The current investigation used qualitative methodology to examine adolescent girls’ perceptions of control over their eating, as well as triggers, and consequences of binge and related eating behaviors. Focus groups were completed with 19 adolescent girls (aged 13-17, 58% African American, 41% White) who endorsed the behaviors. Responses to focus group questions were qualitatively analyzed using a grounded theory approach and constant comparison coding. Results reflected a fundamental lack of awareness of the loss of control (LOC) eating behaviors. Yet, the data did reflect a central theme of the need to affirm independence and autonomy through eating behaviors via three distinct pathways; asserting physical, emotional, and relational control with food. Each strategy produces different positive and negative consequences regarding emotions and physical sensations. This study suggests that adolescent need for autonomy interacts with a sense of feeling out of control of one’s external environment and insufficient coping mechanisms may increase susceptibility to maladaptive eating behaviors.

Binge eating is a pervasive disordered eating behavior associated with numerous psychological and physical comorbidities. Preliminary research indicates that emotion regulation difficulties, behavioral impulsivity, and executive dysfunction may contribute to the onset and/or maintenance of these behaviors. However, few studies have utilized neuropsychological measures to examine this link, and the assessment of behavioral and cognitive emotion regulation strategies are limited in scope. The purpose of the current study was to gain a deeper understanding of the emotional, behavioral and cognitive processes associated with binge eating behavior. Greater clarity regarding how these factors relate to binge eating is critical to the development of effective treatment and prevention efforts. To address these aims, the current study examined the executive functioning, depression, behavioral impulsivity, distress tolerance, and emotion regulation strategies of 50 women engaging in weekly binge eating in the absence of compensatory behaviors; their outcomes were compared to 66 women with no history of binge eating. Hierarchical regression analyses revealed that groups did not significantly differ in executive functioning after controlling for depression, state anxiety, body mass, psychopharmaceutical use, and general intelligence; nonetheless, correlation analyses suggest that, among the binge eating group, individuals endorsing more frequent binge eating might have greater difficulties thinking flexibly or shifting attention. Secondary analyses indicated that individuals who binge eat are more depressed, are more likely to engage in impulsive behavior (but only when distressed), have more difficulties tolerating distress, are more likely to engage in rumination, self-blame, and catastrophizing, and less likely to focus on the positive. Although the current study is unable to determine whether these cognitive, emotional, and behavioral factors precede or follow binge eating episodes, outcomes have clinical implications. Specifically, programs focused on the prevention and treatment of binge eating should help individuals learn to better identify and tolerate difficult affective states and to utilize more adaptive means of coping. Outcomes also provide important directions for future research, including longitudinal designs to better understand the temporal associations of the current study’s variables, as well as suggestions to broaden and standardize neuropsychological assessment and scoring procedures to facilitate comparisons across studies.

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.

This study examined how attentional sub-processes contribute to binge-eating. Dense-array EEG and a version of the canonical attentional blink task were used to ascertain the neural correlates underlying the attentional sub-processes that comprise the Posner model of attention (alerting, orienting, and executive control) and how attentional activation differs for binge-eaters vs. non-binge eaters. Furthermore, we examined a number of the event-related potentials (ERP), including P2 activation, which has been linked with orientating of attention, and N2 activation which has been linked with attentional conflict. We found decreased P2 activation for binge-eaters, in the negative condition, for incorrect target 2 (T2) detection trials. We also found more N2 activation for binge-eaters than non-binge eaters, in negative trials when T2 was not detected. This pattern of results suggest that binge-eaters showed deficiencies in allocating attention to stimuli that followed negative images; this attention deficiency may be a key factor for binge-eating behavior.

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.