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Yang X, Casement M, Yokum S, Stice E. Negative affect amplifies the relation between appetitive-food-related neural responses and weight gain over three-year follow-up among adolescents. Neuroimage Clin 2019; 24:102067. [PMID: 31795036 PMCID: PMC6861567 DOI: 10.1016/j.nicl.2019.102067] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/24/2019] [Accepted: 11/03/2019] [Indexed: 11/26/2022]
Abstract
Interaction of negative affect and hippocampal food-image response predicts BMI gain. Interaction of negative affect, vermis and precuneus food response predicts BMI gain. Interaction of stress and middle occipital gyrus milkshake response predicts BMI gain. Weight gain associated with restrained eating and eating-disorder related behavior.
Obesity is a major public health concern that is associated with disruption in food reward-related brain function. This study examined if negative affect and stressful events enhance the relation between the food reward-related neural response and future weight gain. Initially healthy weight adolescents (N = 135) completed fMRI paradigms in which they tasted milkshakes and viewed palatable food images, and reported on negative affect and stressful events at baseline; BMI was measured annually over 3-year follow-up. Whole-brain analyses revealed that among participants with higher negative affect, weight gain over 3-year follow-up was predicted by elevated response to appetitive versus unappetitive food images in the left hippocampus, and elevated response in the vermis and the bilateral precuneus to tastes of milkshake versus tasteless solution. Among participants who experienced more stressful events, elevated right middle occipital gyrus response to milkshakes predicted future weight gain. Profiling analyses suggested that participants with higher negative affect or more stressful events who later gained weight reported engaging in more restrained eating and eating disorder-related behaviors. Results suggest that negative affect or stressful events may amplify the relation of neural response to food and the risk for future weight gain.
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Affiliation(s)
- X Yang
- University of Oregon, 1451 Onyx St, Eugene, OR 97403, United States.
| | - M Casement
- University of Oregon, 1451 Onyx St, Eugene, OR 97403, United States
| | - S Yokum
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, United States
| | - E Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA 94305, United States.
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Stice E, Yokum S. Relation of neural response to palatable food tastes and images to future weight gain: Using bootstrap sampling to examine replicability of neuroimaging findings. Neuroimage 2018; 183:522-531. [PMID: 30144570 PMCID: PMC6197913 DOI: 10.1016/j.neuroimage.2018.08.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/02/2018] [Accepted: 08/16/2018] [Indexed: 11/30/2022] Open
Abstract
Because understanding neural vulnerability factors that predict future weight gain may guide the design of more effective obesity prevention programs and treatments, we tested whether neural response to palatable food tastes and images predicted future weight gain. We recruited 135 initially healthy weight adolescents, to reduce the possibility that a history of overeating affected neural responsivity, had them complete fMRI paradigms examining neural response to tastes of milkshakes that varied in fat and sugar content and images of palatable foods, and assessed BMI annually over a 3-year follow-up. We used a novel bootstrapping analytic approach to investigate the replicability of the fMRI findings. Whole-brain analyses indicated that lower response in the pre-supplemental motor area to high-fat/low-sugar milkshake taste predicted future BMI gain in the full sample and in 5 out of the 10 bootstrap samples. Elevated response in the precentral gyrus/Rolandic operculum to images of appetizing foods predicted future BMI gain in the full sample and in 4 out of the 10 bootstrap samples. Other peaks that emerged in the full sample did not replicate in most of the bootstrap samples, suggesting they were not reliable. Region of interest analyses did not replicate the predictive effects of peaks reported in past papers that used similar paradigms, including the evidence that TaqIA polymorphism moderated the relation of striatal response to palatable food tastes to future weight gain. Results suggest that lower responsivity of a region implicated in motor processing in response to palatable taste was associated with greater BMI gain over time, and further that bootstrap sampling may be useful for estimating the replicability of findings that emerge from whole brain analyses or regions of interest analyses with the full sample.
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Affiliation(s)
- E Stice
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA.
| | - S Yokum
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR, 97403, USA
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Stanhope KL, Goran MI, Bosy-Westphal A, King JC, Schmidt LA, Schwarz JM, Stice E, Sylvetsky AC, Turnbaugh PJ, Bray GA, Gardner CD, Havel PJ, Malik V, Mason AE, Ravussin E, Rosenbaum M, Welsh JA, Allister-Price C, Sigala DM, Greenwood MRC, Astrup A, Krauss RM. Pathways and mechanisms linking dietary components to cardiometabolic disease: thinking beyond calories. Obes Rev 2018; 19:1205-1235. [PMID: 29761610 PMCID: PMC6530989 DOI: 10.1111/obr.12699] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 03/09/2018] [Accepted: 03/31/2018] [Indexed: 12/11/2022]
Abstract
Calories from any food have the potential to increase risk for obesity and cardiometabolic disease because all calories can directly contribute to positive energy balance and fat gain. However, various dietary components or patterns may promote obesity and cardiometabolic disease by additional mechanisms that are not mediated solely by caloric content. Researchers explored this topic at the 2017 CrossFit Foundation Academic Conference 'Diet and Cardiometabolic Health - Beyond Calories', and this paper summarizes the presentations and follow-up discussions. Regarding the health effects of dietary fat, sugar and non-nutritive sweeteners, it is concluded that food-specific saturated fatty acids and sugar-sweetened beverages promote cardiometabolic diseases by mechanisms that are additional to their contribution of calories to positive energy balance and that aspartame does not promote weight gain. The challenges involved in conducting and interpreting clinical nutritional research, which preclude more extensive conclusions, are detailed. Emerging research is presented exploring the possibility that responses to certain dietary components/patterns are influenced by the metabolic status, developmental period or genotype of the individual; by the responsiveness of brain regions associated with reward to food cues; or by the microbiome. More research regarding these potential 'beyond calories' mechanisms may lead to new strategies for attenuating the obesity crisis.
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Affiliation(s)
- K L Stanhope
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - M I Goran
- Department of Preventive Medicine, Diabetes and Obesity Research Institute, University of Southern California, Los Angeles, CA, USA
| | - A Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - J C King
- Children's Hospital Oakland Research Institute, Oakland, CA, USA
| | - L A Schmidt
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA.,California Clinical and Translational Science Institute, University of California, San Francisco, San Francisco, CA, USA.,Department of Anthropology, History, and Social Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - J-M Schwarz
- Touro University, Vallejo, CA, USA.,Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - E Stice
- Oregon Research Institute, Eugene, OR, USA
| | - A C Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - P J Turnbaugh
- Department of Microbiology and Immunology, G.W. Hooper Research Foundation, University of California, San Francisco, San Francisco, CA, USA
| | - G A Bray
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - C D Gardner
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - P J Havel
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA.,Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - V Malik
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - A E Mason
- Department of Psychiatry, Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - E Ravussin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - M Rosenbaum
- Division of Molecular Genetics, Department of Pediatrics, Columbia University, New York, NY, USA
| | - J A Welsh
- Department of Pediatrics, Emory University School of Medicine, Wellness Department, Children's Healthcare of Atlanta, Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - C Allister-Price
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - D M Sigala
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - M R C Greenwood
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - A Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark
| | - R M Krauss
- Children's Hospital Oakland Research Institute, Oakland, CA, USA
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Stice E, Rohde P, Shaw H, Gau JM. An experimental therapeutics test of whether adding dissonance-induction activities improves the effectiveness of a selective obesity and eating disorder prevention program. Int J Obes (Lond) 2017; 42:462-468. [PMID: 28990590 DOI: 10.1038/ijo.2017.251] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/05/2017] [Accepted: 09/17/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Compare the Healthy Weight obesity and eating disorder prevention program, which promotes participant-driven gradual lifestyle changes to bring energy intake and expenditure into balance, to a new intervention, Project Health, which adds activities to create cognitive dissonance about unhealthy eating, a sedentary lifestyle, and excess body fat, and an obesity education video-control condition. METHOD College students at risk for both outcomes because of weight concerns (N=364, 72% female) were randomized to condition, completing pretest, posttest, and 6, 12 and 24-month follow-up assessments. RESULTS Project Health participants showed significantly smaller increases in measured body mass index (BMI) through 2-year follow-up than both Healthy Weight participants and controls (both d=-0.18), and significantly lower onset of overweight/obesity over 2-year follow-up than Healthy Weight participants and controls (13 vs 21% and 22%). Healthy Weight and Project Health participants showed significantly greater eating disorder symptom reductions than controls through 2-year follow-up. Healthy Weight and Project Health participants showed marginally lower eating disorder onset over follow-up than controls (3 and 3% vs 8% respectively). CONCLUSIONS The reduced increases in BMI and future overweight/obesity onset for Project Health relative to both an active matched intervention and a minimal intervention control condition are noteworthy, especially given the short 6-h intervention duration. The reduction in eating disorder symptoms for Healthy Weight and Project Health relative to controls was also encouraging. Results suggest that adding dissonance-induction activities increased weight loss effects. Yet, effects for both were generally small and the eating disorder onset prevention effects were only marginal, potentially because intervention groups included both sexes, which reduced eating disorder incidence and sensitivity.
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Affiliation(s)
- E Stice
- Oregon Research Institute, Eugene, OR, USA
| | - P Rohde
- Oregon Research Institute, Eugene, OR, USA
| | - H Shaw
- Oregon Research Institute, Eugene, OR, USA
| | - J M Gau
- Oregon Research Institute, Eugene, OR, USA
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Ivezaj V, Stoeckel LE, Avena NM, Benoit SC, Conason A, Davis JF, Gearhardt AN, Goldman R, Mitchell JE, Ochner CN, Saules KK, Steffen KJ, Stice E, Sogg S. Obesity and addiction: can a complication of surgery help us understand the connection? Obes Rev 2017; 18:765-775. [PMID: 28429582 DOI: 10.1111/obr.12542] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 02/12/2017] [Accepted: 02/28/2017] [Indexed: 12/15/2022]
Abstract
Obesity is a multifactorial, chronic disease that has proven difficult to treat. An increased understanding of aetiological mechanisms is critical to the development of more effective obesity prevention and treatment strategies. A growing body of empirical evidence has demonstrated parallels between obesity, overeating and substance abuse, including shared behavioural, psychological and neurophysiological factors implicated in the excessive intake of both food and substances of abuse. Several different lines of research have recently emerged that hold the potential to shed light on the connection between obesity, food reward and addiction, with studies examining changes in alcohol use/misuse after weight loss surgery providing a particularly interesting perspective on these interrelationships. However, these lines of investigation have proceeded in relative isolation, and relevant research findings have yet to be integrated in a synthesized, comprehensive manner. To provide an opportunity to achieve such a synthesis, a scientific symposium was convened at the Radcliffe Institute in Cambridge, Massachusetts. Invited participants were researchers working in diverse domains related to the intersection between obesity and addiction. Extensive discussion was generated suggesting novel research directions. In this article, we summarize and synthesize the symposium participants' ongoing research in this area, incorporating additional relevant research holding potential clues regarding the connections between obesity, weight loss surgery and addiction.
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Affiliation(s)
- V Ivezaj
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - L E Stoeckel
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - N M Avena
- Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - S C Benoit
- Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - A Conason
- Division of Endocrinology, Diabetes, and Metabolism, Mt. Sinai West, New York, NY, USA
| | - J F Davis
- Department of Integrative Physiology & Neuroscience, Washington State University College of Veterinary Medicine, Pullman, WA, USA
| | - A N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - R Goldman
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - J E Mitchell
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA.,Neuropsychiatric Research Institute, Fargo, ND, USA
| | - C N Ochner
- Kendall Regional Medical Center, Hospital, Corporation of America - Physician Services Group, Miami, FL, USA
| | - K K Saules
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA
| | - K J Steffen
- Neuropsychiatric Research Institute, Fargo, ND, USA.,School of Pharmacy, North Dakota State University, Fargo, ND, USA
| | - E Stice
- Oregon Research Institute, Eugene, OR, USA
| | - S Sogg
- Harvard Medical School, Boston, MA, USA.,Massachusetts General Hospital Weight Center, Boston, MA, USA
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Yokum S, Stice E. Initial body fat gain is related to brain volume changes in adolescents: A repeated-measures voxel-based morphometry study. Obesity (Silver Spring) 2017; 25:401-407. [PMID: 28026902 PMCID: PMC5269445 DOI: 10.1002/oby.21728] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/04/2016] [Accepted: 10/26/2016] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Individuals with obesity versus those within a healthy weight range show brain volume differences, but it is unclear whether these differences reflect initial vulnerability factors or are secondary to weight gain. METHODS One hundred sixty-two adolescents (M age = 15.3 ± 1.1; 81 females) with healthy weight were scanned at baseline. Sixty subjects (M baseline age: 15.2 ± 1.1; M follow-up age: 17.7 ± 1.2; 34 females) completed a second scan at 2- or 3-year follow-up. Voxel-based morphometry assessed global and regional gray matter (GM) and white matter (WM) volumes. Body fat percentage was assessed yearly over follow-up. RESULTS Baseline global/regional GM/WM volume did not predict body fat gain over follow-up. Adolescents who gained body fat showed greater decreases in GM volume in the putamen compared with those who showed loss of body fat. Adolescents who gained body fat showed greater increases in WM volume in the anterior cingulate cortex compared with those who showed stability of or loss of body fat. CONCLUSIONS Body fat gain versus stability and loss produce GM and WM volume changes, rather than baseline volumetric differences predicting body fat gain.
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Affiliation(s)
- S. Yokum
- Oregon Research Institute, Eugene, Oregon
- Correspondence: Sonja Yokum, Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon 97403
| | - E. Stice
- Oregon Research Institute, Eugene, Oregon
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Lawrence N, Yokum S, Fuller-Marashi L, Veling H, Kemps E, Stice E. A novel multicomponent food response training intervention reduces body fat and neural and subjective food reward in obese participants. Appetite 2016. [DOI: 10.1016/j.appet.2016.08.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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8
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Val-Laillet D, Aarts E, Weber B, Ferrari M, Quaresima V, Stoeckel L, Alonso-Alonso M, Audette M, Malbert C, Stice E. Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity. Neuroimage Clin 2015; 8:1-31. [PMID: 26110109 PMCID: PMC4473270 DOI: 10.1016/j.nicl.2015.03.016] [Citation(s) in RCA: 275] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 12/11/2022]
Abstract
Functional, molecular and genetic neuroimaging has highlighted the existence of brain anomalies and neural vulnerability factors related to obesity and eating disorders such as binge eating or anorexia nervosa. In particular, decreased basal metabolism in the prefrontal cortex and striatum as well as dopaminergic alterations have been described in obese subjects, in parallel with increased activation of reward brain areas in response to palatable food cues. Elevated reward region responsivity may trigger food craving and predict future weight gain. This opens the way to prevention studies using functional and molecular neuroimaging to perform early diagnostics and to phenotype subjects at risk by exploring different neurobehavioral dimensions of the food choices and motivation processes. In the first part of this review, advantages and limitations of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), pharmacogenetic fMRI and functional near-infrared spectroscopy (fNIRS) will be discussed in the context of recent work dealing with eating behavior, with a particular focus on obesity. In the second part of the review, non-invasive strategies to modulate food-related brain processes and functions will be presented. At the leading edge of non-invasive brain-based technologies is real-time fMRI (rtfMRI) neurofeedback, which is a powerful tool to better understand the complexity of human brain-behavior relationships. rtfMRI, alone or when combined with other techniques and tools such as EEG and cognitive therapy, could be used to alter neural plasticity and learned behavior to optimize and/or restore healthy cognition and eating behavior. Other promising non-invasive neuromodulation approaches being explored are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS). Converging evidence points at the value of these non-invasive neuromodulation strategies to study basic mechanisms underlying eating behavior and to treat its disorders. Both of these approaches will be compared in light of recent work in this field, while addressing technical and practical questions. The third part of this review will be dedicated to invasive neuromodulation strategies, such as vagus nerve stimulation (VNS) and deep brain stimulation (DBS). In combination with neuroimaging approaches, these techniques are promising experimental tools to unravel the intricate relationships between homeostatic and hedonic brain circuits. Their potential as additional therapeutic tools to combat pharmacorefractory morbid obesity or acute eating disorders will be discussed, in terms of technical challenges, applicability and ethics. In a general discussion, we will put the brain at the core of fundamental research, prevention and therapy in the context of obesity and eating disorders. First, we will discuss the possibility to identify new biological markers of brain functions. Second, we will highlight the potential of neuroimaging and neuromodulation in individualized medicine. Third, we will introduce the ethical questions that are concomitant to the emergence of new neuromodulation therapies.
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Key Words
- 5-HT, serotonin
- ADHD, attention deficit hyperactivity disorder
- AN, anorexia nervosa
- ANT, anterior nucleus of the thalamus
- B N, bulimia nervosa
- BAT, brown adipose tissue
- BED, binge eating disorder
- BMI, body mass index
- BOLD, blood oxygenation level dependent
- BS, bariatric surgery
- Brain
- CBF, cerebral blood flow
- CCK, cholecystokinin
- Cg25, subgenual cingulate cortex
- DA, dopamine
- DAT, dopamine transporter
- DBS, deep brain stimulation
- DBT, deep brain therapy
- DTI, diffusion tensor imaging
- ED, eating disorders
- EEG, electroencephalography
- Eating disorders
- GP, globus pallidus
- HD-tDCS, high-definition transcranial direct current stimulation
- HFD, high-fat diet
- HHb, deoxygenated-hemoglobin
- Human
- LHA, lateral hypothalamus
- MER, microelectrode recording
- MRS, magnetic resonance spectroscopy
- Nac, nucleus accumbens
- Neuroimaging
- Neuromodulation
- O2Hb, oxygenated-hemoglobin
- OCD, obsessive–compulsive disorder
- OFC, orbitofrontal cortex
- Obesity
- PD, Parkinson's disease
- PET, positron emission tomography
- PFC, prefrontal cortex
- PYY, peptide tyrosine tyrosine
- SPECT, single photon emission computed tomography
- STN, subthalamic nucleus
- TMS, transcranial magnetic stimulation
- TRD, treatment-resistant depression
- VBM, voxel-based morphometry
- VN, vagus nerve
- VNS, vagus nerve stimulation
- VS, ventral striatum
- VTA, ventral tegmental area
- aCC, anterior cingulate cortex
- dTMS, deep transcranial magnetic stimulation
- daCC, dorsal anterior cingulate cortex
- dlPFC, dorsolateral prefrontal cortex
- fMRI, functional magnetic resonance imaging
- fNIRS, functional near-infrared spectroscopy
- lPFC, lateral prefrontal cortex
- pCC, posterior cingulate cortex
- rCBF, regional cerebral blood flow
- rTMS, repetitive transcranial magnetic stimulation
- rtfMRI, real-time functional magnetic resonance imaging
- tACS, transcranial alternate current stimulation
- tDCS, transcranial direct current stimulation
- tRNS, transcranial random noise stimulation
- vlPFC, ventrolateral prefrontal cortex
- vmH, ventromedial hypothalamus
- vmPFC, ventromedial prefrontal cortex
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Affiliation(s)
| | - E. Aarts
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - B. Weber
- Department of Epileptology, University Hospital Bonn, Germany
| | - M. Ferrari
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - V. Quaresima
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - L.E. Stoeckel
- Massachusetts General Hospital, Harvard Medical School, USA
| | - M. Alonso-Alonso
- Beth Israel Deaconess Medical Center, Harvard Medical School, USA
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Ochner CN, Stice E, Hutchins E, Afifi L, Geliebter A, Hirsch J, Teixeira J. Relation between changes in neural responsivity and reductions in desire to eat high-calorie foods following gastric bypass surgery. Neuroscience 2012; 209:128-35. [PMID: 22406414 DOI: 10.1016/j.neuroscience.2012.02.030] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 02/14/2012] [Accepted: 02/15/2012] [Indexed: 10/28/2022]
Abstract
Reductions in reward-related (e.g. striatal) neural activation have been noted following obesity surgery. It has been speculated that these postoperative neural changes may be related to documented postoperative changes in food preferences; however, this relation has not been previously established. In this study, functional magnetic resonance imaging and rating scales were used to assess neural responsivity, desire to eat (i.e. wanting), and liking for high- and low-calorie food cues in 14 females one month pre- and one month post-Roux-en-Y gastric bypass (RYGB) surgery. Pre- to post-RYGB changes in all variables were assessed, and postoperative changes in neural responsivity were regressed on postoperative changes in desire to eat and liking of foods. Results revealed significant postoperative reductions in mesolimbic (e.g. striatal) neural responsivity, desire to eat (wanting), and liking for high- relative to low-calorie food cues. Postoperative reductions in mesolimbic responsivity were associated with postoperative reductions in wanting, but not liking, for high- versus low-calorie foods. Interestingly, reductions in food wanting were also related to reductions in inhibitory (e.g. dorsolateral prefrontal cortex) activation following RYGB. Results are consistent with the hypothesized delineation between wanting and liking, supporting the notion that wanting, but not liking, is processed through the dopaminergic reward pathway. Concurrent reductions in both reward-related and inhibitory activation-predicted reductions in desire to eat might suggest that less dietary inhibition was elicited to resist potential overconsumption as the anticipated reward value of high-calorie foods decreased following RYGB.
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Affiliation(s)
- C N Ochner
- Department of Psychiatry, Columbia University, College of Physicians & Surgeons, New York, NY, USA.
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Berner L, Butryn M, Mayer L, Stice E, Lowe M. Body fat deposition. Biological predictor of eating disturbance? Appetite 2011. [DOI: 10.1016/j.appet.2011.05.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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11
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Ely A, Butryn M, Stice E, Lowe M. The Power of Food and Disinhibition Scales prospectively predict the emergence of loss of control over eating in young women prone to weight gain. Appetite 2010. [DOI: 10.1016/j.appet.2010.04.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Beevers CG, Clasen P, Stice E, Schnyer D. Depression symptoms and cognitive control of emotion cues: a functional magnetic resonance imaging study. Neuroscience 2010; 167:97-103. [PMID: 20116416 DOI: 10.1016/j.neuroscience.2010.01.047] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Revised: 01/20/2010] [Accepted: 01/22/2010] [Indexed: 01/19/2023]
Abstract
Few studies have examined associations between depressive symptoms and alterations in neural systems that subserve cognitive control. Cognitive control was assessed with an exogenous cueing task using happy, sad, and neutral facial expressions as cues among women with mild to moderate symptoms of depression and a non-depressed control group while functional magnetic resonance imaging (fMRI) measured brain activity. Amygdala and medial/orbital prefrontal cortex (PFC) response to valid emotion cues did not differ as a function of depression symptoms. However, significant depression group differences were observed when task demands required cognitive control. Participants with elevated depression symptoms showed weaker activation in right and left lateral PFC and parietal regions when shifting attentional focus away from invalid emotion cues. No depression group differences were observed for invalid non-emotional cues. Findings suggest that mild to moderate depression symptoms are associated with altered function in brain regions that mediate cognitive control of emotional information.
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Affiliation(s)
- C G Beevers
- Department of Psychology, University of Texas at Austin, Austin, TX, USA.
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13
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Spoor STP, Stice E, Bohon C. Relation of Elevated Food Reward to Risk for Bulimic Pathology. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71384-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abstract
The dorsal striatum plays a role in consummatory food reward, and striatal dopamine receptors are reduced in obese individuals, relative to lean individuals, which suggests that the striatum and dopaminergic signaling in the striatum may contribute to the development of obesity. Thus, we tested whether striatal activation in response to food intake is related to current and future increases in body mass and whether these relations are moderated by the presence of the A1 allele of the TaqIA restriction fragment length polymorphism, which is associated with dopamine D2 receptor (DRD2) gene binding in the striatum and compromised striatal dopamine signaling. Cross-sectional and prospective data from two functional magnetic resonance imaging studies support these hypotheses, which implies that individuals may overeat to compensate for a hypofunctioning dorsal striatum, particularly those with genetic polymorphisms thought to attenuate dopamine signaling in this region.
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Affiliation(s)
- E Stice
- Oregon Research Institute, 1715 Franklin Boulevard, Eugene, OR 97403, USA.
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Stice E, Spoor S, Bohon C, Ng J, Small D. Obese individuals show blunted striatal response to food: Relation moderated by DRD2 gene. Appetite 2008. [DOI: 10.1016/j.appet.2008.04.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Stice E, Cooper J, Schoeller D, Tappe K, Lowe M. Are dietary restraint scales valid measures of longer-term dietary restriction? Objective biological and behavioral data suggest not. Appetite 2007. [DOI: 10.1016/j.appet.2007.03.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Stice E, Bearman SK. Body-image and eating disturbances prospectively predict increases in depressive symptoms in adolescent girls: a growth curve analysis. Dev Psychol 2002. [PMID: 11552756 DOI: 10.1037//0012-1649.37.5.597] [Citation(s) in RCA: 100] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Using data from a longitudinal community study (N = 231), the authors tested whether body-image and eating disturbances might partially explain the increase in depression observed in adolescent girls. Initial pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and bulimic symptoms, but not body mass, predicted subsequent increases in depressive symptoms, as did increases in these risk factors over the study. There was also prospective support for each of the hypothesized mediational relations linking these risk factors to increases in depressive symptoms. Effects remained significant when other established gender-nonspecific risk factors for depression (social support and emotionality) were statistically controlled. Results provide support for the assertion that body-image and eating disturbances, operating above and beyond gender-nonspecific risk factors, contribute to the elevated depression in adolescent girls.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin, 78712, USA.
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18
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Stice E, Presnell K, Bearman SK. Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls. Dev Psychol 2001; 37:608-19. [PMID: 11552757 DOI: 10.1037/0012-1649.37.5.608] [Citation(s) in RCA: 198] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This prospective study tested whether early menarche partially accounts for the increases in depression, eating pathology, substance abuse, and comorbid psychopathology that occur among adolescent girls, with structured interview data from a community sample (N = 496). Early menarche (prior to 11.6 years) was associated with elevated depression, substance abuse, and "any" disorder but did not confer increased risk for anorexia nervosa, bulimia nervosa, or binge eating disorder. Although there was significant comorbidity across all three classes of pathology, early menarche was associated only with comorbid depression and substance abuse. Results provide partial support for the assertion that early menarche is a general risk factor for psychopathology among adolescent girls but suggest that this risk may not apply to certain disorders and that the effects are modest in size.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin, 78712, USA.
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19
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Stice E, Bearman SK. Body-image and eating disturbances prospectively predict increases in depressive symptoms in adolescent girls: a growth curve analysis. Dev Psychol 2001; 37:597-607. [PMID: 11552756 DOI: 10.1037/0012-1649.37.5.597] [Citation(s) in RCA: 409] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Using data from a longitudinal community study (N = 231), the authors tested whether body-image and eating disturbances might partially explain the increase in depression observed in adolescent girls. Initial pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and bulimic symptoms, but not body mass, predicted subsequent increases in depressive symptoms, as did increases in these risk factors over the study. There was also prospective support for each of the hypothesized mediational relations linking these risk factors to increases in depressive symptoms. Effects remained significant when other established gender-nonspecific risk factors for depression (social support and emotionality) were statistically controlled. Results provide support for the assertion that body-image and eating disturbances, operating above and beyond gender-nonspecific risk factors, contribute to the elevated depression in adolescent girls.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin, 78712, USA.
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Abstract
OBJECTIVE Because etiologic and maintenance models of binge eating center around dieting and affect regulation, this study tested whether binge eating-disordered (BED) individuals could be subtyped along dieting and negative affect dimensions and whether subtypes differed in eating pathology, social functioning, psychiatric comorbidity, and response to treatment. METHOD Three independent samples of interviewer-diagnosed BED women (N = 218) were subtyped along dieting and negative affect dimensions using cluster analysis and compared on the outcomes of interest. RESULTS Cluster analyses replicated across the three independent samples and revealed a dietary subtype (63%) and a dietary-depressive subtype (37%). The latter subtype reported greater eating and weight obsessions, social maladjustment, higher lifetime rates of mood, anxiety, and personality disorders, and poorer response to treatment than did the dietary subtype. DISCUSSION Results suggest that moderate dieting is a central feature of BED and that affective disturbances occur in only a subset of cases. However, the confluence of dieting and negative affect signals a more severe variant of the disorder marked by elevated psychopathology, impaired social functioning, and a poorer treatment response.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin, Austin, Texas 78712, USA.
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21
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Abstract
OBJECTIVE The authors developed a methodological basis for investigating how risk factors work together. Better methods are needed for understanding the etiology of disorders, such as psychiatric syndromes, that presumably are the result of complex causal chains. METHOD Approaches from psychology, epidemiology, clinical trials, and basic sciences were synthesized. RESULTS The authors define conceptually and operationally five different clinically important ways in which two risk factors may work together to influence an outcome: as proxy, overlapping, and independent risk factors and as mediators and moderators. CONCLUSIONS Classifying putative risk factors into these qualitatively different types can help identify high-risk individuals in need of preventive interventions and can help inform the content of such interventions. These methods may also help bridge the gaps between theory, the basic and clinical sciences, and clinical and policy applications and thus aid the search for early diagnoses and for highly effective preventive and treatment interventions.
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Affiliation(s)
- H C Kraemer
- Department of Psychiatry and Behavioral Sciences, 401 Quarry Rd., Stanford University Medical Center, Stanford, CA 94305, USA.
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22
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Stice E. A prospective test of the dual-pathway model of bulimic pathology: mediating effects of dieting and negative affect. J Abnorm Psychol 2001. [PMID: 11261386 DOI: 10.1037//0021-843x.110.1.124] [Citation(s) in RCA: 203] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Because there have been few longitudinal investigations of integrative etiological theories of bulimia nervosa, this study prospectively tested the dual-pathway model using random regression growth curve models and data from a 3-wave community sample of adolescent girls (N = 231). Initial pressure to be thin and thin-ideal internalization predicted subsequent growth in body dissatisfaction, initial body dissatisfaction predicted growth in dieting and negative affect, and initial dieting and negative affect predicted growth in bulimic symptoms. There was prospective evidence for most of the hypothesized mediational effects. Results are consistent with the assertion that pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and negative affect are risk factors for bulimic pathology and provide support for the dual-pathway model.
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Affiliation(s)
- E Stice
- Department of Psychology, 330 Mezes Hall, University of Texas at Austin, Austin, Texas 78712, USA.
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Abstract
OBJECTIVE As psychoeducational eating disorder prevention programs have not been shown to reduce bulimic pathology, we developed and evaluated a dissonance-based intervention for high-risk populations. METHOD Young women (N = 87) with body image concerns were randomized to this intervention, which involves verbal, written, and behavioral exercises requiring them to critique the thin-ideal, or to a healthy weight management control group. Participants completed a baseline, termination, and 4-week follow-up survey. RESULTS Participants in the dissonance intervention reported decreased thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptoms at termination and at 4-week follow-up. Unexpectedly, participants in the healthy weight management control group also reported some benefits. DISCUSSION Taken in conjunction with past findings, these preliminary results suggest that the dissonance intervention, and to a lesser extent the healthy weight management intervention, may reduce bulimic pathology and risk factors for eating disturbances.
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Affiliation(s)
- E Stice
- Department of Psychology, 330 Mezes Hall, University of Texas at Austin, Austin, TX 78712, USA.
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Abstract
Alcohol expectancies are important in the mediation and prediction of alcohol use. Expectancies for the effects of other drugs, although less well delineated, appear equally important. Therefore, development and validation of expectancy measures for drugs other than alcohol is necessary for evaluating the importance of these constructs. We examined the factor structure, reliability, and validity of the Marijuana Effect Expectancy Questionnaire (MEEQ) and the Stimulant Effect Expectancy Questionnaire (SEEQ) in clinical and community samples of adolescents as they moved into young adulthood (N=279). Confirmatory factor analyses (CFAs) supported the a priori factors, and we found good reliability for most individual scales. Temporal stability and convergent and discriminant validity of drug effect expectancies were supported in this sample of adolescents and young adults. Drug effect expectancies were associated with drug preference and drug use patterns over 2 years. Use of these measures may aid our understanding of the etiology and course of marijuana and stimulant involvement during adolescence and young adulthood.
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Affiliation(s)
- G A Aarons
- Department of Psychology, University of California San Diego, La Jolla 92093-0109, USA
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25
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Abstract
Because there have been few longitudinal investigations of integrative etiological theories of bulimia nervosa, this study prospectively tested the dual-pathway model using random regression growth curve models and data from a 3-wave community sample of adolescent girls (N = 231). Initial pressure to be thin and thin-ideal internalization predicted subsequent growth in body dissatisfaction, initial body dissatisfaction predicted growth in dieting and negative affect, and initial dieting and negative affect predicted growth in bulimic symptoms. There was prospective evidence for most of the hypothesized mediational effects. Results are consistent with the assertion that pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and negative affect are risk factors for bulimic pathology and provide support for the dual-pathway model.
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Affiliation(s)
- E Stice
- Department of Psychology, 330 Mezes Hall, University of Texas at Austin, Austin, Texas 78712, USA.
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26
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Abstract
The objective of this study was to assess whether private high school students constitute a group that is at high risk for eating pathology. Female and male public and private high school students (N = 465) were compared on self-reported eating disordered attitudes and behaviors. Private high school students reported elevated eating disordered attitudes and behaviors when compared with students from public schools. The results were somewhat stronger for females than males. The findings suggest that private high school students are a group at high risk for eating pathology. The identification of such high risk groups may facilitate etiologic studies and aid in the implementation of targeted prevention programs.
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Affiliation(s)
- M D Lesar
- Center for Health Care Evaluation Department of Veterans Affairs, Paolo Alto Health Care System, USA.
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Stice E, Cameron R, Killen J. Are naturalistic weight-reducing efforts associated with weight gain and onset of obesity in adolescent girls? West J Med 2000; 173:396. [PMID: 11112755 PMCID: PMC1071192 DOI: 10.1136/ewjm.173.6.396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Stice E, Telch CF, Rizvi SL. Development and validation of the Eating Disorder Diagnostic Scale: a brief self-report measure of anorexia, bulimia, and binge-eating disorder. Psychol Assess 2000. [PMID: 10887758 DOI: 10.1037//1040-3590.12.2.123] [Citation(s) in RCA: 185] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This article describes the development and validation of a brief self-report scale for diagnosing anorexia nervosa, bulimia nervosa, and binge-eating disorder. Study 1 used a panel of eating-disorder experts and provided evidence for the content validity of this scale. Study 2 used data from female participants with and without eating disorders (N = 367) and suggested that the diagnoses from this scale possessed temporal reliability (mean kappa = .80) and criterion validity (with interview diagnoses; mean kappa = .83). In support of convergent validity, individuals with eating disorders identified by this scale showed elevations on validated measures of eating disturbances. The overall symptom composite also showed test-retest reliability (r = .87), internal consistency (mean alpha = .89), and convergent validity with extant eating-pathology scales. Results implied that this scale was reliable and valid in this investigation and that it may be useful for clinical and research applications.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin 78712, USA.
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Stice E, Hayward C, Cameron RP, Killen JD, Taylor CB. Body-image and eating disturbances predict onset of depression among female adolescents: a longitudinal study. J Abnorm Psychol 2000; 109:438-44. [PMID: 11016113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
This study examined data from a 4-year school-based longitudinal study (n = 1,124), to test whether the increase in major depression that occurs among girls during adolescence may be partially explained by the body-image and eating disturbances that emerge after puberty. Elevated body dissatisfaction, dietary restraint, and bulimic symptoms at study entry predicted onset of subsequent depression among initially nondepressed youth in bivariate analyses controlling for initial depressive symptoms. Although the unique effect for body dissatisfaction was not significant in the multivariate model, this set of risk factors was able to fairly accurately foretell which girls would go on to develop major depression. Results were consistent with the assertion that the body-image- and eating-related risk factors that emerge after puberty might contribute to the elevated rates of depression for adolescent girls.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin 78712, USA.
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30
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Stice E, Telch CF, Rizvi SL. Development and validation of the Eating Disorder Diagnostic Scale: a brief self-report measure of anorexia, bulimia, and binge-eating disorder. Psychol Assess 2000; 12:123-31. [PMID: 10887758 DOI: 10.1037/1040-3590.12.2.123] [Citation(s) in RCA: 535] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This article describes the development and validation of a brief self-report scale for diagnosing anorexia nervosa, bulimia nervosa, and binge-eating disorder. Study 1 used a panel of eating-disorder experts and provided evidence for the content validity of this scale. Study 2 used data from female participants with and without eating disorders (N = 367) and suggested that the diagnoses from this scale possessed temporal reliability (mean kappa = .80) and criterion validity (with interview diagnoses; mean kappa = .83). In support of convergent validity, individuals with eating disorders identified by this scale showed elevations on validated measures of eating disturbances. The overall symptom composite also showed test-retest reliability (r = .87), internal consistency (mean alpha = .89), and convergent validity with extant eating-pathology scales. Results implied that this scale was reliable and valid in this investigation and that it may be useful for clinical and research applications.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin 78712, USA.
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31
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Abstract
OBJECTIVE Although laboratory experiments suggest that negative affect inductions potentiate the relation between dieting and disinhibited eating, little research has tested whether this finding generalizes to binge eating in the natural environment. Thus, we assessed whether negative affect moderated the relation between dieting and binge eating in a passive-observational study. METHOD This aim was addressed with longitudinal data from a community sample of adolescents (N = 631). RESULTS For females, dieting and negative affect predicted binge eating in cross-sectional and prospective analyses, but negative affect potentiated the relation between dieting and binge eating only in the cross-sectional analyses. Similar, but attenuated results were found for males. DISCUSSION Findings converge with those from laboratory studies in suggesting that negative affect moderates the relation between dieting and binge eating, but also imply that dieting and negative affect constitute independent risk factors for binge eating. The lack of prospective effects may suggest that the interactive relations have a short time lag or are difficult to detect prospectively.
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Affiliation(s)
- E Stice
- Department of Psychiatry, Stanford University, Stanford, California, USA.
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32
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Stice E, Mazotti L, Weibel D, Agras WS. Dissonance prevention program decreases thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptoms: A preliminary experiment. Int J Eat Disord 2000; 27:206-17. [PMID: 10657894 DOI: 10.1002/(sici)1098-108x(200003)27:2<206::aid-eat9>3.0.co;2-d] [Citation(s) in RCA: 188] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Because psychoeducational primary prevention programs for eating disorders have met with little success, this preliminary experiment tested a dissonance-based targeted preventive intervention. METHOD Female undergraduates (N = 30) with elevated body image concerns were assigned to a three-session intervention, wherein they voluntarily argued against the thin ideal, or a delayed-intervention control condition. Participants completed a baseline, termination, and a 1-month follow-up survey. RESULTS The intervention resulted in a subsequent decrease in thin-ideal internalization, body dissatisfaction, dieting, negative affect, and bulimic symptomatology, with most changes remaining at the 1-month follow-up. DISCUSSION These preliminary results suggest that this dissonance-based targeted prevention intervention reduces bulimic pathology and known risk factors for eating disturbances, and provide experimental support for the claim that thin-ideal internalization contributes to body dissatisfaction, dieting, negative affect, and bulimic symptoms.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin, Austin, Texas 78712, USA.
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Stice E, Cameron RP, Killen JD, Hayward C, Taylor CB. Naturalistic weight-reduction efforts prospectively predict growth in relative weight and onset of obesity among female adolescents. J Consult Clin Psychol 2000. [PMID: 10596518 DOI: 10.1037//0022-006x.67.6.967] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined the prospective relations of naturalistic weight-reduction efforts to growth in relative weight and onset of obesity with data from a community study of female adolescents (N = 692). Initial self-labeled dieting, appetite suppressant/laxative use, incidental exercise, vomiting for weight-control purposes, and binge eating predicted elevated growth in relative weight over the 4-year period. Dietary restraint, self-labeled dieting, exercise for weight-control purposes, and appetite suppressant/laxative use predicted an increased risk for obesity onset. Data imply that the weight-reduction efforts reported by adolescents are more likely to result in weight gain than in weight loss and suggest the need to educate youth on more effective weight-control strategies.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin 78712, USA.
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Stice E, Cameron RP, Killen JD, Hayward C, Taylor CB. Naturalistic weight-reduction efforts prospectively predict growth in relative weight and onset of obesity among female adolescents. J Consult Clin Psychol 1999; 67:967-74. [PMID: 10596518 DOI: 10.1037/0022-006x.67.6.967] [Citation(s) in RCA: 358] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined the prospective relations of naturalistic weight-reduction efforts to growth in relative weight and onset of obesity with data from a community study of female adolescents (N = 692). Initial self-labeled dieting, appetite suppressant/laxative use, incidental exercise, vomiting for weight-control purposes, and binge eating predicted elevated growth in relative weight over the 4-year period. Dietary restraint, self-labeled dieting, exercise for weight-control purposes, and appetite suppressant/laxative use predicted an increased risk for obesity onset. Data imply that the weight-reduction efforts reported by adolescents are more likely to result in weight gain than in weight loss and suggest the need to educate youth on more effective weight-control strategies.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin 78712, USA.
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35
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Abstract
OBJECTIVE This study investigated the course of eating attitudes and eating-disordered behaviors in a community sample of adult women. METHOD Participants (N = 166; mean age = 32.8 years) completed the Eating Disorder Inventory (EDI), the Three-Factor Eating Questionnaire (TFEQ), and a questionnaire assessing bulimic behaviors at two time points, 6 years apart. RESULTS Correlations for rank ordering of scores on these measures were all significant, indicating high rank stability over time. Although rates of specific bulimic behaviors decreased over time, mean scores on eating disorder attitude scales tended to increase. DISCUSSION Findings challenge the commonly held belief that disturbed eating attitudes decline with age.
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Affiliation(s)
- S L Rizvi
- Department of Psychiatry, Stanford University, Stanford, California 94305-5722, USA.
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36
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Abstract
Etiologic models of bulimia center on dieting and negative affect, yet no research has subtyped bulimic individuals according to whether they fit dietary versus negative affect profiles. This study subtyped 265 bulimic women along dieting and depressive dimensions and tested whether subtypes showed differences in eating pathology, clinical correlates, and treatment response. Cluster analysis revealed a pure dietary subtype (62%) and a mixed dietary-depressive subtype (38%). Whereas dietary and dietary-depressive bulimic women showed similar levels of bulimic behaviors, the latter reported more eating and weight obsessions; social maladjustment; higher rates of mood, anxiety, eating, impulse control, and personality disorders; and poorer treatment response. Results suggest dieting is a central feature of bulimia, but depressive affect occurs in only a subset of cases. However, the combination of dieting and depressive affect seems to signal a more severe variant of bulimia.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin 78712, USA.
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Myers MG, Stice E, Wagner EF. Cross-validation of the Temptation Coping Questionnaire: adolescent coping with temptations to use alcohol and illicit drugs. J Stud Alcohol 1999; 60:712-8. [PMID: 10487742 DOI: 10.15288/jsa.1999.60.712] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The present study had two primary objectives: (1) to examine differences in adolescent coping with temptations to use alcohol versus temptations for marijuana and/or other drug use and (2) to replicate and extend previous findings regarding the factor structure and psychometric validity of the Temptation Coping Questionnaire (TCQ). METHOD This was a cross-sectional study of 1,273 high school students, 52% female and, on average, 16.6 years old. The TCQ was completed as part of a school-wide survey of cigarette, alcohol and other drug involvement. Responses to the TCQ were elicited in response to two hypothetical temptation situations, one involving offers of alcohol only and the other involving offers of marijuana and/or other drugs. RESULTS The factor structure of the TCQ coping scale was confirmed for the original 11 items, both within and across situations representing temptations to use alcohol or marijuana and/or other drugs. In addition, the mean levels of perceived importance of abstaining and extent of coping efforts endorsed were higher for a marijuana and other drug than for an alcohol temptation situation. Finally, construct and criterion validity of the TCQ was replicated in the present sample. CONCLUSIONS Present results suggest that similar coping strategies are employed regardless of the particular substance encountered in a temptation situation. However, situation appraisal and extent of coping efforts appeared to differ for distinct substance types. These findings corroborate previous evidence for the utility of the TCQ as a brief, reliable measure of adolescent temptation coping and provide convergent support for the temptation-coping construct.
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Affiliation(s)
- M G Myers
- University of California, San Diego, & Veterans Affairs San Diego Healthcare System, 92161, USA
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38
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Abstract
Etiologic models of bulimia center on dieting and negative affect, yet no research has subtyped bulimic individuals according to whether they fit dietary versus negative affect profiles. This study subtyped 265 bulimic women along dieting and depressive dimensions and tested whether subtypes showed differences in eating pathology, clinical correlates, and treatment response. Cluster analysis revealed a pure dietary subtype (62%) and a mixed dietary-depressive subtype (38%). Whereas dietary and dietary-depressive bulimic women showed similar levels of bulimic behaviors, the latter reported more eating and weight obsessions; social maladjustment; higher rates of mood, anxiety, eating, impulse control, and personality disorders; and poorer treatment response. Results suggest dieting is a central feature of bulimia, but depressive affect occurs in only a subset of cases. However, the combination of dieting and depressive affect seems to signal a more severe variant of bulimia.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin 78712, USA.
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39
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Abstract
Bulimia nervosa and binge-eating disorder are characterized by a persistent course, are associated with comorbid psychopathology, and can result in serious medical complications. Although current treatments for these disorders show promise, they are not effective for approximately 40% of clients. Significant advances have been made in psychosocial research on the etiology and maintenance of bulimia nervosa and binge-eating disorder, as well as on the predictors of treatment response. This article reviews these advances and discusses the clinical implications of these findings. Research on etiology and maintenance suggests that eating-disorder treatments might be improved by focusing greater attention on promoting healthy weight-control techniques, increasing resiliency to sociocultural pressures to be thin, reducing thin-ideal internalization, and fostering adaptive affect-regulation skills. Research on the predictors of response to treatment suggests that matching treatments to client characteristics might further bolster intervention effectiveness.
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Affiliation(s)
- E Stice
- Department of Psychology, University of Texas at Austin, 78712, USA
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40
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Abstract
OBJECTIVE Research suggests that eating problems are often present by preadolescence, yet little is known about the age of emergence of these early eating disturbances or risk factors for these behaviors. Thus, we investigated the timing of onset of disturbed eating during childhood and the predictors of these behaviors. METHOD These aims were addressed by following a sample of children and their parents (N = 216) for the first 5 years of the children's lives. RESULTS Data suggested that the risk for emergence of inhibited eating, secretive eating, overeating, and vomiting increased annually through age 5. Maternal body dissatisfaction, internalization of the thin-ideal, dieting, bulimic symptoms, and maternal and paternal body mass prospectively predicted the emergence of childhood eating disturbances. Infant feeding behavior and body mass during the first month of life also predicted the emergence of these behaviors. DISCUSSION Results suggest that eating disturbances emerge during childhood and may be a function of certain parental and child characteristics.
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Affiliation(s)
- E Stice
- Department of Psychiatry, Stanford University, California, USA.
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Stice E, Barrera M, Chassin L. Prospective differential prediction of adolescent alcohol use and problem use: examining the mechanisms of effect. J Abnorm Psychol 1998. [PMID: 9830249 DOI: 10.1037//0021-843x.107.4.616] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This prospective study tested the assertion that psychopathology would predict both adolescent alcohol use and problem use, whereas socialization factors would predict only use, and explored mechanisms by which predictors led to problem use in a community sample of families (N = 216). Externalizing symptoms, parental alcoholism, peer influences, and parental support were indirectly related to negative consequences through their effects on use level. Externalizing symptoms, internalizing symptoms, peer influences, and parental approval of use directly predicted consequences, controlling for the indirect effects through use level. Internalizing pathology potentiated the relation between consumption and consequences, whereas parental support and control mitigated this relation. Collectively, findings provided mixed support for the assertion that psychopathology would predict both use and problem use, whereas socialization factors would predict only use.
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Affiliation(s)
- E Stice
- Department of Psychiatry, Stanford University, USA.
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Stice E, Killen JD, Hayward C, Taylor CB. Age of onset for binge eating and purging during late adolescence: a 4-year survival analysis. J Abnorm Psychol 1998. [PMID: 9830254 DOI: 10.1037//0021-843x.107.4.671] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This prospective study examined age of onset for binge eating and purging among girls during late adolescence and tested whether dieting and negative affectivity predicted these outcomes. Of initially asymptomatic adolescents, 5% reported onset of objective binge eating, 4% reported onset of subjective binge eating, and 4% reported onset of purging. Peak risk for onset of binge eating occurred at age 16, whereas peak risk for onset of purging occurred at age 18. Adolescents more often reported onset of a single symptom rather than multiple symptoms, and symptoms were episodic. Dieting and negative affectivity predicted onset of binge eating and purging. Findings suggest that late adolescence is a high-risk period for onset of bulimic behaviors and identify modifiable risk factors for these outcomes.
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Affiliation(s)
- E Stice
- Department of Psychiatry, Stanford University, USA.
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Stice E, Killen JD, Hayward C, Taylor CB. Age of onset for binge eating and purging during late adolescence: a 4-year survival analysis. J Abnorm Psychol 1998; 107:671-5. [PMID: 9830254 DOI: 10.1037/0021-843x.107.4.671] [Citation(s) in RCA: 182] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This prospective study examined age of onset for binge eating and purging among girls during late adolescence and tested whether dieting and negative affectivity predicted these outcomes. Of initially asymptomatic adolescents, 5% reported onset of objective binge eating, 4% reported onset of subjective binge eating, and 4% reported onset of purging. Peak risk for onset of binge eating occurred at age 16, whereas peak risk for onset of purging occurred at age 18. Adolescents more often reported onset of a single symptom rather than multiple symptoms, and symptoms were episodic. Dieting and negative affectivity predicted onset of binge eating and purging. Findings suggest that late adolescence is a high-risk period for onset of bulimic behaviors and identify modifiable risk factors for these outcomes.
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Affiliation(s)
- E Stice
- Department of Psychiatry, Stanford University, USA.
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Stice E, Barrera M, Chassin L. Prospective differential prediction of adolescent alcohol use and problem use: examining the mechanisms of effect. J Abnorm Psychol 1998; 107:616-28. [PMID: 9830249 DOI: 10.1037/0021-843x.107.4.616] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This prospective study tested the assertion that psychopathology would predict both adolescent alcohol use and problem use, whereas socialization factors would predict only use, and explored mechanisms by which predictors led to problem use in a community sample of families (N = 216). Externalizing symptoms, parental alcoholism, peer influences, and parental support were indirectly related to negative consequences through their effects on use level. Externalizing symptoms, internalizing symptoms, peer influences, and parental approval of use directly predicted consequences, controlling for the indirect effects through use level. Internalizing pathology potentiated the relation between consumption and consequences, whereas parental support and control mitigated this relation. Collectively, findings provided mixed support for the assertion that psychopathology would predict both use and problem use, whereas socialization factors would predict only use.
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Affiliation(s)
- E Stice
- Department of Psychiatry, Stanford University, USA.
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Abstract
Although social influences are thought to promote bulimic pathology, little research has examined the effects of multiple socialization agents, or considered both modeling and social reinforcement processes. Accordingly, these two studies tested whether social reinforcement of the thin-ideal, and modeling of abnormal eating behavior by family, peers, and the media, (i) correlated with bulimic symptoms in a sample of young adult female (N = 114) and (ii) predicted the onset of bulimic behavior in a sample of adolescent females (N = 218). Social reinforcement of the thin-ideal by family, peers, and media was correlated with bulimic symptoms; family and peer social reinforcement prospectively predicted the onset of binge eating and purging. Family and peer, but not media, modeling of abnormal eating behavior was associated with concurrent bulimic symptoms, and predicted the onset of binge eating and purging. Results suggest that both social reinforcement and modeling processes may promote bulimic pathology, but imply that the effects are limited to family and peer influences.
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Affiliation(s)
- E Stice
- Stanford University, Department of Psychiatry, CA 94305-5542, USA.
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Abstract
This study provides estimates of comorbid psychiatric disorders in women with binge eating disorder (BED). Sixty-one BED and 60 control participants, who were recruited from the community, completed the Structured Clinical Interview for DSM-III-R Axis I and Axis II disorders and self-report measures of eating and general psychiatric symptomatology. Regarding psychiatric diagnoses, women with BED had higher lifetime prevalence rates for major depression, any Axis I disorder, and any Axis II disorder relative to controls. BED women also evidenced greater eating and psychiatric symptomatology than did controls. Results suggest that the prevalence of comorbid psychiatric disorders in BED may be lower than previously indicated by clinical studies.
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Affiliation(s)
- C F Telch
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California 94305-5722, USA.
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Stice E, Killen JD, Hayward C, Taylor CB. Support for the continuity hypothesis of bulimic pathology. J Consult Clin Psychol 1998; 66:784-90. [PMID: 9803697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
There has been debate as to whether bulimia represents the endpoint of an eating disorder continuum (the continuity hypothesis) or is categorically different from subthreshold bulimia or an absence of eating disorders (the discontinuity hypothesis). The present study tested whether differences among bulimic, subthreshold bulimic, and control women on weight-concern and psychopathology variables better accord with the continuity or discontinuity hypothesis. These 3 groups were compared on body mass, thin-ideal internalization, body dissatisfaction, dietary restraint, depressive symptoms, anxiety symptoms, and temperamental emotionality. Discriminant function analysis and follow-up pairwise contrasts indicated that the continuity hypothesis was supported for measures of both weight concern and psychopathology. Research and treatment implications of the continuity perspective are discussed.
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Affiliation(s)
- E Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA.
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Abstract
OBJECTIVE Although theorists have proposed that restraint and negative affect cause bulimia nervosa, it is possible that bulimic pathology promotes restraint and negative affect, or that bulimic symptoms are reciprocally related to these two factors. The present study tested these competing models. METHOD Longitudinal data from a community sample of adolescent females (N = 218) was used to test these alternative models. RESULTS Prospective correlations suggested that bulimic pathology was reciprocally related to both restraint and negative affect. However, in more stringent tests controlling for the temporal stability of these factors, restraint was not related to subsequent bulimic symptoms, but bulimic pathology predicted future restraint. Negative affect and bulimic symptoms were not related over time when the stability of these factors was controlled, but they did show contemporaneous reciprocal relations. DISCUSSION Results provide some support for the negative affect model of bulimia, but raise questions about the restraint model.
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Affiliation(s)
- E Stice
- Department of Psychiatry, Stanford University, California 94305-5722, USA
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Abstract
Studies indicate that various measures of dietary restraint show inconsistent relations to bulimic symptomatology. The present study tested the assertion that this is because the scales differ in the extent to which they reflect the success or failure of dietary efforts. This study also tested the competing hypothesis that criterion confounding of the Restraint Scale produced the inconsistent findings. Data from 117 undergraduates indicated that both the Restraint Scale and the Dutch Restrained Eating Scale were correlated with bulimic pathology, but that the magnitude to the relations were higher for the former. These results supported the dietary success failure hypothesis, however, this difference disappeared when the two disinhibited eating items from the Restraint Scale were deleted. Thus, the inconsistent findings in prior research appear to be due to the criterion confounding of the Restraint Scale. Implications for the measurement of restraint are discussed.
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Affiliation(s)
- E Stice
- University of California, San Diego 92093, USA
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Abstract
Longitudinal latent growth models were used to examine the relation between changes in adolescent alcohol use and changes in peer alcohol use over a 3-year period in a community-based sample of 363 Hispanic and Caucasian adolescents. Both adolescent alcohol use and peer alcohol use were characterized by positive linear growth over time. Not only were changes in adolescent alcohol use closely related to changes in peer alcohol use, but the initial status on peer alcohol use was predictive of later increases in adolescent alcohol use and the initial status on adolescent alcohol use was predictive of later increases in peer alcohol use. These results are inconsistent with models positing solely unidirectional effects between adolescent alcohol use and peer alcohol use.
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Affiliation(s)
- P J Curran
- Department of Psychology, Duke University, Durham, North Carolina 27708-0085, USA.
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