The current study assessed the relationship between individuals' tendency to suppress thoughts, particularly related to food and body weight/shape, and outcomes such as weight loss maintenance and diet sabotaging experiences (e.g., binge eating). Community and university individuals (N = 347) who are or previously were overweight completed self-report measures of thought suppression, weight history, and eating behaviors. Suppression of specific thoughts about food/weight/shape was related to weight cycling, binge eating, and food cravings. Participants who believed thoughts of food lead to eating were more likely to attempt suppression of food-related thoughts. Results have implications for improving weight loss maintenance and support further exploration of third wave interventions, such as Acceptance and Commitment Therapy and Mindfulness, in the treatment of obesity.

Findings on executive functions (EFs) in binge-eating disorder (BED) are inconsistent and possibly biased by associated comorbidities. This study aimed to identify whether distinct levels of physical and mental comorbidity are related to EFs in BED. General and food-specific EFs in n = 77 adults with BED were compared to population-based norms and associations with weight status, depressive symptoms, and eating disorder psychopathology were analyzed. To detect within-sample patterns of EF performance, k-means clustering was applied. The results indicated that participants’ general EFs were within the average range with slight deficits in alertness. While depression and eating disorder psychopathology were unrelated to EFs, weight status was associated with food-specific attentional bias that was significantly higher in obesity class 2 than in overweight/obesity class 1 and obesity class 3. Four meaningful clusters with distinct strengths and impairments in general and food-specific EFs but without differences in clinical variables were identified. Altogether, adults with BED showed few specific deficits compared to normative data. Performance was unrelated to depression and eating disorder psychopathology, while weight status was associated with food-specific EFs only. The results highlight the need for longitudinal studies to evaluate the relevance of EFs in BED development and maintenance in neurologically healthy adults.

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Background: Individuals with binge eating disorder (BED) experience a loss of control (i.e., poor inhibitory control) during binge eating, where stress is a common antecedent for binge episodes. However, few studies examine acute stress in BED and, to date, psychosocial stress relationships with inhibitory control are unexamined. Purpose: The current study investigated acute psychosocial stress effects on inhibitory control in BED. Additionally, inhibitory control relationships with BED treatment outcome were explored. Methods: Thirty-three individuals with BED were randomized to a stress (n = 17) or no stress condition (n = 16). All completed self-report measures including the Profile of Mood States and the Binge Urge Scale. Following the stressor, individuals completed the Stop-Signal Task (SST), a well-validated measure of inhibitory control. Relationships between post-stress anxiety with inhibitory control and eating pathology were explored. Furthermore, treatment outcome relationships with levels of inhibitory control, and negative urgency (an impulsive personality trait) were explored. Results: In the stress condition, individuals reported increased state anxiety immediately following stress, but experienced a decrease back to baseline levels of anxiety by the end of the SST. Stress resulted in impaired inhibitory control performance on the SST. Binge urges increased across both conditions over time. Measures of inhibitory control and negative urgency did not relate to treatment outcome. Conclusion: This study is novel in directly examining psychosocial stress effects on inhibitory control, which has not been studied in BED. These results show subjective stress effects in BED are short-lived; however, behaviourally, stress has a lingering effect on inhibitory control. Increasing binge urges across the experimental session in the no stress condition suggests a role for generalized anxiety on this impulse. These findings have clinical implications for binge urges as a therapeutic target, and for informing individuals with BED about the implications of stress on their binge eating. / Thesis / Master of Science (MSc)

Although evidence demonstrated efficacy of cognitive-behavioral therapy (CBT) in adolescents with binge-eating disorder (BED), treatment response is heterogeneous. This study uniquely examined baseline predictors of symptom trajectories in N = 73 adolescents (12–20 years) with an age-adapted diagnosis of BED (i.e., based on objective and subjective binge-eating episodes). Based on evidence from adult BED, dietary restraint, overvaluation of weight/shape, and depressive symptoms were used to predict changes in abstinence from binge eating and eating disorder psychopathology after 4 months of individual, face-to-face CBT using growth models. Longitudinal trajectories of abstinence from objective and subjective binge eating and global eating disorder psychopathology assessed via the Eating Disorder Examination were modeled for five time points (pre- and posttreatment, 6-, 12-, and 24-month follow-up). Beyond significant, positive effects for time, no significant predictors for abstinence from binge eating emerged. In addition to significant decreases in eating disorder psychopathology over time, higher pretreatment dietary restraint and overvaluation of weight/shape significantly predicted greater decreases in eating disorder psychopathology over time. Consistent with research in adult BED, adolescents with higher than lower eating disorder-specific psychopathology especially benefit from CBT indicating that restrained eating and overvaluation of weight/shape may be BED-specific prognostic characteristic across developmental stages. Future predictor studies with an additional focus on potential age-specific predictors, such as family factors, and within-treatment processes may be critical in further evaluating treatment-related symptom trajectories in adolescent BED.

Research suggests that the associations between femininity, body image and eating disorders are intricate. How these constructs are linked to each other still needs to be determined. The purpose of this study was to gain a deeper understanding of these links, examining the mediational relationship among these constructs. Also, the prediction that bulimia and binge eating disorder symptoms have a similar origin was tested and compared. Some researchers have suggested that the pathways leading to these disorders are equivalent and the main difference between the two is the dietary restriction, while others see them as distinct disorders with different etiology. A total of 355 female college students (ages 18 to 26) completed a set of questionnaires that assessed femininity, feminine gender role stress, body dissatisfaction, bulimia, and binge eating disorder. Results showed that body dissatisfaction mediates the relationship between femininity or feminine gender role stress with bulimia symptoms, as well as the relationship between feminine gender role stress and binge eating disorder symptoms. Results indicate that body dissatisfaction related to femininity or to feminine gender role stress may contribute to higher levels of bulimia symptoms. The findings also suggest that body dissatisfaction related to feminine gender role stress may contribute to higher levels of binge eating disorder symptoms. Results did not support the mediational role of body dissatisfaction between femininity and binge eating disorder. However, the mediational role of feminine gender role stress between femininity and body dissatisfaction was partially supported, suggesting that feminine gender role stress might only be one pathway by which femininity may have an impact on body dissatisfaction. / Master of Science

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Many psychiatric disorders are characterized by difficulties in working towards long-term goals. Effort-based decision-making (EBDM) provides a useful framework for understanding this phenomenon, particularly for parsing motivation into various components, and exploring the underpinnings of cost-benefit computations. Importantly, large changes in arousal, like those introduced by strong emotions and stress, can significantly influence high-order cognitive processes. However, the mechanistic properties underlying associations between emotions and various components of EBDM remain unclear, particularly at psychological, neurological and endocrinological levels. The following experiments were designed to examine the effect of positive and negative emotions on various components of EBDM across psychiatric conditions characterized by motivational and impulse-related deficits. In the first experiment, comparing emotional versus behavioural inhibitory systems in binge eating disorder, inverse relationships between disgust sensitivity, inhibitory control and binge-eating behaviours were found, suggesting unique maintenance functions of cognitive-affective links with emotion regulation on eating attitudes. In the second experiment examining neural correlates of effort- and reward-processing in a cannabis using population, findings indicate fronto-striatal but also posterior cortical processing alterations during prospective signaling of effort and reward signals and during effort-reward information integration. In the final experiment assessing the effects of childhood trauma on acute stress responses and gambling urges in a population of problem gamblers, increased reports of childhood trauma were noted relative to a healthy control group. Childhood trauma subsequently predicted subjective and physiological stress responses, and emotional and physical neglect in childhood was further linked to increased gambling urges. Taken as a whole, these studies suggest that emotions plays a crucial role in moderating various components of EBDM, underscoring the significant impact of emotional states on higher-order cognitive functioning. / Dissertation / Doctor of Philosophy (PhD)

Objective: Analysis of short- and long-term effects of rapid response across three different treatments for binge-eating disorder (BED). Method: In a randomized clinical study comparing interpersonal psychotherapy (IPT), cognitive-behavioral guided self-help (CBTgsh), and behavioral weight loss (BWL) treatment in 205 adults meeting DSM-IV criteria for BED, the predictive value of rapid response, defined as ≥ 70% reduction in binge-eating by week four, was determined for remission from binge-eating and global eating disorder psychopathology at posttreatment, 6-, 12-, 18-, and 24-month follow-up. Results: Rapid responders in CBTgsh, but not in IPT or BWL, showed significantly greater rates of remission from binge-eating than non-rapid responders, which was sustained over the long term. Rapid and non-rapid responders in IPT and rapid responders in CBTgsh showed a greater remission from binge-eating than non-rapid responders in CBTgsh and BWL. Rapid responders in CBTgsh showed greater remission from binge-eating than rapid responders in BWL. Although rapid responders in all treatments had lower global eating disorder psychopathology than non-rapid responders in the short term, rapid responders in CBTgsh and IPT were more improved than those in BWL and non-rapid responders in each treatment. Rapid responders in BWL did not differ from non-rapid responders in CBTgsh and IPT. Conclusions: Rapid response is a treatment-specific positive prognostic indicator of sustained remission from binge-eating in CBTgsh. Regarding an evidence-based stepped care model, IPT, equally efficacious for rapid and non-rapid responders, could be investigated as a second-line treatment in case of non-rapid response to first-line CBTgsh.