People high in socially prescribed perfectionism (i.e., those who perceive others demand perfection of them) often behave in ways that are incongruent with their efforts to be perfect for others. This research proposes and tests two models that explain why socially prescribed perfectionism is related to self-defeating behaviours (i.e., behaviours with negative effects on the self that are often detrimental to achieving one’s goals). In Study 1, socially prescribed perfectionism was proposed to contribute to a cycle of self-defeat involving perfectionistic discrepancies, perfectionistic self-presentation, depressive affect, and self-defeating behaviours (i.e., binge eating, procrastination, interpersonal conflict). To test the model, data was collected from 317 undergraduates who completed structured online daily diaries. Results of multilevel structural equation modeling largely supported hypothesized relations such that participants high in socially prescribed perfectionism engaged in, or experienced, patterns of self-evaluation, self-presentation, and emotion that contributed to their imperfect, self-defeating behaviours. These behaviours undermined their efforts to be or look perfect for others—creating a sense of deficiency that sets the stage for another cycle of self-defeat. In Study 2, I tested the perfectionism model of binge eating in 218 mother-daughter dyads using a mixed longitudinal and daily diary design. Results largely supported hypotheses suggesting daughters’ socially prescribed perfectionism and mothers’ psychological control contribute indirectly to daughters’ binge eating by generating situations or experiences that trigger binge eating (i.e., discrepancies, depressive affect, and dietary restraint). For young women who believe their mothers rigidly require them to be perfect and whose mothers are demanding and controlling, binge eating appears to provide a means of coping with or escaping from an unhealthy, unsatisfying mother-daughter relationship. Together, the results of Study 1 and Study 2 help to explain why people who strive to be perfect for others often engage in self-defeating behaviours. These findings have numerous implications for theory and research on personality, relationships, and self-defeating behaviours, and for prevention, assessment, and treatment of perfectionism and associated difficulties. These implications, along with the limitations and future directions of this research are discussed.

abstract: Long-term results of dietary weight loss interventions are not promising, with rates of weight loss maintenance at a mere 20%. Psychological factors related to weight maintenance include setting unrealistic weight goals, poor problem-solving skills, low self-efficacy, dichotomous thinking, and external locus of control. The ability to maintain a stable bodyweight over time has been associated with optimal health outcomes, lower stress levels, and higher general well-being. Dichotomous thinking has been associated with overeating and increased bodyweight. Cognitive restraint, disinhibition, and hunger are three dimensions of human eating behavior that appear to be important to understanding weight loss maintenance. Individuals who attempt to maintain their bodyweight via dietary restraint mechanisms are more susceptible to excessive eating episodes. Disinhibition has been found to be the strongest predictor of weight gain, while the research on the association between hunger and bodyweight is mixed. This study sought to evaluate the relationship between dichotomous thinking toward food and various eating behaviors (binge eating, cognitive restraint, disinhibition, and hunger). A multiple regression analysis revealed that binge eating, cognitive restraint, disinhibition, and hunger were each significant unique predictors of higher body mass index (BMI). Higher levels of hunger predicted lower BMI, controlling for cognitive restraint, disinhibition, and binge eating. Mediation analyses revealed that dichotomous thinking mediated the relationships between binge eating and BMI, cognitive restraint and BMI, and disinhibition and BMI. Further analysis revealed that binge eating mediated the relationship between dichotomous thinking and BMI, indicating that thinking of food in black-and-white could lead to higher rates of binge eating, and the excess calorie consumption could lead to increased BMI. The study findings suggest that a strong focus should be made to promote a more flexible attitude toward food in an effort to improve weight loss maintenance in the population. / Dissertation/Thesis / Masters Thesis Psychology 2018

Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2017-03-29T19:31:11Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) TESE_MADGE FARIAS FECHINE_.pdf: 4788089 bytes, checksum: 648782ee88724431e5d44996b0235367 (MD5) / Made available in DSpace on 2017-03-29T19:31:11Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) TESE_MADGE FARIAS FECHINE_.pdf: 4788089 bytes, checksum: 648782ee88724431e5d44996b0235367 (MD5) Previous issue date: 2016-05-31 / CAPES / Objetivo: Investigar os efeitos da desnutrição proteica perinatal ou manipulação do sistema serotoninérgico durante a lactação sob o comportamento alimentar compulsivo após ciclos de Restrição/Realimentação (R/R). Materiais e métodos: Foram formados quatro grupos conforme os tratamentos dietéticos e farmacológicos: Controle (17% caseína na vida perinatal) e Desnutrido (8% caseína na vida perinatal); Salina (10mg/Kg) e Fluoxetina (10mg/Kg) foram submetidos a três consecutivos ciclos de Restrição/Realimentação (ciclos R/R). Cada ciclo R/R é composto por uma fase de restrição (4 dias com 40% do consumo individual médio de dieta padrão nos 7 dias antes de iniciar os ciclos R/R) seguida por uma fase realimentação (4 dias com dieta padrão ad libitum). Assim, os quatro grupos anteriormente descritos foram subdivididos ou não de acordo com a fase de restrição dos ciclos R/R para formar oito grupos: Grupos não restritos [Controle Naïve (CN) n=6 e 10 ou Desnutrido Naïve (DN) n=7 e 11 e Salina Naïve (SN) n=13/15 ou Fluoxetina Naïve (FN) n=12/13] e Grupos restritos [Controle Restrito (CR) n=6 e 11 ou Desnutrido Restrito (DR) n=7 e 10 e Salina Restrito (SR) n=11/13 ou Fluoxetina Restrito (FR) n=13/14]. Após os três ciclos R/R, todos os animais foram submetidos ao teste alimentar (dieta padrão e palatável por 24hs). Após uma semana, os animais dos grupos [Controle Naïve (CN) n=10 ou Controle Restrito (CR) n=11 e Desnutridos Naïve (DN) n=11 ou Desnutrido Restrito (DR) n=10] foram submetidos a um teste de privação alimentar (24hs sem dieta padrão) e em seguida receberam dieta palatável (2hs) e dieta padrão (22hs). Já todos os animais dos grupos Salina e Fluoxetina, aos 120 dias de vida foram submetidos a outro teste alimentar semelhante ao primeiro teste alimentar (após os ciclos R/R). Resultados: Após ciclos R/R os animais Desnutrido Restrito demonstraram hiperfagia por dieta palatável comparados com os animais do grupo Controle Naïve, como também aumentaram o peso corporal sugerindo o desenvolvimento de obesidade. Contudo, estes animais perderam a capacidade para aumentar o consumo de dieta palatável quando estavam com fome, após a privação alimentar. Em relação aos grupos Salina e Fluoxetina não houve diferenças significativas no consumo alimentar (dieta palatável e padrão) nos dois testes alimentares. Conclusão: Desnutrição proteica perinatal ou tratamento de fluoxetina no aleitamento não contribuem para o desenvolvimento de compulsão alimentar após três ciclos R/R. / Objective: To investigate the effects of the perinatal protein undernourishment or manipulation of the serotonergic system in breastfeeding on the binge eating behavior after Restriction/Refeeding cycles (R/R cycles). Materials and methods: Four groups were formed as dietary and pharmacological treatments: Control (17% casein in perinatal life) and Undernourished (8% casein in perinatal life); Saline (10mg/kg) and Fluoxetine (10mg/kg) were submitted to three consecutive cycles of Restriction/Refeeding cycles (R/R cycles). Each R/R cycle was composed of a restriction phase (4 days with 40% of the mean individual consumption standard diet 7 days before starting cycles R/R) followed by a feedback phase (4 days with a standard diet ad libitum). Thus, the four groups described above were subdivided or not according to the restriction phase of R/R cycles to form eight groups: not restricted Groups [Control Naïve (CN) n=6 and 10 or Undernourished Naïve (UN) n=7 and 11 and Saline Naïve (SN) n=13/15 or Fluoxetine Naïve (FN) n=12/13] and Restricted Groups [Restricted Control (CR) n=6 and 11 or Undernourished Restricted (DR) n=7 and 10 and Saline Restricted (SR) n=11/13 or Fluoxetine Restricted (FR) n=13/14]. After three R/R cycles, all animals were subjected to the feeding test (standard diet and palatable food for 24hrs). After one week, the animals of the groups [Control Naïve (CN) n=10 or Restricted Control (CR) n=11 and Undernourished Naïve (DN) n=11 or Undernourished Restricted (UR) n=10] were subjected to a test food deprivation (24hrs without standard diet) and then received palatable food (2hrs) and standard diet (22hrs). Already all the animals of Saline and Fluoxetine groups at 120 days of age were subjected to a similar feeding test the first test (after R/R cycles). Results: After R/R cycles the Restricted Undernourished animals showed hyperphagia by palatable food compared to animals Naïve control group, as well as increased body weight suggesting the development of obesity. However, these animals have lost the ability to increase the intake of palatable food when they were hungry after food deprivation. Regarding Saline and Fluoxetine groups there was not significant differences in food intake (standard diet and palatable food) in both feeding tests. Conclusion: Perinatal protein undernourishment or treatment of fluoxetine in breastfeeding do not contribute to the development of binge eating after three R/R cycles.

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 Renata Lopes (renatasil82@gmail.com) on 2016-09-26T14:25:54Z No. of bitstreams: 1 claudiarochafranco.pdf: 1295484 bytes, checksum: e185d6d953ea86e2ada3c92396dbddd3 (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2016-09-26T20:33:58Z (GMT) No. of bitstreams: 1 claudiarochafranco.pdf: 1295484 bytes, checksum: e185d6d953ea86e2ada3c92396dbddd3 (MD5) / Made available in DSpace on 2016-09-26T20:33:58Z (GMT). No. of bitstreams: 1 claudiarochafranco.pdf: 1295484 bytes, checksum: e185d6d953ea86e2ada3c92396dbddd3 (MD5) Previous issue date: 2016-07-08 / A síndrome metabólica é um aglomerado de fatores de risco metabólico e cardiovascular, que apresenta como um dos principais componentes a obesidade abdominal. A obesidade associase frequentemente à compulsão alimentar periódica. O objetivo do presente estudo foi avaliar a presença da compulsão alimentar periódica em mulheres com Síndrome Metabólica e a possível associação com parâmetros sociodemográficos, clínicos e comportamentais. Em estudo transversal, foram selecionados 124 indivíduos com Síndrome Metabólica, distribuídos em dois grupos: Grupo 1 (ausência de compulsão alimentar periódica) e Grupo 2 (presença de compulsão alimentar periódica). A avaliação clínica incluiu medidas de peso e altura, circunferência da cintura e pressão arterial de consultório. Foram também avaliados parâmetros comportamentais, como presença de compulsão alimentar periódica, nível de atividade física, consumo de álcool, imagem corporal, sintomas depressivos e qualidade de vida. A avaliação laboratorial incluiu as dosagens de glicose e insulina em jejum, TSH, perfil lipídico e taxa de filtração glomerular estimada. A média de idade foi 41 ± 10,9 anos, 64% se declararam como não brancas, 60% tinham escolaridade igual ou superior a oito anos de estudo, 56% se declararam casadas ou em união estável e 59% não tinham ocupação formal. A totalidade da amostra apresentava obesidade abdominal, com média da circunferência da cintura de 110 ± 11,0 cm, 70% eram hipertensas, com média de Pressão arterial sistólica de 133 ± 13,0 mmHg e Pressão arterial diastólica de 89 ± 11,0 mmHg. Além disso, 95% eram sedentárias, 7% eram fumantes, 12% faziam uso nocivo do álcool, 98% declararam insatisfação com a imagem corporal e 62% apresentavam depressão. Observou-se presença de compulsão alimentar periódica em 57% das mulheres avaliadas. Houve associação entre compulsão alimentar periódica e idade, com predomínio na faixa etária entre 20 e 39 anos (p = 0,010) e entre compulsão alimentar periódica e pior qualidade de vida (p = 0,039). Quanto aos parâmetros laboratoriais, não foi observado diferença significativa entre os grupos. Em conclusão, a presença de compulsão alimentar periódica foi um achado frequente em indivíduos com Síndrome Metabólica, sendo observada associação da compulsão alimentar periódica com faixa etária mais jovem e com pior qualidade de vida. / Metabolic syndrome is a cluster of metabolic and cardiovascular risk factors in which abdominal obesity is one of the main components. Obesity is frequently associated with binge eating. The aim of this study was to evaluate the occurrence of binge eating in women with metabolic syndrome and its possible association with sociodemographic, clinical, and behavioral parameters. This was a cross-sectional study that included 124 individuals with MS distributed in two groups: Group 1 (without binge eating) and Group 2 (with binge eating). Clinical evaluation included measurement of weight and height, waist circumference, and office blood pressure. We also evaluated behavioral parameters including the occurrence of binge eating, level of physical activity, alcohol consumption, body image, depressive symptoms, and quality of life. Laboratory evaluation included the determination of fasting glucose and insulin, TSH, lipid profile, and estimated glomerular filtration rate. The mean age of the participants was 41 ± 10.9 years. Sixty four percent were self-reported non-Whites, 60% had received education for 8 or more years, 56% reported being married or in a stable relationship, and 59% had no formal occupation. The entire cohort presented abdominal obesity, with an average waist circumference of 110 ± 11.0 cm, and 70% of the individuals were hypertensive. In addition, 95% were sedentary, 7% were smokers, 12% abused alcohol, 98% declared dissatisfaction with body image, and 62% had depression. We observed the occurrence of binge eating in 57% of the women evaluated. There was an association between binge eating and age, which predominated in the age range of 20 to 39 years (p = 0.010) and between binge eating and poor quality of life (p = 0.039). Regarding laboratory parameters, there were no significant differences between the groups. In conclusion, the occurrence of BE was a frequent finding in individuals with MS and was associated with younger age and poorer quality of life.

Submitted by isabela.moljf@hotmail.com (isabela.moljf@hotmail.com) on 2017-05-22T10:35:46Z No. of bitstreams: 1 gilmarajaqueschaves.pdf: 1761470 bytes, checksum: f4673b60f6e22822f7c804429925379d (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-05-22T17:17:40Z (GMT) No. of bitstreams: 1 gilmarajaqueschaves.pdf: 1761470 bytes, checksum: f4673b60f6e22822f7c804429925379d (MD5) / Made available in DSpace on 2017-05-22T17:17:40Z (GMT). No. of bitstreams: 1 gilmarajaqueschaves.pdf: 1761470 bytes, checksum: f4673b60f6e22822f7c804429925379d (MD5) Previous issue date: 2010-08-30 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O objetivo deste trabalho exploratório foi investigar a prevalência de Compulsão Alimentar Periódica, Síndrome Depressiva, Síndrome Ansiosa e Insatisfação corporal, bem como verificar suas possíveis associações entre si, ao consumo de psicoativos, a outras variáveis sócio-demográficas e comportamentais entre 1.590 universitários do 1º e 7º períodos de todos os cursos de graduação da Universidade Federal de Juiz de Fora. O questionário aplicado na pesquisa foi semiestruturado, autoaplicável, anônimo, sigiloso, contendo variáveis diversas — estudantis, demográficas, sociais, pessoais, relativas à sexualidade, comportamentais ligadas ao uso de psicoativos, estéticas, de tratamento médico, massa corporal, bem como resultados de rastreamento para compulsão alimentar periódica, depressão, ansiedade e insatisfação corporal. Foram efetivadas análises exploratórias, bivariadas e, para caracterizar o peso relativo das variáveis estudadas sobre os desfechos analisados, utilizou-se a regressão logística. Os resultados indicaram que, dentre os estudantes avaliados, foi positivamente identificado pelos instrumentos de rastreamento que: 8,2% apresentavam compulsão alimentar periódica; 3,8%, depressão; 13,9%, ansiedade e 10,1%, insatisfação corporal. Nos modelos de regressão logística desenvolvidos, observou-se que as escalas de compulsão alimentar periódica e de ansiedade associaram-se significantemente à presença de depressão e de insatisfação corporal. As escalas de depressão e de insatisfação corporal associaram-se à presença de compulsão alimentar periódica e de ansiedade. Os universitários com Índice de Massa Corporal elevado tiveram maior probabilidade de apresentar compulsão alimentar periódica e insatisfação corporal e, os que usaram psicoativos sob prescrição médica, de desenvolver compulsão alimentar periódica e depressão. As mulheres foram vulneráveis aos quadros de ansiedade e de insatisfação corporal e, aqueles que mencionaram sentir-se nunca ou raramente felizes, aos de depressão e de ansiedade. Universitários que relataram fazer tratamento para alguma doença crônica e com renda familiar de até 10 salários mínimos apresentaram maiores chances de ter ansiedade e, os possíveis dependentes alcoólicos, de ter depressão. Finalmente, os que mencionaram ser o abdome a parte do corpo de que menos gostavam, que tinham vontade de fazer cirurgia plástica e que cursavam disciplinas da saúde foram suscetíveis à insatisfação corporal. / The objective of this exploratory study was to investigate the prevalence of Binge Eating, Depressive Syndrome, Anxiety Syndrome and Body dissatisfaction as well as to verify their possible associations within these different disorders, with the use of psychoactive drugs and with other socio-demographic and behavioral variables among 1,590 college students attending the 1st and 7th semesters of all undergraduate courses at the Federal University of Juiz de Fora. The questionnaire applied for this research was semi-structured, self-applied, anonymous, confidential, containing several variables — related to student life style, demographic, social, personal, sexuality, related behaviorally to the use of psychoactive drugs, aesthetic, related to medical treatment, body mass/weight, as well as to traced results for Binge Eating, Depressive Syndrome, Anxiety Syndrome and Body image dissatisfaction. Exploratory bivariate analyzes were executed and logistic regression was used to characterize the relative weight of the studied variables over the analyzed outcomes. Among the students evaluated, it was indicated that the following results were positively identified through the tracing instruments utilized: 8.2% presented Binge Eating; 3.8% presented Depression; 13.9% presented Anxiety and 10.1% presented Body dissatisfaction. In the logistic regression models developed it was observed that the levels of Binge Eating and anxiety were associated to the presence of depression and body dissatisfaction. The levels of depression and body dissatisfaction were associated to the presence of Binge Eating and anxiety. The students with elevated body mass indexes were more likely to present Binge Eating and body dissatisfaction and the ones taking psychoactive prescription drugs were more likely to develop Binge Eating and depression. Female students were vulnerable to present anxiety and body dissatisfaction and the students who reported rarely or never feeling happy were prone to present depression and anxiety. College students that reported being under treatment for any chronic diseases and placed in the monthly income bracket of up to 10 minimum wages showed higher likelihood to display anxiety as well as the presence of alcoholism and depression among their children. Finally, the students that reported dissatisfaction with their bodies, particularly with their midsection, the desire to undergo plastic surgery and were taking health related courses were more susceptible to body dissatisfaction.

There is evidence that functions related to attachment may play an important role in the etiology and maintenance of eating disorders, particularly anorexia and bulimia nervosa (Kuipers & Bekker, 2012; Tasca & Balfour, 2014). However, there is little research available on attachment functioning in those with binge-eating disorder (BED). This dissertation consists of three studies that examine the role of attachment states of mind and attachment dimensions in understanding BED and co-morbid overweight, and to examine mechanisms related to group treatment response for those with BED. The first study assessed attachment state of mind classifications (i.e., attachment categories) to understand better: 1) the psychopathology and maintenance of BED and co-morbid overweight, and 2) the treatment response of women with BED who receive Group Psychodynamic Interpersonal Psychotherapy (GPIP; Tasca, Mikail, & Hewitt, 2005). Overweight women with BED (subsequently referred to as women with BED), overweight women without BED, and normal weight women without BED completed the Adult Attachment Interview (AAI; Main, Goldwyn, & Hesse, 2002). Those with BED completed the AAI pre- and six months post- GPIP and those without BED completed the AAI at one-time point. Women with BED have significantly higher rates of insecure (preoccupied) and unresolved/disorganized attachment states of mind compared to normal weight women without BED. Women with BED had similar rates of insecure and unresolved/disorganized attachment states of mind as overweight women without BED. With respect to treatment completers, changes in attachment states of mind were not statistically significant. However, follow-up analyses indicated clinically meaningful changes which are discussed in the study. The second study used attachment dimensions of coherence of mind and reflective functioning (measured using the AAI) to add to our understanding of the psychopathology and maintenance of BED and co-morbid overweight. Higher Reflective Functioning scores differentiated normal weight women from both women with BED and overweight women without BED, and the latter two groups did not differ from each other. Coherence of Mind scores did not differentiate the groups. The third study used attachment dimensions of coherence of mind and reflective functioning to understand better group psychotherapy response for those with BED who received GPIP. Greater reflective functioning at pre-treatment was associated with a decline in binge eating frequency at 12 months post-treatment. Pre-treatment levels of coherence of mind was not related to group treatment outcomes. Reflective Functioning scores significantly improved from pre- to six months post-treatment. Further, more than 39% of participants demonstrated clinically reliable improvement and almost 32% experienced clinically reliable recovery with respect to reflective functioning. These results were moderated by pre-treatment self-reported attachment anxiety. That is, those with lower attachment anxiety showed significant improvement in reflective functioning, whereas those with higher attachment anxiety did not show this improvement. A third of participants experienced clinically significant improvement in coherence of mind, but this change was not statistically significant. Overall, attachment dimensions and attachment state of mind classification contribute to our understanding of the etiology and maintenance of BED and co-morbid overweight, as well as to our understanding of the group treatment response of those with BED. Addressing attachment insecurity and low reflective functioning in those with BED may improve treatment outcomes.

Nonsuicidal Self-Injury (NSSI), or the deliberate damage of bodily tissue without suicidal intent, is a prevalent issue in young people. Relative to those who have never self-injured, young people with either recent (i.e., past-year) or distal (i.e., lifetime, but not in the past year) histories of NSSI demonstrate difficulties with emotion regulation, the process of modulating emotional responses. Emotion regulation difficulties are a risk factor for other forms of Self-Damaging Behaviours (SDBs), including binge drinking, substance use, and binge eating, which are more prevalent among individuals with a history of NSSI. Prominent theoretical models of NSSI and other SDBs posit that these behaviours may share a common function of altering negative mood states, explaining their frequent co-occurrence. The present study hypothesized that first-year university students with distal, recent, or no history of NSSI a) would differ in their rates of SDB engagement over seven months, and b) would differ in their strength of association between changes in stress and concurrent SDB engagement. Further, the present study hypothesized that emotional dysregulation would moderate the association between stress and SDB engagement. Multilevel modelling with longitudinal data from two cohorts of first-year undergraduates (N=540) revealed that students with either distal or recent NSSI histories were more likely to engage in substance use than their peers who had never self-injured, but did not report a greater frequency of binge eating or binge drinking. Regardless of NSSI history, substance use was unrelated to within-person changes in stress or emotional dysregulation. Higher-than-usual stress was associated with increased frequency of binge eating and binge drinking, but this association was unrelated to NSSI history or emotional dysregulation. Results suggest that elevated risk for substance use may persist even after NSSI has stopped, while other forms of SDBs (i.e., binge drinking and binge eating) were not predicted by NSSI history. Further, results suggest that some SDBs (i.e., binge drinking and binge eating) are enacted more frequently during periods of stress, but that this pattern is not unique to those with a history of NSSI or those who struggle to regulate their emotions. Consistent with person-centred models of NSSI recovery, these results suggest that vulnerability to some SDBs may persist even after NSSI has stopped. Future research should further examine the mechanisms underlying the complex association between NSSI and SDBs. / Graduate

Introducción: La ansiedad puede causar sentimientos de profunda preocupación y se ha asociado con inadecuada alimentación y uno de los grupos afectados son los universitarios, quienes presentan cambios en la calidad de la alimentación y suelen tener atracones, sobre todo en quienes cursan los primeros años de la carrera de medicina. Por esta razón, el objetivo de este estudio fue la asociación entre el estado de ansiedad y el grado de Binge eating en estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas (UPC). Metodología: Estudio analítico de corte transversal en estudiantes mayores de 18 años de la carrera de Medicina de la UPC. Se invitó a 126 estudiantes en quienes se aplicó el cuestionario de Ansiedad de Beck (BAI) y de acuerdo con el puntaje obtenido se clasificó el nivel de ansiedad como: muy baja (menor de 22 puntos, ansiedad moderada (22 a 35 puntos), ansiedad alta (36 o más puntos). Para evaluar Binge eating se aplicó un cuestionario que mide la Binge Eating Scale (BES) y de acuerdo con los resultados se clasificó como: inexistencia de Binge eating (0 a 17 puntos), presencia moderada (18 a 26 puntos) y presencia severa (27 o más puntos). Resultados: Se observó un aumento en la prevalencia de Binge eating en participantes con niveles más elevados de ansiedad. Conclusiones: Se evidenció una asociación significativa entre el estado de ansiedad y el grado de Binge eating. Se observó mayor prevalencia de Binge eating en mujeres. / Introduction: Anxiety can generate feelings of deep concern and has been associated with inadequate nutrition and one of the affected groups is university students, who present changes in the quality of food and tend to binge, especially in those who are in the first years of the medical career. The objective of this study is to identify the association between the state of anxiety and the degree of Binge Eating in medical students from the Universidad Peruana de Ciencias Aplicadas (UPC). Methodology: Cross-sectional analytical study in students over 18 years of age of the Medicine career of the UPC. 126 students were invited to applied the Beck anxiety questionnaire (BAI) and according to the score obtained, the level of anxiety was classified as: very low (less than 22 points, moderate anxiety (22 to 35 points), high anxiety (36 or more points) To evaluate Binge Eating, a questionnaire that measures the Binge Eating Scale (BES) was used and according to the results it was classified as: nonexistence of Binge Eating (0 to 17 points), moderate presence (18 to 26 points). points) and severe presence (27 or more points). Results: An increase in the prevalence of Binge Eating was observed in participants with higher levels of anxiety. Conclusions: Although there was evidence of an association between the state of anxiety and the degree of Binge eating, the presence of variables such as symptoms of depression, measured with PHQ-2, showed a greater relationship with it. / Trabajo de investigación

Die Arbeit beschäftigt sich mit dem Nachweis eines Aufmerksamkeit-Bias auf visuelle Nahrungsreize bei Personen mit Binge-Eating-Störung, im Vergleich zu Personen ohne Essstörungssymptome via Eye-Tracking.