آسیب شناسی غذایی، تنظیم احساسات و پرخوری هیجانی در افراد چاق مبتلا به اختلال پرخوری افراطی
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|38844||2013||5 صفحه PDF||سفارش دهید||4016 کلمه|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Eating Behaviors, Volume 14, Issue 3, August 2013, Pages 309–313
Abstract Objective The purpose of the current study was to examine the relationship among emotional regulation, emotional overeating, and general eating pathology in a treatment seeking sample of adults with Binge Eating Disorder (BED). Method The sample was composed of 326 adults (248 women, 78 men) who were obese and met DSM-IV-TR criteria for BED. Prior to treatment, participants completed the Difficulties in Emotion Regulation Scale (DERS), Emotional Overeating Questionnaire (EOQ), Beck Depression Inventory (BDI), and Eating Disorder Examination-Questionnaire (EDE-Q) as part of a larger assessment battery. Results A series of hierarchical regression analyses indicated that difficulties with emotion regulation accounted for unique variance in both emotional overeating and general eating pathology above and beyond sex and negative affect. Discussion Emotion regulation may play a significant role in the maintenance of emotional overeating and eating pathology in obese adults with BED.
Introduction A predominant theoretical model for explaining disordered eating behaviors suggests that these behaviors are undertaken as an attempt to regulate or escape from negative affect (Heatherton and Baumeister, 1991 and Stice et al., 2001). Past research suggests that many individuals who struggle with excess weight or have an eating disorder also engage in a maladaptive behavior termed emotionally-driven eating, which is eating in response to emotions (Goossens et al., 2009, Masheb and Grilo, 2006 and Ricca et al., 2009). Negative affect is one of the most commonly reported precipitants of binge eating episodes (Polivy & Herman, 1993) and a meta-analytic review examining studies implementing ecological momentary assessment (EMA) demonstrates that increases in negative affect often precede binge episodes in individuals with binge eating disorder (BED) and bulimia nervosa (Haedt-Matt & Keel, 2011). Experimentally-induced negative affect is also associated with binge eating and loss-of-control eating in laboratory settings in obese women with BED (Agras and Telch, 1998 and Chua et al., 2004). It has been hypothesized that individuals with eating disorders are vulnerable to engaging in emotional overeating because they lack adaptive emotion regulation strategies and skills, including being able to clearly identify and adaptively cope with emotional states (Sim and Zeman, 2006 and Wiser and Telch, 1999). Compared to healthy controls, individuals with anorexia nervosa and bulimia nervosa report more difficulties with emotion regulation, although there is not yet evidence demonstrating a causal relationship between emotion regulation difficulties and disordered eating behaviors in these groups (Harrison, Sullivan, Tchanturia, & Treasure, 2010). Initial studies suggest that emotion regulation difficulties explain a significant portion of the variance of binge eating behaviors in a non-clinical college sample and a non-clinical sample of children (Czaja et al., 2009 and Whiteside et al., 2007). Binge eating disorder is found in between 1 and 3% of the population, with the prevalence increasing to approximately 8% in overweight and obese samples (Bruce and Agras, 1992 and Spitzer et al., 1992). Among overweight and obese samples seeking weight loss treatment, the prevalence of BED is between 20% and 30% (Striegel-Moore & Franko, 2003). A substantial body of literature suggests that individuals with BED report overeating in response to emotions (Eldredge and Agras, 1996, Masheb and Grilo, 2006 and Stein et al., 2007). There have been a number of trials examining the efficacy of treatments for BED which focus on developing adaptive emotion regulation skills, with the intent of reducing emotional overeating (Robinson, 2012 and Telch et al., 2001). It is important to better characterize the relationship between emotion regulation difficulties and disordered eating behaviors within a sample of adults with BED, as this may provide us with valuable information regarding appropriate points of intervention for these individuals. The purpose of the current study was to determine whether emotion regulation difficulties significantly contributed to emotional overeating and general eating disorder pathology in a clinical sample of obese, treatment-seeking adults with BED after accounting for sex and negative affect. We hypothesized that emotion regulation difficulties would explain unique variance in both emotional overeating and general eating disorder pathology. Furthermore, we sought to examine what specific types of emotion regulation difficulties would significantly account for variance in these two outcome variables.
نتیجه گیری انگلیسی
3. Results 3.1. Emotional overeating, general eating pathology, and emotion regulation difficulties Table 1 provides means and standard deviations for the total scores and subscale scores for all variables. Hierarchical regression was used to determine whether emotion regulation difficulties explained unique variance in emotional overeating and general eating pathology above and beyond sex and negative affect. For the first regression EOQ: Negative Affect, our measure of emotional overeating in response to negative affect, was regressed on Sex at Step 1. Negative affect, as measured by the BDI, was added at Step 2. Finally, emotion regulation difficulties, as operationalized by the DERS total score, were added at Step 3. Table 2 presents these regression results. For the second regression, Global EDE-Q, our measure of general eating pathology, was regressed on Sex at Step 1, with BDI and DERS total score added at Steps 2 and 3 respectively. Table 3 presents these regression results. Table 1. Means and standard deviations for total scales and subscales. Scales and subscales M SD Global EDE-Q 3.41 0.93 EDE-Q: Eating Concern 3.14 1.43 EDE-Q: Shape Concern 4.56 1.00 EDE-Q: Weight Concern 3.99 1.05 EDE-Q: Dietary Restraint 1.97 1.33 EOQ: Negative Affect 2.11 1.34 BDI 16.18 9.17 DERS total 82.31 24.07 DERS Non-acceptance 12.09 5.21 DERS Goals 13.27 4.90 DERS Impulse 12.71 5.16 DERS Awareness 16.77 5.45 DERS Strategies 16.85 7.01 DERS Clarity 10.62 3.84 Note. N = 326; EDE-Q = eating disorder examination-questionnaire; EOQ: Negative Affect = emotional overeating questionnaire: negative affect; BDI = Beck depression inventory; DER = difficulties in emotion regulation scale. Table options Table 2. Hierarchical regression analysis predicting emotional overeating as a function of sex, negative affect, and emotion regulation difficulties. Variable B SE B β Step 1 Sex .57 .18 .18⁎⁎ Step 2 Sex .35 .16 .11⁎ Negative affect .07 .01 .45⁎⁎⁎ Step 3 Sex .34 .16 .11⁎ Negative affect .05 .01 .31⁎⁎⁎ Emotion regulation difficulties .01 .00 .21⁎⁎ Note. N = 326; R2 = .032 for Step 1; Δ R2 = .200 for Step 2; Δ R2 = .022 for Step 3. ⁎ p < .05. ⁎⁎ p < .01. ⁎⁎⁎ p < .001. Table options Table 3. Hierarchical regression analysis predicting disordered eating pathology as a function of sex, negative affect, and emotion regulation difficulties. Variable B SE B β Step 1 Sex .51 .12 .23⁎⁎⁎ Step 2 Sex .37 .12 .17⁎⁎ Negative affect .04 .01 .43⁎⁎⁎ Step 3 Sex .36 .11 .17⁎⁎ Negative affect .03 .01 .31⁎⁎⁎ Emotion regulation difficulties .01 .00 .17⁎ Note. N = 326; R2 = .055 for Step 1; Δ R2 = .177 for Step 2; Δ R2 = .015 for Step 3. ⁎ p < .05. ⁎⁎ p < .01. ⁎⁎⁎ p < .001. Table options Results revealed that participant sex (Sex) at Step 1 uniquely explained 3.2% of the variance in emotional overeating and 5.5% of the variance in general eating pathology. At Step 2, negative affect (BDI) accounted for 20% of variance in emotional overeating and 17.7% of variance in general eating pathology. At Step 3, emotion regulation difficulties (Total DERS) accounted for 2.2% of variance in emotional overeating and 1.5% of variance in general eating pathology. Taken together, the three predictor variables accounted for 25% of the variance within emotional overeating and 24% of the variance within general eating pathology. 3.2. Emotional overeating, general eating pathology, and specific types of emotion regulation difficulties Multiple regression was then implemented to identify how specific emotion regulation difficulties are uniquely related to emotional overeating and general eating pathology. First, EOQ: Negative Affect was regressed on the six DERS subscales. Results from these analyses can be found in Table 4. The combination of the six subscales accounted for 21% of the variance in emotional overeating, F(6, 305) = 13.77, p < .001. Two DERS subscales, measuring limited access to emotion regulation strategies (Strategies) and lack of emotional clarity (Clarity) uniquely predicted emotional overeating. Next, Global EDE-Q was regressed on the six DERS subscales. Results from these analyses can be found in Table 5. The combination of the six subscales accounted for 19% of the variance in general eating pathology, F(6, 313) = 12.24, p < .001. Two DERS subscales, measuring non-acceptance of emotional responses (Non-acceptance) and difficulties engaging in goal-directed behavior (Goals) uniquely predicted general eating pathology. Table 4. Multiple regression analysis predicting emotional overeating as a function of DERS subscales. Variable B SE B β t Non-acceptance .02 .02 .09 1.25 Goals − .01 .02 − .05 − 0.59⁎⁎⁎ Impulse .02 .02 .07 0.85 Awareness − .01 .02 − .06 − 0.81 Strategies .06 .02 .29 2.87⁎⁎ Clarity .06 .03 .17 2.08⁎ Note. N = 326. ⁎ p < .05. ⁎⁎ p < .01. ⁎⁎⁎ p < .001. Table options Table 5. Multiple regression analysis predicting disordered eating pathology as a function of DERS subscales. Variable B SE B β t Non-acceptance .04 .01 .22 2.92⁎⁎ Goals .03 .02 .17 2.24⁎ Impulse − .01 .01 − .05 − .57 Awareness − .01 .01 − .02 − .25 Strategies .01 .01 .08 .79 Clarity .03 .02 .11 1.41⁎⁎⁎ Note. N = 326. ⁎ p < .05. ⁎⁎ p < .01. ⁎⁎⁎ p < .001.