A functional analysis of binge-eating

Cognitive content among bulimic women: the role of core beliefs

OBJECTIVE

Most cognitive analyses of bulimic disorders have stressed the role of negative automatic thoughts or dysfunctional assumptions regarding weight, shape, and food. This study considered the role of more general core beliefs in the cognitive content of bulimic disorders.

METHODS

Fifty bulimic and 50 comparison women completed the Schema Questionnaire (YSQ) and a diary measure of bulimic behaviors.

RESULTS

The groups could be differentiated using just three of the beliefs: perceived Defectiveness/Shame, Insufficient Self-Control, and Failure to Achieve. This discrimination included differences between bulimic subgroups. At the symptomatic level, the bulimic women's Emotional Inhibition beliefs predicted their severity of binging, whereas their Defectiveness/Shame beliefs predicted severity of vomiting.

CONCLUSIONS

The findings support a model of bulimic psychopathology where the central cognitions encompass more than beliefs about food, shape, and weight. Clinical implications are considered.

Cognitive avoidance and bulimic psychopathology: the relevance of temporal factors in a nonclinical population

OBJECTIVE

Previous research has provided evidence of both an attentional bias towards, and a cognitive avoidance of threat cues, by individuals with unhealthy eating attitudes and disorders. It has been suggested that an initial attentional bias might be followed by a later avoidance process. The present study assessed the speed of processing of self-directed ego threat words following different interstimulus intervals (500, 1,000, 1,500, and 2,000 ms).

METHOD

Fifty female students completed a computer-driven threat processing task and the Eating Disorders Inventory.

RESULTS

Women were significantly slower to process ego-self threat cues following the 2, 000-ms interval than following the other intervals (500, 1,000, and 1,500 ms). Those women with increased levels of bulimic attitudes were slower to process threats following the 1,500-ms interval, but not after the longer or shorter intervals.

CONCLUSIONS

The results stress the importance of temporal factors in the processing of threat by individuals with high levels of eating psychopathology. The findings are discussed in terms of an appropriate cognitive model.

Subliminal activation of abandonment- and eating-related schemata: relationship with eating disordered attitudes in a nonclinical population

OBJECTIVE

Previous research has demonstrated that subliminal abandonment cues can facilitate eating behavior. It is believed that such eating is a response to the activation of specific core schemata. However, the precise nature of those schemata has not been established. This study examined whether the presentation of subliminal abandonment and food/shape cues results in the activation of abandonment-related or food-related schemata.

METHOD

Eighty-two women were exposed to one of three subliminal cues- an abandonment cue ("lonely"), an appetitive cue ("hungry"), and a neutral cue ("gallery"). They subsequently completed Stroop tasks to measure activation of relevant schemata.

RESULTS

Subliminal presentation of abandonment cues led to the activation of food- and shape-related schemata. In contrast, subliminal appetitive cues resulted in an activation of abandonment-related schemata.

CONCLUSIONS

The results show preliminary support for a multilevel cognitive model, involving indirect links between subliminal cue type and the activation of eating-related cognitions.

Differences in daily stress, mood, coping, and eating behavior in binge eating and nonbinge eating college women

This study investigated differences between binge eaters and controls on measures of daily stress, mood, coping, and eating behavior. The same measures were also used to compare binge days to nonbinge days for the binge group. Participants included 20 college women who reported binge eating at least two times per week and 20 women who reported no disturbance in their eating behavior. They were asked to self-monitor their daily stress, coping, mood, and eating behavior for three weeks. Results indicated that the binge group reported more stress and negative mood over the three weeks than the control group. The binge group reported experiencing a similar number of stressful events on binge days as compared to nonbinge days, however, the impact of those events was much greater on binge days. The binge eaters also reported less positive mood and more episodes of eating on binge days. The groups did not differ in the number of coping strategies used. Stress and negative mood appear to be common antecedents for binge eating. The role of coping responses and daily eating behavior (i.e., restraint) on binge eating is somewhat less clear.

Emotional eating and eating psychopathology in nonclinical groups: a cross-cultural comparison of women in Japan and the United Kingdom

OBJECTIVE

Emotional eating is associated with eating psychopathology among Western populations. It is not known whether the same conclusions hold in non-Western cultures, where norms for emotional expression differ. This study examined whether emotional eating has the same eating psychopathology correlates in different cultures.

METHOD

Three groups of nonclinical women were compared-Japanese living in Japan; Japanese living in the United Kingdom; and British living in the United Kingdom. They completed an Emotional Eating Scale and the Eating Disorders Inventory.

RESULTS

There were different patterns of association between emotional eating and eating attitudes in the three groups. British women showed a strong linkage, Japanese women living in Japan showed no association, and Japanese women in the United Kingdom showed an intermediate pattern.

CONCLUSIONS

Emotional eating may be less of an index of eating psychopathology in non-Western cultures. However, there appears to be an acculturative process, linking the two when one enters a Western culture. This cross-cultural difference may have implications for the targeting of therapies, although this conclusion requires support from further research.

Binge eating disorder: a review of the literature after publication of DSM-IV

Binge eating disorder (BED) is a syndrome marked by recurrent episodes of binge eating, in the absence of the regular use of inappropriate compensatory behaviors. Since the inclusion of BED in DSM-IV as a Diagnostic Category in Need of Further Research, a great deal of research has been conducted. This paper reviews research on BED since publication of DSM-IV in 1994. We conclude that questions about the definition of BED persist. Furthermore, recent studies which have strictly used the DSM-IV definition of BED have found that the full syndrome is found in less than 3% of obese adults seeking weight loss treatment and occurs in less than 1% of the general adult population. Binge eating is a common symptom associated with obesity, however. BED may be conceptualized as a psychiatric syndrome or it may be viewed as a behavioral symptom associated with obesity. We conclude that clarification of this conceptual issue is needed if research on BED is to progress.

Evaluating direct and indirect measures for the functional assessment of binge eating

OBJECTIVE

This study examined the usefulness of the Function of Binge Eating Scale and monitoring forms for a sample of subclinical binge eaters.

METHOD

Participants included 23 college students who reported engaging in binge eating an average of two or more times per week. Participants completed the Function of Binge Eating Scale at the initial session, at 2 weeks, and at 4 weeks. Participants also monitored binge eating behavior and completed an Antecedent Checklist each time they engaged in binge eating.

RESULTS

Participants responded similarly to direct and indirect measures of antecedents of binge eating although they tended to rate items on the indirect measures as more intense than on the direct measures. Boredom and dissatisfaction with body weight and shape were rated as the most intense proximate antecedents while anxiety and anger at others were reported as least intense. Irritability and depressed mood were the most frequently reported temporally remote antecedents.

DISCUSSION

Implications and suggestions for future research are discussed.

The impact of emotion upon eating behavior: the role of subliminal visual processing of threat cues

OBJECTIVE

Previous research has demonstrated that subliminal threat cues can influence eating behavior. The present study examined whether this effect is due to general emotional activation (by comparing positive and negative emotional cues), whether it is a product of specific negative emotional activation, and whether it can be achieved by activating appetite-related schemata.

METHOD

One hundred women avoided food for at least 4 hr and then completed a task where they were exposed to one of five subliminal visual cues. The dependent variable was the amount eaten subsequently.

RESULTS

Women who were exposed to the abandonment cue (lonely) ate significantly more than those who were exposed to the neutral cue (gallery), the positive emotional cue (happy), or the appetitive cue (hungry). Those with unhealthy eating attitudes also ate more after the hostile emotion cue (angry) than after the neutral cue.

CONCLUSIONS

The results support cognitive models that stress an important role for threat processing in the facilitation of eating, rather than models advocating the centrality of food-related information. Abandonment schemata appear to be activated at an earlier stage than appetite-related schemata.