Cross-sectional evidence shows that loss of control (LOC) eating is a common and psychopathologically relevant experience in preadolescence. This study sought to investigate the natural course of preadolescent LOC eating in relation to psychopathology and body weight trajectory. A community sample of 55 children ages 8-13 years with LOC eating, defined as at least one episode of LOC eating within the past 3 months (LOC+), and 59 matched children without LOC history (LOC-), were assessed with the Eating Disorder Examination adapted for Children and self-report questionnaires every 6 months over a 2-year follow-up. Of the LOC+ children, 54.5% of children remitted from LOC eating, 3.6% showed persistent LOC eating, and 41.8% showed recurring LOC eating over the follow-up period. Of the LOC- children, 19% revealed an onset of LOC episodes, mostly with a low level of stability. Multilevel modeling showed that LOC eating predicted a partial binge eating disorder diagnosis and greater global eating disorder psychopathology, but not depressive symptoms or growth in body fatness. Between-person higher shape concern and weight-related teasing, as well as within-person decreases in shape concern and increases in depression, predicted a greater likelihood of subsequent LOC eating. The results indicate a moderate stability of LOC eating in preadolescent children, with prognostic significance for clinically relevant eating problems and eating disorder psychopathology.
Objective: To examine the ability to regulate emotions in children with binge eating.Method: A community sample of 60 children ages 8-13 with at least one episode of loss of control (LOC) eating during the past 3 months and a matched control group without LOC (n 5 60) underwent a clinical interview (Eating Disorder Examination adapted for Children) and completed self-report questionnaires assessing emotion regulation strategies, eating pathology, and depressive symptoms.Results: Children with LOC eating made a significantly higher use of dysfunctional emotion regulation strategies (p \ .01), especially for the regulation of anxiety (p \ .01). Maladaptive strategies were associated with greater depressiveness (p \ .001). Use of adaptive emotion regulation strategies did not differ between children with and without LOC eating.Discussion: Results document an association between LOC eating and difficulties in regulating negative emotions in children. Interventions targeting LOC eating in children should include training for coping with negative emotions.
The results showed objective abnormalities in the eating behavior of children with LOC eating that were mostly unrelated to negative mood or dysfunctional mealtime interactions. Further research is required to specify factors maintaining LOC eating.
The Eating Disorder Examination adapted for children (ChEDE) is the child version of the semi-structured gold standard eating disorder interview for adults. This study was a comprehensive test statistic evaluation of the German ChEDE in a large sample of children and adolescents with anorexia nervosa, binge eating disorder, loss of control eating, overweight and obesity, as well as non-eating-disordered and chronically ill control probands (n = 352). Excellent inter-rater reliability, adequate internal consistency and satisfactory stability of ChEDE indicators were demonstrated. ChEDE indicators discriminated between diverse forms of eating and weight disturbances and normative eating and were significantly correlated with conceptually related measures. Factorial validity was not convincing; a brief eight-item scale showed the best fit. Item statistics were mostly acceptable. Overall, the ChEDE's German translation reliably and validly assesses psychopathology across the eating and weight disorder spectrum and facilitates international comparison of eating disorder research.
Overall, this evaluation of the diagnostic validity of binge eating disorder in middle childhood suggests that only a few modifications to the adult DSM-IV-TR criteria are necessary to identify children with LOC eating suffering from clinically significant eating disorder psychopathology and increased general psychopathology.
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