1
|
Tempia Valenta S, Rapezzi M, Marcolini F, Speciani M, Giordani G, De Panfilis C, De Ronchi D, Atti AR. Assessing motivation for treatment in eating disorders: psychometric validation of the Italian version of the Autonomous and Controlled Motivation for Treatment Questionnaire (ACMTQ-ITA). Eat Weight Disord 2024; 29:23. [PMID: 38573529 PMCID: PMC10995063 DOI: 10.1007/s40519-024-01653-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 03/26/2024] [Indexed: 04/05/2024] Open
Abstract
PURPOSE Treatment resistance is a significant challenge in addressing eating disorders (EDs). The Autonomous and Controlled Motivation for Treatment Questionnaire (ACMTQ) has been previously validated in ED populations to assess patients' motivation for treatment. This study aimed to validate the ACMTQ in the Italian language (ACMTQ-ITA) and evaluate its psychometric properties. METHODS We recruited a clinical sample of adults aged 18 or older, diagnosed with EDs, proficient in the Italian language, and providing written informed consent. Participants with psychiatric comorbidities such as schizophrenia, bipolar disorder, and substance use disorder were excluded from the study. Validity of the ACMTQ-ITA was assessed using reliability analysis with Cronbach's α and McDonald's ω estimates, and Confirmatory Factor Analysis (CFA). RESULTS Results from the reliability analysis confirmed the internal consistency of the Autonomous Motivation (AM) factor (α = 0.82, ω = 0.82), the Controlled Motivation (CM) factor (α = 0.76, ω = 0.77), and the ACMTQ-ITA overall score (α = 0.79). The CFA confirmed the two-factor solution (i.e., AM and CM) identified in the original validation of the ACMTQ (Comparative Fit Index = 0.92, Akaike Information Criterion = 3427.26, Bayesian Information Criterion = 3486.82; Root Mean Square Error of Approximation = 0.08, Standardized Root Mean Square Residual = 0.09). CONCLUSION The ACMTQ-ITA emerged as a valid and reliable tool for measuring motivation for treatment in individuals with EDs. Its implementation may facilitate the comprehension of treatment motivation, offering valuable clinical insights and implications for health management practices. LEVEL OF EVIDENCE Level V, descriptive studies.
Collapse
Affiliation(s)
- Silvia Tempia Valenta
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Viale Pepoli 5, 40123, Bologna, Italy.
| | - Matilde Rapezzi
- Department of Management, University of Bologna, Bologna, Italy
| | - Federica Marcolini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Viale Pepoli 5, 40123, Bologna, Italy
| | - Maurizio Speciani
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Viale Pepoli 5, 40123, Bologna, Italy
| | - Gabriele Giordani
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Viale Pepoli 5, 40123, Bologna, Italy
| | - Chiara De Panfilis
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Viale Pepoli 5, 40123, Bologna, Italy
| | - Anna Rita Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Viale Pepoli 5, 40123, Bologna, Italy
| |
Collapse
|
2
|
Kalan RE, Smith A, Mason TB, Smith KE. Independent associations of food addiction and binge eating measures with real-time eating behaviors and contextual factors: An exploratory ecological momentary assessment study. Appetite 2024; 192:107127. [PMID: 37980955 PMCID: PMC10843748 DOI: 10.1016/j.appet.2023.107127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/26/2023] [Accepted: 11/14/2023] [Indexed: 11/21/2023]
Abstract
Food addiction (FA) is a concept centered around the addictive potential of highly palatable processed foods, though there is debate over the discriminative validity of FA as a distinct construct from binge-eating symptomatology. This study explored how trait measures of FA and binge-eating symptoms independently and interactively predicted eating behaviors and posited correlates of FA and binge eating measured via ecological momentary assessment (EMA). Adult participants (N = 49) who met the criteria for FA and/or binge-eating disorder completed baseline measures of FA (Yale Food Addiction Scale [YFAS 2.0]) and binge-eating symptoms (Eating Pathology Symptom Inventory [EPSI] binge eating scale) followed by a 10-day EMA protocol. Generalized linear mixed models examined the independent effects of YFAS 2.0, EPSI, and their interaction predicting EMA outcomes. Higher YFAS 2.0 symptom count scores were uniquely related to greater EMA-measured overeating, loss of control eating, negative and positive affect, and impulsivity when controlling for EPSI scores. Conversely, higher EPSI scores were uniquely related to greater EMA-measured eagerness and urge to eat, and expectancies that eating would improve mood. No interaction effects were significant. These results highlight potential distinctions between phenomena captured by FA and other measures of binge eating, in that FA symptoms may be a marker of heightened binge-eating severity, emotional arousal, and impulsivity.
Collapse
Affiliation(s)
- Rachel E Kalan
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA; Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Alexandro Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA.
| |
Collapse
|
3
|
Dissociative experiences of compartmentalization are associated with food addiction symptoms: results from a cross-sectional report. Eat Weight Disord 2023; 28:28. [PMID: 36867281 PMCID: PMC9984353 DOI: 10.1007/s40519-023-01555-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/04/2022] [Indexed: 03/04/2023] Open
Abstract
PURPOSE Studies have shown significant associations of dissociative symptoms with both eating and addictive disorders; however, the different forms of dissociation have been relatively understudied in relation to food addiction (FA). The main aim of this study was to investigate the association of certain forms of dissociative experiences (i.e., absorption, detachment and compartmentalization) with FA symptoms in a nonclinical sample. METHODS Participants (N = 755; 543 women; age range: 18-65; mean age: 28.22 ± 9.99 years) were evaluated using self-report measures of FA, dissociation, eating disturbances, and general psychopathology. RESULTS Compartmentalization experiences (defined as pathological over-segregation of higher mental functions) were independently associated with FA symptoms (β = 0.174; p = 0.013; CI = [0.008; 0.064]) even when confounding factors were controlled for. CONCLUSION This finding suggests that compartmentalization symptoms can have a role in the conceptualization of FA, with such two phenomena possibly sharing common pathogenic processes. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
Collapse
|
4
|
Clinical Considerations of Ultra-processed Food Addiction Across Weight Classes: an Eating Disorder Treatment and Care Perspective. CURRENT ADDICTION REPORTS 2022; 9:255-267. [PMID: 35531579 PMCID: PMC9058754 DOI: 10.1007/s40429-022-00411-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 12/27/2022]
Abstract
Purpose of Review To examine the prevalence rates of ultra-processed food addiction across different weight classes and offer guidelines for diagnosis and treatment. Clinicians are provided with practical considerations in the assessment of ultra-processed food addiction beyond the use of validated instruments. Recent Findings The weighted mean prevalence of ultra-processed food addiction is approximately 20% worldwide and varies widely based on the sample. At first glance, there appears a linear relationship between ultra-processed food addiction and BMI class. Further investigation indicates a J-shaped curve with heightened prevalence among the underweight. These findings highlight the need to assess for additional factors that may increase objective or subjective food addiction symptoms including eating disorders, dietary restraint, and other mental health diagnoses. Summary While clinical considerations across different weight classes vary, overemphasis on weight status may detract from the clinical utility of the ultra-processed food addiction construct. Considering weight status in conjunction with other psychiatric symptoms helps to better understand the various biopsychosocial mechanisms that influence eating behavior and can inform individualized treatment strategies.
Collapse
|
5
|
Park EJ, Hwang SSH, Lee MS, Bhang SY. Food Addiction and Emotional Eating Behaviors Co-Occurring with Problematic Smartphone Use in Adolescents? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4939. [PMID: 35564334 PMCID: PMC9103653 DOI: 10.3390/ijerph19094939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 02/06/2023]
Abstract
Addiction in adolescence is increasing and has a significant impact on physical and mental health. Notably, addictions can be comorbid and affect each other. Despite the recent growing interest in food addiction (FA) and problematic smartphone use (PSU), few studies have investigated their association in adolescents. We investigated the relationship between FA and PSU in adolescents and the effects of eating behaviors. A total of 209 adolescents (44.5% male; mean age = 12.86 ± 0.7 years) participated in the current school-based community study. We found a positive correlation between the dimensional Yale Food Addiction Scale for Children 2.0 (dYFAS-C2.0) and the Smartphone Overdependence Scale after adjusting for age, sex, body mass index, and socioeconomic status. The high-risk PSU group accounted for 17.2% of participants. Furthermore, this group showed 2.3 times higher dYFAS-C2.0 scores than the general group. Emotional overeating and satiety responsiveness were correlated with PSU. A comprehensive evaluation of addiction symptoms is needed for proper intervention, especially in adolescents with symptoms of abnormal eating behaviors.
Collapse
Affiliation(s)
- Eun-Jin Park
- Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang 10380, Korea;
- Center for School Mental Health, Eulji University, Seoul 01830, Korea;
| | | | - Mi-Sun Lee
- Center for School Mental Health, Eulji University, Seoul 01830, Korea;
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul 06591, Korea
| | - Soo-Young Bhang
- Center for School Mental Health, Eulji University, Seoul 01830, Korea;
- Department of Psychiatry, Eulji University Hospital, School of Medicine, Eulji University, Seoul 01830, Korea
| |
Collapse
|
6
|
USTA E, PEHLİVAN M. Mediation Effect of Depression on the Association between Food Addiction and Body Image in Individuals with Obesity. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.897251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
7
|
Prevalence and correlates of food addiction: Systematic review of studies with the YFAS 2.0. Obes Res Clin Pract 2021; 15:191-204. [PMID: 33846067 DOI: 10.1016/j.orcp.2021.03.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 03/19/2021] [Accepted: 03/28/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Research on food addiction (FA) has been growing and increasing interest has been seen in comprehending its mechanisms and clinical and psychological correlates of this phenomena. This field of study is specially apply to understand obesity and eating behavior issues related to eating disorders (ED). OBJECTIVES We performed a literature review that describe recent research using the updated version of the Yale Food Addiction Scale (YFAS 2.0) or modified-YFAS (mYFAS 2.0), from the date of its publication. METHODS Search were performed in Web of Science, Pubmed and PsycNET databases for studies that used the YFAS 2.0 and mYFAS 2.0. RESULTS The studies (n = 53) investigated adaptation and validation of the scale in different cultures (n = 13), prevalence on nonclinical populations and representative samples (n = 5), food addiction in obesity samples (n = 11), in samples with ED and disordered eating (n = 10) and studies that investigated FA in association with other clinical and psychological variables (n = 14). DISCUSSION Studies with the YFAS 2.0 reveal higher prevalence of FA in different samples, and a great association between FA and BED, BN and obesity. Implications for diagnostic of this phenomena and the overlap between FA and other disorders are discussed. CONCLUSIONS The field of FA remains an open subject and effort must be implied to understand the subjective experience of addiction related to eating and food.
Collapse
|
8
|
Lacroix E, von Ranson KM. Body image disturbance partially explains eating-related psychosocial impairment in food addiction. Eat Behav 2021; 41:101512. [PMID: 33932882 DOI: 10.1016/j.eatbeh.2021.101512] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 03/08/2021] [Accepted: 04/20/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND This study aimed to explore the association of food addiction (FA) with eating-related psychosocial impairment and examine the extent to which this association was explained directly by FA symptoms themselves, versus through body image disturbance. MATERIALS AND METHODS Participants (356 university students and 544 crowdsourced adults) completed self-report measures of FA (Yale Food Addiction Scale; YFAS 2.0), psychosocial impairment (Clinical Impairment Assessment; CIA 3.0), and body image disturbance (Eating Disorders Examination Questionnaire; EDE-Q 6.0), and reported their body mass index (BMI) and gender. RESULTS Endorsement of distress and/or impairment on the YFAS corresponded to ratings on the CIA. Structural equation models indicated the relationship between FA and eating-related psychosocial impairment was partially mediated by body image disturbance. The indirect effect of body image disturbance explained more variance in eating-related psychosocial impairment than did YFAS scores themselves. Neither BMI nor gender significantly moderated any direct or indirect pathways from food addiction to psychosocial impairment. CONCLUSIONS Food addiction is associated with clinical impairment in men and women across the weight spectrum. A large portion of psychosocial impairment associated with food addiction may be explained by body image disturbance. Due to its role in explaining psychosocial impairment, body image disturbance warrants increased attention in FA research.
Collapse
Affiliation(s)
- Emilie Lacroix
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada
| | - Kristin M von Ranson
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
| |
Collapse
|
9
|
Psychometric properties of the modified Yale Food Addiction Scale Version 2.0 in an Italian non-clinical sample. Eat Weight Disord 2019; 24:37-45. [PMID: 30414076 DOI: 10.1007/s40519-018-0607-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 10/24/2018] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To assess the dimensionality and psychometric properties of the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) in an Italian non-clinical sample. METHODS 262 adults (184 women) were administered the Italian versions of the mYFAS 2.0, and questionnaires measuring binge eating severity, anxiety and depression symptoms, and emotional dysregulation. RESULTS 15 individuals (5.7%) met the criteria for a diagnosis of food addiction according to the mYFAS 2.0. Bayesian confirmatory factor analysis supported a single-factor solution for the mYFAS 2.0. The mYFAS 2.0 had good internal consistency (Ordinal α = 0.91), and convergent validity with binge eating severity (r = 0.67, p < 0.001), both anxiety (r = 0.31, p < 0.001) and depressive (r = 0.35, p < 0.001) symptoms, and difficulties in emotion regulation (r = 0.35, p < 0.001). Finally, both discriminant validity with dietary restraint (Gamma = 0.11; p = 0.52) and incremental validity in predicting binge eating severity over emotion dysregulation and psychopathology (b = 0.52; t = 11.11; p < 0.001) were confirmed. CONCLUSIONS The Italian mYFAS 2.0 has satisfactory psychometric properties and can be used as a brief instrument for the assessment of addictive eating behaviors when time constraints prevent the use of the original version. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
Collapse
|