 9), overweight/obesity only (OW; n = 16), and non-overweight status (NW; n = 7). Youth completed spatial and numerical WM tasks requiring varying degrees of cognitive effort and reported on their eating behavior daily for 14 days via smartphone-based ecological momentary assessment. Linear mixed effects models estimated group-level differences in WM performance, as well as associations between contemporaneously completed measures of WM and dysregulated eating. RESULTS LOC-OW were less accurate on numerical WM tasks compared to OW and NW (ps < .01); groups did not differ on spatial task accuracy (p = .41). Adjusting for between-subject effects (reflecting differences between individuals in their mean WM performance and its association with eating behavior), within-subject effects (reflecting variations in moment-to-moment associations) revealed that more accurate responding on the less demanding numerical WM task, compared to one's own average, was associated with greater overeating severity across the full sample (p = .013). There were no associations between WM performance and LOC eating severity (ps > .05). CONCLUSIONS Youth with LOC eating and overweight/obesity demonstrated difficulties mentally retaining and manipulating numerical information in daily life, replicating prior laboratory-based research. Overeating may be related to improved WM, regardless of LOC status, but temporality and causality should be further explored. PUBLIC SIGNIFICANCE STATEMENT Our findings suggest that youth with loss of control eating and overweight/obesity may experience difficulties mentally retaining and manipulating numerical information in daily life relative to their peers with overweight/obesity and normal-weight status, which may contribute to the maintenance of dysregulated eating and/or elevated body weight. However, it is unclear whether these individual differences are related to eating behavior on a moment-to-moment basis.
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Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine/Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
| | - Stephanie P. Goldstein
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Florian Schmiedek
- Department of Education and Human Development, DIPF | Leibniz Institute for Research and Information in Education, Frankfurt, Germany
| | - Erin Stalvey
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Bailey Irizarry
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - J. Graham Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
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25
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Fitzgerald EH, Joyner KJ, Keel PK. Examining trait-like factors as predictors of state-level responses to food intake in women with bulimia nervosa, purging disorder, and controls. Int J Eat Disord 2023; 56:2328-2335. [PMID: 37850623 PMCID: PMC10841483 DOI: 10.1002/eat.24077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE Theories suggest that elevated negative affect and weight/shape concerns explain both who is affected by bulimic symptoms as well as when bulimic symptoms occur, suggesting that individual differences predict within-subject differences. However, few studies have tested this theoretical premise. METHOD In the present study, participants (N = 119) diagnosed with bulimia nervosa (N = 57), purging disorder (N = 31), and non-eating disorder controls (N = 31) completed measures of negative affect and weight/shape concerns and later made momentary affect and weight/shape concerns ratings before and after an ad lib meal. RESULTS State negative affect and weight/shape concerns increased post-meal. No moderating effect of trait negative affect was observed for state affect. In contrast, between-subject differences in weight/shape concerns moderated within-subject increases in state weight/shape concerns. Diagnostic group did not account for this effect. DISCUSSION Findings point to viable treatment targets for disordered eating. Targeting elevated weight/shape concerns early in interventions could facilitate reductions in purging after food intake for bulimia nervosa and purging disorder. PUBLIC SIGNIFICANCE In the present study, individual differences in weight/shape concerns at baseline predicted greater increases in state weight/shape concerns following eating. These effects were maintained when considering possible differences related to presence and type of eating disorder. Results suggest that targeting weight/shape concerns earlier in treatment may be important for reducing maladaptive responses to eating across eating disorders.
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26
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Kambanis PE, Bottera AR, De Young KP. Responses to bright light exposure in individuals with binge-spectrum eating disorders characterized by high dietary restraint and negative affect. Int J Eat Disord 2023; 56:2250-2259. [PMID: 37644851 DOI: 10.1002/eat.24054] [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: 01/24/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Circadian rhythm disruptions are associated with binge eating, can be causal of negative mood, and may be corrected with bright light exposure. A subtype of individuals with binge-spectrum eating disorders are characterized by combined high dietary restraint and negative affect. These individuals have higher eating disorder psychopathology and poorer treatment response. We aimed to test the targeted effects of morning bright light exposure on individuals with binge-spectrum eating disorders, hypothesizing significant reductions in binge eating for those characterized by high dietary restraint and negative affect. METHODS Participants (N = 34 females with binge-eating disorder and bulimia nervosa) used a morning bright light and normal light for 10 consecutive days each, in randomized order. They completed the Change in Eating Disorder Symptoms (CHEDS) scale at baseline, day 12 (when they switched lamps), and day 22. We conducted moderation analyses, clustering data by person, controlling for order, and examining the effect of light condition on binge eating according to baseline restraint and negative affect. RESULTS At high levels of combined dietary restraint and negative affect, participants experienced a reduction in binge eating and food preoccupation following exposure to morning bright light. There were no changes in restrictive eating, body preoccupation, body dissatisfaction, or body checking following exposure to morning bright light for these individuals. DISCUSSION These findings suggest that morning bright light may be a useful adjunct to empirically supported eating disorder treatments that target binge eating, especially for individuals characterized by the difficult to treat restraint/negative affect subtype. PUBLIC SIGNIFICANCE At high levels of combined dietary restraint and negative affect, participants with binge-spectrum eating disorders experienced a reduction in binge eating and food preoccupation following exposure to morning bright light. These findings suggest that morning bright light may be a useful adjunct to empirically supported eating disorder treatments that target binge eating, especially for individuals characterized by the difficult-to-treat restraint/negative affect subtype.
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Affiliation(s)
- P Evelyna Kambanis
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Kyle P De Young
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
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27
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Lampe EW, Presseller EK, Abber SR, Sonnenblick RM, Juarascio AS, Manasse SM. Affective profiles of exercise episodes are associated with maladaptive and adaptive motivations for exercise. EUROPEAN EATING DISORDERS REVIEW 2023; 31:863-873. [PMID: 37436089 DOI: 10.1002/erv.3012] [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: 01/27/2023] [Revised: 04/26/2023] [Accepted: 07/01/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE Maladaptive exercise (i.e., driven and/or compensatory exercise) is common in binge-spectrum eating disorders (EDs; e.g., bulimia nervosa, binge ED) and associated with adverse treatment outcomes. Alternatively, individuals with EDs are often also engaging in adaptive exercise (e.g., for enjoyment or health improvement), and increasing adaptive exercise may decrease ED symptoms. The current study aimed to understand which exercise episodes are likely to be maladaptive/adaptive so that interventions can appropriately decrease/increase maladaptive and adaptive exercise. METHOD We used latent profile analysis (LPA) to identify pre-exercise affective profiles of 661 exercise episodes among 84 individuals with binge-spectrum EDs and examined associations between LPA-identified profiles and subsequent exercise motivations using ecological momentary assessment. RESULTS A two-profile solution best fit our data: Profile 1 (n = 174), 'positive affectivity,' and Profile 2 (n = 487), 'negative affectivity.' Episodes in the 'negative affectivity' profile were more likely to be endorsed as both driven and intended to influence body shape/weight. Episodes in the 'positive affectivity' profile were more likely to be endorsed as exercising for enjoyment. CONCLUSIONS Results support two phenotypes of exercise episodes, and differential associations of these phenotypes with adaptive and maladaptive motivations for exercise.
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Affiliation(s)
- Elizabeth W Lampe
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Emily K Presseller
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Sophie R Abber
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Ross M Sonnenblick
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne S Juarascio
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
| | - Stephanie M Manasse
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, Pennsylvania, USA
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Eichin KN, Georgii C, Schnepper R, Voderholzer U, Blechert J. Emotional food-cue-reactivity in anorexia nervosa and bulimia nervosa: An electroencephalography study. Int J Eat Disord 2023; 56:2096-2106. [PMID: 37565581 PMCID: PMC10946739 DOI: 10.1002/eat.24028] [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: 11/17/2022] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Food-cue-reactivity entails neural and experiential responses to the sight and smell of attractive foods. Negative emotions can modulate such cue-reactivity and this might be central to the balance between restrictive versus bulimic symptomatology in Anorexia Nervosa (AN) and Bulimia Nervosa (BN). METHOD Pleasantness ratings and electrocortical responses to food images were measured in patients with AN (n = 35), BN (n = 32) and matched healthy controls (HC, n = 35) in a neutral state and after idiosyncratic negative emotion induction while electroencephalography (EEG) was recorded. The EEG data were analyzed using a mass testing approach. RESULTS Individuals with AN showed reduced pleasantness for foods compared to objects alongside elevated widespread occipito-central food-object discrimination between 170 and 535 ms, indicative of strong neural cue-reactivity. Food-object discrimination was further increased in the negative emotional condition between 690 and 1200 ms over centroparietal regions. Neither of these effects was seen in individuals with BN. DISCUSSION Emotion modulated food-cue-reactivity in AN might reflect a decreased appetitive response in negative mood. Such specific (emotion-)regulatory strategies require more theoretical work and clinical attention. The absence of any marked effects in BN suggests that emotional cue-reactivity might be less prominent in this group or quite specific to certain emotional contexts or food types. PUBLIC SIGNIFICANCE Negative affectivity is a risk factor for the development of eating disorders and individuals with eating disorders experience problems with emotion regulation. To better understand the effects of negative emotions, the present study investigated how they affected neural correlates of food perception in anorexia nervosa and bulimia nervosa.
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Affiliation(s)
- Katharina Naomi Eichin
- Department of Psychology and Centre for Cognitive NeuroscienceUniversity of SalzburgSalzburgAustria
- Department of PsychologyJohannes Kepler UniversityLinzAustria
| | - Claudio Georgii
- Department of Psychology and Centre for Cognitive NeuroscienceUniversity of SalzburgSalzburgAustria
| | - Rebekka Schnepper
- Department of Psychology and Centre for Cognitive NeuroscienceUniversity of SalzburgSalzburgAustria
- Department of Psychosomatic MedicineUniversity Hospital BaselBaselSwitzerland
| | | | - Jens Blechert
- Department of Psychology and Centre for Cognitive NeuroscienceUniversity of SalzburgSalzburgAustria
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Messer M, Lee S, Linardon J. Longitudinal association between self-compassion and intuitive eating: Testing emotion regulation and body image flexibility as mediating variables. J Clin Psychol 2023; 79:2625-2634. [PMID: 37462510 PMCID: PMC10952370 DOI: 10.1002/jclp.23569] [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: 03/12/2023] [Revised: 06/07/2023] [Accepted: 07/03/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVES Growing evidence suggests that intuitive eating is associated with numerous positive mental health and well-being constructs. Understanding factors that predict intuitive eating is necessary for identifying practical targets to enhance this style of eating, yet research identifying such predictors is scarce. Self-compassion is one variable that could enhance intuitive eating because it involves the practice of healthy emotion regulation skills that may disrupt the tendency to turn to food to cope during distressing situations. The present study tested for a longitudinal association between self-compassion and intuitive eating. We also tested whether this association was mediated by indices of emotion regulation (i.e., global emotion regulation skill scores and body image flexibility). METHOD Adult women (n = 3039) were invited to completed study measures at baseline (T1), 4-month follow-up (T2), and 8-month follow-up (T3). Path analyses were computed to test hypothesized indirect effects. RESULTS A direct path from T1 self-compassion to T3 intuitive eating emerged, such that higher self-compassion levels predicted increased intuitive eating over time. However, this association was not mediated by T2 emotion regulation skills nor body image flexibility. CONCLUSION Findings suggest that self-compassion may facilitate an intuitive eating style, which does not appear to be explained by certain emotion regulation skills.
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Affiliation(s)
- Mariel Messer
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
| | - Sohee Lee
- Faculty of Health and Environmental ScienceAuckland University of TechnologyAucklandNew Zealand
| | - Jake Linardon
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
- Center for Social and Early Emotional Development and School of PsychologyDeakin UniversityBurwoodVictoriaAustralia
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30
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Bronfman K, Chao AM. Psychosocial Factors, Technology Use, and Disordered Eating in College Students During the COVID-19 Pandemic. J Psychosoc Nurs Ment Health Serv 2023; 61:29-38. [PMID: 37134280 DOI: 10.3928/02793695-20230421-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The current cross-sectional study aimed to evaluate the effects of psychosocial factors and technology use on disordered eating in college students (aged 18 to 23 years) during the coronavirus disease 2019 (COVID-19) pandemic. An online survey was distributed between February and April 2021. Participants completed questionnaires on eating disorder behaviors and cognitions, depressive symptoms, anxiety, impacts of the pandemic across personal and social domains, social media use, and screen time. Of all participants (N = 202), 40.1% of students reported moderate or greater depressive symptoms and 34.7% endorsed moderate or greater anxiety symptoms. Higher depressive symptoms were associated with increased odds of bulimia nervosa (BN) (p = 0.03) and binge eating disorder (p = 0.02). People with higher COVID-19 infection scores were at increased odds of reporting BN (p = 0.01). Mood disturbances and COVID-19 infection history were associated with increased eating disorder psychopathology in college students during the pandemic. [Journal of Psychosocial Nursing and Mental Health Services, 61(10), 29-38.].
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Schnepper R, Blechert J, Arend AK, Yanagida T, Reichenberger J. Emotional eating: elusive or evident? Integrating laboratory, psychometric and daily life measures. Eat Weight Disord 2023; 28:74. [PMID: 37702801 PMCID: PMC10499733 DOI: 10.1007/s40519-023-01606-8] [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: 06/19/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023] Open
Abstract
PURPOSE Emotional eating (EE) refers to eating in response to (negative) emotions. Evidence for the validity of EE is mixed: some meta-analyses find EE only in eating disordered patients, others only in restrained eaters, which suggest that only certain subgroups show EE. Furthermore, EE measures from lab-based assessments, ecological momentary assessment (EMA), and psychometric measures often diverge. This paper tested whether the covariance of these three different EE methods can be modeled through a single latent variable (factorial validity), and if so, how this variable would relate to restrained eating (construct validity), Body-Mass-Index (BMI), and subclinical eating disorder symptomatology (concurrent validity). METHODS 102 non-eating disordered female participants with a wide BMI range completed EE measures from three methods: psychometric questionnaires, a laboratory experiment (craving ratings of food images in induced neutral vs. negative emotion) and EMA questionnaires (within-participant correlations of momentary negative emotions and momentary food cravings across 9 days). Two measures for each method were extracted and submitted to confirmatory factor analysis. RESULTS A one-factor model provided a good fit. The resulting EElat factor correlated positively with subclinical eating disorder symptoms and BMI but not with restrained eating. CONCLUSIONS The one-factor solution shows that the EE construct can validly be assessed with three different methods. Individual differences in EE are supported by the data and are related to eating and weight problem symptomatology but not to restrained eating. This supports learning accounts of EE and underscores the relevance of the EE construct to physical and mental health. LEVEL OF EVIDENCE II (Evidence obtained from well-designed controlled trials without randomization).
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Affiliation(s)
- Rebekka Schnepper
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria
- Department of Psychosomatics, University Hospital Basel, Hebelstr. 2, 4056, Basel, Switzerland
| | - Jens Blechert
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria
| | - Ann-Kathrin Arend
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria
| | - Takuya Yanagida
- Faculty of Psychology, Department of Developmental and Educational Psychology, University of Vienna, Universitaetsstr. 7, 1010, Vienna, Austria
| | - Julia Reichenberger
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria.
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Nechita DM, David D. Shame facets as predictors of problematic eating behaviors: An ecological momentary assessment study. Behav Res Ther 2023; 168:104381. [PMID: 37542804 DOI: 10.1016/j.brat.2023.104381] [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: 06/15/2022] [Revised: 07/09/2023] [Accepted: 07/28/2023] [Indexed: 08/07/2023]
Abstract
It is well-established that negative affect acts as predictor and maintenance factor of problematic eating behaviors. However, the relevance of different facets of negative affect is unclear. While guilt was consistently shown as having a relevant contribution in relation with problematic eating patterns, shame might play a similar role. The current study used an ecological momentary assessment design to assess associations between facets of shame and subsequent disturbed eating behaviors. The study included 57 females with high levels of eating disorders (ED) symptomatology who completed five surveys per day for 14 consecutive days. Participants completed measures of facets of shame (i.e., general shame, body shame, shame around eating), negative affect and problematic eating behaviors (i.e., binge eating, restriction, weighting, body checking, purging, taking laxative/diuretics and excessive exercise). Data were analyzed using multilevel models. In general, between-subjects facets of shame were associated with more disturbed eating behaviors, with shame explaining a significantly and clinically relevant percent of the variance of these problematic eating behaviors. At the within-subject level, facets of shame predicted subsequent binge eating, body checking and excessive exercise. These findings support the role of shame in ED symptomatology and the relevance of directly tackling shame in psychological treatments.
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Affiliation(s)
- Diana-Mirela Nechita
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, 37 Republicii Street, 400015, Cluj-Napoca, Romania; International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, 37 Republicii Street, 400015, Cluj-Napoca, Romania
| | - Daniel David
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, 37 Republicii Street, 400015, Cluj-Napoca, Romania.
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Kinnear A, Siegel JA, Masson PC, Bodell LP. Functions of disordered eating behaviors: a qualitative analysis of the lived experience and clinician perspectives. J Eat Disord 2023; 11:141. [PMID: 37605248 PMCID: PMC10440936 DOI: 10.1186/s40337-023-00854-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/28/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND One method to improve treatment outcomes for individuals with eating disorders (EDs) may be understanding and targeting individuals' motives for engaging in DE behaviors-or the functions of DE behaviors. The goal of this study was to investigate and categorize the various functions of DE behaviors from the perspectives of adults who engage in DE behaviors and clinicians who treat EDs. METHODS Individuals who engage in DE behaviors (n = 16) and clinicians who treat EDs (n = 14) were interviewed, and a thematic analysis was conducted to determine key functions of DE behaviors. RESULTS Four main functions of DE behaviors were identified by the authors: (1) alleviating shape, weight, and eating concerns; (2) regulating emotions; (3) regulating one's self-concept; and (4) regulating interpersonal relationships/communicating with others. CONCLUSIONS Differences in participant responses, particularly regarding the relevance of alleviating shape and weight concerns as an DE behavior function, highlight the importance of individualized conceptualizations of DE behavior functions for any given client.
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Affiliation(s)
- Abbigail Kinnear
- Department of Psychology, University of Western Ontario, London, ON Canada
| | - Jaclyn A. Siegel
- Department of Psychology, University of Western Ontario, London, ON Canada
- Department of Psychology, San Diego State University, San Diego, CA USA
| | - Philip C. Masson
- Department of Psychology, University of Western Ontario, London, ON Canada
| | - Lindsay P. Bodell
- Department of Psychology, University of Western Ontario, London, ON Canada
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Schaefer LM, Forester G, Burr EK, Laam L, Crosby RD, Peterson CB, Crow SJ, Engel SG, Dvorak RD, Wonderlich SA. Examining the role of craving in affect regulation models of binge eating: Evidence from an ecological momentary assessment study. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2023; 132:725-732. [PMID: 37307313 PMCID: PMC10695167 DOI: 10.1037/abn0000839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Affect regulation models hypothesize that aversive affective states drive binge-eating behavior, which serves to regulate unpleasant emotions. Research using ecological momentary assessment (EMA) demonstrates that increases in guilt most strongly predict subsequent binge-eating episodes, raising the question: why would individuals with binge-eating pathology engage in a binge-eating episode when they feel guilty? Food craving is a robust predictor of binge eating and is commonly associated with subsequent feelings of guilt. The current study used EMA to test the hypothesis that food craving may promote increased feelings of guilt, which then predict an increased risk of binge eating within a sample of 109 individuals with binge-eating disorder. Multilevel mediation models indicated that increased momentary craving at Time 1 directly predicted a greater likelihood of binge eating at Time 2, and craving also indirectly predicted binge eating at Time 2 through momentary increases in guilt at Time 2. In other words, experiencing food craving at one time point was related to an increased likelihood of binge eating at the next time point, and a portion of this influence was attributable to increasing feelings of guilt. These results challenge simple affect regulation models of binge eating, suggesting that food-related anticipatory reward processes (i.e., craving) may be the primary driver of binge-eating risk and account for the increases in guilt commonly observed prior to binge-eating episodes. Although experimental studies are needed to confirm this possibility, these results suggest the importance of addressing food cravings within interventions for binge-eating disorder. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Glen Forester
- Sanford Research, Sanford Center for Biobehavioral Research
| | - Emily K Burr
- Sanford Research, Sanford Center for Biobehavioral Research
| | - Leslie Laam
- Sanford Research, Sanford Center for Biobehavioral Research
| | - Ross D Crosby
- Sanford Research, Sanford Center for Biobehavioral Research
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
| | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
| | - Scott G Engel
- Sanford Research, Sanford Center for Biobehavioral Research
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Schaefer LM, Forester G, Dvorak RD, Steinglass J, Wonderlich SA. Integrating aspects of affect, reward, and cognition to develop more comprehensive models of binge-eating pathology. Int J Eat Disord 2023; 56:1502-1510. [PMID: 37084184 PMCID: PMC10681362 DOI: 10.1002/eat.23971] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/28/2023] [Accepted: 04/13/2023] [Indexed: 04/22/2023]
Abstract
Reward-related processes are an increasing focus of eating disorders research. Although evidence suggests that numerous distinct reward processes may contribute to eating pathology (e.g., reward learning and delay discounting), existing etiological models of reward dysfunction tend to focus on only a limited number of reward processes, and frequently lack specificity when identifying the individual reward processes hypothesized to contribute to dysregulated eating behavior. Moreover, existing theories have been limited in their integration of reward-related processes with other demonstrated risk and maintenance factors for eating disorders (e.g., affect and cognition), potentially contributing to underdeveloped models of eating pathology. In this article, we highlight five distinct reward processes with theorized or demonstrated relevance to eating disorders involving binge-eating, followed by a review of two well-established risk/maintenance factors for binge-eating pathology. We then introduce two novel models of binge eating onset and maintenance that integrate these factors (i.e., the Affect, Reward, Cognition models), and discuss methods for testing each of the models in future research. Ultimately, we hope that the proposed models provide a springboard for the continued evolution of more precise and comprehensive theories of reward dysfunction in the eating disorders, as well as the development of novel intervention approaches. PUBLIC SIGNIFICANCE STATEMENT: Eating disorders are associated with abnormalities in multiple domains of reward functioning. However, models of reward dysfunction within the eating disorders have not been well-integrated with prominent models of affect and cognition. This article presents two novel models of onset and maintenance for binge-eating pathology, which attempt to integrate observed reward abnormalities with other affective and cognitive processes implicated in binge-type eating disorders.
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Affiliation(s)
- Lauren M. Schaefer
- Center for Biobehavioral Research, Sanford Research, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, North Dakota, USA
| | - Glen Forester
- Center for Biobehavioral Research, Sanford Research, North Dakota, USA
| | - Robert D. Dvorak
- Center for Biobehavioral Research, Sanford Research, North Dakota, USA
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Joanna Steinglass
- Department of Psychiatry, Columbia University Medical Center, New York, USA
- Department of Psychiatry, New York State Psychiatric Institute, New York, USA
| | - Stephen A. Wonderlich
- Center for Biobehavioral Research, Sanford Research, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, North Dakota, USA
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D'Adamo L, Sonnenblick RM, Juarascio AS, Manasse SM. Relations between forms of dietary restraint, restriction, and loss-of-control eating among adolescents seeking weight control: An ecological momentary assessment study. Eat Behav 2023; 50:101791. [PMID: 37544108 PMCID: PMC10528310 DOI: 10.1016/j.eatbeh.2023.101791] [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: 03/06/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE This study aimed to: 1) compare rates of dietary restraint and restriction between adolescents with and without loss-of-control (LOC) eating who were seeking weight control and 2) examine temporal relations between restraint/restriction and LOC eating. METHOD 37 adolescents seeking weight control (mean age: 15.4 ± 1.5; 62 % White; 57 % female; mean BMI percentile = 97.3 ± 3.1) completed a one-week ecological momentary assessment protocol and reported on dietary restraint/restriction and eating behavior prior to beginning a weight control intervention. Chi-square tests examined differences in frequency of restraint/restriction between participants with and without LOC eating. Multilevel models examined associations between dietary restraint/restriction and LOC eating at the next survey and on the next day. RESULTS Of 37 participants, 15 (41 %) reported engaging in LOC eating. Participants with LOC eating more frequently endorsed several forms of restraint and restriction versus participants without LOC eating. Attempting to avoid enjoyable foods and attempting to limit eating at one survey predicted greater likelihood of LOC eating at the next survey. CONCLUSIONS Findings suggest that attempted restraint, but not actual restriction, was associated with LOC eating. Research should explore additional factors that may influence these relationships, which could inform weight control treatments that address restraint/restriction.
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Affiliation(s)
- Laura D'Adamo
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA; Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
| | - Ross M Sonnenblick
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
| | - Adrienne S Juarascio
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
| | - Stephanie M Manasse
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St., Philadelphia, PA 19104, USA
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Williamson G, Cotter EW, Cao L, Guidinger C, Kelly NR. Ecological momentary assessment of state affect prior to and following loss of control eating in young men. Eat Behav 2023; 50:101782. [PMID: 37517107 DOI: 10.1016/j.eatbeh.2023.101782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/14/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Loss of control (LOC) eating is prevalent but understudied among young men. Affect regulation models propose that LOC eating functions as a maladaptive effort to escape from distressing affective states. As such, negative affect is thought to increase before and decrease after LOC eating. However, examinations with young men are lacking and it remains unclear whether specific emotional experiences are differentially implicated in their LOC eating. METHODS The current study examined the temporal roles of affect in LOC eating in 31 young men (18-35 years; Mage = 25.74 ± 5.61y; 46.7 % White; 30 % Black/African American; 10 % Hispanic/Latino, 10 % South Asian) who reported engaging in recurrent LOC eating. Participants completed a 14-day ecological momentary assessment protocol and recorded all eating episodes each day and their state affect five times per day. Generalized linear mixed models were conducted to examine the trajectories of global and item-level negative and positive affect pre- and post-LOC eating episodes. RESULTS Negative affect did not change significantly before or after LOC eating (ps > .05). Positive affect did not change significantly before LOC eating (ps > .05). Global positive affect, excitement, and happiness decreased significantly after LOC eating (ps ≤ .001). DISCUSSION Study findings contradict extant theory and empirical data largely from female samples. Negative affect did not increase risk for LOC eating, nor did LOC eating function to improve participants' mood; rather, positive mood slightly decreased after LOC eating. Further investigation around the observed decline in positive affect after LOC eating will clarify if this is a relevant intervention point in this population.
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Affiliation(s)
- Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America.
| | - Elizabeth W Cotter
- Department of Health Studies, American University, United States of America.
| | - Li Cao
- Sanford Center for Biobehavioral Research, United States of America.
| | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America.
| | - Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, United States of America; The Prevention Science Institute, University of Oregon, United States of America.
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Schag K, Sandler L, Zipfel S, Derntl B, Giel KE. Inhibitory control towards angry stimuli in patients with binge eating disorder: a pilot study. J Eat Disord 2023; 11:125. [PMID: 37525245 PMCID: PMC10388460 DOI: 10.1186/s40337-023-00848-2] [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: 08/04/2022] [Accepted: 07/22/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Emotion regulation theories and the negative urgency concept assume that negative mood increases binge eating. Negative emotions are considered as a trigger for binge eating, while binge eating itself is regarded as an impulsive behavior and should thus be increased within the negative urgency concept. Anger might be a specific negative emotion triggering binge eating in patients with binge eating disorder (BED). We investigated how inhibitory control as one main factor of impulsivity is influenced by anger stimuli in patients with BED and two control groups. METHODS We compared patients with BED (N = 20) with normal-weight healthy control participants (NW-CG, N = 20) and BMI-matched overweight and obese control participants (BMI-CG, N = 18). We used the emotional Stop Signal task (eSST) to investigate inhibitory control, where we presented angry facial expressions in comparison with neutral facial expressions as emotional stimuli. RESULTS All participants showed decreased inhibitory control in the angry versus neutral condition, i.e., a faster Stop Signal Reaction Time and a lower percentage of correct reactions. However, no significant group differences emerged in terms of performance. Performance in the eSST did not correlate with negative urgency, disorder- or emotion-related characteristics. CONCLUSIONS The current pilot study does not deliver evidence for decreased inhibitory control towards angry stimuli in patients with BED, as we detected a general and not disorder-related effect in all participants that might represent the conjunction of inhibitory control and anger. A direct mood induction technique might have led to different results. Further research in healthy and clinical groups is needed.
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Affiliation(s)
- Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Osianderstraße 5, 72076, Tübingen, Germany.
- Centre of Excellence for Eating Disorders Tübingen (KOMET), Tübingen, Germany.
| | - Lea Sandler
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Osianderstraße 5, 72076, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Osianderstraße 5, 72076, Tübingen, Germany
- Centre of Excellence for Eating Disorders Tübingen (KOMET), Tübingen, Germany
- DZPG (German Center for Mental Health), Tübingen, Germany
| | - Birgit Derntl
- DZPG (German Center for Mental Health), Tübingen, Germany
- Department for Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Osianderstraße 5, 72076, Tübingen, Germany
- Centre of Excellence for Eating Disorders Tübingen (KOMET), Tübingen, Germany
- DZPG (German Center for Mental Health), Tübingen, Germany
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Bresin K, Hunt RA. Appetitive and Aversive Motivation in Dysregulated Behaviors: A Meta-Analysis. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2023:1461672231185509. [PMID: 37475669 DOI: 10.1177/01461672231185509] [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: 07/22/2023]
Abstract
Appetitive and aversive motivation are prominent in theories of dysregulated behaviors. The authors conducted a meta-analysis of the association between individual differences in appetitive and aversive motivation and several dysregulated behaviors (i.e., alcohol use, marijuana use, tobacco use, binge eating, aggression, gambling, and nonsuicidal self-injury). Alcohol use (r = .17, k = 141), marijuana use (r = .13, k = 23), aggression (r = .22, k = 52), and gambling (r = .08, k = 55) were all significantly positively related to appetitive motivation. Binge eating (r = .28, k = 34) and self-injury (r = .17, k = 10) were significantly positively related to aversive motivation. Effect sizes were similar to the median effect size in personality research. Together, these results provide some evidence that some dysregulated behaviors are more correlated with approach motivation, whereas others are more correlated with aversive motivation, which may indicate distinct etiological pathways.
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Yao L, Yang Y, Wang Z, Pan X, Xu L. Compliance with ecological momentary assessment programmes in the elderly: a systematic review and meta-analysis. BMJ Open 2023; 13:e069523. [PMID: 37438069 DOI: 10.1136/bmjopen-2022-069523] [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] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVE Ecological momentary assessment (EMA) refers to the repeated sampling of information about an individual's symptoms and behaviours, enabling the capture of ecologically meaningful real-time information in a timely manner. Compliance with EMA is critical in determining the validity of an assessment. However, there is limited evidence related to how the elderly comply with EMA programmes or the factors that are associated with compliance. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Embase, the Cochrane Library and Web of Science were searched up to 17 July 2022. ELIGIBILITY CRITERIA We included observational studies on EMA in the elderly reported in English. DATA EXTRACTION AND SYNTHESIS Two investigators independently performed screening and data extraction. Discrepancies were resolved by discussion or a third investigator. A systematic review was carried out to characterise the basic characteristics of the participants and EMA programmes. Random-effects meta-analysis was conducted to assess overall compliance and to explore factors associated with differences in compliance among the elderly. RESULTS A total of 20 studies with 2047 participants were included in the systematic review and meta-analysis. Meta-analysis showed that the combined compliance rate was 86.41% (95% CI: 77.38% to 92.20%; I2=96.4%; p<0.001). Subgroup analysis revealed high levels of heterogeneity in terms of the methods used to assess population classification, assessment method and assessment frequency, although these may not be the sources of heterogeneity. Meta-regression analysis showed that population classification and assessment period might have a significant impact on heterogeneity (p<0.05). Egger's test indicated significant publication bias (p<0.001). CONCLUSIONS Compliance with EMA programmes is high in the elderly. It is recommended that scholars design reasonable EMA programmes according to the health status of the elderly in the future.
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Affiliation(s)
- Lin Yao
- Department of Nursing, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yiqun Yang
- Department of Nursing, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Zhi Wang
- Departments of Neurology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xi Pan
- Departments of Neurology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lan Xu
- Department of Nursing, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Peschel SKV, Fürtjes S, Voss C, Sigrist C, Berwanger J, Ollmann TM, Kische H, Rückert F, Koenig J, Beesdo-Baum K. Temporal associations between experiential avoidance and disordered eating behaviors in adolescents and young adults: findings from an epidemiological cohort study with ecological momentary assessment. Eat Weight Disord 2023; 28:58. [PMID: 37405497 DOI: 10.1007/s40519-023-01584-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023] Open
Abstract
PURPOSE Previous studies linking experiential avoidance (EA) and eating pathology have largely relied on single measurements based on traditional retrospective questionnaires. Taking advantage of available repeated assessments of EA and disordered eating behaviors (DEBs) in the everyday lives of young people from an epidemiological cohort, we aimed to investigate ecologically valid temporal associations between these constructs. METHODS A random population sample of N = 1180 14-21-year-olds from Dresden, Germany, participated at baseline (2015/2016). As part of smartphone-based ecological momentary assessment (EMA), participants reported on engagement in EA and four DEBs (skipping eating, eating large amounts of food, loss-of-control eating, and restrained eating) up to eight times per day for four days. Multilevel modeling of concurrent and time-lagged associations between EA and DEBs, was conducted among those with at least 50% EMA-compliance (n = 1069). RESULTS EA was associated with higher concurrent levels of all four types of concurrent DEBs. In addition, EA significantly predicted subsequent levels of restrained eating. Only loss-of-control eating significantly predicted subsequent EA, and this effect depended on the timespan between consecutive assessments. When this timespan was short, higher Loss-of-control eating predicted lower subsequent EA, while it predicted higher subsequent EA when the timespan was longer. CONCLUSION The present findings suggest that EA is temporally closely linked to greater engagement in DEBs, supporting theoretical assumptions that DEBs may serve an attempted avoidance function in the context of unpleasant inner experiences. Future studies may benefit from examining samples with more pronounced eating pathology. LEVEL OF EVIDENCE Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies.
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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
| | - Catharina Voss
- 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
| | - 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
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Smith KE, Wang WL, Mason TB. Facets of impulsivity and reward in relation to binge-eating disorder course of illness among children: findings from the Adolescent Brain Cognitive Development study. J Child Psychol Psychiatry 2023; 64:1056-1066. [PMID: 36951577 PMCID: PMC10860341 DOI: 10.1111/jcpp.13789] [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] [Accepted: 01/31/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND The present study examined facets of impulsivity and reward sensitivity [as measured by the UPPS-P Impulsive Behavior Scale and Behavioral Activation and Behavioral Inhibition Scales (BIS/BAS)] as multivariable predictors of subsequent binge-eating disorder (BED) course of illness in middle childhood. METHODS The current sample included children aged 9-10 years (N = 9,438) who took part in the baseline and 1-year follow-up assessments of the Adolescent Brain Cognitive Development (ABCD) study. BED course was operationalized as those who never developed BED or subthreshold BED (SBED) ('control'), were diagnosed with BED/SBED at year 1 but not baseline ('developers'), were diagnosed with BED/SBED at baseline but not year 1 ('remitters'), or were diagnosed with BED/SBED at both times ('maintainers'). RESULTS Higher baseline BIS/BAS reward responsivity scores were related to the greater likelihood of belonging to the maintainer group relative to the control and remitter groups (ORs1.12-1.19). Regarding covariates, higher baseline body mass index percentile and internalizing symptoms were related to the greater likelihood of BED development, remittance, and maintenance compared to the control group (ORs = 1.04-1.14); no variables were uniquely related to BED development. Exploratory analyses showed that the likelihood of belonging to the maintainer group compared to the control group was greatest at higher levels of negative urgency in combination with high reward responsivity. CONCLUSIONS Heightened reward responsivity may convey risk for poorer BED course in children, while emotional disorder symptomatology may act as a more general risk and maintenance factor for BED.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Wei-Lin Wang
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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Ranzenhofer LM, Solhjoo S, Crosby RD, Kim BH, Korn R, Koorathota S, Lloyd EC, Walsh BT, Haigney MC. Autonomic indices and loss-of-control eating in adolescents: an ecological momentary assessment study. Psychol Med 2023; 53:4742-4750. [PMID: 35920245 PMCID: PMC10336770 DOI: 10.1017/s0033291722001684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Loss-of-control (LOC) eating commonly develops during adolescence, and it predicts full-syndrome eating disorders and excess weight gain. Although negative emotions and emotion dysregulation are hypothesized to precede and predict LOC eating, they are rarely examined outside the self-report domain. Autonomic indices, including heart rate (HR) and heart rate variability (HRV), may provide information about stress and capacity for emotion regulation in response to stress. METHODS We studied whether autonomic indices predict LOC eating in real-time in adolescents with LOC eating and body mass index (BMI) ⩾70th percentile. Twenty-four adolescents aged 12-18 (67% female; BMI percentile mean ± standard deviation = 92.6 ± 9.4) who reported at least twice-monthly LOC episodes wore biosensors to monitor HR, HRV, and physical activity for 1 week. They reported their degree of LOC after all eating episodes on a visual analog scale (0-100) using a smartphone. RESULTS Adjusting for physical activity and time of day, higher HR and lower HRV predicted higher self-reported LOC after eating. Parsing between- and within-subjects effects, there was a significant, positive, within-subjects association between pre-meal HR and post-meal LOC rating. However, there was no significant within-subjects effect for HRV, nor were there between-subjects effects for either electrophysiologic variable. CONCLUSIONS Findings suggest that autonomic indices may either be a marker of risk for subsequent LOC eating or contribute to LOC eating. Linking physiological markers with behavior in the natural environment can improve knowledge of illness mechanisms and provide new avenues for intervention.
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Affiliation(s)
- Lisa M Ranzenhofer
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Soroosh Solhjoo
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, ND, USA
| | - Brittany H Kim
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Rachel Korn
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | | | - E Caitlin Lloyd
- Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - B Timothy Walsh
- Columbia University Irving Medical Center, New York, NY, USA
| | - Mark C Haigney
- F. Edward Hébert School of Medicine, Bethesda, MD, USA
- Military Cardiovascular Outcomes Research (MiCOR), Bethesda, MD, USA
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Abene JA, Tong J, Minuk J, Lindenfeldar G, Chen Y, Chao AM. Food insecurity and binge eating: A systematic review and meta-analysis. Int J Eat Disord 2023; 56:1301-1322. [PMID: 37040535 PMCID: PMC10524553 DOI: 10.1002/eat.23956] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 04/13/2023]
Abstract
OBJECTIVE This review synthesized literature on the relationship between food insecurity and binge eating. METHODS Relevant studies were identified by searching PubMed, CINAHL, PsycINFO, and gray literature from inception to October 2022. Eligible studies included primary research that assessed the relationship between food insecurity and binge eating. Data extraction was performed independently by two reviewers. Pooled odds ratios and 95% confidence intervals (CI) were obtained from random effect models with the R package meta. Analyses were stratified by binge eating versus binge-eating disorder (BED), study type (cross-sectional vs. longitudinal), and age (adults vs. adolescents). RESULTS We included 24 articles that reported on 20 studies, and 13 articles were included in the meta-analysis. Based on the random effects meta-analysis, the odds of adults in the food insecure group having binge eating were 1.66 (95% CI = 1.42, 1.93) times the odds of adults in the food secure group having binge eating. The odds of adults in the food insecure group having BED were 2.70 (95% CI = 1.47, 4.96) times the odds of adults in the food secure group having BED. Insufficient data were available for a meta-analysis on adolescents or longitudinal relationships. CONCLUSIONS These findings support that food insecurity is associated with binge eating in adults. There is a need for research to investigate the mechanisms underlying this relationship. Results highlight the importance of screening participants with food insecurity for disordered eating behaviors and vice versa. Future research is needed to examine whether interventions targeting food insecurity may help to mitigate disordered eating behaviors. PUBLIC SIGNIFICANCE Food insecurity is a common but under-recognized contributor to binge eating. In this article, we systematically reviewed research that has been published on the relationship between food insecurity and binge eating. We found support that food insecurity should be considered in the prevention and treatment of binge eating.
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Affiliation(s)
- Jessica A. Abene
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
| | - Jiayi Tong
- University of Pennsylvania, Department of Biostatistics, Epidemiology, and Informatics, Philadelphia, PA, USA
| | - Jeffrey Minuk
- Temple University Hospital, Department of Internal Medicine, Philadelphia, PA, USA
| | | | - Yong Chen
- University of Pennsylvania, Department of Biostatistics, Epidemiology, and Informatics, Philadelphia, PA, USA
| | - Ariana M. Chao
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
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Klatzkin RR, Nadel T, Wilkinson LL, Gaffney K, Files H, Gray ZJ, Slavich GM. Lifetime stressor exposure, eating expectancy, and acute social stress-related eating behavior: A pre-registered study of the emotional eating cycle. Appetite 2023; 185:106494. [PMID: 36805424 PMCID: PMC11216972 DOI: 10.1016/j.appet.2023.106494] [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: 09/09/2022] [Revised: 01/30/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023]
Abstract
Eating behaviors in response to acute stressors are highly variable: whereas many individuals eat more following stressors, others eat less or show no change in food consumption. Understanding factors that predict individual differences in eating behaviors may help elucidate the psychosocial mechanisms underlying obesity, yet few experimental studies on this topic have been conducted to date. To address this issue, we conducted the present pre-registered study, where we investigated how lifetime stressor exposure moderates the extent to which eating expectancies enhance the learned association between stress-induced negative affect and snack intake. Participants were 44 women (30% non-White) between 18 and 50 years old (M = 27.9), with a mean body mass index of 25.6, who completed assessments of lifetime stressor exposure, eating behaviors, and eating expectancies (eating helps manage negative affect); in a subsequent visit, they were given snacks after an acute social stress task (TSST). The moderated moderation model (PROCESS model 3) yielded a significant three-way interaction. When eating expectancies were high, acute social stress-induced negative affect predicted greater M&M intake for women with very high total lifetime stressor exposure but less M&M intake for women with fewer lifetime stressors. These data thus highlight how lifetime stressor exposure interacts with eating expectancies and acute stress-induced negative affect to predict eating behavior. Replications in larger samples may help explain variability in stress-eating as well as how lifetime stressors contribute to obesity.
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Affiliation(s)
| | - Tzvi Nadel
- Department of Psychology, Rhodes College, Memphis, TN, USA
| | | | - Katie Gaffney
- Department of Psychology, Rhodes College, Memphis, TN, USA
| | - Helen Files
- Department of Psychology, Rhodes College, Memphis, TN, USA
| | - Zach J Gray
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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Legg NK, Robillard CL, Turner BJ. Examining the components and stability of negative affect in disordered eating frequency. EUROPEAN EATING DISORDERS REVIEW 2023. [PMID: 37243507 DOI: 10.1002/erv.2990] [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: 09/13/2022] [Revised: 04/03/2023] [Accepted: 05/11/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE There is a limited understanding of the unique components of negative affect that are most important to disordered eating. Our study tested the contributions and stabilities of unique components of negative affect in the frequency of both binge eating and restricted eating. We examined if: (1) symptoms of depression, anxiety and stress share unique, concurrent associations with binge eating and restricted eating, respectively, and if (2) instability of depression, anxiety, and stress predict binge eating and restricted eating, respectively. METHOD 627 first year undergraduate students completed 7 assessments of these constructs across their first academic year. Generalised multilevel modelling was employed. RESULTS Higher than average anxiety, but not depression or stress, was concurrently associated with restricted eating. No concurrent associations between negative affect and binge eating were found. Instability of depression, but not anxiety or stress, predicted both binge and restricted eating. CONCLUSION Anxiety may be a more salient predictor of restricted eating than depression or stress. However, larger monthly changes in depression may confer risk for more frequent binge eating and restricted eating.
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Affiliation(s)
- Nicole K Legg
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Christina L Robillard
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
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Azzi R, Samaha S, Malaeb D, Akel M, Azzi V, Hallit S, Obeid S. The association between mental health and Bulimia Nervosa among a sample of Lebanese young adults: the indirect effect of difficulties in emotion regulation. BMC Psychiatry 2023; 23:335. [PMID: 37173734 PMCID: PMC10175933 DOI: 10.1186/s12888-023-04847-0] [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: 11/16/2022] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Bulimia nervosa (BN) is defined as repeated episodes of binge eating, followed by compensatory behaviors such as self-induced vomiting. BN has been shown to be associated with many co-morbidities including depression and anxiety. BN has also been associated with stress, which was shown to trigger binge eating episodes in BN. Furthermore, difficulties in emotion regulation have been seen to play an important role in the psychopathology of eating disorders, including BN. Seeing that BN is the most prevalent eating disorder in Lebanon, which is linked to the stressful events the country has been through, the study aims to examine the indirect effect of emotional dysregulation on this relationship between mental health issues (stress, anxiety and depression) and bulimia nervosa among young adults. We hypothesize that difficulties in emotion regulation would have an indirect effect in the relationship between mental health and BN. METHODS This was a cross-sectional observational study, based on an online anonymous survey, which was carried out between September and December of 2020. Participants were all 18 years and above, recruited from all Lebanese governorates (n = 1175). RESULTS Difficulties in emotion regulation mediated the association between anxiety/stress/depression and bulimia. Higher mental health issues were significantly associated with more difficulties in emotion regulation; higher difficulties in emotion regulation were significantly associated with more bulimia. Finally, higher anxiety and higher stress, but not depression, were significantly and directly associated with higher bulimia. CONCLUSION Results of this study could be used by mental health professional to shed light on the difficulties in emotion regulation in patients with BN and try to use therapeutic strategies to help them better regulate their emotions.
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Affiliation(s)
- Reine Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Serena Samaha
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
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48
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Bottera AR, De Young KP. Characterizing naturalistic meal timing, energy intake, and macronutrient intake among individuals with loss of control eating. Appetite 2023; 184:106524. [PMID: 36871601 PMCID: PMC10033373 DOI: 10.1016/j.appet.2023.106524] [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: 01/13/2023] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/06/2023]
Abstract
Binge eating demonstrates an evening diurnal shift among individuals with eating disorders. Disruptions to diurnal appetitive rhythms may be somewhat chronic and set the stage for additional disruptions to prompt binge eating. Despite known diurnal shifts in binge eating and related constructs (e.g., mood) and detailed characterizations of binge-eating episodes, no findings to date describe the naturalistic diurnal timing and composition of energy and nutrient intake on days with and without loss of control eating. We aimed to characterize eating behaviors (i.e., meal timing, energy intake, and macronutrient composition) across seven days in individuals with binge-spectrum eating disorders, assessing differences between eating episodes and days with and without loss of control eating. Undergraduate students (N = 51; 76.5% female) who endorsed past 28-day loss of control eating completed a 7-day naturalistic ecological momentary assessment protocol. Participants completed daily food diaries and reported instances of loss of control eating across the 7-day period. Results indicated that episodes of loss of control were more likely to occur later in the day, but overall meal timing did not differ across days with and without loss of control. Similarly, greater caloric consumption was more likely for episodes with loss of control, but overall caloric consumption did not differ between days with and without loss of control. Analysis of nutritional content demonstrated differences between both episodes and days with and without loss of control for carbohydrates and total fats, but not for protein. Findings provide support for the hypothesized role disruptions in diurnal appetitive rhythms play in maintaining binge eating via consistent irregularities, underscoring the importance of examining treatment adjuncts that intervene on the regulation of meal timing to enhance eating disorder treatment outcomes.
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Affiliation(s)
- Angeline R Bottera
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, USA.
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Mediation of self-concept clarity and self-control between negative emotional states and emotional eating in Chinese adolescents. Appetite 2023; 183:106457. [PMID: 36638962 DOI: 10.1016/j.appet.2023.106457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 01/11/2023]
Abstract
Recent studies have consistently lent support for the significant relationship between negative emotional states (e.g., anxiety, stress, and depression) and emotional eating; however, only a handful of studies focused on examining the potential mediator in this association. The present study aimed to contribute to the literature surrounding the link between negative emotional states and emotional eating and to examine the mediating role of self-concept clarity and self-control in this association among a sample of Chinese adolescents (N = 1347, 62.44% girls). Results indicated that adolescents perceived higher levels of negative emotional states were linked to higher emotional eating. Additionally, the structural equation model suggested that symptoms of stress and depression could be associated with emotional eating through self-control. Moreover, the serial mediation effect of self-concept clarity and self-control could account for the association of negative emotional states (e.g., symptoms of anxiety, stress, and depression) and emotional eating. Overall, this study advances our understanding of the underlying mechanisms through which negative emotional states predict emotional eating in adolescence. If future studies reveal converging findings, this knowledge points to the need for programs preventing the development of emotional eating in adolescence through increasing the level of self-control and self-concept clarity.
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50
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Smith KE, Varnado A, Thomas JG, Vithiananthan S, Jones DB, Papasavas P, Bond DS. Characterizing the Course of Loss of Control Eating and Prognostic Factors Following Bariatric Surgery: an Exploratory Analysis. Obes Surg 2023; 33:1170-1177. [PMID: 36808385 PMCID: PMC10079698 DOI: 10.1007/s11695-023-06497-3] [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: 12/12/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/21/2023]
Abstract
PURPOSE Postoperative loss of control eating (LOCE) has detrimental associations with weight outcomes and mental health following bariatric surgery. However, little is known regarding LOCE course following surgery and preoperative factors that predict remittance, continuance, or development of LOCE. The present study aimed to characterize LOCE course in the year following surgery by identifying four groups: individuals with (1) postoperative de novo LOCE, (2) maintained LOCE (endorsed at pre- and post-surgery), (3) remitted LOCE (endorsed only at pre-surgery), and (4) those who never endorsed LOCE. Exploratory analyses examined group differences in baseline demographic and psychosocial factors. MATERIALS AND METHODS A total of 61 adult bariatric surgery patients completed questionnaires and ecological momentary assessment at pre-surgery and 3-, 6-, and 12-month postoperative follow-ups. RESULTS Results showed that 13 (21.3%) never endorsed LOCE prior to or after surgery, 12 (19.7%) developed LOCE after surgery, 7 (11.5%) evidenced remittance from LOCE after surgery, and 29 (47.5%) maintained LOCE prior to and after surgery. Relative to those who never endorsed LOCE, all groups who evidenced LOCE before and/or after surgery reported greater disinhibition; those who developed LOCE reported less planned eating; and those with maintained LOCE reported less satiety sensitivity and greater hedonic hunger. CONCLUSION These findings highlight the importance of postoperative LOCE and need for longer-term follow-up studies. Results also suggest a need to examine the longer-term impact of satiety sensitivity and hedonic eating on LOCE maintenance, and the extent to which meal planning may buffer risk for de novo LOCE following surgery.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, 90033, USA.
| | - Aimee Varnado
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, 90033, USA
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, RI, 02903, USA
| | | | - Daniel B Jones
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Pavlos Papasavas
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, 06106, USA
| | - Dale S Bond
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, 06106, USA
- Department of Research, Hartford Hospital/HealthCare, Hartford, CT, 06106, USA
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