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

Department of Psychology, Washington University, 660 South Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, USA.
Behaviour Research and Therapy (Impact Factor: 3.85). 08/2008; 46(7):777-87. DOI: 10.1016/j.brat.2008.03.004
Source: PubMed


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.
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.
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).
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.

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Available from: Andrea B Goldschmidt
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    • "Furthermore, both objective binge eating (i.e., a sense of loss of control over eating is present and an objectively large amount of food is consumed) and subjective binge eating (i.e., a sense of loss of control over eating is present but an objectively large amount of food is not consumed) were assessed. Both forms of a sense of loss of control over eating are closely associated with psychological distress and weight gain and are equally important when assessing binge eating in childhood and adolescence (Allen et al., 2012; Goldschmidt et al., 2008; Goossens et al., 2009; Shomaker et al., 2010; Tanofsky-Kraff, 2008; Tanofsky-Kraff et al., 2007). "
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    ABSTRACT: Stice’s (1994, 2001) dual pathway model proposed a mediational sequence that links body dissatisfaction to lack of control over eating through dieting and negative affect. Van Strien et al. (2005) extended the negative affect pathway of the original dual pathway model by adding two additional intervening variables: interoceptive deficits and emotional eating. The purpose of this study was to test and compare the original and extended model using prospective data. Both types of loss of control over eating (i.e., subjective and objective binge eating) were evaluated. Data collected from 361 adolescent girls, who were interviewed and completed self-report measures annually over a 2-year period, were analysed using structural equation modeling. Although both models provided a good fit to the data, the extended model fit the adolescent girls’ sample data better and accounted for a greater proportion of variance in binge eating than the original model. All proposed mediational pathways of both models were supported and all indirect effects examined through bootstrap procedure were significant. Although our results confirmed the validity of both models and extended previous findings to an early- to middle adolescent group, the bi-directional relationship between dietary restriction and negative affect suggests that the association between these key risk factors for binge eating are more complex than outlined in both the original and extended dual-pathway models.
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    • "As part of the process of tailoring or ''matching'' treatments to particular patient populations, we will need to first identify those youth and families most likely to benefit from our interventions. A study by Goldschmidt et al. (2008) provides an example of ''subtyping'' youth with regard to loss of control eating, negative affect, and dietary restraint. This kind of research has implications for development of effective interventions that target the psychological underpinnings of obesity for some youth. "

    Preview · Article · Sep 2013 · Journal of Pediatric Psychology
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    • "Individual differences in eating behaviors are widely varied (Blundell & Cooling, 2000) and have been shown to differentially alter liability for binge eating (Brownell & Fairburn, 2005). In particular , individuals who engage in dietary restraint have been found to be at a heightened risk to binge eat (Baucom & Aiken, 1981; Goldschmidt et al., 2008; Grilo & Shiffman, 1994 "
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    ABSTRACT: It is well documented that negative urgency, a personality trait characterized by a tendency to act impulsively in the face of negative emotions, and dietary restraint independently increase risk to binge eat; however, it is unclear how these factors interact to alter risk for such behavior. It may be that individuals high on negative urgency, who also engage in dietary restraint, are at a greater risk to binge eat than individuals low on negative urgency. Accordingly, we sought to investigate whether negative urgency moderated the prospective association between dietary restraint and binge eating frequency among a sample of college women. We hypothesized that women who engaged in dietary restraint would report a greater binge eating frequency across the first semester of college and that this effect would be strengthened among individuals higher on negative urgency. Results indicated that negative urgency moderated the prospective association between dietary restraint and binge eating frequency. This effect was found to be "protective but reactive," such that low levels of dietary restraint protected against binge eating frequency at low to moderate levels of negative urgency, but this buffering effect was lost at high levels of negative urgency where binge eating frequency was equal across all levels of dietary restraint. These findings demonstrate that negative urgency and dietary restraint interact to differentially alter risk for binge eating frequency, and individuals high on negative urgency are at the greatest risk to engage in more frequent binge eating regardless of level of dietary restraint.
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