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Davis HA, Patarinski AGG, Hahn SL, Kesselring-Dacey D, Smith GT. A longitudinal test of problematic alcohol use and binge eating among college women: The moderating role of shame. Alcohol 2024; 118:65-73. [PMID: 37952786 PMCID: PMC11150035 DOI: 10.1016/j.alcohol.2023.11.003] [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: 09/18/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023]
Abstract
Problematic alcohol use and binge eating frequently co-occur. High levels of negative affect, negative urgency, and/or shame may increase the likelihood that problematic alcohol use and binge eating co-occur over time. OBJECTIVE Examine 1) the temporal relationship between problematic alcohol use and binge eating among college women, who are at high risk for both, and 2) the additive and moderating effects of shared, emotion-based risk factors in models involving both problematic alcohol use and binge eating. METHOD In n = 302 college women assessed at two time points across 8 months, we used hierarchical linear regression to invstigate our objectives. RESULTS Baseline problematic alcohol use and baseline shame independently predicted increases in follow-up binge eating, controlling for baseline binge eating. In addition, the interaction between problematic alcohol use and shame accounted for further variance in subsequent binge eating (the influence of baseline problematic alcohol use on follow-up binge eating was stronger at higher levels of baseline shame). The reciprocal relationship was not significant: baseline binge eating did not predict follow-up problematic alcohol use independently or in conjunction with risk factors. Neither negative affect nor negative urgency showed predictive effects beyond prior behavior and shame. Results support 1) problematic alcohol use as a prospective risk factor for binge eating, 2) shame as an additive predictor of binge eating, and 3) shame as a positive moderator of binge eating prediction from problem drinking. CONCLUSION Addressing shame and problematic alcohol use may be warranted in binge eating interventions for college women.
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Affiliation(s)
- Heather A Davis
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States.
| | - Anna Gabrielle G Patarinski
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Samantha L Hahn
- College of Medicine, Central Michigan University, Mount Pleasant, MI, United States
| | - Denise Kesselring-Dacey
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Gregory T Smith
- Department of Psychology, University of Kentucky, Lexington, KY, United States
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2
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Gerges S, Hallit S, Malaeb D, Laghi F, Obeid S. Drunkorexia Among a Sample of Lebanese Adults: The Role of Early Maladaptive Schemas. Psychol Rep 2024; 127:1175-1200. [PMID: 36321443 DOI: 10.1177/00332941221137242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background: Drunkorexia is a food and alcohol disturbance described as being a range of disordered and compensatory eating behaviors that co-occur with excessive alcohol consumption. The remarkable correlation, highlighted in the literature, between dysfunctional cognitions and both eating disorders and substance use disorders is able to emphasize that cognitive phenomena can be an intrapersonal factor linked to drunkorexia disorder. The aim of this study was to assess the correlation between early maladaptive schemas (EMSs) and drunkorexia among a sample of Lebanese adults.Method: We conducted a cross-sectional study across all the Lebanese governorates (September-December 2020; N = 258). The Drunkorexia Motives and Behaviors Scales, Drunkorexia Fails Scale, Drunkorexia during an Alcohol Consumption Event Scale, and Post-Drinking Compensation Scale were used to assess drunkorexia, whereas the Young Schema Questionnaire-Short Form three was used to measure EMSs.Results: Emotional deprivation and subjugation were significantly associated with more drunkorexia motives, whereas emotional inhibition was significantly associated with less drunkorexia motives. Failure was significantly associated with more drunkorexia behaviors. Abandonment and mistrust were significantly associated with more drunkorexia fails, whereas unrelenting standards was significantly associated with less drunkorexia fails. Subjugation was significantly associated with more drunkorexia during alcohol consumption on events. Social isolation was significantly associated with more post-drinking compensation, whereas unrelenting standards was significantly associated with less post-drinking compensation.Conclusion: Our findings showed that drunkorexia is positively associated with EMSs, delineating as well the specific relationships between dysfunctional cognitive schemas and drunkorexia's maladaptive behavioral aspects. They support the hypothesis that EMSs might play an important role in drunkorexia's development and perpetuation. This study could therefore serve healthcare professionals for the cognitive approach of patients with concomitant alcohol misuse and eating disorders while emphasizing the value of cognitive-behavioral interventions-namely schema therapy.
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Affiliation(s)
- Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sahar Obeid
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
- Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
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3
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Corran C, Khan M, Gallant S, Shalev U, O'Connor RM. Restrained eating and alcohol use: Testing drinking to cope and impulsivity as moderators. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:671-675. [PMID: 35471931 DOI: 10.1080/07448481.2022.2062246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 12/16/2021] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
The association between restrained eating and alcohol use remains poorly understood among undergraduates. Consistent with tension reduction theory, individuals with disordered eating may be motivated to drink alcohol to cope with negative emotionality. Perhaps what pushes them to drink despite restriction goals is impulsivity. The combined impact of drinking to cope and impulsivity on the theoretically complex link between restrained eating and alcohol outcomes has not been previously examined. The current study tested the moderating effect of drinking to cope and impulsivity on the association between restrained eating and alcohol use and problems. Undergraduates (N = 1,619) self-reported on eating disorder symptoms, alcohol use motives, impulsivity, and alcohol outcomes. A moderation model revealed that restrained eating predicted past 30-day alcohol use, but only for women high in both drinking to cope and impulsivity. These findings help characterize alcohol misuse risk among young adults who restrict their eating, thereby, results may inform interventions.
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Affiliation(s)
| | | | | | - Uri Shalev
- Concordia University, Montreal, QC, Canada
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4
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Murley WD, Oberle CD, Howard KJ, Perrotte JK. Anxiety connects social media use to food and alcohol disturbance and disordered eating when social support is low. Eat Behav 2024; 53:101879. [PMID: 38663045 DOI: 10.1016/j.eatbeh.2024.101879] [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: 01/03/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 06/03/2024]
Abstract
Food and alcohol disturbance (FAD) is an understudied form of disordered eating, in which the consumption of calories is restricted in preparation for drinking alcohol. Guided by previous literature, the present study examined the direct, indirect, and interactive relationships between social media use, anxiety, social support, FAD, and disordered eating among young adults. Recruited from a large southwestern public university, the sample included 679 undergraduate students who completed an online survey in spring of 2022 and who indicated that they consume alcohol and are 18 to 29 years old. Two moderated mediation analyses assessed the indirect effects of anxiety on the relationships between social media use with FAD and disordered eating, and the conditional contribution of social support. Results indicated that social media use was related to disordered eating both directly and indirectly through anxiety, but it was only related to FAD through anxiety. Furthermore, indirect effects connecting social media use to FAD and disordered eating were conditional upon social support. Our findings suggest FAD and disordered eating may be coping mechanisms for anxiety stemming from social media exposure, though these associations appear to be attenuated when social support is high. As such, these findings may be relevant for shaping future intervention and prevention efforts for emerging adults experiencing FAD and disordered eating.
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Affiliation(s)
- William D Murley
- Department of Psychology, Texas State University, San Marcos, TX, United States of America
| | - Crystal D Oberle
- Department of Psychology, Texas State University, San Marcos, TX, United States of America
| | - Krista J Howard
- Department of Psychology, Texas State University, San Marcos, TX, United States of America
| | - Jessica K Perrotte
- Department of Psychology, Texas State University, San Marcos, TX, United States of America.
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5
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Speed S, Ward RM. Drunkorexia and trait mindfulness among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:571-577. [PMID: 35298361 DOI: 10.1080/07448481.2022.2048837] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 01/07/2022] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
Objective: Combined alcohol and disordered eating (drunkorexia) are alcohol fueled weight management behaviors. Mindfulness negatively relates to both disordered eating and alcohol use. Participants: Participants (n = 344, average age 20) were primarily female (85.2%, n = 293), and Caucasian (82.6%, n = 284). Methods: Students reported drunkorexia and mindfulness. Results: Drunkorexia behaviors were negatively correlated with Acting with Awareness (AA; full attention to a present moment; r = -.21, p < .001) and Nonjudgment (NJ; understanding and leniency toward oneself; r = -.22, p < .001). Drunkorexia motivations are significantly correlated with AA (r = -.13, p = .01) and NJ (r = -.18, p = .001). Structural equation modeling revealed higher levels of NJ related to higher levels of drunkorexia. Conclusion: The objective was to determine a potential relationship between drunkorexia behaviors and motivations, and trait mindfulness. Findings suggest a nonjudgmental disposition relates to lower levels of drunkorexia.
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Affiliation(s)
- Shannon Speed
- Department of Kinesiology, Nutrition & Health, Miami University, Oxford, Ohio, USA
| | - Rose Marie Ward
- Department of Kinesiology, Nutrition & Health, Miami University, Oxford, Ohio, USA
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6
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Pompili S, Bianchi D, Di Tata D, Cannoni E, Di Norcia A, Lonigro A, Longobardi E, Laghi F. Social Anxiety and Drunkorexia Behaviors among Adolescents and Young Adults: The Moderating Role of Resilience. Subst Use Misuse 2024; 59:825-831. [PMID: 38263611 DOI: 10.1080/10826084.2024.2305790] [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] [Indexed: 01/25/2024]
Abstract
Background: Existing evidence showed that social anxiety represents a significant factor in eating disorders. However, to our knowledge, no prior study has examined the association between social anxiety and drunkorexia behaviors. Objectives: The present study aimed at exploring the relationship between social anxiety and drunkorexia behaviors, and investigating resilience as a moderator of this relationship. Participants were 333 adolescents and young adults aged 15-24 years (Mage=18.26, SDage= 1.55; 66% females) who completed an online survey. Results: The results indicated that drunkorexia behaviors were positively correlated to three dimensions of social anxiety; however, only fear of negative evaluation had a significant predictive effect. In addition, resilience only moderated the relationship between fear of negative evaluation and drunkorexia behaviors, such that youths reporting high fear of negative evaluation and low resilience showed greater drunkorexia behaviors, whereas youths reporting high resilience showed no correlation between fear of negative evaluation and drunkorexia behaviors. Conclusions: The findings highlight the importance of drunkorexia interventions and preventive measures aimed at strengthening youths' resilience and ability to effectively manage stress and social anxiety (i.e., fear of negative evaluation).
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Affiliation(s)
- Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Daniele Di Tata
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Eleonora Cannoni
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Anna Di Norcia
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Antonia Lonigro
- Department of Education Science, University of Rome Tre, Rome, Italy
| | - Emiddia Longobardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
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7
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Sedemedes K, Knäuper B, Sadikaj G, Yuan TY, Wrosch C, Santosa S, Alberga AS, Kakinami L. Compensatory health motivations and behaviors scale: Development, evaluation, psychometric properties and a preliminary validation. Appetite 2023; 191:107075. [PMID: 37804879 DOI: 10.1016/j.appet.2023.107075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/07/2023] [Accepted: 10/05/2023] [Indexed: 10/09/2023]
Abstract
The "Compensatory Health Beliefs" scale assesses the degree to which one believes that unhealthy behaviours can be compensated through healthier ones. However, no validated scale to assess compensatory weight-related behaviors exists. The study's objective was to develop (Study 1) and validate (Study 2) a questionnaire measuring compensatory health motivations and behaviors (CHMB) and to assess their associations with body mass index (BMI) and psychological weight-related measures. An initial 34-item measure was constructed based on a target sample's (Study 1, n = 158) suggestions and refined based on expert feedback. The measure was then tested in a representative Canadian adult sample (N = 1400, 48.7% male). The sample was stratified by sex and age and then randomly split into two (N = 701 for exploratory factor analysis; N = 699 for confirmatory factor analysis (CFA) cross-validation). Fit indices, standardized Cronbach's alphas and the associations between the CHMB model with cognitive restraint, weight concerns, and BMI were assessed in multiple linear regression models controlling for age and sex. The final CHMB model (n = 17 items) consisted of four subscales: (1) motivation, (2) use on special occasions, (3) general use, (4) compensatory health beliefs. Fit indices (Goodness of Fit Index = 0.922) and Cronbach's alphas were good (α = 0.88). In multiple linear regression models, all CHMB subscales were associated with greater cognitive restraint in eating. Compensatory behavior use on special occasions was associated with greater weight concern (B = 0.12, p < .0001), while general compensatory behavior use was associated with lower weight concern (B = -0.07, p < .05). None of the subscales were associated with BMI. The validated CHMB scale allows for the assessment of compensatory health motivations and behaviors in a Canadian population. Research on whether this scale can predict weight changes and general health is needed.
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Affiliation(s)
- Kalista Sedemedes
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada
| | - Bärbel Knäuper
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada
| | - Gentiana Sadikaj
- Department of Psychology, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada
| | - Trista Yue Yuan
- Faculty of Land and Food Systems, Food, Nutrition and Health, University of British Columbia, 248-2357 Main Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Carsten Wrosch
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada
| | - Sylvia Santosa
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada; School of Health, Concordia University, 7200 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada; Metabolism, Obesity, Nutrition Lab, School of Health, Concordia University, 7200 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada
| | - Angela S Alberga
- Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada; School of Health, Concordia University, 7200 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada
| | - Lisa Kakinami
- School of Health, Concordia University, 7200 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada; Department of Mathematics and Statistics, Concordia University, 1455 de Maisonneuve West, Montreal, QC, H3G 1M8, Canada.
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8
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Shepherd CB, Berry KA, Ye X, Li K. Food and alcohol disturbance among US college students: a mixed methods scoping review. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1715-1731. [PMID: 34292851 DOI: 10.1080/07448481.2021.1947300] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 05/05/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Conduct a scoping review of food and alcohol disturbance (FAD) in US college students to overview the literature within this population and identify research opportunities. METHODS Studies (n = 39) were selected using systematic searches of databases and references. Search terms included: drunkorexia, "food and alcohol disturbance," and "compensatory behavior" AND alcohol AND eating. RESULTS Issues with methodological quality were noted. Most studies used quantitative methods and cross-sectional designs with small, biased samples. Terminologies, conceptualizations, and measures varied; however, 30% of studies neglected enhanced intoxication effects. Prevalence ranged from approximately 10-55%, with greater risk for women. Alcohol use and disordered eating were primary predictors. Personality, affective, and social factors are potential correlates. Alcohol-related consequences were higher for those with FAD. CONCLUSIONS While the literature is inconsistent and unclear, FAD appears to be common among college students and associated with negative consequences. Suggestions and considerations for future research are provided.
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Affiliation(s)
- Caitlin B Shepherd
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Katherine A Berry
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Xian Ye
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
| | - Kathie Li
- Department of Psychology, Smith College, Northampton, Massachusetts, USA
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9
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Herchenroeder L, Speed S, Ward RM, Yeung EW. Sexual minority status and food and alcohol disturbance among college students: The moderating role of body esteem. Eat Behav 2023; 49:101745. [PMID: 37235994 DOI: 10.1016/j.eatbeh.2023.101745] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
Food and alcohol disturbance (FAD; restricting caloric intake before, during, or after drinking to either offset calories or to increase intoxication) is common among college students and poses a threat to students' health. In conjunction, sexual minority (SM; i.e., not exclusively heterosexual) college students may be at increased risk of engaging in alcohol misuse and disordered eating compared to their heterosexual peers due to exposure to minority stress. However, little research has examined whether engagement in FAD differs by SM status. Body esteem (BE) is an important resilience factor among SMs that may influence SM students' risk of participating in FAD. Therefore, the aim of the present study was to understand the association between SM status and FAD with additional interest in BE as a moderating factor. Participants were 459 college students who engaged in past 30-day binge drinking. Most participants identified as White (66.7 %), female (78.4 %), heterosexual (69.3 %), with a mean age of 19.60 (SD = 1.54) years. Participants completed two surveys (3 weeks apart) over the course of an academic semester. Analyses revealed a significant interaction between SM status and BE, such that SMs with lower BE (T1) reported more engagement in FAD-intoxication (T2), whereas SMs with higher BE (T1) reported less engagement in FAD-calories (T2) and FAD-intoxication (T2) than their heterosexual peers. Stressors associated with body esteem may contribute to increased FAD engagement among SM students. Consequently, BE may be an especially important target for interventions aimed at reducing FAD among SM college students.
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Affiliation(s)
- Luke Herchenroeder
- Department of Psychological and Brain Sciences, George Washington University, United States of America.
| | - Shannon Speed
- NIH IRP, NIDA/NIAAA, Translational Addiction Medicine Branch Lab, Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, United States of America
| | | | - Ellen W Yeung
- Department of Psychological and Brain Sciences, George Washington University, United States of America
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10
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Speed S, Ward RM, Budd K, Branscum P, Barrios V, Miljkovic K. The Relationship between Drunkorexia, Alcohol, and Blackouts Among College Students: An Exploratory Study. Alcohol 2023; 110:51-56. [PMID: 37105336 DOI: 10.1016/j.alcohol.2023.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/24/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023]
Abstract
College drinkers commonly report blacking out (i.e., alcohol-induced amnesia), and those who drink with the intention to blackout are at risk for harmful consequences. Drunkorexia (i.e., restriction of calories on planned drinking days) is a high-risk behavior potentially associated with blacking out. Informed by the Theory of Planned Behavior (TPB), this study explores blackout experiences and intentions to blackout association with drunkorexia. College students (n=2335) who primarily identified as female and White participated via an online survey. Participants received a $3 coupon for completion of the study. Consistent with the literature, 40% and 60.7% participants reported experiencing blackouts and drunkorexia respectively in the last year. Informed by the TPB, a structural equation model assessed if more frequency blackout experiences (IV) related to drunkorexia behaviors (DV1) and alcohol behaviors (DV2), and if there was a significant indirect effect through blackout intention. The model fit the data well (CFI=.98, TLI=.95) and suggests that more frequent blackout experiences relate to more drunkorexia experiences (R2=.04) and higher levels of alcohol consumption (R2=.44). In addition, the relationship between blackout experiences and drunkorexia flows through intentions to blackout (i.e., a significant indirect effect). Findings are consistent with TPB, which suggests intentions predict health behavior. Future interventions should consider modifying intentions and other possible TPB constructs to minimize high risk alcohol consumption and drunkorexia behaviors.
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Affiliation(s)
| | | | - Kristen Budd
- Miami University, Oxford, OH 45056, United States.
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11
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Di Tata D, Bianchi D, Pompili S, Laghi F. The Psychological Impact of the COVID-19 Pandemic on Alcohol Abuse and Drunkorexia Behaviors in Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3466. [PMID: 36834161 PMCID: PMC9967230 DOI: 10.3390/ijerph20043466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 outbreak negatively affected young adults' psychological well-being, increasing their stress levels and symptoms of anxiety and depression, and potentially triggering health-risk behaviors. The present study was aimed at investigating the psychological impact of the COVID-19 pandemic on alcohol abuse and drunkorexia behaviors among young adults living in Italy. Participants were 370 emerging adults (63% women, 37% men; Mage = 21.00, SDage = 2.96, range: 18-30) who were recruited through an online survey between November 2021 and March 2022. Participants completed measures of alcohol abuse, drunkorexia behaviors, negative life experiences, and post-traumatic symptoms related to the COVID-19 outbreak. The results showed that the emotional impact and negative life experiences associated with the pandemic predicted both alcohol abuse and drunkorexia behaviors, albeit in different ways. Specifically, the number of negative life experiences during the pandemic and the tendency to avoid COVID-19-related negative thoughts positively predicted alcohol abuse; and the presence of intrusive thoughts associated with the pandemic significantly predicted the frequency of drunkorexia behaviors. Implications for research and clinical practice are discussed.
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Affiliation(s)
- Daniele Di Tata
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy
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12
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Vasiliu O. An integrative model as a step toward increasing the awareness of eating disorders in the general population. Front Psychiatry 2023; 14:1184932. [PMID: 37205977 PMCID: PMC10188970 DOI: 10.3389/fpsyt.2023.1184932] [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: 03/12/2023] [Accepted: 04/18/2023] [Indexed: 05/21/2023] Open
Abstract
Eating disorders (EDs) represent a contradictory chapter of clinical psychiatry, i.e., although they are associated with significant prevalence and risks in the long term (including vital risk, especially for anorexia nervosa), the therapeutic resources are minimal and based on low-quality data. Another contradiction arose in the last few decades, i.e., a variety of new EDs have been described, either by clinicians or signaled by mass media, but their systematic exploration is progressing very slowly. Entities like "food addiction," "orthorexia nervosa," or "emotional eating disorder" still require intensive exploration in order to find the most accurate diagnostic instruments, diagnosis criteria, prevalence data, vulnerability factors, and therapeutic approaches. This article is focused on integrating into a comprehensive model a variety of EDs not specified or loosely defined by the current international classifications of psychiatric disorders. This framework is intended as an instrument for stimulating clinical and epidemiological research, with potential favorable consequences for therapeutic research. The dimensional model suggested here includes four main categories that accommodate the already recognized EDs (i.e., anorexia nervosa, bulimia nervosa, and binge eating disorder) as well as ten EDs that still need intensive research to find their clinical and pathophysiological characteristics. More good-quality studies are urgently required regarding this topic, based on the mental and physical negative impact these EDs may have in the short and long term, especially in vulnerable populations (e.g., pregnant women, athletes, adolescents, etc.).
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13
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Booker R, Galloway R, Novik M, Jones R, Holmes ME. Differences between preemptive and non-preemptive physical activity among 'drunkorexia'-positive college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-5. [PMID: 36328802 PMCID: PMC10204643 DOI: 10.1080/07448481.2022.2136973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 06/27/2022] [Accepted: 10/07/2022] [Indexed: 05/20/2023]
Abstract
Objective: 'Drunkorexia' is characterized by compensating for alcohol-related calories using physical activity (PA). Drunkorexia is common on college campuses but little is known about the PA behaviors within the drunkorexia paradigm. Methods: First-year college students living on campus completed an online survey collecting drunkorexia, PA, and alcohol consumption data. A total of 127 participants reported engaging in drunkorexia behaviors. Results: Fifty-three participants were classified as preemptively physically active (e.g., PA and drink on Tuesday) compared to 74 as non-preemptively physically active. Preemptively physically active participants consumed more alcohol on Fridays and Saturdays than those non-preemptively physically active. Preemptively physically active participants engaged in significantly greater amounts PA. Females accounted for all significant differences between groups. Discussion: Among drunkorexia-positive participants, many made preemptive efforts to control their calories before consuming alcohol, which may predispose them to higher incidences of adverse outcomes such as alcohol poisoning, unwanted sexual advances, and death.
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Affiliation(s)
- Robert Booker
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611
| | - Riley Galloway
- School of Kinesiology and Nutrition, University of Southern Mississippi, 118 College Drive #5142, Hattiesburg, MS 39406
| | - Melinda Novik
- Department of Public Health and Sports Medicine, Missouri State University, Springfield, MO
| | - Raymond Jones
- Department of Medicine, University of Alabama at Birmingham, 1313 13 Street South, Birmingham, AL 35205
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, 1313 13 Street South, Birmingham, AL 35205
| | - Megan E. Holmes
- Department of Kinesiology, Mississippi State University, 216 McCarthy Gym, Mississippi State, MS 39762
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14
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Validation of a shortened version of the Eating Attitude Test (EAT-7) in the Arabic language. J Eat Disord 2022; 10:127. [PMID: 36028891 PMCID: PMC9412802 DOI: 10.1186/s40337-022-00651-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating disorders are quite common around the world, disabling, and potentially lethal; but they remain so far under-captured and subject to substantial delays in treatment. We propose through this study to develop and validate a shortened version of the Eating Attitude Test (EAT) in the Arabic language among non-clinical Arabic-speaking Lebanese participants from the general population. METHODS 1175 participants enrolled in this cross-sectional study, based on an online survey. The Eating Attitude Test-26 items, Drunkorexia Motives and Behaviors Scales and Lebanese Anxiety Scale were used to answer our objectives. RESULTS Our results confirmed validity and reliability of the questionnaire. Exploratory Factor Analyses showed that all items converged over a one-factor solution, with an excellent Cronbach's alpha (> 0.9). Confirmatory Factor Analyses found that the 7-item-version yielded excellent model fit. The instrument also revealed strong evidence of divergent validity, being highly correlated with measures of anxiety and drunkorexia motives and behaviors. DISCUSSION Findings provided evidence supporting that the Arabic seven-item one-factor structure of the scale (EAT-7) is valid, reliable, and can be used in clinical practice, preventive interventions and future eating disorders research in Arab settings.
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15
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Speed S, Ward RM, Haus L, Branscum P, Barrios V, Budd KM, Lemons K, Humenay E. A Systematic Review of Common Drunkorexia Measures: Examining Gender Differences across Scales. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2100846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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16
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Azzi V, Bianchi D, Pompili S, Laghi F, Gerges S, Akel M, Malaeb D, Obeid S, Hallit S. Emotion regulation and drunkorexia behaviors among Lebanese adults: the indirect effects of positive and negative metacognition. BMC Psychiatry 2022; 22:391. [PMID: 35689196 PMCID: PMC9185707 DOI: 10.1186/s12888-022-04030-x] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although metacognition processes are a core feature of restrictive eating and alcohol cravings and entail an individual to control both of his/her emotions and thoughts, yet, to our knowledge, a scarcity of research has examined their potential role in drunkorexia as cognitive and emotional predictors. The following study investigates the different associations between two emotion regulation strategies (i.e. emotional suppression and cognitive reappraisal) and drunkorexia behaviors in a sample of Lebanese adults, exploring the possible indirect effects of positive and negative alcohol-related metacognitions. METHODS This was a cross-sectional study that enrolled 335 participants (March-July 2021). RESULTS Higher problematic alcohol use (beta = 5.56), higher physical activity index (beta = 0.08), higher expressive suppression (beta = 0.23), higher negative metacognitive beliefs about cognitive harm due to drinking (beta = 0.75) and higher cognitive reappraisal (beta = 0.20) were significantly associated with more drunkorexic behaviors. The positive metacognitive beliefs about cognitive self-regulation significantly mediated the association between cognitive reappraisal and drunkorexia behaviors. Both the positive metacognitive beliefs about cognitive self-regulation and the negative metacognitive beliefs about the uncontrollability of drinking significantly mediated the association between expressive suppression and drunkorexia behaviors. CONCLUSION This study demonstrated that emotional and metacognitive processes are associated with drunkorexia, addressing as well the mediating effect between deficient emotional regulation and risky behavioral patterns. Overall, our results would speculate that the lack of emotional and cognitive assets might enhance internal distress perceived out of control, leading individuals to indulge in maladaptive behavioral patterns for managing the underlying impairment.
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Affiliation(s)
- Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- School of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
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Drunkorexia behaviors and motives, eating attitudes and mental health in Lebanese alcohol drinkers: a path analysis model. Eat Weight Disord 2022; 27:1787-1797. [PMID: 34713408 PMCID: PMC8553592 DOI: 10.1007/s40519-021-01321-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Drunkorexia refers to limited intake of high-calorie food to avert gaining weight and the need to increase in alcohol excessive consumption. The present study aimed to check for an association between depression, anxiety, and stress with drunkorexia behaviors/motives among Lebanese adults, while evaluating the mediating role of inappropriate eating attitude in those associations. METHODS Two hundred and fifty-eight participants enrolled in this cross-sectional study, who filled an online survey (September-December 2020). RESULTS Drunkorexia behaviors were considered as the dependent variable; the path coefficients from stress to anxiety, from anxiety to eating attitudes, from eating attitudes to drunkorexia behaviors and from anxiety to drunkorexia behaviors were all significant. The indirect relationships showed that eating attitudes mediated the association between anxiety and drunkorexia behaviors. When taking the drunkorexia motives as the dependent variable, the path coefficients from stress to anxiety, from anxiety to eating attitudes, from eating attitudes to drunkorexia motives, and from anxiety to drunkorexia motives were all significant. The indirect relationships showed that eating attitudes mediated the association between anxiety and drunkorexia motives. CONCLUSION This study highlighted that individuals with more psychological problems (depression, anxiety, and stress) and inappropriate eating habits exhibit more drunkorexic motivations and behaviors. LEVEL OF EVIDENCE Level V, Cross-sectional study.
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18
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Vogt KS, Harper M, Griffin BL. "… because I'm so drunk at the time, the last thing I'm going to think about is calories": Strengthening the argument for Drunkorexia as a food and alcohol disturbance, evidence from a qualitative study. Br J Health Psychol 2022; 27:1188-1208. [PMID: 35384176 PMCID: PMC9540538 DOI: 10.1111/bjhp.12594] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 01/02/2023]
Abstract
Objectives Drunkorexia are inappropriate compensatory behaviours in response to alcohol consumption (restricting food intake, excessive exercise, and purging). Past (predominantly quantitative) research shows that Drunkorexia is prevalent in 18–26‐year‐olds, and has significant negative health‐related consequences. There is a debate whether Drunkorexia constitutes an eating or substance disorder, or a Food and Alcohol Disturbance (FAD). To further explore this, and understand underlying motivators, this study utilized qualitative methods. Design Qualitative interviews with ten participants (aged 18–26). Methods Interviews were analysed with Thematic Analysis. Results Three themes were developed: (1) Appearance concerns as motivators, (2) Drunkorexia behaviours to get value for money, and (3) “It’s just a pattern… something I’ve always done”: Drunkorexia as a routine. Results show that Drunkorexia is driven by appearance‐related concerns, such as, wanting to look better/slimmer, engaged in, in relation to an event, such as going out drinking, and carried out despite negative health‐related consequences. However, disregard for compensatory behaviours once drunk was also described, culminating in the consumption of high‐calorie food. This suggests that Drunkorexia is not a persistent pattern of maladaptive behaviour as found in eating or substance use disorders. Wanting value for money (i.e., feeling the maximum intoxication) was described as another reason for Drunkorexia engagement; thus showing that participants consider compensatory behaviours part of their routine of going out drinking. Conclusions These result support the view of Drunkorexia as a FAD, rather than an eating or substance use disorder, and show that 18–26‐year‐olds are an at‐risk group for Drunkorexia and its negative health‐related consequences.
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Affiliation(s)
- Katharina Sophie Vogt
- Bradford Institute for Health Research, Bradford Royal Infirmary, UK.,School of Psychology, University of Leeds, UK
| | - Michela Harper
- Department of Psychology, The University of Huddersfield, Queensgate, UK
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19
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Pompili S, Di Tata D, Bianchi D, Lonigro A, Zammuto M, Baiocco R, Longobardi E, Laghi F. Food and alcohol disturbance among young adults during the COVID-19 lockdown in Italy: risk and protective factors. Eat Weight Disord 2022; 27:769-780. [PMID: 34052989 PMCID: PMC8164478 DOI: 10.1007/s40519-021-01220-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/20/2021] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The COVID-19 lockdown measures have had a significant impact on risk behaviors as alcohol use and disordered eating. However, little is known about a serious health-risk-behavior named "food and alcohol disturbance" (FAD), characterized by engaging in dysfunctional eating on days of planned alcohol consumption. The aim of the present study was to investigate potential factors that may have put young adults at risk or protected against FAD during the COVID-19 lockdown. METHODS A sample of 447 young adults (280 females, 167 males; range 18-26) completed an online survey during the country's nationwide lockdown composed of self-reported measures assessing FAD behaviors, alcohol consumption, compensatory behaviors, eating and weight concerns, social support, emotion regulation strategies, and living arrangement. RESULTS Our findings showed that FAD was significantly and positively correlated to alcohol consumption, use of laxatives, self-induced vomiting, eating and weight concerns, and expressive suppression, and negatively correlated to social support and living with family. Hierarchical regression analysis revealed that alcohol consumption, eating concern, and expression suppression positively predicted FAD, while social support and living with family were negative predictors. CONCLUSIONS Our results suggest that during the COVID-19 lockdown, preoccupation with eating and the use of expressive suppression may have increased vulnerability to FAD; conversely, perceived social support and living with family may have been a source of protection against this dysfunctional behavior. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- Sara Pompili
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Daniele Di Tata
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Dora Bianchi
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Antonia Lonigro
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Marta Zammuto
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Roberto Baiocco
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy
| | - Emiddia Longobardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Social and Developmental Psychology, Sapienza University of Rome, via dei Marsi, 78 00185, Rome, Italy.
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20
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Joshi D, Dodge T. Compensatory physical activity: Impact on type of physical activity and physical activity habits among female young adults. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:39-48. [PMID: 32045337 DOI: 10.1080/07448481.2020.1719113] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 12/12/2019] [Accepted: 01/16/2020] [Indexed: 06/10/2023]
Abstract
Engaging in physical activity (PA) to compensate for drinking-related calories is common among female college students. The objective was to test whether frequency of compensatory PA was associated with type of PA (Study 1) and PA habit strength (Study 2). Study 1 utilized a cross-sectional design. Female undergraduates (N = 198) completed questionnaires assessing frequency of compensatory PA and PA types. In Study 2, female undergraduates (N = 280) were assessed on frequency of compensatory PA at Time 1 and PA habit strength at Time 2, 4-weeks later. Study 1 revealed that frequency of compensatory PA was significantly related to high intensity PA but was unrelated to low or moderate intensity PA. Study 2 revealed that frequency of compensatory PA at Time 1 was a significant predictor of PA habit strength at Time 2. The studies advance our understanding of the immediate and long-lasting impact of compensatory PA on behaviors and habits.
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Affiliation(s)
- Deepti Joshi
- Department of Psychology, George Washington University, Washington, DC, USA
| | - Tonya Dodge
- Department of Psychology, George Washington University, Washington, DC, USA
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21
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Drunkorexia: is it really "just" a university lifestyle choice? Eat Weight Disord 2021; 26:2021-2031. [PMID: 33125626 PMCID: PMC8292268 DOI: 10.1007/s40519-020-01051-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/13/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The current study investigated the prevalence of compensatory behaviours (caloric restriction, increased exercise and bulimic tendencies) in response to alcohol consumption (also known as Drunkorexia) in students, non-students and previous students, as well as beginning to understand the presence of possible predictors of these behaviours (body esteem, sensation seeking). METHODS A volunteer sample of students, non-students and previous students (n = 95) completed the Compensatory Eating and Behaviours in Response to Alcohol Consumption Scale, a questionnaire which measures overall Drunkorexia engagement. The participants also completed the Body Esteem Scale for Adolescents and Adults Scale (BESAA) and the Brief Sensation Seeking Scale (BSSS) to investigate predictors of Drunkorexia. RESULTS The results indicated that there was no significant difference in Drunkorexia engagement and behaviours between students, non-students and previous students. It was also found that both low body esteem and high sensation seeking tendencies were significant predictors of Drunkorexia; specifically, the appearance esteem factor of the BESAA and the disinhibition factor of the BSSS. CONCLUSIONS Findings suggest that Drunkorexia is also present outside of student populations, and therefore, future interventions and research should include non-students in samples. In addition, findings support the idea that Drunkorexia cannot be classified solely as an eating disorder or a substance abuse disorder. As a result of this, further research should be conducted to fully understand why this complex behaviour exists. EVIDENCE-BASED MEDICINE LEVEL III (Evidence obtained from case-control analytic study).
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22
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Oswald BB, Ward RM, Glazer S, Sternasty K, Day K, Speed S. Baseline cortisol predicts drunkorexia in female but not male college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:625-632. [PMID: 31944913 DOI: 10.1080/07448481.2019.1705834] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 09/23/2019] [Accepted: 12/12/2019] [Indexed: 06/10/2023]
Abstract
"Drunkorexia" or compensatory eating behaviors in response to alcohol consumption, resembles a subclinical eating disorder, and is a current public health concern. Eating disorders and alcohol abuse are associated with dysfunction of the hypothalamic-pituitary-adrenal axis (HPA). One index of HPA function is cortisol. As causes of drunkorexia remain elusive, the present study examined cortisol function as it relates to drunkorexia. Participants:n = 73 (49 women) college students. Method: Participants provided daytime saliva samples for cortisol analyses prior to completing an online survey measuring alcohol consumption, drunkorexia, and alcohol problems as measured by the Rutgers Alcohol Problem Index (RAPI). Results: Multiple regressions indicated that baseline cortisol significantly positively correlated with drunkorexia behaviors in women but not men. Higher baseline cortisol and aspects of drunkorexia related to alcohol problems. Conclusion: Programs educating about stress management and health risks of drunkorexia may decrease engagement in drunkorexia behaviors among college students.
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Affiliation(s)
- Barbara B Oswald
- Department of Social and Behavioral Sciences, Miami University, Hamilton, Ohio, USA
| | - Rose Marie Ward
- Department of Kinesiology and Health, Miami University, Oxford, Ohio, USA
| | - Sandra Glazer
- Department of Psychology, Miami University, Oxford, Ohio, USA
| | - Katie Sternasty
- Department of Psychology, Miami University, Oxford, Ohio, USA
| | - Kristen Day
- Department of Psychology, Miami University, Oxford, Ohio, USA
| | - Shannon Speed
- Department of Kinesiology and Health, Miami University, Oxford, Ohio, USA
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23
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Booker R, Novik M, Galloway R, Holmes ME. Relationship between physical activity intensities and drunkorexia severity among first-year college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:689-692. [PMID: 32045319 DOI: 10.1080/07448481.2019.1710151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/16/2019] [Accepted: 12/24/2019] [Indexed: 06/10/2023]
Abstract
Investigate the relationship between intensities of physical activity and severity of drunkorexia behaviors. Participants: First-year college students living in residence halls (n = 127) completed an online survey comprising drinking, drunkorexia, and physical activity. Methods: Multiple hierarchical linear regressions were implemented to examine if physical activity intensity correlates to drunkorexia severity. Results: Vigorous physical activity was the only physical activity intensity significantly associated with severity of drunkorexia behaviors. Conclusions: First-year college students' duration of vigorous physical activity in relation to severity of drunkorexia behaviors may vary contingently on the motivation for vigorous physical activity. Practitioners need to consider physical activity can be a co-occurring risk behavior in combination with alcohol misuse.
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Affiliation(s)
- Robert Booker
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
| | - Melinda Novik
- Department of Kinesiology, Missouri State University, Springfield, MO, USA
| | - Riley Galloway
- Department of Kinesiology, Missouri State University, Springfield, MO, USA
| | - Megan E Holmes
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
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24
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An Ecological Momentary Assessment Examination of the Transdiagnostic Model of Food and Alcohol Disturbance. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09908-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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25
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Moeck EK, Thomas NA. Food and alcohol disturbance in a broad age-range adult sample. Eat Behav 2021; 41:101510. [PMID: 33901799 DOI: 10.1016/j.eatbeh.2021.101510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 12/14/2022]
Abstract
Food and alcohol disturbance involves restricting, purging, or excessively exercising to compensate for the calories consumed from drinking alcohol, or to enhance intoxication levels. But these compensatory behaviors, colloquially termed "drunkorexia," have only been investigated in young adult samples-primarily college students-who are presumed to be at risk due to their high episodic drinking rates. Therefore, this study sought preliminary evidence that food and alcohol disturbance occurs in a broader age-range sample of adult drinkers. We recruited 253 participants aged 18 to 76 (Mage = 38.71) from Mechanical Turk. Rates of food and alcohol disturbance (measured by the Compensatory Eating Behaviors in Response to Alcohol Consumption) were high: 64% of the sample endorsed performing at least one compensatory behavior in the past three months. There were no gender differences in overall prevalence, though men were more likely than women to engage in food and alcohol disturbance to enhance intoxication levels. Drinking habits, drinking motivated by conformity, and abnormal eating attitudes were the strongest predictors of food and alcohol disturbance. However, eating attitudes were a stronger predictor of these behaviors in men than women, whilst drinking habits were a stronger predictor of these behaviors in women than men. The high prevalence of food and alcohol disturbance in our broad age-range sample, alongside the far-reaching health consequences of these behaviors, highlights the need for increased awareness in younger, middle, and older adults alike.
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Affiliation(s)
- Ella K Moeck
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
| | - Nicole A Thomas
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia
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26
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Exploring the association between psychological distress and drunkorexia behaviors in non-clinical adolescents: the moderating role of emotional dysregulation. Eat Weight Disord 2021; 26:797-806. [PMID: 32356142 DOI: 10.1007/s40519-020-00912-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/21/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Although drunkorexia seems to represent a new form of eating disorder, it shares several features with traditional eating disorders. However, very little is known about the association between drunkorexia and a widely studied correlate of eating disorders, such as psychological distress and about mechanisms underlying this association. The present study aimed to investigate the relation between symptoms of anxiety and depression and drunkorexia, and to explore the role of emotional dysregulation as moderator of this relationship. METHODS The sample was composed of 402 adolescents (222 females, 180 males; range 15-21) who completed self-reported measures: Drunkorexia Motives and Behaviors Scale, which assesses different behaviors and motivations associated with drunkorexia, Emotional dysregulation scale from the Eating Disorder Inventory-3, reflecting difficulties regulating emotions, and Anxiety and Depression scales from the Symptom CheckList-90 Revised, assessing general signs of anxious and depressive symptoms. RESULTS Anxious symptomatology resulted a significant statistical predictor of drunkorexia behaviors (β = .28, p = .001). Furthermore, emotional dysregulation moderated the relation between anxiety and drunkorexia; specifically, a positive relation was found both at medium levels (β = .22, p = .007) and at higher levels of emotional dysregulation (β = .38, p = .000), whereas at lower levels of emotional dysregulation, this association became nonsignificant. CONCLUSIONS Findings suggest that adolescents who experience both elevated anxiety and emotional dysregulation may be more likely to turn to drunkorexia to reduce their unregulated negative affect in the absence of more adaptive emotion regulation strategies. Implications for intervention and prevention programs are discussed. LEVEL OF EVIDENCE Level V, descriptive study.
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27
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Azzi V, Hallit S, Malaeb D, Obeid S, Brytek-Matera A. Drunkorexia and Emotion Regulation and Emotion Regulation Difficulties: The Mediating Effect of Disordered Eating Attitudes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052690. [PMID: 33800011 PMCID: PMC7967414 DOI: 10.3390/ijerph18052690] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 01/22/2023]
Abstract
Drunorexia refers to food calorie intake restriction to prevent weight gain and the desire to enhance the more extensive intoxicating effects of alcohol. The present study aimed to investigate the association of drunkorexia with emotion regulation as well as emotion regulation difficulties across the Lebanese population, and assess disordered eating attitudes as a potential mediator of these relationships. The cross-sectional study enrolled participants (n = 258) from all Lebanese districts. The study was performed through an online survey based on a self-designed and structured questionnaire. The Drunkorexia Motives and Behaviors Scales (DMBS), the College Life Alcohol Salience Scale (CLASS), the Difficulties in Emotion Regulation Scale (DERS-16), the Emotion Regulation Questionnaire (ERQ) and the Eating Attitudes Test (EAT-26) were used in the present study. The results showed that higher EAT-26 total scores (more disordered eating attitudes) (B = 0.16) and higher DERS-16 total score (B = 0.30) were significantly associated with more drunkorexia motives. Also, higher EAT-26 total scores (B = 0.09) and higher DERS-16 total score (B = 0.17) were significantly associated with more drunkorexia behaviors. In addition, higher EAT-26 total scores (B = 0.10) and higher DERS-26 total score (B = 0.36) were significantly associated with more drunkorexia fails. Furthermore, higher EAT-26 total scores (B = 0.07), and higher DERS-16 total score (B = 0.37) were significantly associated with more drunkorexia during an alcohol consumption event. Higher EAT-26 total scores (B = 0.09), and higher DERS-16 total score (B = 0.22) were significantly associated with more post-drinking compensation. Higher EAT-26 total scores (B = 0.21), higher DERS-16 total scores (B = 0.65) and higher emotion regulation (B = 0.33) were significantly associated with higher CLASS scores. The results showed that EAT-26 total scores partially mediated the association between DERS-16 total score and drunkorexia motives (25.20%), between DERS-16 total score and drunkorexia behaviors (25.16%), between DERS-16 total score and drunkorexia fails (106.87%), between DERS-16 total score and drunkorexia during an alcohol consumption event (11.84%), between DERS-16 total score and post-drinking compensation (22.55%), between ERQ total score and college life alcohol salience (8.35%) and between DERS-16 total score and college life alcohol salience (20.14%). This study highlighted that only emotional regulation difficulties were associated with drunkorexia, whereas emotional regulation was not significantly associated with such behavior.
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Affiliation(s)
- Vanessa Azzi
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon;
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon;
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut 6573-14, Lebanon;
- Correspondence: (S.H.); (A.B.-M.)
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut 1083, Lebanon;
| | - Sahar Obeid
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut 6573-14, Lebanon;
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon
| | - Anna Brytek-Matera
- Institute of Psychology, University of Wroclaw, Dawida 1, 50-527 Wroclaw, Poland
- Correspondence: (S.H.); (A.B.-M.)
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28
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Berro J, Akel M, Hallit S, Obeid S. Relationships between inappropriate eating habits and problematic alcohol use, cigarette and waterpipe dependence among male adolescents in Lebanon. BMC Public Health 2021; 21:140. [PMID: 33446162 PMCID: PMC7809860 DOI: 10.1186/s12889-021-10184-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND it is important to investigate the relationship between disordered eating in male adolescents and smoking and alcohol consumption as they are risk factors to other diseases as well. For example, high levels of alcohol accompanied by the acidic damage and nutritional deficit exhibited in people with disordered eating habits - due to induced vomiting - has been shown to increase risk of esophageal cancer. Considering the very few studies done on disordered eating prevailing in males and the prevalence of smoking and drinking habits, our study aims to investigate the correlation between inappropriate eating habits and one's dependence on cigarettes, waterpipes, and alcohol all the while focusing on male adolescents. METHODS This was a cross-sectional observational study that enrolled 389 male students (13-17 years of age) drawn from five Lebanese schools between October and December 2019. RESULTS The MANCOVA analysis was performed taking the addiction scales as the dependent variables and the EAT-26 score as an independent variable, adjusting for the covariates (age, BMI and household crowding index). Higher EAT-26 scores (more inappropriate eating attitudes) were significantly associated with higher waterpipe dependence (B = 0.11; CI 0.06-0.17) and more problematic alcohol use (B = 0.08; CI 0.04-0.12), but not cigarette dependence. CONCLUSIONS This study revealed an association between inappropriate eating and increased drinking and smoking the waterpipe, but not cigarettes. The manifestation of inappropriate eating habits was found to be significant among male adolescents; in the literature, this is also true for female adolescents. In Lebanon, the engagement of adolescents in alcohol drinking and waterpipe smoking is frequent as they are accessible due to the lack of law enforcement and supervision in the country. In addition, while this study found an association between inappropriate eating habits and dependency on smoking and drinking, further investigation should be done on the role of one's psychology in their exhibition of disordered eating as means to prevent the manifestation of these habits.
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Affiliation(s)
- Jana Berro
- Faculty of Arts & Sciences, Lebanese American University, Byblos, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Sahar Obeid
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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Simons RM, Hansen JM, Simons JS, Hovrud L, Hahn AM. Drunkorexia: Normative behavior or gateway to alcohol and eating pathology? Addict Behav 2021; 112:106577. [PMID: 32861988 DOI: 10.1016/j.addbeh.2020.106577] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/06/2020] [Accepted: 07/25/2020] [Indexed: 12/14/2022]
Abstract
Drunkorexia is characterized by a group of behaviors designed to minimize caloric intake while maximizing levels of alcohol intoxication. Individuals plan and modify their diet, via skipping meals, exercising, or purging, to save calories for a night of alcohol consumption. Minimal research has examined risk factors related to drunkorexia, and little is known regarding associated problems. We used structural equation modeling to test associations between coping and enhancement motives, drive for thinness, body dissatisfaction, and disordered eating (i.e., bulimia behaviors) and drinking among an at-risk college population (N = 364). Drive for thinness and alcohol coping motives were positively associated with drunkorexia. Notably, drunkorexia was associated with alcohol-related outcomes, but not bulimia. While common risk factors are shared with eating pathology, drunkorexia appears to be a unique construct apart from bulimia behaviors. Results indicate drunkorexia behaviors may extend past normative drinking and place individuals at increased risk of alcohol-related problems. The current study contributes to greater understanding of functional models and maladaptive outcomes related to drunkorexia behaviors.
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Examining the role of body esteem and sensation seeking in drunkorexia behaviors. Eat Weight Disord 2020; 25:1507-1513. [PMID: 31587177 DOI: 10.1007/s40519-019-00784-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/21/2019] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The purpose of the present study was to examine the role of body esteem (BE), sensation seeking (SS), and their interaction in drunkorexia, a behavior pattern marked by calorie restriction/compensation in the context of alcohol consumption. While previous research on drunkorexia has focused on a range of variables, the present study examined two novel variables and their potential interaction: body esteem (weight, appearance) and sensation seeking. METHODS A sample of college students (n =488) completed the Body Esteem Scale for Adolescents and Adults, the Brief Sensation Seeking Scale, and the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale, which measures overall drunkorexia engagement as well as four dimensions: alcohol effects, bulimia, dietary restraint and exercise, and restriction. RESULTS Moderated linear regression analyses indicated that SS and BE (weight, appearance) did not interact in predicting drunkorexia. Rather, only main effects were observed; SS, weight esteem (WE), and appearance esteem (AE) were significant in predicting overall drunkorexia engagement. In terms of the drunkorexia dimensions, AE was a significant predictor in the alcohol effects, dietary restraint and exercise, and restriction models. WE was significant in the dietary restraint and exercise model as well as the restriction model. SS was a significant predictor across all drunkorexia dimensions. CONCLUSIONS Our findings suggest that both elevated SS and lowered BE are associated with drunkorexia engagement. Implications for practice are discussed. Drunkorexia is a complex and multifaceted behavior pattern; therefore, further research is needed in this area of study. LEVEL OF EVIDENCE Level V (descriptive study).
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31
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Herchenroeder L, Bravo AJ. College alcohol beliefs and negative alcohol-related consequences: A moderated mediation model of enhancement drinking motives and restricted eating. Addict Behav 2020; 110:106541. [PMID: 32683171 DOI: 10.1016/j.addbeh.2020.106541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/19/2020] [Accepted: 07/03/2020] [Indexed: 10/23/2022]
Abstract
College alcohol beliefs (CABs; i.e., beliefs that alcohol use is an integral feature of college life) have been shown to be positively associated with negative alcohol-related consequences among college students. Given this information, the present study examined restricted eating before consuming alcohol to increase intoxication as one drinking behavior mechanism through which CABs relate to negative alcohol-related consequences. Additionally, we examined whether the indirect association of CABs and negative alcohol-related consequences through restricted eating differed as a function of enhancement drinking motives, specifically the CABs-restricted eating association (i.e., first-stage moderated mediation). Participants included college students (n = 1347) across 10 states/universities who consumed alcohol in the last month. The majority of participants identified as being White, non-Hispanic (69.0%), female (70.1%), and reported a mean age of 20.92 (Median = 20.00; SD = 4.60) years. As hypothesized, restricted eating mediated the association between CABs and negative alcohol-related consequences. Further, the indirect effect of CABs on negative alcohol-related consequences through restricted eating was stronger in students who endorsed high levels of enhancement motives, compared to students with low or average levels. Our findings suggest that college students with high levels of enhancement motives are at a relatively higher risk of experiencing negative alcohol-related consequences related to CABs via restricted eating, compared to those with average or low levels. Future research is needed to examine additional drinking-related factors that may influence the pathways between CABs and negative alcohol-related consequences among college students.
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Affiliation(s)
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- Department of Psychological Sciences, William & Mary, United States
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32
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Castañeda G, Colby SE, Barnett TE, Olfert MD, Zhou W, Leite WL, El Zein A, Mathews AE. Examining the effect of weight conscious drinking on binge drinking frequency among college freshmen. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:906-913. [PMID: 31348733 DOI: 10.1080/07448481.2019.1642204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 01/18/2019] [Accepted: 07/05/2019] [Indexed: 06/10/2023]
Abstract
To examine the effect of weight-conscious drinking and compensatory behavior temporality on binge drinking frequency of college freshmen. Participants: Freshmen (n = 1149) from eight US universities, Fall 2015. Methods: Participants completed the Compensatory Eating Behaviors in Response to Alcohol Consumption Scale and Alcohol Use Disorders Identification Test-Consumption. Structural equation modeling was used to model the effect of weight-conscious drinking constructs on binge drinking frequency. Results: Bulimia, Dietary Restraint and Exercise, Restriction, proactive Alcohol Effects, during Alcohol Effects, and proactive Dietary Restraint and Exercise factors significantly predicted binge drinking frequency. Conclusion: Weight-conscious drinking among this cohort of college students comprises temporal factors significantly associated with binge drinking frequency. Relationships between Bulimia, Dietary Restraint and Exercise, and Restriction compensatory behaviors and binge drinking should be considered in interventions to address binge drinking among college students.
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Affiliation(s)
- Gail Castañeda
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Sarah E Colby
- Department of Nutrition, College of Education, Health & Human Sciences, University of Tennessee, Knoxville, TN, USA
| | - Tracey E Barnett
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Melissa D Olfert
- Human Nutrition and Foods, West Virginia University, Morgantown, WV, USA
| | - Wenjun Zhou
- Department of Business Analytics and Statistics, University of Tennessee, Knoxville, TN, USA
| | - Walter L Leite
- Research and Evaluation Methodology Program, School of Human Development and Organizational Studies, University of Florida, Gainesville, FL, USA
| | - Aseel El Zein
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, USA
| | - Anne E Mathews
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, USA
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College students’ engagement in drunkorexia: Examining the role of sociocultural attitudes toward appearance, narcissism, and Greek affiliation. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00382-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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34
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Tuazon VE, Travis SP, Honderich EM, Williams AE, Menefee SEI, Gressard CF. Drunkorexia: An Exploratory Investigation of College Students With Alcohol‐Related Infractions. JOURNAL OF COLLEGE COUNSELING 2019. [DOI: 10.1002/jocc.12111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Victor E. Tuazon
- School Psychology and Counselor EducationWilliam & Mary
- Now at Department of Counselor EducationNew Jersey City University
| | - Sterling P. Travis
- School Psychology and Counselor EducationWilliam & Mary
- Now at Department of Counseling & Human ServicesJohns Hopkins University
| | - Eleni M. Honderich
- Department of Behavioral HealthWalden University
- Now at The Family InstituteNorthwestern University
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35
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Choquette EM, Rancourt D, Kevin Thompson J. From fad to FAD: A theoretical formulation and proposed name change for "drunkorexia" to food and alcohol disturbance (FAD). Int J Eat Disord 2018; 51:831-834. [PMID: 30051491 DOI: 10.1002/eat.22926] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/19/2018] [Accepted: 06/20/2018] [Indexed: 11/10/2022]
Abstract
"Drunkorexia" is a term that has been used to describe behaviors such as restricting food intake in anticipation of alcohol consumption to offset total caloric intake, and/or to enhance the intoxicating effect of alcohol consumption. Scattered studies over the past few years have indicated the potential problematic nature of the intersection of these behaviors, yet there remain significant gaps in the operationalization of the construct, limiting research progress. In this article, we articulate limitations of the current research, including problems with the definition of the construct and a lack of theoretical guidance. We suggest a broader and more accurate phrase to guide future work with this phenomenon: Food and alcohol disturbance (FAD). Additionally, we suggest adapting Fairburn's transdiagnostic theoretical model for FAD. It is hoped these changes might provide a roadmap for future work in this area on risk factors and adaptations of current preventive and treatment approaches to focus on this emerging form of eating disturbance.
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Affiliation(s)
- Emily M Choquette
- Department of Psychology, University of South Florida, Tampa, Florida
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, Florida
| | - J Kevin Thompson
- Department of Psychology, University of South Florida, Tampa, Florida
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36
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Patte KA, Leatherdale ST. A cross-sectional analysis examining the association between dieting behaviours and alcohol use among secondary school students in the COMPASS study. J Public Health (Oxf) 2018; 39:321-329. [PMID: 27165667 DOI: 10.1093/pubmed/fdw034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Unhealthy weight-control methods and problematic alcohol use appear linked, with individuals engaging in both behaviours at greater risk of adverse consequences. Most studies have been conducted among females and young adults, yet both dieting and binge drinking emerge at earlier stages of development. Moreover, gender differences are likely due to contrasting body ideals. This study investigated the co-occurrence of dieting and alcohol use among youth, focusing on varying weight goals in males and females, and meal skipping, as a form of food restriction. Methods Cross-sectional analyses were conducted in sample of 44 861 Grade 9-12 students from Year 2 (2013-14) of the COMPASS study. Results and conclusions The majority of females were trying to lose weight, while males tended to report efforts to gain and these two groups demonstrated the highest odds of alcohol use and binge drinking. Breakfast and lunch skipping predicted binge drinking and alcohol use in females, but only the former was related to drinking behaviour in males. Breakfast skipping rarely occurred for weight loss purposes, although more females reported this reason for missing meals than males. Results support hypothesized gender variations in weight goals and meal skipping, and differing associations with drinking behaviour.
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Affiliation(s)
- Karen A Patte
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue, Waterloo, ON, CanadaN2L 3G1
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue, Waterloo, ON, CanadaN2L 3G1
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Pompili S, Laghi F. Drunkorexia among adolescents: The role of motivations and emotion regulation. Eat Behav 2018; 29:1-7. [PMID: 29413818 DOI: 10.1016/j.eatbeh.2018.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 01/08/2018] [Accepted: 01/10/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The co-occurrence of disordered eating and alcohol use and misuse has frequently been highlighted in literature. METHOD The first aim of the present study was to examine the association of drunkorexia with various disordered eating behaviors and alcohol consumption in a sample of male and female adolescents. The second goal was to investigate the motivations underlying drunkorexia and the third goal was to examine the relationship between drunkorexia and different dimensions of emotion regulation. One thousand adolescents (608 females and 392 males; range 16-21) completed a survey of self-report measures. RESULTS Results from hierarchical multiple regression analyses revealed that fasting and engaging in binge drinking and getting drunk were significant predictors of drunkorexia in both males and females; furthermore, females were found to engage in drunkorexia mainly for enhancement motives. Conversely, drunkorexia in males was significantly predicted by difficulties regulating emotions. CONCLUSION This research suggests that disordered eating and alcohol use similarly contribute to drunkorexia in male and female adolescents, even though highlights important gender differences.
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Affiliation(s)
- Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy.
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38
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Peralta RL, Barr PB. Gender orientation and alcohol-related weight control behavior among male and female college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2017; 65:229-242. [PMID: 27982766 DOI: 10.1080/07448481.2016.1271802] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE We examine weight control behavior used to (a) compensate for caloric content of heavy alcohol use; and (b) enhance the psychoactive effects of alcohol among college students. We evaluate the role of gender orientation and sex. PARTICIPANTS Participants completed an online survey (N = 651; 59.9% women; 40.1% men). METHOD Weight control behavior was assessed via the Compensatory-Eating-and-Behaviors-in Response-to-Alcohol-Consumption-Scale. Control variables included sex, race/ethnicity, age, and depressive symptoms. Gender orientation was measured by the Bem Sex Role Inventory. The prevalence and probability of alcohol-related weight control behavior using ordinal logistic regression are reported. RESULTS Men and women do not significantly differ in compensatory-weight-control-behavior. However, regression models suggest that recent binge drinking, other substance use, and masculine orientation are positively associated with alcohol-related weight control behavior. CONCLUSIONS Sex was not a robust predictor of weight control behavior. Masculine orientation should be considered a possible risk factor for these behaviors and considered when designing prevention and intervention strategies.
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Affiliation(s)
- Robert L Peralta
- a Department of Sociology , The University of Akron , Akron , Ohio , USA
| | - Peter B Barr
- b Department of Psychology , Virginia Commonwealth University , Richmond , VA , USA
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39
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Eisenberg MH, Johnson CC, Zucker AN. Starving for a drink: Sexual objectification is associated with food-restricted alcohol consumption among college women, but not among men. Women Health 2017; 58:175-187. [DOI: 10.1080/03630242.2017.1292342] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Miriam H. Eisenberg
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
- Department of Psychology, George Washington University, Washington, DC, USA
| | | | - Alyssa N. Zucker
- Department of Psychology, George Washington University, Washington, DC, USA
- Center for Women’s Studies and Gender Research, University of Florida, Gainesville, Florida, USA
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40
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Hunt TK, Forbush KT. Is "drunkorexia" an eating disorder, substance use disorder, or both? Eat Behav 2016; 22:40-45. [PMID: 27085168 DOI: 10.1016/j.eatbeh.2016.03.034] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 03/11/2016] [Accepted: 03/30/2016] [Indexed: 10/22/2022]
Abstract
Researchers have identified a specific behavior pattern labeled "drunkorexia" to describe recurrent inappropriate compensatory behaviors (e.g., fasting and self-induced vomiting) to avoid weight gain from consuming alcohol (referred to as ICB-WGA). Several studies have investigated the prevalence of these behaviors among college students, but few have tested whether this behavior pattern is more strongly related to substance use or disordered eating, which may have future implications for eating disorder and substance abuse research fields. The aim of this project was to test: (1) whether disordered eating or alcohol use adds incremental validity to the prediction of ICB-WGA when controlling for the other variable and (2) the effect of sex on ICB-WGA. College participants (N=579; 53% female) completed the Eating Pathology Symptoms Inventory (EPSI), the Alcohol Use Disorders Identification Test (AUDIT), and several questions designed to measure ICB-WGA. Results indicated that EPSI Restricting and Body Dissatisfaction scales were not significant predictors of ICB-WGA, whereas the AUDIT and EPSI Cognitive Restraint, Excessive Exercise, Purging, and Binge Eating scales significantly predicted ICB-WGAs. Results indicated that disordered eating and alcohol use both added incremental validity to the prediction of ICB-WGA; however, ICB-WGA was more strongly related to disordered eating, and this was particularly true for women. Our findings suggest that individuals engaging in ICB-WGA may be at-risk for future development of both eating and substance disorders. Notably, our findings highlight the need for future research to focus on trans-diagnostic prevention programs that target mechanisms that underlie both disordered eating and substance misuse.
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Affiliation(s)
- Tyler K Hunt
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, KS, USA; Department of Psychology, University of Kansas, Lawrence, KS 66045, USA.
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Pinna F, Milia P, Mereu A, di Santa Sofia SL, Puddu L, Fatteri F, Ghiani A, Lai A, Sanna L, Carpiniello B. Validation of the Italian version of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS). Eat Behav 2015; 19:120-6. [PMID: 26356633 DOI: 10.1016/j.eatbeh.2015.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/08/2015] [Accepted: 08/26/2015] [Indexed: 11/16/2022]
Abstract
The aim of the study was to evaluate, in a representative sample of high school students, the psychometric characteristics of the Italian version of the CEBRACS scale (Rahal et al., 2011), a questionnaire investigating compensatory eating behaviors correlated with alcohol consumption. These behaviors are adopted to make up for calories consumed through the drinking of alcohol and/or to enhance the intoxicative effects of alcohol. Study participants were selected from an initial sample of 965 students. Out of the 965 youths originally recruited, 640 (376 males and 264 females) reported drinking alcohol over the previous 3 months, and were considered eligible for the purpose of the study. The following questionnaires were administered: CEBRACS, Alcohol Use Disorders Identification Test (AUDIT) (Saunders, 1993), and the Eating Disorder Inventory-3 (EDI-3) (Garner, 2004). Test/retest reproducibility was evaluated on a subgroup of 189 youths. The factorial structure, internal consistency, test–retest reliability and concurrent validity of CEBRACS were evaluated. Factor analysis of inter-item correlation indicated 5 factors as being better suited to describe data, with an estimated 68.85% variance: "Alcohol Effect, "Laxative Use", "Dietary Restraint and Exercise", "Diuretic Use", "Restriction and Vomiting". A high degree of reproducibility and homogeneity (ICC = 0.806; Cronbach's Alpha = 0.886) of the scale was detected. A significant correlation was revealed between CEBRACS, the three eating disorder risk scales comprised in EDI-3 and scores and clinical risk yielded by AUDIT. The overall reliability and validity of the CEBRACS scale was confirmed in an extensive sample of Italian students, highlighting a satisfactory construct validity, good internal consistency and good degree of reproducibility. In view of the relevance of the problem, associated with serious health risks, a more widespread investigation of the phenomenon should be conducted using evaluation tools of proven validity and reliability on both representative samples of the general population and clinical samples.
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Affiliation(s)
- Federica Pinna
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Paola Milia
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Alessandra Mereu
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | | | - Laura Puddu
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Francesca Fatteri
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Alice Ghiani
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Alice Lai
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Lucia Sanna
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy
| | - Bernardo Carpiniello
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Italy.
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