Examining trait-like factors as predictors of state-level responses to food intake in women with bulimia nervosa, purging disorder, and controls.

OBJECTIVE: Theories suggest that elevated negative affect and weight/shape concerns explain both who is affected by bulimic symptoms as well as when bulimic symptoms occur, suggesting that individual differences predict within-subject differences. However, few studies have tested this theoretical premise. METHOD: In the present study, participants (N = 119) diagnosed with bulimia nervosa (N = 57), purging disorder (N = 31), and non-eating disorder controls (N = 31) completed measures of negative affect and weight/shape concerns and later made momentary affect and weight/shape concerns ratings before and after an ad lib meal. RESULTS: State negative affect and weight/shape concerns increased post-meal. No moderating effect of trait negative affect was observed for state affect. In contrast, between-subject differences in weight/shape concerns moderated within-subject increases in state weight/shape concerns. Diagnostic group did not account for this effect. DISCUSSION: Findings point to viable treatment targets for disordered eating. Targeting elevated weight/shape concerns early in interventions could facilitate reductions in purging after food intake for bulimia nervosa and purging disorder. PUBLIC SIGNIFICANCE: In the present study, individual differences in weight/shape concerns at baseline predicted greater increases in state weight/shape concerns following eating. These effects were maintained when considering possible differences related to presence and type of eating disorder. Results suggest that targeting weight/shape concerns earlier in treatment may be important for reducing maladaptive responses to eating across eating disorders.

Evaluating the role of negative affect and negative interpretation biases in emotional eating behavior.

OBJECTIVE: The study of emotional eating, or (over)eating in response to emotions, may inform transdiagnostic interventions for eating pathology. Prior work has focused on the role of negative affect in promoting emotional eating. The present study sought to extend this work through examining the role of cognitive biases. METHOD: Women who self-reported (n = 50) and did not self-report (n = 40) emotional eating completed self-report questionnaires of negative affect and negative interpretation biases, an implicit measure of cognitive bias, and a behavioral assay of emotional eating involving an ad lib test meal following a stress induction task. RESULTS: The emotional eating group endorsed elevated trait negative affect, explicit shame biases, and implicit negative biases compared to controls. In addition, state negative affect increased after the stress induction task, and the emotional eating group endorsed greater state negative affect before and after the task and consumed more food following the stress induction. Only explicit cognitive shame biases demonstrated significant indirect effects in the association between group and food consumption. Specifically, elevated explicit shame biases were positively associated with amount of food consumed for the emotional eating group. DISCUSSION: Future research should examine whether interventions that target cognitive biases related to shame reduce emotional eating. PUBLIC SIGNIFICANCE: Individuals with emotional eating consumed more food than controls following a stress induction. Explicit shame cognitive biases were positively associated with amount of food consumed for the emotional eating group. Shame cogntiive biases may be fruitful targets for reducing emotional eating.

How changing life roles predict eating disorder pathology over 30-year follow-up.

Epidemiological data support higher prevalence of eating disorders in midlife than previously believed. Yet, few studies have examined risk factors unique to adult development. The present study examined how changes in life roles (educational, marital, and parental status) predicted disordered eating as participants transitioned from their 20s to their 50s. Participants (N = 624 women and N = 276 men) completed baseline assessments in college and at 10-, 20-, and 30-year follow-up, with 72% of women and 67% of men completing 30-year follow-up. Multilevel models examined how changes in life roles predicted changes in disordered eating. For women, obtaining a graduate degree predicted decreased eating pathology initially but over time predicted subsequent increases in Drive for Thinness. Men's eating pathology was not affected by obtaining a graduate degree. Changes in marital status demonstrated no significant association with disordered eating for either gender. Becoming a parent predicted a significant decrease in Drive for Thinness at the subsequent assessment but no further declines with age, whereas those who never had children showed significant decreases in both Drive for Thinness and Bulimia with age. For both women and men, becoming a parent may decrease the importance of shape and weight as sources of self-evaluation. However, women obtaining advanced degrees and parents may experience shifts in eating pathology related to the "Career-and-Care-Crunch" according to Mehta and colleagues' (2020) recent conceptualization of adult developmental stages. Pending independent replication, future research might design interventions for those whose role transitions put them at greater risk for disordered eating during midlife. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Enduring value of perfectionism and maturity fears for predicting eating disorder maintenance over 10-, 20-, and 30-year follow-up.

OBJECTIVE: The Eating Disorder Inventory provides a theoretically informed multidimensional assessment of eating disorder symptoms and associated psychological factors widely used to examine the development and maintenance of eating disorders. Yet, mixed findings for some factors raise questions about whether their prognostic value varies as a function of duration of follow-up or type of eating pathology studied. METHOD: The current study compared prognostic value of perfectionism, maturity fears, and interpersonal distrust as predictors of restrictive versus bulimic symptom patterns at 10-, 20-, and 30-year follow-up in N = 127 individuals diagnosed with eating disorders at baseline. Multivariable regression analyses and statistical comparison of effect sizes were used. RESULTS: Drive for Thinness at 10- and 30-year follow-up was predicted by higher Perfectionism and higher Maturity Fears at baseline. Baseline Maturity Fears also predicted higher Drive for Thinness at 20-year follow-up and higher Bulimia at 10- and 20-year follow-up. Interpersonal Distrust did not demonstrate prognostic significance in multivariable models. Comparisons of effect sizes support that some differences in statistical significance reflect differences in prognostic value of psychological factors. DISCUSSION: Both duration of follow-up and type of pathology impact the predictive value of psychological factors and have important implications for understanding illness maintenance. Findings support the utility of targeting Perfectionism for restrictive symptoms. Developing interventions focused on Maturity Fears may provide a novel approach to reducing both restrictive and bulimic symptoms.