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

Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, USA.
Behaviour Research and Therapy (Impact Factor: 3.85). 05/2010; 48(5):424-8. DOI: 10.1016/j.brat.2009.12.012
Source: PubMed


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 +/- 2.8 y; 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.

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    • "For example, Ansell and colleagues (2012) found that negative/depressive affect mediated the relationship between interpersonal problems on binge eating and eating disorder psychopathology in a community sample of 350 adult women who responded to an advertisement for a research study on eating and dieting. Elliott et al. (2010) found a similar relationship with regard to loss of control over eating on social problems in a sample of non-treatment-seeking children and adolescents. The theorized mechanism of the interpersonal model of binge eating has not been examined with a clinical sample of women with BED. "
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    ABSTRACT: This study evaluated the validity of the interpersonal model of binge-eating disorder (BED) psychopathology in a clinical sample of women with BED. Data from a cross-sectional sample of 255 women with BED were examined for the direct effects of interpersonal problems on BED symptoms and psychopathology, and indirect effects mediated by negative affect. Structural equation modelling analyses demonstrated that higher levels of interpersonal problems were associated with greater negative affect, and greater negative affect was associated with higher frequency of BED symptoms and psychopathology. There was a significant indirect effect of interpersonal problems on BED symptoms and psychopathology mediated through negative affect. Interpersonal problems may lead to greater BED symptoms and psychopathology, and this relationship may be partially explained by elevated negative affect. The results of the study are the first to provide support for the interpersonal model of BED symptoms and psychopathology in a clinical sample of women. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    European Eating Disorders Review 01/2015; 23(2). DOI:10.1002/erv.2344 · 2.46 Impact Factor
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    • "g upon the extent to which this feedback was expect - ed . The chatroom paradigm was specifically designed to disentangle the neural circuits engaged during each step of this temporally dynamic pro - cess . Individuals with LOC eating commonly report that their eating be - havior is elicited by social conflict or rejection ( Czaja et al . , 2011 ; Elliott et al . , 2010 ; Hartmann et al . , 2012 ; Hilbert et al . , 2010 ) ."
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    ABSTRACT: The interpersonal model of loss of control (LOC) eating proposes that socially distressing situations lead to anxious states that trigger excessive food consumption. Self-reports support these links, but the neurobiological underpinnings of these relationships remain unclear. We therefore examined brain regions associated with anxiety in relation to LOC eating and energy intake in the laboratory. Twenty-two overweight and obese (BMIz: 1.9±0.4) adolescent (15.8±1.6y) girls with LOC eating (LOC+, n=10) and without LOC eating (LOC-, n=12) underwent functional magnetic resonance imaging (fMRI) during a simulated peer interaction chatroom paradigm. Immediately after the fMRI scan, girls consumed lunch ad libitum from a 10,934-kcal laboratory buffet meal with the instruction to "let yourself go and eat as much as you want." Pre-specified hypotheses regarding activation of five regions of interest were tested. Analysis of fMRI data revealed a significant group by peer feedback interaction in the ventromedial prefrontal cortex (vmPFC), such that LOC+ had less activity following peer rejection (vs. acceptance), while LOC- had increased activity (p<.005). Moreover, functional coupling between vmPFC and striatum for peer rejection (vs. acceptance) interacted with LOC status: coupling was positive for LOC+, but negative in LOC- (p<.005). Activity of fusiform face area (FFA) during negative peer feedback from high-value peers also interacted with LOC status (p<.005). A positive association between FFA activation and intake during the meal was observed among only those with LOC eating. In conclusion, overweight and obese girls with LOC eating may be distinguished by a failure to engage regions of prefrontal cortex implicated in emotion regulation in response to social distress. The relationship between FFA activation and food intake supports the notion that heightened sensitivity to incoming interpersonal cues and perturbations in socio-emotional neural circuits may lead to overeating in order to cope with negative affect elicited by social discomfort in susceptible youth. Published by Elsevier Inc.
    NeuroImage 12/2014; 108. DOI:10.1016/j.neuroimage.2014.12.054 · 6.36 Impact Factor
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    • "Most notably, children with higher eating pathology at randomization regained less relative weight following SFM than did similar children assigned to BSM or the control condition, perhaps because SFM promotes positive body image, which may be a barrier to physical activity among overweight children (Hayden-Wade et al., 2005). Conversely , SFM may reduce interpersonally driven overeating (Elliott et al., 2010) via its focus on improving overall social functioning (e.g., positive responding to teasing, encouragement to engage in more social or peer-based activities). Overall, when considered in conjunction with our previous findings that children with low social problems particularly benefited from SFM, results cumulatively suggest that SFM capitalizes on existing skills in some areas but also benefits children with impairments in others. "
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    ABSTRACT: Objective: To examine general and treatment-specific predictors of children's weight outcomes during a pediatric weight management trial. Method: One hundred fifty overweight children-69.3% female; M body mass index (BMI) z score (z-BMI) = 2.21 ± 0.30-completed family-based behavioral weight loss treatment (FBT), followed by randomization to social facilitation maintenance (SFM) treatment addressing social support and body image; behavioral skills maintenance treatment (BSM), which extended FBT skills to maintenance; or a control condition with no maintenance treatment. Regression and mixed-effects repeated-measures analysis of covariance (ANCOVA) examined child and parent anthropometric, demographic, and psychosocial variables in predicting relative weight outcomes over short- and long-term follow-ups. Results: Among FBT completers, lower child baseline z-BMI and age, and greater parent BMI reductions during FBT and baseline self-efficacy, predicted better child relative weight loss following FBT, F(6, 137) = 7.77, p < .001. Higher child-reported post-FBT eating pathology predicted greater relative weight loss in SFM than BSM or control from post-FBT to 2-year follow-up, F(4,255.88) = 3.48, p = .009, whereas higher parent-reported post-FBT social support predicted greater relative weight loss in BSM than control, F(2,141.65) = 3.28, p = .04. Lower parent-reported post-FBT behavioral problems predicted greater relative weight loss in SFM and BSM versus control, F(2,147.84) = 7.37, p < .001; higher problems predicted equivalent outcome across treatments. Conclusion: SFM may improve weight outcomes for FBT completers with initially higher eating pathology, whereas extending FBT skills may be effective for those with higher familial support. These results suggest that certain pretreatment variables moderate the effectiveness of different pediatric weight control interventions. Further understanding these findings may help optimally match families to treatments.
    Journal of Consulting and Clinical Psychology 06/2014; 82(6). DOI:10.1037/a0037169 · 4.85 Impact Factor
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