Examining associations among sensitivity to punishment and reward, shame, and eating pathology through tests of mediation

Sensitivity to punishment and emotional eating: The mediating role of shame and rumination

OBJECTIVES

The relationship between sensitivity to punishment (SP) and emotional eating has been previously examined. However, effective variables in this relationship have yet to be recognized. This study aimed to investigate the relationship between SP and emotional eating via facets of shame and rumination.

DESIGN

Serial Mediation model was proposed.

METHOD

Female university students in Iran (n = 174) completed Sensitivity to Punishment and Sensitivity to Reward Questionnaire-Revised and Clarified (SPSRQ-RC), Dutch Eating Behaviour Questionnaire (DEBQ), Experience of Shame Scale (ESS) and Ruminative Responses Scale (RRS).

RESULTS

SP showed a significant effect on emotional eating. Moreover, we observed that the relationship between SP and emotional eating was separately mediated by shame (general, characterological and bodily shame) and rumination. We further noticed the sequentially mediating role of shame (general, characterological and behavioural shame) and rumination in the relationship between SP and emotional eating.

CONCLUSION

Findings suggest that high SP can increase the risk of emotional eating through negative emotions (e.g. shame) and disturbed cognitions (e.g. rumination). Therefore, for a better understanding, it seems necessary to consider emotional eating a maladaptive behaviour adopted as a possible result of the impairment of temperamental, emotional and cognitive systems.

Evaluating the role of negative affect and negative interpretation biases in emotional eating behavior

OBJECTIVE

The study of emotional eating, or (over)eating in response to emotions, may inform transdiagnostic interventions for eating pathology. Prior work has focused on the role of negative affect in promoting emotional eating. The present study sought to extend this work through examining the role of cognitive biases.

METHOD

Women who self-reported (n = 50) and did not self-report (n = 40) emotional eating completed self-report questionnaires of negative affect and negative interpretation biases, an implicit measure of cognitive bias, and a behavioral assay of emotional eating involving an ad lib test meal following a stress induction task.

RESULTS

The emotional eating group endorsed elevated trait negative affect, explicit shame biases, and implicit negative biases compared to controls. In addition, state negative affect increased after the stress induction task, and the emotional eating group endorsed greater state negative affect before and after the task and consumed more food following the stress induction. Only explicit cognitive shame biases demonstrated significant indirect effects in the association between group and food consumption. Specifically, elevated explicit shame biases were positively associated with amount of food consumed for the emotional eating group.

DISCUSSION

Future research should examine whether interventions that target cognitive biases related to shame reduce emotional eating.

PUBLIC SIGNIFICANCE

Individuals with emotional eating consumed more food than controls following a stress induction. Explicit shame cognitive biases were positively associated with amount of food consumed for the emotional eating group. Shame cogntiive biases may be fruitful targets for reducing emotional eating.

Parsing the link between reinforcement sensitivity theory and eating behavior: A systematic review

The Reinforcement Sensitivity Theory (RST) is a widely studied psychobiological model of personality. RST factors seem to influence eating behavior, but how these personality traits are associated with distinct features of eating behavior is still unclear. In the present systematic review, we analyzed the relationship between RST personality factors and eating behavior using a parsing approach in which BMI-related results, self-reported results, and behavioral results were distinguished. Our analysis revealed that reward and punishment sensitivity seem to correlate and influence distinct features of eating behavior. The association between BMI and RST factors was uncertain, but nonlinear associations between reward sensitivity and weight need further testing. Reward sensitivity was linked to most eating behavior phenotypes (e.g., emotional eating and restrained eating), but only punishment sensitivity was primarily correlated with eating pathology. Reward sensitivity was the main factor linked with reactivity to food stimuli on many behavioral measures. The neurobiological personality factors of RST offer parsimonious concepts to understand eating behavior outcomes and the differential relationships observed are useful to translational research.

Shame and eating disorders symptoms: A meta-analysis

OBJECTIVE

Numerous empirical studies and theoretical models posit that shame is a common experience among individuals across the eating disorder spectrum. In this study we aim to investigate the association between shame and eating disorders symptoms using a meta-analytical approach.

METHOD

In this meta-analysis, we synthesized findings from 195 studies to examine the proposed association between shame and eating disorders symptoms. We looked at the associations with both general eating disorders symptoms and with specific eating disorders symptoms (i.e., anorexic, bulimic, and binge-eating symptoms). Moderation analyses testing for the effect of type of shame, type of eating symptoms, clinical status, quality of the study, age, and gender were conducted.

RESULTS

Shame was significantly associated with a medium to large effect size with all types of eating disorders symptoms (rs between .40 and .52). Body shame (r = .55) and shame around eating (r = .59) were more strongly related with eating disorders pathology. Type of eating disorders symptoms did not moderate the relationship between shame and disturbed eating.

DISCUSSION

Overall, the magnitude of the effect size of the association between shame and eating disorders symptoms is a medium to large one. Body shame and shame around eating seem to be the types of shame most closely tied with eating disorders symptoms, suggesting that directly targeting them in interventions might be highly beneficial. Findings highlight current gaps in the literature (e.g., mostly correlational studies, low quality studies) with implications for future research.

Bulimic symptoms in a sample of college women: disentangling the roles of body size, body shame and negative urgency

Purpose This study set out to disentangle the roles of body size, body shame and negative urgency on bulimic symptomatology in a sample of college women. We predicted that body shame would mediate the relationship between body size and bulimic symptomatology: with increasing body size, the greater would be the experience of body shame and, in turn, the greater the bulimic symptomatology. We also predicted that negative urgency would exacerbate this mediation pathway, and that the moderated mediation model would occur over and above current levels of depression.

METHOD

A convenience sample of 237 college women indicated their age, height and weight and then completed measures of body shame, negative urgency, depression and bulimic symptomatology. Bootstrap analysis was used to test the predicted moderation mediation model.

RESULTS

The bootstrap analysis supported all predictions. Thus, with greater the increase in body size, the greater was the body shame and the more frequent bulimic symptomatology. Furthermore, negative urgency moderated the relationship between body shame and bulimic symptomatology, such that those with both higher negative urgency and body shame had more frequent bulimic symptomatology.

CONCLUSIONS

Results suggest that those college women higher in both BMI and negative urgency are likely to experience higher levels of bulimic symptoms. These women may benefit from emotion regulation interventions targeted at preventing, as well as coping effectively with, the experience of body shame.

LEVEL OF EVIDENCE

V: cross-sectional descriptive study.

Sensitivity to punishment and eating pathology among undergraduate women: The mediating role of shame

Punishment sensitivity can contribute to eating pathology, but the mechanisms of this relationship are understudied. In a longitudinal study of undergraduate females (N = 95), results supported an indirect association between sensitivity to punishment and eating pathology via shame. Findings suggest that sensitivity to punishment was associated with greater shame, which in turn predicted greater eating pathology over time. Further, there was an indirect effect of sensitivity to punishment on eating pathology via greater levels of behavioral shame. Future studies may wish to examine the potential role of behavioral shame in the development and exacerbation of eating problems, especially in the context of temperamental traits such as punishment sensitivity.