Does the tendency to act impulsively underlie binge eating and alcohol use problems? An empirical investigation

The co-occurrence of problem drinking and binge eating and purging has been well documented. However, there has been relatively little investigation of etiological models that may influence the development of this  co-occurrence. This study tests the hypotheses that impulsivity is heightened in eating disordered women compared with controls, and that women with comorbid bulimia and alcohol use disorders show higher impulsivity than bulimic-only women. The Impulsivity scale, BIS/BAS scales, State Anxiety Inventory, and a behavioural measure of reward responsiveness (CARROT) were administered to 22 women with bulimia, 23 women with comorbid bulimia and alcohol abuse/dependence, and 21 control women. As hypothesised, eating disordered women scored higher than controls on several self-report measures of impulsivity and sorted cards faster during a financially rewarded trial on the behavioural task. Also, as predicted, comorbid women scored higher than bulimic women on the Impulsivity scale. These findings suggest that individual differences in impulsiveness and a tendency to approach rewarding stimuli may contribute to developing these disorders.

Negative perceptions about self-control and identification with gender-role stereotypes related to binge eating, problem drinking, and to co-morbidity among adolescents

Purpose
To examine the role of both positive and negative styles of self-control, and gender-role stereotypes in binge eating and problem drinking.

Method
Participants were 428 adolescent boys and 555 girls from predominantly Anglo-Australian backgrounds who attended regional state schools in New South Wales, Australia. Students completed standardized questionnaires that assessed problem drinking, binge eating, self-control styles, and identification with gender-role stereotypes. ANOVA and post hoc Tukey tests were conducted to examine differences among adolescents who reported problems in binge eating, drinking, and both domains.

Results
Adolescents who reported eating and drinking problems also reported a high negative and a low positive sense of self-control coupled with self-identification with the traits that typically describe negative dimensions of gender-role stereotypes. Regardless of gender, problem drinking was mainly related to traits of negative masculinity (bossy, noisy aggressive, etc.) whereas binge eating was mainly related to negative femininity (shy, needs approval from others, etc.). Participants who reported eating and drinking symptoms recorded low scores on positive control, high scores on negative control, and also high scores on the negative dimensions of masculinity and femininity.

Summary
A negative and passive style of self-control coupled with an identification with negative dimensions of gender summarizes the type of self-regulation that is implicated in both binge eating and problem drinking, and co-morbid symptoms. There is a need for interventions working toward a more balanced gender self-concept and a positive sense of self-control.

The relationship between dissociation and binge eating

Despite research findings demonstrating a relationship between dissociation and binge eating, the psychological processes that may underlie this association remain unclear. The present study examined 2 potential explanations: (a) that dissociation disinhibits behavioral control over eating and (b) that dissociation interferes with self-awareness and undermines body image. A total of 151 female university students completed measures of dissociation, body dissatisfaction, impulsivity, internalization of the thin ideal, body comparison, and binge eating. Correlations confirmed the presence of a relationship between dissociation and binge eating, and regression analyses revealed that this relationship is limited to body-specific (somatic) symptoms of dissociation. Path analyses identified body dissatisfaction, comparison, and impulsivity as significant mediators of this relationship. However, inclusion of all 3 mediated paths in a full model revealed that only body dissatisfaction is a unique mediator. The relevance of somatic symptoms, and the unique contribution of body dissatisfaction as a mediator, are consistent with an explanation of the relationship between dissociation and binge eating that is based on a vulnerability of body image. The results emphasize the need for future research to consider the relation of dissociation to a broader range of disordered eating symptoms than simply binge eating.

Investigating the association between attachment and binge eating

A model was developed revealing direct and indirect effects of attachment anxiety and avoidance on various coping, regulatory, and affective factors that lead to the development and maintenance of binge eating. Insecurely attached individuals demonstrated more use of food as a source of comfort and security than their insecure counterparts.

Understanding the link between body image and binge eating: a model comparison approach

Purpose
The present study tests several competing, explanatory models—dual pathways, escape from awareness, and objectification theory—for the established link between body dissatisfaction and binge eating.

Methods
408 women aged between 18 and 40 years completed a survey designed to assess contributions of proposed mediators (dietary restraint and negative affect from the dual pathway model, self-distraction from the escape from awareness model, and interoceptive deficits from objectification theory) for the body dissatisfaction–binge eating relationship.

Results
Although mediation analyses supported the dual pathway model and objectification theory when tested separately, the dual pathway model most strongly predicted the body dissatisfaction–binge eating relationship. Both model-implied mediators (dietary restraint and negative affect) made significant unique contributions, accounting for roughly one-quarter of the shared variance between body dissatisfaction and binge eating when tested separately from other mediators. Improvements in variance explained were negligible once other proposed mediators were included in a test of models combined.

Conclusions
Collectively, these findings suggest the superiority of the dual pathway model over objectification theory and the escape model, but the remaining unaccounted for covariance suggests need to consider alternative mechanisms that may also account for the relationship between body dissatisfaction and binge eating.

Understanding the link between body dissatisfaction and binge eating: a model comparison approach

 This thesis explored the association between body dissatisfaction and binge eating by comparing three competing theoretical frameworks. Study I utilised a cross-sectional design and collectively these findings suggest the superiority of the dual pathway model (dietary restraint and negative affect) over the objectification theory and the escape model. The purpose of Study II was then to extend on the findings from Study I by further examining in real-time the model/theory that most strongly explained the body dissatisfaction-binge eating relationship. Participants were prompted at random intervals seven times daily across the course of a week to self-report their state body dissatisfaction, current mood experiences, and eating practices. Results revealed that negative mood, but not dietary restraint, significantly mediated the state body dissatisfaction-binge eating relationship. These results highlight that the dual pathway model is robust, but raise the possibility that the dietary restraint path in the model is not well operationalized. In light of the non-significant mediating effect of dietary restraint, this led the researcher to identify various modeling alternatives to further understand the mediating influences of the pathways of negative affect and dietary restraint.

Optimizing prediction of binge eating episodes : a comparison approach to test alternative conceptualizations of the affect regulation model

Background : Although a wealth of studies have tested the link between negative mood states and likelihood of a subsequent binge eating episode, the assumption that this relationship follows a typical linear dose–response pattern (i.e., that risk of a binge episode increases in proportion to level of negative mood) has not been challenged. The present study demonstrates the applicability of an alternative, non-linear conceptualization of this relationship, in which the strength of association between negative mood and probability of a binge episode increases above a threshold value for the mood variable relative to the slope below this threshold value (threshold dose response model).

Methods : A sample of 93 women aged 18 to 40 completed an online survey at random intervals seven times per day for a period of one week. Participants self-reported their current mood state and whether they had recently engaged in an eating episode symptomatic of a binge.

Results : As hypothesized, the threshold approach was a better predictor than the linear dose–response modeling of likelihood of a binge episode. The superiority of the threshold approach was found even at low levels of negative mood (3 out of 10, with higher scores reflecting more  negative mood). Additionally, severity of negative mood beyond this threshold value appears to be useful for predicting time to onset of a binge episode.

Conclusions : Present findings suggest that simple dose–response formulations for the association between  negative mood and onset of binge episodes miss vital aspects of this relationship. Most  notably, the impact of mood on binge eating appears to depend on whether a threshold value  of negative mood has been breached, and elevation in mood beyond this point may be useful  for clinicians and researchers to identify time to onset.