The relationship between neuroticism and night eating: exploring the mediating roles of psychological distress and maladaptive coping

Night Eating Syndrome has been shown to be associated with various negative physical and psychological consequences. This study explored the relationship between neuroticism and night eating, which had not been studied before. We also examined the possible mediating roles of psychological distress and maladaptive coping for the relationship between neuroticism and night eating. A sample of 578 Chinese college students were assessed on several measures: The Revised Eysenck Personality Questionnaire Short Scale, the Night Eating Questionnaire, the Depression Anxiety Stress Scales, and the Simplified Coping Style Questionnaire. Results indicated that neuroticism was significantly and positively related to night eating (r = .38, p < .01), and the relationship between neuroticism and night eating was partially mediated by psychological distress, but not by maladaptive coping. The results not only revealed a medium-sized relationship between neuroticism and night eating, but also pointed out the importance of psychological distress as related to the relationship between neuroticism and night eating. Unlike neuroticism, which is a personality trait, psychological distress is an emotional state, and it is much more malleable through appropriate intervention. The treatment and intervention for night eating may benefit from our attention to the psychological distress.     

Significance of overvaluation of shape and weight in an ethnically diverse sample of obese patients with binge-eating disorder in primary care settings

Undue influence of shape or weight on self-evaluation--referred to as overvaluation--is a core feature across eating disorders, but is not a diagnostic requirement for binge-eating disorder (BED). This study examined overvaluation of shape/weight in ethnically diverse obese patients with BED seeking treatment in primary care. Participants were a consecutive series of 142 (105 female and 37 male) participants with BED; 43% were Caucasian, 37% were African-American, 13% were Hispanic-American, and 7% were of "other" ethnicity. Participants categorized with overvaluation (N=97; 68%) versus without clinical overvaluation (N=45; 32%) did not differ significantly in ethnicity/race, age, gender, body mass index, or binge-eating frequency. The overvaluation group had significantly greater levels of eating disorder psychopathology, poorer psychological functioning (higher depression, lower self-esteem), and greater anxiety disorder co-morbidity than the group who did not overvalue their shape/weight. The greater eating disorder and psychological disturbance levels in the overvaluation group relative to the non-overvaluation group persisted after controlling for psychiatric co-morbidity. Our findings, based on an ethnically diverse series of patients seeking treatment in general primary care settings, are consistent with findings from specialist clinics and suggest that overvaluation does not simply reflect concerns commensurate with being obese or with frequency of binge-eating, but is strongly associated with heightened eating-related psychopathology and psychological distress. Overvaluation of shape/weight warrants consideration as a diagnostic specifier for BED as it provides important information about severity.     

Three-way interaction of neuroticism,extraversion, and conscientiousness in the internalizing disorders: Evidence of disorder specificity in a psychiatric sample

It is well-established that neuroticism, extraversion, and conscientiousness are individually associated with internalizing disorders, but research suggests that these main effects may be qualified by a three-way interaction when predicting depression. The current study was the first to examine this three-way interaction in a psychiatric sample (N = 463) with a range of internalizing symptoms as the outcomes. Using two omnibus personality inventories and a diagnostic interview, the expected three-way interaction emerged most consistently for symptoms of major depression, and there was also evidence of synergistic effects for post-traumatic stress disorder and generalized anxiety disorder. Findings indicate that, even in a clinically-distressed and currently-disordered sample, high levels of extraversion and conscientiousness protect against distress disorders for those with high levels of neuroticism.     

Defining recovery from an eating disorder: Conceptualization, validation, and examination of psychosocial functioning and psychiatric comorbidity

Conceptually, eating disorder recovery should include physical, behavioral, and psychological components, but such a comprehensive approach has not been consistently employed. Guided by theory and recent recovery research, we identified a “fully recovered” group (n = 20) based on physical (body mass index), behavioral (absence of eating disorder behaviors), and psychological (Eating Disorder Examination-Questionnaire) indices, and compared them with groups of partially recovered (n = 15), active eating disorder (n = 53), and healthy controls (n = 67). The fully recovered group was indistinguishable from controls on all eating disorder-related measures used, while the partially recovered group was less disordered than the active eating disorder group on some measures, but not on body image. Regarding psychosocial functioning, both the fully and partially recovered groups had psychosocial functioning similar to the controls, but there was a pattern of more of the partially recovered group reporting eating disorder aspects interfering with functioning. Regarding other psychopathology, the fully recovered group was no more likely than the controls to experience current Axis I pathology, but they did have elevated rates of current anxiety disorder. Results suggest that a stringent definition of recovery from an eating disorder is meaningful. Clinical implications and future directions regarding defining eating disorder recovery are discussed.     

神经质对青少年情绪化饮食的影响：一个有调节的中介效应模型

摘 要 为探讨神经质、青少年情绪化饮食、体验回避及自尊之间的关系,选取1000名青少年为被试,采用简式大五人格问卷、荷兰饮食行为问卷、接纳行动量表及自尊量表进行测试。结果表明：（1）神经质对青少年情绪化饮食有显著的正向影响,并间接地通过体验回避对青少年情绪化饮食产生作用;（2）自尊在体验回避对青少年情绪化饮食的影响中起显著的调节作用,具体而言,在低自尊水平下,体验回避能显著地正向预测青少年情绪化饮食,而在高自尊水平下,体验回避对青少年情绪化饮食的预测作用不显著。     

Perceived acceptability of anorexia and bulimia in women with and without eating disorder symptoms

Perceptions of the acceptability of eating‐disordered behaviour were examined in young adult women with (n = 44) and without (n = 268) eating disorder symptoms. All participants viewed vignettes of anorexia nervosa (AN) and bulimia nervosa (BN) and responded to the same series of questions—addressing different possible ways in which the conditions described might be seen to be acceptable—in relation to each vignette. Participants with eating disorder symptoms perceived eating‐disordered behaviour to be more acceptable than asymptomatic participants, and this was the case for both AN and BN vignettes and for a range of different items. Differences on items tapping the perception that it ‘might not be too bad’ to have an eating disorder and that an eating disorder is ‘nothing to be concerned about’ were particularly pronounced. The findings could not be accounted for by between‐group differences in body weight. The findings indicate the ambivalence towards eating‐disordered behaviour that exists among a subgroup of young women in the community and the clear association between such ambivalence and actual eating disorder symptoms. The perceived acceptability of eating‐disordered behaviour may need to be addressed in prevention and early‐intervention programs for eating disorders.     

The control of death and the death of control: The effects of mortality salience,neuroticism, and worldview threat on the desire for control

Two studies were designed to examine whether neuroticism would moderate the effect of mortality salience on desire for control. In Study 1, participants completed a neuroticism scale, contemplated their mortality or a control topic, and then completed a desire for control scale. Results indicated that those low in neuroticism evidenced an increase in desire for control following mortality salience whereas those high in neuroticism showed decreased desire for control. Study 2 used a 2 (neuroticism level) ×2 (worldview threat) ×2 (mortality salience) design to examine whether confident faith in a belief system is responsible for the increased desire for control among low neuroticism participants. Here results indicated that if participants scoring low in neuroticism were confronted with a threat to their worldview and were then reminded of their death, they showed reduced desires for control. Discussion focuses on the implications of these results for understanding the relationship between neuroticism, desire for control, and terror management processes.     

Eating Disorders Among Urban and Rural African American and European American Women

Abstract

It is alleged that eating disorders are nonexistent in African American women and that eating disorder symptomatology occurs predominantly among White middle class women (Kumanyika, Wilson, & Guilford-Davenport, 1993; Smolak & Striegel-Moore, 2001). This research attempted to identify differences in eating disorder symptomatology in African American and White American women. An eating disorder is a disability because it can damage the person physically, emotionally and socially. It can be undetected for years and society may reinforce the hidden disorder by being complimentary regarding the thin appearance of the person. The Eating Disorder Inventory (EDI) was used to measure psychological traits and symptom clusters associated with the understanding and treatment of eating disorders (Garner, 1990). Measures of self-esteem, depression and coping were also examined. Findings indicated differences between African American and White women on the Ineffectiveness scale of the EDI, differences between the urban/rural women on Ineffectiveness and Perfectionism, and differences in coping strategies and education among this sample group of women. Successful treatment usually involves psychotherapy and/or medication for depression.     

Neuroticism,BIS, and reactivity to discrete negative mood inductions

Research has established relationships between the personality dimensions of neuroticism and BIS and broad negative emotional reactivity. However, few researchers have examined the relationships among neuroticism, BIS, and discrete negative emotional reactivities. The present study examined whether individuals scoring high on neuroticism and BIS were more reactive across four discrete negative mood inductions, relative to those scoring low on these traits. Participants (n = 166) completed personality questionnaires, measures of current mood, viewed a specific mood-inducing film clip (sadness, anger, fear or disgust) and then reported their moods a second time. Results revealed that neuroticism/BIS was associated with high reactivity to the fear and sadness inductions. Neuroticism/BIS did not predict anger or disgust reactivity, but neuroticism/BIS and extraversion/BAS interacted in predicting anger. Although further research is needed to extend generalizability, it appears that neuroticism and BIS predict negative emotional reactivity broadly, but not ubiquitously.     

Psychological Correlates of Anorexic and Bulimic Symptomatology

Few studies examining the relationship between eating disorders and personality have been theoretically derived; thus, findings have been equivocal. From a theoretical and empirical perspective (S. Orbach, 1986; R. L. Rogers & T. A. Petrie, 1997; G. J. Williams et al., 1994), this study investigated the connection between eating disorder symptomatology and several psychological correlates—obsessiveness, dependency, overcontrolled hostility, assertiveness, locus of control, and self‐esteem. Regression analyses indicated that obsessiveness and 2 factors of dependency accounted for 21% of the variance in a measure of anorexic attitudes and behaviors. One factor of dependency and obsessiveness accounted for 20% of the variance in a measure of bulimic symptomatology.     

Neuroticism and vigilance revisited: A transcranial doppler investigation

Selecting for vigilance assignments remains an important factor in human performance research. The current study revisits the potential relationship between vigilance performance and trait neuroticism, in light of two possible theories. The first theory suggests that neuroticism impairs vigilance performance by competing for available resources. The second theory, attentional control theory, posits that high neuroticism can result in similar or superior performance levels due to the allocation of compensatory effort. In the present study, Transcranial Doppler Sonography was used to investigate the neurophysiological underpinnings of neuroticism during a 12-min abbreviated vigilance task. Performance results were not modified by level of neuroticism, but high neuroticism was associated with higher initial CBFV levels and a greater CBFV decrement over time. These findings indicate that participants higher in neuroticism recruited additional cognitive resources in order to achieve similar performance, suggesting that there is more of an effect on processing efficiency than effectiveness.     

BECOMING ANOREXIC: ON LOSS,DEATH AND IDENTIFICATION AND THE EMERGENCE OF ANOREXIA NERVOSA

This paper investigates the connections between death, pathological identifications and anorexia nervosa. Literature is reviewed concerning various psychodynamic models of causation of anorexia, and in particular transgenerational patterns in the evolution of this eating disorder, with reference to problems in the development of autonomy of the emerging self. The role of loss in the family is examined, and the development of pathological identifications is described. A case of an adolescent girl initially presenting with an unexplained seizure is described in which multiple identifications seem to be occurring while the patient develops anorexia, perhaps reflecting previous losses in the family and also in a kind of strange identification with, and mimesis of, the parents' unmourned dead. It is suggested that the development of these multiple identifications gives some aetiological clues to this puzzling illness and also indicates a therapeutic focus. It is argued that a psychodynamically‐informed child psychiatrist can bring an enriching approach to working with patients with this disorder.     

Friendship clique and peer influences on body image concerns, dietary restraint, extreme weight-loss behaviors, and binge eating in adolescent girls.

This study explored friendship variables in relation to body image, dietary restraint, extreme weight-loss behaviors (EWEBs), and binge eating in adolescent girls. From 523 girls, 79 friendship cliques were identified using social network analysis. Participants completed questionnaires that assessed body image concerns, eating, friendship relations, and psychological family, and media variables. Similarity was greater for within than for between friendship cliques for body image concerns, dietary restraint, and EWLBs, but not for binge eating. Cliques high in body image concerns and dieting manifested these concerns in ways consistent with a high weight/shape-preoccupied subculture. Friendship attitudes contributed significantly to the prediction of individual body image concern and eating behaviors. Use of EWLBs by friends predicted an individual's own level of use.     

A study of temperament and personality in anorexia and bulimia nervosa

Although temperament and personality traits could influence the development and course of eating disorders, only a few studies examined the similarities and differences in personality between anorexia and bulimia nervosa. We compared 72 patients with DSM-IV eating disorders and 30 healthy controls. Dimensions of personality and personality disorders were evaluated with the Eysenck's EPQ, Cloninger's TCI, and the SCID-II questionnaires. The rates of impulsivity and clinical features were evaluated using specific rating scales. A comorbid personality disorder was found in 61.8% of patients with eating disorder. Avoidant personality disorder appeared was relatively common in anorexia nervosa restricting type; borderline personality disorder was most frequent in bulimia nervosa and the binge eating-purging type of anorexia nervosa. From a dimensional perspective, anorexic patients presented high scores in the dimension of persistence. Higher harm avoidance and impulsivity was found in bulimic patients. The overall eating disorders group presented high scores in neuroticism and low scores in self-directedness. Eating disorder patients have heterogeneous features of temperament and personality traits. Cluster C personality disorders seem more common in anorexia nervosa restricting type and impulsive personality features are associated with bulimic symptoms. Impulsivity seems to be a key aspect of temperament of bulimic patients, whereas anorexic symptoms are linked to persistent temperament traits.     

Belastungen in der Kindheit und in der Jugend Essgestörter

Depending on definition and sample, a minority of varying size of women with eating disorders report to be victims of sexual and/or physical abuse. These stressful experiences are risk factors for mental disorders in general and not specifically for eating disorders. Parental high expectations and pre-morbid negative self-evaluation seem to be specific risk factors for anorexia nervosa and bulimia nervosa. Probably, patients with bulimia nervosa suffered more childhood adversity than those with restrictive anorexia nervosa. Patients with a history of sexual and/or physical abuse may be more severely ill and more difficult to treat than other patients with eating disorders. Careful questioning about childhood adversity seems advisable. In therapy, maintaining factors—like problems of self-esteem—are more important than predisposing or precipitating factors. For prevention, it is recommended to provide for the safety of children when treating their parents with mental illness—particularly substance use disorders—and to avoid parental high expectations.     

Objective and subjective bulimic episodes in the classification of bulimic-type eating disorders: Another nail in the coffin of a problematic distinction

We sought to further explore the validity of the distinction between objective bulimic episodes (OBEs) and subjective bulimic episodes (SBEs) in the study of bulimic-type eating disorders. Drawing on data obtained at the second, interview phase of a large-scale epidemiological study, we identified mutually exclusive subgroups of women with bulimic-type eating disorders who engaged in regular OBEs but not SBEs (n = 37) or regular SBEs but not OBEs (n = 52). These subgroups were compared on a wide range of outcomes, including socio-demographic characteristics, current levels of eating disorder psychopathology, general psychological distress and impairment in role functioning, current and lifetime impairment in quality of life specifically associated with an eating problem, (self)-recognition of an eating problem, health service utilization and use of psychotropic medication. The only difference between groups was that participants who reported regular OBEs were heavier than those who reported regular SBEs. The findings converge with those of previous research in suggesting that bulimic-type eating disorders characterized by regular SBEs, but not OBEs, do not differ in any clinically meaningful way from those characterized by regular OBEs, but not SBEs. Inclusion of bulimic-type eating disorders characterized by regular SBEs as a provisional category requiring further research in DSM-V appears warranted.     

Distress Tolerance as a Familial Vulnerability for Distress-Misery Disorders

Low perceived distress tolerance (DT), a trait-like individual difference factor reflecting one’s perceived ability to withstand aversive affective states, has been linked with current internalizing and substance use disorders (SUDs). However, perceived DT has not been systematically evaluated as a familial, transdiagnostic vulnerability factor for internalizing and SUDs. The current study tested whether perceived DT runs in families and whether it is reduced among individuals with versus without remitted internalizing/SUD psychopathology. Perceived DT and internalizing/SUDs were measured in 638 individuals (nested within 256 families). Analyses also adjusted for the effects of neuroticism to test whether DT was a specific vulnerability factor independent of temperamental negative affect. Analyses revealed that perceived DT was lower in individuals with remitted distress (i.e., major depression, generalized anxiety disorder, posttraumatic stress disorder) but not fear disorders (i.e., panic disorder, social anxiety disorder, specific phobia, obsessive-compulsive spectrum disorders) relative to healthy controls, and the effect of distress-misery disorder history remained significant when adjusting for neuroticism. Perceived DT was not significantly different among individuals with versus without a remitted SUD. There were no effects for comorbid SUD and distress-misery disorders. Finally, perceived DT was also significantly correlated within families, suggesting that it runs in families. Overall, results suggest that independent of neuroticism, low perceived DT is a familial vulnerability for distress (but not fear or substance use) disorders.     

Eating Disorders—The Regulation of Positive as well as Negative Emotion Experience

Disordered eating behaviors are often conceptualized as maladaptive emotion regulation strategies. The present study investigated links between emotional experience, schematic belief systems, and psychological themes associated with eating disorders. In contrast to the majority of studies, which focus on just one or two emotions and use nonclinical samples, this study compared the full range of emotional experience in women with eating disorders to a control group. Measures used include the Differential Emotional Scale-IV, Youngs Early Maladaptive Schema Questionnaire, and Eating Disorder Inventory-2. The study provides the first empirical evidence that women diagnosed with eating disorders report experiencing pleasant as well as unpleasant emotions more frequently than do controls. A surprising finding was that pleasant emotions (joy, interest, surprise) correlated with eating disorder themes (EDI-2 subscales) more consistently than unpleasant emotions in the eating disorder group, while the reverse was true of the control group. Also of note, eating-disordered women reported significantly less anger and similar levels of fear vs. controls. While eating-disordered women scored more highly than do controls on all maladaptive schema (suggesting high levels of distress in women with eating disorders), the pattern of correlations between schema and emotion experience was distinctly different for each group and counterintuitive for the eating disorder group. In particular, pleasant emotion was highly correlated with maladaptive schema in the eating-disordered group but not in the control group. These marked group differences in the pattern of relationships between emotion experience, eating disorder themes, and belief systems suggest that it is not valid to draw conclusions about eating disorders from research that employs only nonclinical samples. The authors discuss these findings, and suggest that women with eating disorders are proficient at using disordered eating behaviors to manipulate their experience of both positive and negative emotional states, and that this dynamic should be recognized as an important maintenance factor.     

Using the PAI with an eating disordered population: scale characteristics,factor structure,and differences among diagnostic groups

Psychometric properties of the Personality Assessment Inventory (PAI; Morey 1991) within an eating disordered sample seeking treatment (N = 238) and differences among eating disorder diagnostic groups on the PAI were examined. The PAI showed acceptable alpha coefficients, item-total correlations, and interitem correlations. The factor structure was similar to that reported by Morey (1991), with the addition of another factor related to interpersonal coolness and distance. Those with binge eating disorder (BED) reported fewer problems and less distress in general compared to other eating disordered groups. The BED and bulimia nervosa groups were different from the anorexia nervosa groups in frequency of matching on two PAI clusters. Use of the PAI with an eating disordered population and its utility in understanding eating disorder diagnostic groups is supported.     

Early Onset Binge Eating and Purging Eating Disorders: Course and Outcome in a Population-Based Study of Adolescents

This study aimed to describe the course of early onset eating disorders in a population-based sample followed from 14 to 20 years; identify variables that could account for the persistence of eating disorders from 14 to 20 years; and describe outcome of early onset eating disorders with reference to general and psychological functioning at age 20. Participants (N?=?1,383; 49 % male) were drawn from the Western Australian Pregnancy Cohort (Raine) Study, which has followed children from pre-birth to young adulthood. Eating disorder symptoms were assessed using an adapted version of the Eating Disorder Examination-Questionnaire, at ages 14, 17 and 20. At age 14, 70 participants met DSM-IV criteria for a binge eating or purging eating disorder. Nearly half (44 %) of these adolescents ceased to meet criteria for an eating disorders at ages 17 and 20, whilst one-quarter still met criteria for an eating disorder at age 20 and one-fifth met criteria for an eating disorder at all three time points. Purging at age 17 and externalising behaviour problems at age 14 were the strongest predictors of eating disorder persistence to age 20. Participants who experienced a persistent eating disorder were less likely to complete high school than other participants, and reported pronounced depressive and anxiety symptoms at age 20. This study provides new data the course and outcome of early onset eating disorders at a population level. Behavioural difficulties in early adolescence and purging in middle adolescence may predict persistent eating pathology to young adulthood.