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Pine AE, Shank LM, Burke NL, Higgins Neyland MK, Schvey NA, Quattlebaum M, Leu W, Wilfley DE, Stephens M, Jorgensen S, Olsen CH, Sbrocco T, Yanovski JA, Klein DA, Quinlan J, Tanofsky-Kraff M. Examination of the Interpersonal Model With Adolescent Military Dependents at High Risk for Adult Obesity. Am J Psychother 2020; 73:43-49. [PMID: 32050783 PMCID: PMC7286799 DOI: 10.1176/appi.psychotherapy.20190034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Adolescent military dependents may be at higher risk for psychosocial stressors and disordered eating compared with civilian youths, but the mechanisms underlying these risks are unclear. Interpersonal theory proposes that difficult relationships lead to negative affect, thereby promoting emotional eating, which has been linked to and predictive of disordered eating. The interpersonal model may have particular relevance for understanding disordered eating among adolescent military dependents, given the unique stressors related to their parents' careers. This study aimed to examine the premise of the interpersonal model (that negative emotions mediate the association between multiple aspects of social functioning and emotional eating) among a cohort of adolescent military dependents. METHODS Military dependents (N=136; 56% female, mean±SD age=14±2 years, body mass index adjusted for age and sex [BMIz]=2.0±0.4) at risk for adult obesity and binge eating disorder, as indicated by reported loss-of-control eating and/or anxiety symptoms, were assessed prior to participation in a study of excess weight-gain prevention. Bootstrapped mediation analyses were conducted to examine depressive symptoms as a potential mediator of the relationship between social functioning and emotional eating. Analyses were adjusted for age, sex, race-ethnicity, BMIz, and presence of reported loss-of-control eating and anxiety. RESULTS Depressive symptoms were a significant mediator of the relationship between multiple domains of social functioning, including loneliness, social adjustment related to family and friends, attachment to father and peers, and emotional eating (p<0.05). CONCLUSIONS The interpersonal model may contribute to our understanding of excess weight gain and binge eating disorder among adolescent military dependents. Prospective data are needed to determine the utility of interpersonal theory in predicting treatment response and outcomes among this population.
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Affiliation(s)
- Abigail E Pine
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Natasha L Burke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - M K Higgins Neyland
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Mary Quattlebaum
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - William Leu
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Denise E Wilfley
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Mark Stephens
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Sarah Jorgensen
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Cara H Olsen
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Jack A Yanovski
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - David A Klein
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Jeffrey Quinlan
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
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Shank LM, Crosby RD, Grammer AC, Shomaker LB, Vannucci A, Burke NL, Stojek M, Brady SM, Kozlosky M, Reynolds JC, Yanovski JA, Tanofsky-Kraff M. Examination of the interpersonal model of loss of control eating in the laboratory. Compr Psychiatry 2017; 76:36-44. [PMID: 28410467 PMCID: PMC5478390 DOI: 10.1016/j.comppsych.2017.03.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 01/10/2017] [Revised: 03/04/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The interpersonal model of loss of control (LOC) eating proposes that interpersonal problems lead to negative affect, which in turn contributes to the onset and/or persistence of LOC eating. Despite preliminary support, there are no data examining the construct validity of the interpersonal model of LOC eating using temporally sensitive reports of social stress, distinct negative affective states, and laboratory energy intake. METHOD 117 healthy adolescent girls (BMI: 75th-97th %ile) were recruited for a prevention trial targeting excess weight gain in adolescent girls who reported LOC eating. Prior to the intervention, participants completed questionnaires of recent social stress and consumed lunch from a multi-item laboratory test meal. Immediately before the test meal, participants completed a questionnaire of five negative affective states (anger, confusion, depression, fatigue, anxiety). Bootstrapping mediation models were conducted to evaluate pre-meal negative affect states as explanatory mediators of the association between recent social stress and palatable (desserts and snack-type) food intake. All analyses adjusted for age, race, pubertal stage, height, fat mass percentage, and lean mass. RESULTS Pre-meal state anxiety was a significant mediator for recent social stress and palatable food intake (ps<.05). By contrast, pre-meal state anger, confusion, depression, and fatigue did not mediate the relationship between social stress and palatable food intake (ps>.05). DISCUSSION Pre-meal anxiety appears to be the salient mood state for the interpersonal model among adolescent girls with LOC eating. Interventions that focus on improving both social functioning and anxiety may prove most effective at preventing and/or ameliorating disordered eating and obesity in these adolescents.
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Affiliation(s)
- Lisa M. Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA
| | - Ross D. Crosby
- Department of Biomedical Statistics & Methodology, Neuropsychiatric Research Institute, 120 Eighth Street South, Fargo, ND, 58107, USA
| | - Anne Claire Grammer
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Lauren B. Shomaker
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Department of Human Development and Family Studies and Colorado School of Public Health, Colorado State University, Fort Collins, CO 80523-1570, USA
| | - Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Natasha L. Burke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Monika Stojek
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Merel Kozlosky
- Nutrition Department, Clinical Center, NIH, DHHS, 10 Center Drive, Bethesda. MD 20892, USA
| | - James C. Reynolds
- Radiology and Imaging Sciences Department, Warren Grant Magnuson Clinical Center, NIH, DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA.
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