Dataset Information

The role of affect in the maintenance of binge-eating disorder: Evidence from an ecological momentary assessment study.

ABSTRACT: Affect regulation models of eating disorder behavior, which predict worsening of affect prior to binge-eating episodes and improvement in affect following such episodes, have received support in anorexia nervosa and bulimia nervosa. However, limited work has examined the trajectories of affect surrounding binge eating in binge-eating disorder (BED). In the current study, ecological momentary assessment data from 112 men and women with BED were used to examine the trajectories of positive affect (PA), negative affect (NA), guilt, fear, hostility, and sadness relative to binge-eating episodes. Prior to binge episodes, PA significantly decreased, whereas NA and guilt significantly increased. Following binge episodes, levels of NA and guilt significantly decreased and PA stabilized. Overall, results indicate improvements in affect following binge-eating episodes, suggesting that binge eating may function to alleviate unpleasant emotional experiences among individuals with BED, which is consistent with affect regulation models of eating pathology. Because improvements in negative affect were primarily driven by change in guilt, findings also highlight the relative importance of understanding the relationship between guilt and binge-eating behavior within this population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

SUBMITTER: Schaefer LM

PROVIDER: S-EPMC7174093 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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The role of affect in the maintenance of binge-eating disorder: Evidence from an ecological momentary assessment study.

Schaefer Lauren M LM Smith Kathryn E KE Anderson Lisa M LM Cao Li L Crosby Ross D RD Engel Scott G SG Crow Scott J SJ Peterson Carol B CB Wonderlich Stephen A SA

Journal of abnormal psychology 20200326 4

Affect regulation models of eating disorder behavior, which predict worsening of affect prior to binge-eating episodes and improvement in affect following such episodes, have received support in anorexia nervosa and bulimia nervosa. However, limited work has examined the trajectories of affect surrounding binge eating in binge-eating disorder (BED). In the current study, ecological momentary assessment data from 112 men and women with BED were used to examine the trajectories of positive affect ...[more]

PMID: 32212743

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Project description:BackgroundPrevention of binge eating through just-in-time mobile interventions requires the prediction of respective high-risk times, for example, through preceding affective states or associated contexts. However, these factors and states are highly idiographic; thus, prediction models based on averages across individuals often fail.ObjectiveWe developed an idiographic, within-individual binge-eating prediction approach based on ecological momentary assessment (EMA) data.MethodsWe first derived a novel EMA-item set that covers a broad set of potential idiographic binge-eating antecedents from literature and an eating disorder focus group (n=11). The final EMA-item set (6 prompts per day for 14 days) was assessed in female patients with bulimia nervosa or binge-eating disorder. We used a correlation-based machine learning approach (Best Items Scale that is Cross-validated, Unit-weighted, Informative, and Transparent) to select parsimonious, idiographic item subsets and predict binge-eating occurrence from EMA data (32 items assessing antecedent contextual and affective states and 12 time-derived predictors).ResultsOn average 67.3 (SD 13.4; range 43-84) EMA observations were analyzed within participants (n=13). The derived item subsets predicted binge-eating episodes with high accuracy on average (mean area under the curve 0.80, SD 0.15; mean 95% CI 0.63-0.95; mean specificity 0.87, SD 0.08; mean sensitivity 0.79, SD 0.19; mean maximum reliability of rD 0.40, SD 0.13; and mean rCV 0.13, SD 0.31). Across patients, highly heterogeneous predictor sets of varying sizes (mean 7.31, SD 1.49; range 5-9 predictors) were chosen for the respective best prediction models.ConclusionsPredicting binge-eating episodes from psychological and contextual states seems feasible and accurate, but the predictor sets are highly idiographic. This has practical implications for mobile health and just-in-time adaptive interventions. Furthermore, current theories around binge eating need to account for this high between-person variability and broaden the scope of potential antecedent factors. Ultimately, a radical shift from purely nomothetic models to idiographic prediction models and theories is required.

Project description:BackgroundEcological momentary assessment (EMA) is used to capture daily lived experiences, states, and environments. Although EMA is commonly used in behavioral health research, there remains a dearth of literature on how researchers account for design considerations of EMA techniques when designing studies. The goal of this formative mixed methods study was to elicit feedback on EMA study procedures and materials from the target populations for a larger study about binge eating among sexual minority and heterosexual young women, in which data are collected entirely remotely.MethodsSexual minority (n=12) and heterosexual (n=9) women ages 18-30 who binge ate took part in a pilot EMA study and exit interview and survey. As part of the consent and orientation process, participants reviewed video and written materials describing the study purpose and procedures. Using a smartphone app, for seven consecutive days they completed a survey each morning, 5 random surveys per day, and self-initiated a survey each time they binge ate. Participants then provided feedback on the study via a 1-hour virtual interview and online survey. Interviews were transcribed and reviewed by two coders to identify themes on the acceptability and feasibility of the EMA procedures with a focus on: (I) the training and study description materials; (II) general smartphone app and survey preferences; and (III) specific EMA survey question content and wording.ResultsThe qualitative and quantitative data converged to suggest participants were able to easily download and use the app to complete surveys and report on binge eating events. Participants provided feedback that was incorporated into revisions on general study procedures, the training video content, and EMA question content for binge eating, identity-related stressors, and appearance-related pressures. No systematic themes in the quantitative or qualitative data emerged to suggest questions were perceived differently by sexual minority and heterosexual young women.ConclusionsThese findings provide evidence for the feasibility of conducting a remote EMA study to assess young women's experiences around binge eating. This formative study provides an example of how a mixed methods approach can be used to refine EMA study methods and questions to improve study design.

Dataset Information

The role of affect in the maintenance of binge-eating disorder: Evidence from an ecological momentary assessment study.

Publications

The role of affect in the maintenance of binge-eating disorder: Evidence from an ecological momentary assessment study.

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