Both eating disorders and smoking are significant problems for Black and White college women. Additionally, these two negative health behaviors frequently co-occur. This study aimed to investigate the relationship between these health behaviors using a multivariate model. Two models, one for full and one for partial mediation, were tested using Structural Equation Modeling. The Model for full mediation tested whether the relationship among general distress and smoking are fully mediated by body dissatisfaction, restraint, and binge eating. The model for partial mediation hypothesized that the relationships among general distress, and smoking are mediated by body dissatisfaction, restraint, and binge eating. Results indicated that there was not a significant difference between the full and partial model and therefore, the full model was retained as it is more parsimonious. In addition, a test of model invariance was conducted on the full mediation model to test form potential differences in Black and Whites. It was found that the structural model is invariant across these two groups. Results of this study may have important implications for future research as well as for treatment and preventative interventions.

Attention deficit/hyperactivity disorder (ADHD) is a childhood disorder that often persists into adulthood. Among adults, ADHD is highly comorbid with addictive behaviors (e.g., substance abuse and dependence), and depressive disorders. Recently, an association between ADHD and obesity has been reported in the literature; emotional and binge eating may be “addictive behaviors” that contribute to weight gain in this population. The purpose of this study was to test competing models of the hypothesized link between ADHD symptomology and overweight. Specifically, in Model 1, symptoms of depression are expected to mediate the relationship between symptoms of impulsivity and inattention and emotional and binge eating which, in turn, leads to weight gain (i.e., increased BMI). In Model 2, however, the impulsive symptoms have direct relationships with emotional and binge eating in addition to being mediated by depressive symptoms. Structural equation modeling (SEM) was employed to test how the models fit the data of 790 college men. Both models fit the data well, with Model 2 being preferred because of its greater connection to theory. All paths were significant indicating that increased impulsive and inattentive symptoms predicted increased symptoms of depression that, in turn, predicted increased emotional/binge eating, which has a direct and positive relationship with increased BMI. Moreover, impulsive symptoms were also directly related to emotional/binge eating, suggesting different paths to overweight across ADHD subtypes. The findings of the current study elucidate the links between ADHD symptoms and overweight (i.e., increased BMI).

A obesidade é considerada distúrbio de difícil controle que gera sérios riscos à saúde e representa grave problema para a saúde pública. Os pacientes portadores de obesidade mórbida que apresentam compulsão diferem em vários aspectos dos não compulsivos e a operação, como recurso de tratamento para estes pacientes, influencia diferentemente na sua evolução. Obesidade e compulsão alimentar podem estar associadas em uma relação que compromete o resultado da cirurgia e contribui para complicações pós-operatórias. Neste sentido, o objetivo deste estudo foi analisar os indícios de compulsão alimentar em pacientes submetidos à cirurgia bariátrica, pela técnica de Fobi-Capella, antes e pelo menos dois anos após a operação. Participaram deste estudo 50 pacientes submetidos à cirurgia bariátrica no Serviço de Cirurgia do Aparelho Digestivo do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Destes 43 (86%) eram mulheres e 7 (14%) homens, com idade média de 42,4 anos, IMC inicial médio de 48,5 e tempo médio de seguimento pós-operatório de 36,6 meses. Os pacientes foram submetidos à avaliação psicológica antes e dois a cinco anos após a operação. Os instrumentos utilizados foram o teste das Pirâmides Coloridas de Max Pfister, aplicado antes e após a operação, para identificar indícios de compulsão e entrevista clínica semiestruturada, aplicada somente no pós-operatório para observar os hábitos alimentares e mecanismos associados à compulsão referidos pelo paciente antes e após a operação. Os dados foram submetidos à análise estatística e pode-se perceber características de compulsão através da identificação de pacientes com estrutura emocional prejudicada, ansiedade, depressão, necessidade de controle, dificuldade na elaboração das emoções, rigidez e busca da comida diante de situações conflitivas, de mo do que a diminuição da ingestão alimentar poderia ter contribuído para alterações na estrutura emocional destes pacientes. Observou-se alterações nas preferências alimentares; passaram a comer mais, em intervalos curtos, doces, torradas, bolachas e outros petiscos, de modo que os pacientes permaneceram recorrendo à comida por não encontrarem recursos que favorecessem uma ação adequada e adaptada. A partir da análise dos dados concluiu-se que os pacientes portadores de obesidade mórbida submetidos à cirurgia bariátrica apresentam indícios de compulsão alimentar antes e após a operação. A compulsão alimentar estaria relacionada a aspectos psicológicos como dificuldade em organizar emoções, ansiedade, depressão e estrutura emocional prejudicada. Características de impulsividade, controle, rigidez e instabilidade emocional também contribuiria m para a manifestação de episódios compulsivos. Os hábitos e preferências alimentares modificaram-se após a operação, uma vez que os pacientes passaram a consumir alimentos de fácil ingestão frente a situações que os faziam comer compulsivamente, não sendo observado trocas de compulsão / Obesity is considered a disorder that is difficult to control, creates serious health risks and represents a serious problem for public health. Patients with morbid obesity who present compulsiveness differ in several aspects of non-compulsive patients, so the operation, may have a different outcome. Obesity and binge eating may be associated, compromising the outcome of surgery and contributing to postoperative complications. The aim of this study was to analyze the influence of bariatric surgery using Fobi- Capellas technique on compulsive behavior. Fifty patients were studied, 43 (86%) women and 7 (14%) men, with an average age of 42.4 years, an average baseline BMI of 48.5 and an average follow-up time of 36.6 months. The patients were psychologically evaluated before and two to five years after surgery using the Colorful Pyramids of Max Pfister test and semi-structured clinical interviews. Evidence of compulsiveness was observed in patients with emotional disorders, anxiety, depression, controlling attitudes, difficulties in dealing with emotions, stiffness and demand for food in situations of emotional difficulty. Therefore, a decrease in food intake could have contributed to emotional alterations in these patients. Changes in food preferences were also observed. The patients began to eat more sweets, toast, biscuits and other snacks in short intervals, indicating that they were not finding resources to encourage appropriate action. Data analysis suggested that patients with morbid obesity who submitted to bariatric surgery show evidence of binge eating before and after the operation. Binge eating is related to psychological issues such as difficulty organizing emotions, anxiety, depression and a damaged emotional structure. Characteristics of impulsivity, self-control, rigidity and emotional instability also contribute to the onset of compulsive episodes. Habits and food preferences changed after the operation. The patients began consuming foods that were easier to ingest (eating small amounts throughout the day instead of meals) in response to situations that would have stimulated compulsive episodes preoperatively. Transfers or exchanges in compulsive attitudes, such as using drugs, drinking or shopping in excess, were not demonstrated

Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2016-04-08T13:55:08Z No. of bitstreams: 1 PDF - Mielle Neiva Santos.pdf: 1770622 bytes, checksum: 763f433b505a4065e3ce458785efed2b (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2016-04-12T17:22:57Z (GMT) No. of bitstreams: 1 PDF - Mielle Neiva Santos.pdf: 1770622 bytes, checksum: 763f433b505a4065e3ce458785efed2b (MD5) / Made available in DSpace on 2016-04-12T17:23:52Z (GMT). No. of bitstreams: 1 PDF - Mielle Neiva Santos.pdf: 1770622 bytes, checksum: 763f433b505a4065e3ce458785efed2b (MD5) Previous issue date: 2014-02-25 / Goal: Assess the feeding behavior, the occurrence of binge eating and its relationship with nutritional status and cardiovascular risk score Pathobiological Determinants of Atherosclerosis in Youth (PDAY) in school adolescents. Methodology: Study of 540 teenagers between 15 and 19 years of high school public schools. Students were interviewed for the evaluation of cardiovascular risk, through PDAY score and other related variables, answered questionnaires auto applied to identification of binge eating (Dutch Food frequency Questionnaire-QHCA) and were evaluated by Anthropometry. Results: PDAY score was ranked low risk (58.5%) and intermediate/high risk cardiovascular risk (41.5%). Obtained 13.9% of adolescents with some level of binge eating. There was substantial consumption of unhealthy food markers. He was also the high prevalence of physical inactivity (79.1%) and of inactivity/lack in physical activity (58.9%). According to the simple linear regression, the abdominal circumference is the variable that most interferes in BMI (51.7%), relationship that remained in multivariate regression (54.3%). Conclusions: The nutritional status was related to the score of binge eating and this was related to increased levels of total cholesterol, LDL cholesterol and lower levels of physical activity. PDAY score and score of compulsion not shown associates. He was the high prevalence of adolescents with some level of binge eating, pointing out that the maintenance of nutritional status mechanisms need to be further studied, to configure how eating disorders. / Objetivo: Avaliar o comportamento alimentar, a ocorrência de compulsão alimentar e sua relação com o estado nutricional e com o risco cardiovascular pelo escore Pathobiological Determinants of Atherosclerosis in Youth (PDAY) em escolares adolescentes. Metodologia: Estudo realizado com 540 adolescentes entre 15 e 19 anos de escolas públicas de ensino médio. Os estudantes foram entrevistados para avaliação do risco cardiovascular, através do escore PDAY e outras variáveis relacionadas, responderam questionários auto aplicados para identificação de compulsão alimentar (Questionário Holandês de Frequência AlimentarQHCA) e foram avaliados por antropometria. Resultados: O escore PDAY foi classificado em baixo risco (58,5%) e risco intermediário/alto risco cardiovascular (41,5%). Obteve-se 13,9% de adolescentes com algum nível de compulsão alimentar. Houve o consumo substancial de marcadores de alimentação não saudável. Destacou-se também a alta prevalência de sedentarismo (79,1%) e de inatividade/insuficiência na atividade física (58,9%). De acordo com a regressão linear simples, a circunferência abdominal é a variável que mais interfere no IMC (51,7%), relação que permaneceu na regressão multivariada (54,3%). Conclusões: O estado nutricional mostrou-se relacionado ao escore de compulsão alimentar e esta esteve relacionada com maiores níveis de colesterol total, colesterol LDL e com menores níveis de atividade física. O escore PDAY e escore de compulsão não se mostraram associados. Destacou-se a elevada prevalência de adolescentes com algum nível de compulsão alimentar, apontando que os mecanismos de manutenção do estado nutricional precisam ser mais bem estudados, para que não se configurem como transtornos alimentares futuros.

CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior / Nossa pesquisa partiu dos achados advindos de nossa experiÃncia clÃnica junto a uma equipe de trabalho interdisciplinar que tinha o propÃsito de tratar transtornos alimentares. No nosso caso, trabalhamos mais especificamente com pacientes que nos eram indicados com o diagnÃstico prÃvio de transtorno de compulsÃo alimentar. Os problemas clÃnicos decorrentes desse tipo de diagnÃstico nos levaram a problematizar os diferentes fenÃmenos relacionados com o esse tipo de patologia que incide sobre a pulsÃo em sua relaÃÃo com o alimento. Tal aspecto nos levou ao objetivo de procurar compreender e diferenciar, à luz da teoria psicanalÃtica, as manifestaÃÃes psicopatolÃgicas da impulsÃo e da compulsÃo em geral e mais especificamente em relaÃÃo ao alimento, em suas relaÃÃes com os conceitos de gozo, desejo e angÃstia. AlÃm disso, buscamos refletir acerca das implicaÃÃes clÃnicas dessas relaÃÃes para o tratamento de pacientes que manifestam tais sintomas ou atos, levando em consideraÃÃo, principalmente, as possÃveis medidas terapÃuticas a serem propostas pela equipe para o tratamento do paciente, sobretudo sobre a prescriÃÃo ou nÃo da cirurgia bariÃtrica e suas possÃveis consequÃncias para os pacientes em sua singularidade, tendo em vista a ocorrÃncia, jà registrada em pesquisas anteriores, de Ãbitos ou de reganho de peso apÃs a realizaÃÃo da mesma. Do ponto de vista metodolÃgico, nos valemos da precisÃo de conceitos necessÃrios à nossa reflexÃo clÃnica, principal condutora de nossa anÃlise, acerca de casos por nÃs atendidos e por casos clÃssicos e contemporÃneos que se revelaram relevantes para o tratamento de nossas questÃes de pesquisa. Neste contexto nos ocuparmos, mais detidamente, na anÃlise desses casos para compreendermos a complexidade e a relevÃncia clÃnica das articulaÃÃes que as impulsÃes e as compulsÃes estabelecem com as categorias de sintoma e ato. A partir disso, destacamos a importÃncia de diferenciar a direÃÃo do tratamento e a posiÃÃo do analista, quando no contexto de um tratamento padrÃo e quando inserido em equipes interdisciplinares que se dedicam ao tratamento de pacientes que manifestam tais sintomas ou atos como, por exemplo, à o caso dos programas voltados para o tratamento de patologias que produzem efeitos de recusa ou excesso alimentares e que, em geral, as definem, segundo a classificaÃÃo internacional das doenÃas, como Transtornos Alimentares. Dentre nossos principais achados conclusivos, constatamos que as aÃÃes compulsivas devem ser compreendidas como encarnaÃÃo dos sintomas, estÃo inseridas na lÃgica do gozo fÃlico e sÃo formadas com o fito de evitar a emergÃncia da angÃstia. Jà as impulsÃes sÃo atos que emergem suscitando uma satisfaÃÃo corporal que deixa o sujeito mudo e sem lugar e estÃo inseridas na lÃgica de um gozo autoerÃtico, situado entre o gozo do ser e o gozo fÃlico. Por nÃo serem compreendidas como sintomas, mas como atos, as impulsÃes podem aparecer em sujeitos organizados em qualquer uma das trÃs estruturas clÃnicas. Tais achados nos possibilitaram refletir acerca da direÃÃo do tratamento em casos de compulsÃo e/ou impulsÃo diagnosticados pela psiquiatria como portadores de compulsÃo alimentar. Assim, a originalidade do nosso trabalho està na abordagem que realizamos do diagnÃstico psiquiÃtrico de compulsÃo alimentar, a partir da perspectiva psicanalÃtica da impulsÃo e da compulsÃo. Consideramos, afinal, que os resultados deste trabalho podem contribuir para o tratamento de casos relacionados a outros quadros clÃnicos que envolvem outros objetos que nÃo aqueles das patologias alimentares como, por exemplo, as adiÃÃes em geral, o vÃcio em jogo, o consumo patolÃgico, dentre outros.

Binge eating and drinking have been studied with respect to stress, anxiety, and depression, but little is known about the emerging phenomenon of binge watching television programming. Guided by escape theory and the uses and gratification theory, this cross-sectional, correlational study addressed multivariate relations of binge drinking, binge eating, and binge watching with depression, anxiety, and stress among 102 college students ages 18 to 24. Multivariate canonical correlation results revealed that participants with low anxiety scores tended to have low scores on binge eating and drinking but high scores on binge watching. Participants with low stress scores and high anxiety scores tended to have low scores on binge watching and eating. In a regression model, anxiety, stress, and gender were important predictors of binge eating. Binge drinking was influenced by where a student lived, fraternity/sorority status, athletic participation, depression, and stress. Binge watching was best predicted by a model including stress, anxiety, athletic participation, and whether binge episodes were planned or unplanned. More binge watching occurred among participants not involved in athletics to pass time but not for information. Results may provide college mental health student services centers with empirical data to create programs to identify maladaptive binge behaviors among students and help them more effectively cope with stress, anxiety, and depression.

Childhood overweight and obesity is a significant and increasing health problem both nationally and globally. Yet few interventions for preventing obesity have been successful, particularly in the long-term, suggesting that important factors are being overlooked. The aims of this thesis were to investigate (a) the prevalence of childhood overweight, obesity, and binge eating; and (b) the relationships between body weight, binge eating behaviour, and a set of physical, psychological, and psychosocial variables including parent body size, body dissatisfaction, size-related teasing experiences, internalisation of sociocultural messages, depression, dieting attitudes and behaviour, and emotional eating. Participants were 569 grade five and six primary school children (272 boys and 297 girls) from Catholic and Government schools across metropolitan Melbourne, Australia. Almost 25% of participants were classified as overweight or obese. Thirteen percent of participants reported engaging in overeating (with or without loss of control), 14% reported loss of control (with or without overeating), and 6% reported engaging in binge eating (overeating and loss of control). Structural equation modelling analyses found that body weight and binge eating were indirectly related. Body weight was directly and positively associated with parent body size, size-related teasing experiences, body dissatisfaction, and internalisation of sociocultural messages, negatively associated with emotional eating, and indirectly associated with depression, and dieting attitudes and behaviour. Binge eating was directly and positively related to parent body size, emotional eating, depression, and body dissatisfaction, while indirect associations were found with size-related teasing experiences, internalisation of sociocultural messages, and dieting attitudes and behaviour. A direct relationship between body dissatisfaction and loss of control was also found. Some gender differences were detected. Multivariate analysis of variance also revealed that binge eaters scored significantly higher on measures of depression, size-related teasing experiences, internalisation of sociocultural messages, and angry and worried related emotional eating than non-binge eaters. Differences were also found for participants reporting the presence or absence of overeating (regardless of loss of control) and loss of control (regardless of overeating). Overall, the study demonstrated that psychological and psychosocial factors have a significant association with both weight and binge eating behaviour in a non-clinical sample of preadolescent Australian school children. As such, future intervention programs may benefit by addressing these factors. In addition, these results support the idea of working toward the prevention of obesity and eating disorders simultaneously in children, and of extending research in this area to examine causality.

Perfectionism is implicated in the onset, course, and remission of disordered eating (Bastiani, Rao, Weltzin, & Kaye, 1995; Bruch, 1979; Cockell et al., 2002; Stice, 2002; Tozzi, et al., 2005; Vohs, Bardone, Joiner, & Abramson, 1999; references are contained in Appendix F on p. 271). Building on the above research tradition, this dissertation proposed and evaluated a model relating perfectionism to binge eating. This new model is termed the Perfectionism Model of Binge Eating (PMOBE). According to the PMOBE, perfectionism confers vulnerability to binge eating by generating encounters with and by magnifying responses to specific triggers of binge eating: namely, perceived discrepancies, low self-esteem, depressive affect, and dietary restraint. <p>A multi-site, 7-day, web-based structured daily diary study was conducted to test the PMOBE. Overall, 566 female university students participated, and these individuals provided 3509 useable diary responses. A data analytic strategy involving structural equation modeling and multilevel modeling generally supported the PMOBE. For example, a structural model relating socially prescribed perfectionism (i.e., perceiving that others are demanding perfection of oneself) to binge eating through the aforementioned binge eating triggers demonstrated acceptable fit. Multilevel mediation also indicated that the influence of self-oriented perfectionism (i.e., demanding perfection of oneself) and socially prescribed perfectionism on binge eating operated through the abovementioned binge eating triggers (excepting dietary restraint). Support for multilevel moderation was limited, but suggested that the relationship between self-oriented perfectionism and binge eating was conditional upon dietary restraint. <p>This study is, to my knowledge, the first to examine the perfectionism-disordered eating connection using a structured daily diary methodology. Thus, this study offered a unique perspective apart from the usual cross-sectional and nomothetic research on perfectionism and eating pathology. In particular, this study suggested that, in their day-to-day lives, perfectionistic individuals (especially socially prescribed perfectionists) inhabit a world permeated with putative triggers of binge eating. Although perfectionism appeared to generate exposure to binge eating triggers, by and large, it did not seem to magnify responses to these same triggers (Bolger & Zuckerman, 1995, p. 890). A somewhat qualified version of the PMOBE was thus supported, with socially prescribed perfectionism assuming greater importance than self-oriented perfectionism and with perfectionism conferring vulnerability to binge eating by generating environments with, but not magnifying responses to, binge triggers. Overall, this dissertation contributed new knowledge to our understanding of the precipitants and the correlates of binge eating and highlighted the idea that perfectionism may play an important part in binge eating.

Perfectionism is implicated in the onset, course, and remission of disordered eating (Bastiani, Rao, Weltzin, & Kaye, 1995; Bruch, 1979; Cockell et al., 2002; Stice, 2002; Tozzi, et al., 2005; Vohs, Bardone, Joiner, & Abramson, 1999; references are contained in Appendix F on p. 271). Building on the above research tradition, this dissertation proposed and evaluated a model relating perfectionism to binge eating. This new model is termed the Perfectionism Model of Binge Eating (PMOBE). According to the PMOBE, perfectionism confers vulnerability to binge eating by generating encounters with and by magnifying responses to specific triggers of binge eating: namely, perceived discrepancies, low self-esteem, depressive affect, and dietary restraint. <p>A multi-site, 7-day, web-based structured daily diary study was conducted to test the PMOBE. Overall, 566 female university students participated, and these individuals provided 3509 useable diary responses. A data analytic strategy involving structural equation modeling and multilevel modeling generally supported the PMOBE. For example, a structural model relating socially prescribed perfectionism (i.e., perceiving that others are demanding perfection of oneself) to binge eating through the aforementioned binge eating triggers demonstrated acceptable fit. Multilevel mediation also indicated that the influence of self-oriented perfectionism (i.e., demanding perfection of oneself) and socially prescribed perfectionism on binge eating operated through the abovementioned binge eating triggers (excepting dietary restraint). Support for multilevel moderation was limited, but suggested that the relationship between self-oriented perfectionism and binge eating was conditional upon dietary restraint. <p>This study is, to my knowledge, the first to examine the perfectionism-disordered eating connection using a structured daily diary methodology. Thus, this study offered a unique perspective apart from the usual cross-sectional and nomothetic research on perfectionism and eating pathology. In particular, this study suggested that, in their day-to-day lives, perfectionistic individuals (especially socially prescribed perfectionists) inhabit a world permeated with putative triggers of binge eating. Although perfectionism appeared to generate exposure to binge eating triggers, by and large, it did not seem to magnify responses to these same triggers (Bolger & Zuckerman, 1995, p. 890). A somewhat qualified version of the PMOBE was thus supported, with socially prescribed perfectionism assuming greater importance than self-oriented perfectionism and with perfectionism conferring vulnerability to binge eating by generating environments with, but not magnifying responses to, binge triggers. Overall, this dissertation contributed new knowledge to our understanding of the precipitants and the correlates of binge eating and highlighted the idea that perfectionism may play an important part in binge eating.

This study examined the interrelationships between adolescent weight and several other variables thought to impact weight and obesity: physical activity, depressive symptoms, binge-eating symptoms, dieting, socio-economic status, special education status, gender, and ethnicity. The sample consisted of 251 high school students in rural Florida who completed measures of depression, binge-eating, dieting, and physical activity. Measurement instruments included the Reynolds Adolescent Depression Scale-2nd Edition (RADS-2), the bulimia scale of the Eating Disorder Inventory-2 (EDI-2), the dieting scale of the Dutch Eating Behavior Questionnaire (DEBQ), and a physical activity questionnaire derived from the Youth Risk Behavior Scale for Students (YRBSS). The study utilized path analysis, a group correlational design, to determine whether the proposed path model fit the data. Obese and non-obese students also were compared with regard to a) the levels of binge-eating symptoms, and b) the relationship between binge-eating and depression. Path analysis results were not statistically or clinically significant, suggesting a poor fit of the model to the data. Results indicated 19% of participants were obese and 20% were overweight. More than three times as many obese students than non-obese students reported experiencing a binge-eating experience at some time in the past. However, on the bulimia scale of the EDI-2, obese and non-obese participants did not differ statistically in their responses. Statistically but not clinically significant correlations were revealed between depression and binge-eating for the sample and also for non-obese students. For the sub-sample of 13 students who had both binged and dieted, 7 had binged first, 3 had dieted first, and 3 binged and dieted for the first time at the same age. Future research should continue to investigate the relationships of the variables related to obesity. Future directions might include a larger sampl e size and a modified sample selection process. Action research should continue in the areas of obesity prevention and intervention, and student services personnel should promote healthy lifestyle choices and a recognition of obesity as a socio-cultural problem.