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 Caroline Xavier (caroline.xavier@pucrs.br) on 2017-07-17T18:44:48Z No. of bitstreams: 1 DIS_JEFERSON_CRISTIANO_CORTES_ZAMBOM_CARDOSO_COMPLETO.pdf: 2414682 bytes, checksum: a28fa961a9801c5698c6ff6e48429406 (MD5) / Made available in DSpace on 2017-07-17T18:44:48Z (GMT). No. of bitstreams: 1 DIS_JEFERSON_CRISTIANO_CORTES_ZAMBOM_CARDOSO_COMPLETO.pdf: 2414682 bytes, checksum: a28fa961a9801c5698c6ff6e48429406 (MD5) Previous issue date: 2017-03-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / This dissertation analyzes the phenomenon called binge-watching and how this new way of watching television is changing the behavior of viewers who come to play roles of users, hiperviewers and multipliers. For this was done an anlytical in two stages. In the first was done an monitoring, measurement and analysis of the comments of this public on Twitter before, during and after the launch of sitcom Orange Is The New Black (OITNB), production of Netflix, in addition to posts in Brazilian official accounts (@OITNBrazil) and American (@OITNB) to check public behavior in these spaces. In the second stage was done an monitoring, measurement and analysis of the comments of this public on Twitter before, during and after an marathon simulation, in the pay television, of sitcom The Walking Dead (TWD), production of AMC, displayed by Fox, in addition to posts in Brazilian official accounts (@TWDBrasil) and American (@WalkingDead_AMC), to see what changes when the binge-watching is spontaneous, occurring in a file environment, in which one can determine when will be marathon or not, or when the binge-watching is induced, occurring in a flow environment in which the viewer can not determine when it will do the marathon, can only choose whether to follow what it is being broadcast on television or not. It was contacted that the official accounts are restricted to participation of moderators and in Brazil the public does not use the term binge-watching, but marathon, watching the series mainly on launch day, when in file, and not having a strong attachment to the simulations. To support this research were used authors as Jenkins (2009), Kinder, (1991), Cannito (2010), Bauman (2008/2009/2013), Anderson (2006), Jenkins, Green and Ford (2014), Lipovetsky and Serroy (2012), Johnson (2012), Shirky (2011), Scolari (2014), Mattos (2013), Negroponte (1995), Eco (1986), Foucault (2002), Wolton (1996) and McLuhan (1979).. The methodology used was the Depth Hermeneutics as Thompson's vision (1995), using as technique of structuring data collection Bardin's Content Analysis (2011) and the analysis of data Computer Discourse Mediated Analysis (CDMA ) Herring (2004). / Esta disserta??o analisa o fen?meno chamado binge-watching e como esse novo modo de assistir televis?o vem modificando o comportamento dos telespectadores, que passam a desempenhar pap?is de usu?rios, hipertelespectadores e multiplicadores. Para isso foi realizada uma an?lise em duas etapas. Na primeira foi feito um acompanhamento, mensura??o e an?lise dos coment?rios desse p?blico no Twitter antes, durante e ap?s o lan?amento do seriado Orange Is The New Black (OITNB), produ??o do Netflix, al?m das postagens nas contas oficiais brasileira (@OITNBrazil) e americana (@OITNB), a fim de verificar o comportamento do p?blico nesses espa?os. Numa segunda etapa foi feito um acompanhamento, mensura??o e an?lise dos coment?rios desse p?blico no Twitter antes, durante e ap?s uma simula??o de maratona, na televis?o paga, da s?rie The Walking Dead (TWD), produ??o da AMC, exibida pela Fox, al?m das postagens nas contas oficiais brasileira (@TWDBrasil) e americana (@WalkingDead_AMC), a fim de verificar o que modifica quando o binge-watching ? espont?neo, ocorrendo em um ambiente de arquivo, no qual a pessoa pode determinar quando vai maratonar ou n?o, ou quando o binge-watching ? induzido, ocorrendo em um ambiente de fluxo, no qual o telespectador n?o pode determinar quando ir? fazer a maratona, podendo apenas escolher se ir? acompanhar o que est? sendo transmitido pela televis?o ou n?o. Contatou-se que as contas oficiais ficam restritas a participa??o dos moderadores e que no Brasil o p?blico n?o utiliza o termo binge-watching, mas sim maratona, assistindo aos seriados principalmente no dia do lan?amento, quando em arquivo, e n?o tendo uma forte ades?o as simula??es. Para embasar essa pesquisa foram usados autores como Jenkins (2009), Kinder (1991), Cannito (2010), Bauman (2008/2009/2013), Anderson (2006), Jenkins, Green e Ford (2014), Lipovetsky e Serroy (2012), Johnson (2012), Shirky (2011), Scolari (2014), Mattos (2013), Negroponte (1995), Eco (1986), Foucault (2002), Wolton (1996) e McLuhan (1979). A metodologia utilizada foi a Hermen?utica de Profundidade conforme a vis?o de Thompson (1995), usando como t?cnica de estrutura??o da coleta de dados a An?lise de Conte?do de Bardin (2011) e para a an?lise dos dados a An?lise de Discurso Mediada por Computador (CDMA) de Herring (2004).

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.

Background: In 2012, 62,939 cases of child sexual abuse (CSA) were reported in the United States (US). During the same year, binge drinking (BD) cost the US nearly $250 billion. Currently there are 38 million Americans who participate in BD. Researchers have found a significant association between adults who experienced adverse childhood events (ACEs) and BD in adulthood. However, CSA and BD have yet to be investigated using a nationally representative study sample. Objective: This study seeks to investigate the association between CSA and BD among adults in the US. Methods: Data from 2012 Behavioral Risk Factor Surveillance System (BRFSS) were used to analyze a sample of 25,037 adult participants from states that included the ACE questionnaire in the survey. CSA components, including forced touched sexually, forced to touch sexually, and forced sex, were assessed in relation to BD. Covariates included parental alcoholism, parental substance abuse, parental depression, age, sex, income, race, education level, and marital status. Descriptive statistics and logistic regression models were conducted using SAS 9.4. Results: Approximately 17% of the study sample reported BD. Adults who had been touched forcefully during their childhood had around 2.18 times increased odds (adjusted odds ratio (aOR): 2.18; 95% confidence interval (CI) 1.97 – 2.41) of being involved in BD compared to those who did not have this experience. Being forced to touch sexually or forced to have sex during childhood was not significantly associated with BD and was not included in the adjusted model. Having parents who abused drugs (aOR 6.14; 95%CI: 5.56–6.79) and parents who were depressed (aOR: 3.35; 95%CI: 3.09-3.64) significantly increased the odds of BD among this population. Conclusion: Forced sexual touch was found to be significantly associated with BD. Further epidemiologic studies are necessary to determine if this is consistent in different years for the association between CSA and BD, since forced to touch sexually and forced sex were not found to impact BD in adults. The increased odds for BD from experiencing forced touch identifies a population where health education and awareness is vital to reduce the risk for BD in adults, thus reducing alcohol-related health problems and injuries. Health promotion campaigns for families affected by parental substance abuse and parental depression is also important to reduce the risk for BD among adults growing up with these experiences.

Maternal alcohol consumption during pregnancy is a public health concern due to the possible lifelong physical and cognitive effects in offspring. Prevention of alcohol-exposed pregnancies (AEP) should begin preconceptionally, either by preventing unintended pregnancies or by discouraging alcohol consumption in women who are at-risk for pregnancy. The purpose of this dissertation is to utilize the Theory of Planned Behavior's construct of perceived behavioral control (PBC)--including perceived power and control beliefs--to guide the measurement and understanding of two behaviors related to AEP among non-pregnant women: birth control use and binge drinking. For the first specific aim--to estimate the prevalence of alcohol-exposed pregnancies--a secondary data analysis was conducted using surveillance data from North Dakota and South Dakota women who have had a child with FAS. The FAS prevalence estimates (per 1,000 live births) in both states (ND=0.8/1,000; SD=0.9/1,000) were found to be higher than that calculated from national averages (0.7/1,000) using a comparable surveillance methodology. The goal of Specific Aim 2 was to determine risk for AEP among a random group of women, while Specific Aim 3 determined the control beliefs and perceived power to using birth control and decreasing binge drinking levels, and Specific Aim 4 focused on relating PBC of these two behaviors to behavioral intentions. Data for aims 2-4 were derived from a mailed, cross-sectional survey of 190 non-pregnant women randomly chosen from an electronic health records system in the upper Midwest. Of the 190 women included in the analyses, eight (6.6%) were binge drinking while being at-risk for pregnancy (i.e., being sexually active but not always using an effective form of birth control) (Specific Aim 2). This is lower than national estimates. For Specific Aim 3, there were high direct PBC scores for both birth control and binge drinking, and there was a positive correlation between birth control direct and indirect scores (although a negative correlation between binge drinking direct and indirect scores). Finally, Specific Aim 4 uncovered high intentions to both use birth control and to not binge drink. Also, the direct birth control PBC measure was significantly associated with birth control intention when controlling for other variables, although neither PBC nor intention appeared to be associated with actual birth control behavior. For binge drinking, the intention score and the direct measure of PBC were significantly associated with one another; as well, the direct measure of PBC and intention were both significantly associated with actual binge drinking behavior. Therefore, the relationship between PBC and intention was validated for both behaviors, and the association between PBC, intention, and actual behavior was indicated for binge drinking. Overall, the study both supported and disagreed with previous research, indicating that additional research with this theory and topic matter is necessary.

This project study addressed the problem of alcohol and binge drinking at a local rural college campus in the Northeast United States and the lack of an effective long-term academic intervention program to address the problem. The purpose of this research study was to determine the prevalence of the problem of the alcohol abuse problem and to develop a long-term program that would respond to the problem of repeat alcohol offenders. Guided by Mezirow’s transformative learning theory, which holds that transformational learning causes changes in a learner that significantly shift the pattern of a learner’s future experiences, this study examined the awareness by participants of the prevalence of alcohol abuse on the college campus and explored alcohol intervention programs. A qualitative, instrumental case study research design was used and involved interviews with 6 key professional stakeholders and 5 students. Interview transcripts were color coded and thematically analyzed. The themes that developed from the interviews revealed discrepant perspectives regarding the prevalence of the problem, and the discovery that no long-term intervention is available to students who are repeat offenders. The analysis of the data revealed the need for an increased awareness of the problem, as well as the development of a long-term program that contained an academic curriculum that addressed the problem of alcohol abuse and binge drinking for the repeat offender. This project study has the potential to revise to alcohol abuse programs and may spawn an awareness of the problem of heavy alcohol consumption. Student participation in the long-term program may offer greater student academic success and the avoidance of academic expulsion, thereby creating an important social change for those students who are repeat alcohol offenders.

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.