Loss of control eating and psychological maintenance in children: An ecological momentary assessment study

Objective

Recent research suggests that binge eating is a common experience in youth. However, it remains largely unknown how children's binge eating presents in everyday life and which psychological factors serve to maintain this binge eating.

Methods

Children aged 8-13 years with binge eating (n = 59), defined as at least one episode of loss of control (LOC) over eating within the past three months, and 59 matched children without LOC history were recruited from the community. Following a combined random- and event-sampling protocol, children were interviewed about their day-to-day eating behavior, mood, and eating disorder-specific cognitions using child-specific cell phones during a 4-day assessment period in their natural environment.

Results

LOC episodes led to a significantly greater intake of energy, particularly from carbohydrates, than regular meals of children with and without LOC eating. While LOC episodes were preceded and followed by cognitions about food/eating and body image, there was minimal evidence that negative mood states were antecedents of LOC eating.

Conclusions

The results provide support for the construct validity of LOC eating in children. Maintenance theories of binge eating for adults apply to children regarding eating disorder-specific cognitions, but the association with affect regulation difficulties requires further investigation.     

Father locus of control and child emotional and behavioral outcomes: a prospective study

In a prospective longitudinal study the authors examined the associations between parent locus of control of reinforcement (LOCR), measured before the birth of a child, and behavioral-emotional outcomes in that child at age 7 years. A total of 307 couples completed questionnaires regarding their emotional status and LOCR at their first prenatal care appointment. When their children turned 7 years old, teachers completed questionnaires regarding each participating child's behavior. Findings indicate significant associations between fathers' prenatal LOCR and child outcomes, particularly hyperactivity in sons. Hyperactivity and behavioral-emotional problems in girls, in contrast, were better predicted by maternal prenatal emotional distress. Results provide evidence that paternal and maternal characteristics that predate the birth of a child relate to later behavioral outcomes in that child. Implications for prevention of child psychopathology are discussed.     

A daily diary study of internalised weight bias and its psychological,eating and exercise correlates

Objective: The current investigation extends ecological momentary assessment (EMA) and daily diary weight stigma research in internalised weight bias (IWB). This investigation used daily diaries to examine the relationship between IWB, mood, coping, body appreciation, exercise behaviours and eating behaviours. Design: The study sample consisted of individuals who were overweight or obese (85% female) with M_BMI?=?36.0, SD_BMI?=?6.2. Participants completed a daily diary each evening and wore a Fitbit for 30 days. Main Outcome Measures: Participants reported on IWB, mood, coping, body appreciation, exercise behaviours and eating behaviours.

Results: Both within- and between-subjects IWB were significantly related to positive affect, negative affect, several coping responses, body appreciation, eating behaviours and the urge to avoid exercise. Exploratory analyses indicated that positive and negative affect mediated many of the associations between IWB and coping responses, body appreciation, and eating and exercise behaviours.

Conclusion: This investigation provides evidence that IWB experiences have daily impacts on psychological well-being, body appreciation, coping, eating and exercise behaviours. Also, this study raises awareness about IWB and its potential impact on psychological well-being and health behaviours.     

The interaction of psychological and metabolic factors in the control of eating and obesity

Since psychological or learning factors can trigger metabolic consequences and , likewise, physiological or metabolic events can affect our behaviour or learned responses to food, advances in the study of food intake and obesity can best be made by considering the interaction of psychological and metabolic factors. A hypothesis integrating these factors is presented.     

Overvaluation of shape and weight among overweight children and adolescents with loss of control eating

Little is known about the phenomenology of pediatric loss of control (LOC) eating. Overvaluation of shape and weight, however, appears to be diagnostically meaningful among binge eating adults. We explored the significance of shape and weight overvaluation among children and adolescents with LOC eating. Participants (n = 526) included 149 overweight youth with LOC eating and 377 overweight controls (CON). Participants were categorized as those reporting at least moderate overvaluation (LOC-Mod, n = 74; CON-Mod, n = 106) or less than moderate overvaluation (LOC-Low, n = 75; CON-Low, n = 271), and compared on measures of eating-related and general psychopathology. LOC-Mod evidenced lower self-esteem than CON-Low, and greater behavioral problems than CON-Mod and CON-Low, but did not differ from LOC-Low in these domains. With the exception of LOC-Low and CON-Mod, all groups differed on global eating-disorder severity, with LOC-Mod scoring the highest. Overvaluation of shape and weight appears to be of questionable importance in defining subtypes of youth with LOC eating. However, as overvaluation and LOC eating each independently predicts eating-disorder onset, their confluence may confer even further risk for eating-disorder development. Longitudinal studies should address this possibility. Developmentally appropriate discussion about body image disturbance may be indicated in interventions targeting pediatric LOC eating and/or obesity.     

Subtyping children and adolescents with loss of control eating by negative affect and dietary restraint

OBJECTIVE: Research suggests that subtyping adults with binge eating disorders by dietary restraint and negative affect predicts comorbid psychopathology, binge eating severity, and treatment outcome. Little research has explored the validity and clinical utility of subtyping youth along these dimensions. METHOD: Children (aged 8-18 years) reporting loss of control eating (n=159) were characterized based upon measures of dietary restraint and negative affect using cluster analysis, and then compared regarding disordered eating attitudes and behaviors, and parent-reported behavior problems. RESULTS: Robust subtypes characterized by dietary restraint (n=114; 71.7%) and dietary restraint/high negative affect (n=45; 28.3%) emerged. Compared to the former group, the dietary restraint/high negative affect subtype evidenced increased shape and weight concerns, more frequent binge eating episodes, and higher rates of parent-reported problems (all ps<0.05). CONCLUSION: Similar to findings from the adult literature, the presence of negative affect may mark a more severe variant of loss of control eating in youth. Future research should explore the impact of dietary restraint/negative affect subtypes on psychiatric functioning, body weight, and treatment outcome.     

A comparison of psychological and pharmacological treatment of pediatric migraine

A comparison was carried out of the efficacy of psychological and drug treatments for children with migraine. Forty-three children aged between 8 and 16 years (mean age: 11.3 years) who suffered from migraine received either progressive relaxation or cephalic vasomotor feedback, both with stress management training, or metoprolol, a beta-blocker. Psychological treatment was administered in ten sessions lasting six weeks and the drug treatment lasted ten weeks. Relaxation and stress management training reduced the headache index (frequency×intensity of headache episodes), more effectively than metoprolol with cephalic vasomotor feedback and stress management training in between. An overall improvement over time was found with regard to frequency and intensity of headache episodes and analgesics intake. When comparing pre- to post-treatment data, children treated with relaxation training improved significantly in headache frequency and intensity, whereas those treated with cephalic vasomotor feedback improved significantly in headache frequency and duration as well as mood. The clinical improvement was stable at an 8-months follow-up.     

An examination of the interpersonal model of loss of control eating in children and adolescents

The interpersonal model of binge eating disorder proposes that social problems lead to negative affect which, in turn, precipitates binge eating episodes. However, no study to date has examined this model among youth who report loss of control (LOC) eating. Participants were 219 non-treatment-seeking children and adolescent volunteers, age 8-17 years (13.1 ± 2.8y; 50% female). Children's social problems were assessed by parent report. Youth completed self-report questionnaires of negative affect that assessed depressive symptoms and anxiety. Participants were interviewed to determine the presence or absence of LOC eating in the month prior to assessment. Structural equation modeling analyses found that social problems were positively related to LOC eating presence (p = .02). Negative affect mediated the relationship between social problems and LOC eating (95% CI Product = .00247, .01336). These preliminary results suggest that the interpersonal model of binge eating may describe one possible pathway for the development of LOC eating among non-treatment-seeking youth.     

Coping strategies: A prospective study of patterns,stability, and relationships with psychological distress

The aims of this article are: (1) to explore patterns (clusters) of coping strategies; (2) to examine the stability of individual coping strategies and patterns of coping over time; and (3) to establish long term associations between coping and psychological distress. Coping strategies were assessed with the Brief Cope questionnaire, whereas psychological distress was measured with the ten‐item version of the Hopkins Symptom Checklist, in a two‐year prospective sample comprising 3,738 employees. Based on TwoStep cluster analysis of the Brief Cope, three different coping patterns were identified: low coping, engagement coping, and disengagement coping. Analyses of long‐term stability indicated malleable properties for the individual coping strategies as well as the three clusters. Disengagement coping strategies in the form of self‐blame and self‐distraction were most strongly associated with distress at follow‐up, whereas baseline distress was related to increased use of these strategies two years later. Coping patterns at baseline had no main effects on later levels of distress, but levels of distress at baseline predicted subsequent use of engagement and disengagement coping patterns. The finding that specific coping strategies are malleable suggests that it is possible to modify and develop dysfunctional strategies. The associations between disengagement coping strategies and distress indicate that this kind of coping is especially problematic with regard to mental health problems. A main contribution of this study is that it establishes cluster analytic techniques as beneficial in the assessment of coping.     

Relationships between psychological stress, coping and disordered eating: A review

Abstract Objective: Psychological stress and inadequate coping skills have been hypothesized to play important roles in the etiology of disordered eating. This paper reviews the empirical evidence which has emerged regarding the proposed relationships among stress. coping skills and various forms of disordered eating. Method: A search of psychological and medical databases was conducted to identify studies examining life events, and other types of psychological stress and coping strategies, in relation to the onset of disordered eating. Results: Despite methodological limitations such as the use of non-representative samples and retrospective methodologies, evidence of relationships between stress. coping and disordered eating was obtained in the majority of studies reviewed. Discussion: The implications of these findings am discussed and suggestions for future research, including the utilization of longitudinal. prospective studies, am presented.     

Relationships between psychological stress,coping and disordered eating: A review

Abstract

Objective: Psychological stress and inadequate coping skills have been hypothesized to play important roles in the etiology of disordered eating. This paper reviews the empirical evidence which has emerged regarding the proposed relationships among stress. coping skills and various forms of disordered eating. Method: A search of psychological and medical databases was conducted to identify studies examining life events, and other types of psychological stress and coping strategies, in relation to the onset of disordered eating. Results: Despite methodological limitations such as the use of non-representative samples and retrospective methodologies, evidence of relationships between stress. coping and disordered eating was obtained in the majority of studies reviewed. Discussion: The implications of these findings am discussed and suggestions for future research, including the utilization of longitudinal. prospective studies, am presented.     

A method for the control of eating rate: A potential intervention in eating disorders

A method for the control of eating rate gave subjects feedback from a computer screen on how much and at what rate to eat during a meal. The method also allowed us to record the development of satiety during the meal. Linear eaters—that is, women selected for eating at an approximately constant rate—underate when challenged to eat at a lower rate and overate when challenged to eat at a higher rate, thereby modeling the eating behavior of patients with anorexia nervosa and binge eating disorder, respectively. In both cases, the women’s postmeal perception of satiety mimicked that of the respective patient group. The results provide support for the notion that linear eaters have the capacity to exhibit disordered eating.     

The Big Five and eating disorders: a prospective study in the general population

The present study assessed the Big‐Five personality dimensions according to the lexical hypothesis among participants with a lifetime history of eating disorders (ED) (n = 84), as well as participants with a first‐time incidence of ED (n = 33) compared to participants with no history of ED (non‐ED, n = 1014). Personality and ED were investigated with self‐report questionnaires among women (n = 1157) randomly selected from the general population. Participants with a lifetime ED reported significantly lower levels of Agreeableness. Conscientious, Emotional Stability, and a significantly higher level of Openness compared to the non‐ED. When Emotional Stability was controlled for, participants with ED scored higher on Openness compared to controls. Participants were followed up after two years. Thirty‐three participants with complete data on all the scales developed an eating disorder for the first time at follow‐up. This first‐time incidence group had a very similar pattern of personality prior to developing any symptoms of ED (i.e. low on Agreeableness and Emotional Stability, and high on Openness) to those with a lifetime history of ED, and significantly different from those who never reported any symptoms of ED (controls, n = 636). This pattern resembles the Type 3 personality according to Caspi and colleagues. It is suggested that the presence of some specific personality traits may be regarded as a risk factor for developing ED. Copyright © 2000 John Wiley & Sons, Ltd.     

The co-development of chores and effortful control among Mexican-origin youth and prospective work outcomes

The present research examined: (a) the co-development of chores and effortful control, and (b) the prospective impact of effortful control development (i.e., initial levels and the trajectory of effortful control from late childhood through adolescence) on work outcomes in young adulthood. We used data from a longitudinal study of 674 Mexican-origin youth assessed at ages 10, 12, 14, 16, and 19. We found no evidence of co-developmental associations between chores and effortful control, but we found that higher initial levels of effortful control (age 10) predicted working-student status, less job stress, and better job fit, and steeper increases in effortful control from age 10 to 16 predicted higher job satisfaction and job autonomy in young adulthood (age 19).     

Explaining enduring empowerment: a comparative study of collective action and psychological outcomes

An ethnographic study of two crowd events was carried out in order to develop a hypothesis about the experience of empowerment in collective action. Qualitative comparison of an anti‐roads occupation and a mass eviction suggests that empowerment as an outcome of collective action is a function of the extent to which one's own action is understood as expressing social identity, a process we term collective self‐objectification. The comparison indicates that empowerment is not reducible to the experience of success. While both events came to be construed by participants as ‘victories’, their associated emotions (joy versus despair and anger) and rationales for future participation (confidence versus enhanced self‐legitimacy) were different. The relation between collective self‐objectification and self‐efficacy is discussed. Copyright © 2005 John Wiley & Sons, Ltd.     

Loss of control over eating reflects eating disturbances and general psychopathology

This study examined the clinical significance of the loss of control over eating as a key component of eating disorders. It investigated the association of eating-related psychopathology and general psychopathology with objective bulimic episodes (OBEs; experiencing a loss of control while consuming large amounts of food) and subjective bulimic episodes (SBEs; experiencing a loss of control while consuming small/moderate amounts). A community sample of 81 women with a range of disordered eating was recruited: binge-eating disorder, bulimia nervosa, subclinical eating disturbances, or no eating disorders. They were interviewed using the Eating Disorder Examination and completed measures of eating-related and general psychopathology. Both OBE and SBE frequencies correlated significantly with measures of eating-related and general psychopathology, and no significant differences were found between the magnitudes of the correlations with either binge episode type. SBE frequency significantly and independently predicted global eating disorder psychopathology. The loss of control over eating, without consuming large amounts of food, was as closely associated with specific eating disorder psychopathology and general mental health as were traditionally defined OBEs. SBEs may be an important target of treatment and should be considered for future diagnostic classifications of eating disorders.