Iowa State University Capstones, Theses and Graduate Theses and Dissertations Dissertations 2020 Modification of the dual pathway model for binge eating Davelle May Cheng Iowa State University Follow this and additional works at: https://lib.edu/etd Recommended Citation Cheng, Davelle May, "Modification of the dual pathway model for binge eating" (2020). Graduate Theses and Dissertations.edu/etd/17851 This Thesis is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact digirep@iastate.
Modification of the dual pathway model for binge eating by Davelle Cheng A thesis submitted to the graduate faculty in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE Major: Psychology Program of Study Committee: Meifen Wei, Major Professor Kristi Costabile David Vogel The student author, whose presentation of the scholarship herein was approved by the program of study committee, is solely responsible for the content of this thesis. The Graduate College will ensure this thesis is globally accessible and will not permit alterations after a degree is conferred. Iowa State University Ames, Iowa 2020 Copyright © Davelle Cheng, 2020. All rights reserved.
ii TABLE OF CONTENTS Page LIST OF FIGURES iii LIST OF TABLES iv ABSTRACT v CHAPTER 1. LITERATURE REVIEW 10 CHAPTER 3. DISCUSSION 50 REFERENCES 60 APPENDIX A: DEMOGRAPHIC INFORMATION 70 APPENDIX B: BODY DISSATISFACTION (PREDICTOR) 72 APPENDIX C: RESTRICTED EATING (MEDIATOR) 73 APPENDIX D: DIFFICULTIES IN EMOTION REGULATION (MEDIATOR) 75 APPENDIX E: SELF-COMPASSION (MODERATOR) 77 APPENDIX F: BINGE EATING (OUTCOME) 79 APPENDIX G: NEGATIVE AFFECT (MEDIATOR) 80 APPENDIX H: INSTITUTIONAL REVIEW BOARD APPROVAL FORM 81 iii LIST OF FIGURES Page Figure 1. Dual Pathway Model for binge eating.
Modified Dual Pathway Model for binge eating. Hypothesized moderation effect of self-compassion on the association 8 between body dissatisfaction and difficulties in emotion regulation. Regression coefficients for the modified Dual Pathway Model for women, 47 controlling for BMI. Regression coefficients for the modified Dual Pathway Model for men, 47 controlling for BMI.
Regression coefficients for the Dual Pathway Model for women, 48 controlling for BMI. Regression coefficients for the Dual Pathway Model for men, 48 controlling for BMI. The effect of body dissatisfaction on negative affect at lower versus higher 49 levels of self-compassion. iv LIST OF TABLES Page Table 1.
Independent Samples T-Test Results for Women and Men. Means, Standard Deviations, and Intercorrelations for Women. Means, Standard Deviations, and Intercorrelations for Men. Bootstrap Analyses of the Magnitude and Statistical Significance 46 of Indirect Effects.
v ABSTRACT The present study tested a modification of the Dual Pathway Model describing the development of binge eating (Stice, 1994) with difficulties in emotion regulation as a mediator in the place of negative affect, as well as self-compassion as a moderator. A total of 440 undergraduate students attending a predominately White, Midwestern university completed an online survey. Due to significantly different mean differences on most variables, results were examined separately for women (N = 230) and men (N = 205). The moderation of self- compassion on the association between body dissatisfaction and difficulties in emotion regulation was tested using PROCESS (Hayes, 2013) and was found to be non-significant.
Using path analysis, direct and indirect effects of body dissatisfaction, restricted eating, difficulties in emotion regulation, and binge eating were tested. A multiple-group analysis demonstrated gender differences for these relationships; in particular, the path from body dissatisfaction to restricted eating was significant for women but not for men. The mediation of body dissatisfaction to binge eating through restricted eating was not significant for either group. Restricted eating and difficulties in emotion regulation mediated the indirect effect of body dissatisfaction to binge eating only for women.
The mediation of body dissatisfaction to binge eating through difficulties in emotion regulation was supported for women and men. Post-hoc analyses supported the moderation effect of self-compassion on the association between body dissatisfaction and negative affect for women only. Specifically, women with greater in self- compassion reported lower negative affect in the face of body dissatisfaction. Finally, post-hoc analyses examining the paths of the original Dual Pathway Model were conducted.
Results showed only the mediation from body dissatisfaction to binge eating through negative affect was vi supported, both for women and men. Limitations, contributions, future research directions, and implications were discussed. INTRODUCTION Binge eating is the overconsumption of food within a discrete time period that occurs due to disinhibition (American Psychiatric Association, 2013). This behavior can include eating more rapidly than what is considered normal, feeling uncomfortably full, eating when not physically hungry, eating in isolation due to embarrassment, and feeling distressed about it afterward.
Binge eating is a problem on college campuses. Lipson and Sonneville (2017) found in a survey across twelve college campuses that the prevalence rate for binge eating was 49% in women and 30% in men. These high rates of binge eating indicate that college students are an at-risk population who can benefit from early prevention, identification, and intervention for this disordered eating behavior. Binge eating is related to low self-esteem, depression, substance abuse, self-harm, and suicide (Heatherton & Baumeister, 1991).
The mental and physical health consequences associated with binge eating stress the importance of studying risk factors that can be associated with the development of this disordered eating behavior, as well as protective factors that may interrupt this trajectory. This study aimed to examine the relationships among body dissatisfaction, restricted eating, difficulties in emotion regulation, and binge eating, as well as the protective role of self-compassion. Modification of Dual Pathway Model for Binge Eating Body dissatisfaction is a state of awareness of the discrepancies between one’s body and an internalized ideal. Considering the enormous pressures to look certain ways and the salience of these messages in our society, body dissatisfaction is a predictor of eating disorders as people try to control the way their body looks or cope with the painful emotions related to body dissatisfaction (Stice & Shaw, 2002).
Stice (1994) proposed a Dual Pathway Model that explains 2 the relationship between body dissatisfaction and binge eating. The temporal sequencing for risk factors in this model has been supported in a longitudinal study (Stice & Van Ryzin, 2019). The original model includes sociocultural influences on body dissatisfaction, however, this study focused on how body dissatisfaction is related to binge eating. Figure 1 is provided below for clarification.
The first pathway is through restricted eating, which can result in binge eating through two mechanisms. The first mechanism is that restricted eating mediates the relationship between body dissatisfaction and binge eating. Body dissatisfaction may drive individuals to diet, or restrict their eating, as a method of weight control (Figure 1, path A). Restricted eating may lead to binge eating through disinhibited eating (Figure 1, path B).
This is because some who restrict their eating may engage in subsequent binge eating due to caloric deprivation. Those who restrict their eating may also binge eat due to the abstinence-violation effect (Stice, 2001). Essentially, one who lapses from a commitment such as restricted eating may then uncontrollably engage in the behavior they were originally trying to prevent (i. The second mechanism is through the relationship between restricted eating and negative affect.
Once again, individuals who experience body dissatisfaction may engage in restricted eating to control their weight (Figure 1, path A). They may then be more at risk to experience negative affect because they can be in a starvation state or are cognitively controlling their eating instead of listening to their physiological cues of hunger and satiety (Figure 1, path C). Finally, they may binge eat as a distraction or for comfort to cope with their experience of negative affect (Figure 1, path E). The second pathway is through a mediational negative affect regulation pathway.
Those who experience body dissatisfaction may experience negative affect because they are not measuring up to their ideal body (Figure 1, path D). Experiencing negative affect may result in 3 binge eating because eating may be a distraction from feeling painful emotions and food may be used as a comfort (Figure 1, path E). A Restricted Eating B C Body Dissatisfaction Binge Eating D E Negative Affect Figure 1. Dual Pathway Model for binge eating.
Restricted Eating A B C Body Dissatisfaction Binge Eating D F E Difficulties in Emotion Regulation Self-Compassion Figure 2. Modified Dual Pathway Model for binge eating. The first hypothesis in the present study was that restricted eating partially mediates the relationship between body dissatisfaction and binge eating (Figure 1, paths A and B). More specifically, it was anticipated that there would be a positive association between body dissatisfaction and restricted eating (Figure 1, path A), and a positive association between 4 restricted eating and binge eating (Figure 1, path B).
The rationale was that those who experience body dissatisfaction may restrict their eating to control their weight or appearance. However, food restriction may relate to feelings of hunger and they may turn to binge eating due to caloric deprivation, over-focusing on food, and loss of control eating after food deprivation (Polivy, 1996; Stice, 2001). This study attempted to modify Stice’s model by proposing difficulties in emotion regulation in the place of negative affect to predict binge eating. The modified model is presented in Figure 2.
Negative affect is the experience of negative emotions such as shame and fear (Watson, Clark, & Tellegen, 1988). This study made the argument that difficulties in regulating painful emotions in particular can result in binge eating. The rationale for this modification was that this study sought to explore how the experience of negative affect and its management were related to binge eating. For example, some who experience body dissatisfaction may become consumed by their negative emotions and have a difficult time concentrating on tasks, they may feel out of control, and they may criticize themselves for having painful emotions.
As a result of their difficulties in regulating their emotions, they may turn to binge eating to distract or comfort themselves. There is evidence that those who restrict their eating may have difficulty regulating their emotions. Those who diet can develop an obsession with food (Jones & Rogers, 2003). This preoccupation can prevent them from focusing on internal states.
They may therefore ignore their experiences of emotions because thoughts of food dominate their minds. Indeed, those who diet may experience less awareness and understanding of their emotions and lack access to adaptive emotion regulation strategies (Lavender et al. They may then engage in binge eating after experiencing difficulty in emotion regulation to alleviate themselves 5 from their painful emotions. Thus, the second hypothesis of this study was to support the modification of the mechanism from body dissatisfaction to restricted eating (Figure 2, path A), to difficulties in emotion regulation (Figure 2, path C), and to binge eating (Figure 2, path E).
Specifically, there would be a positive relationship between body dissatisfaction and restricted eating, a positive relationship between restricted eating and difficulties in emotion regulation, and a positive relationship between difficulties in emotion regulation and binge eating. Body dissatisfaction can be associated with difficulties in emotion regulation. Those who experience body dissatisfaction may feel angry at themselves for failing to control how they look. They may experience this anger as dominating their mind and have trouble focusing on other things.
Supporting this, Sim and Zeman (2005) found in a sample of teenage girls that body dissatisfaction was associated with symptoms of emotion dysregulation. Furthermore, Whiteside et al. (2007) found that greater difficulties in emotion regulation predicted binge eating in a large sample of undergraduates. In particular, difficulties identifying emotions and limited access to emotion regulation strategies were strong predictors.
This provides support that those who have difficulties in emotion regulation may binge eat in response to painful feelings. Finally, Sim and Zeman evidenced that the relationship between body dissatisfaction and bulimic symptoms was partially mediated by emotion dysregulation variables for teenage girls.