Avoidance coping during mealtimes predicts higher eating disorder symptoms

Vanzhula, Irina A.; Sala, Margarita; Christian, Caroline; Hunt, Rowan A.; Keshishian, Ani C.; Wong, Valerie; Ernst, Sarah E; Spoor, Samantha P.; Levinson, Cheri A.

doi:10.1002/eat.23254

Cited by 26 publications

(14 citation statements)

References 36 publications

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“…Rates of being bullied, electronically bullied, and getting into physical fights were also associated with the severe DEB and suicidality class, as per prior research (Copeland et al, 2015; Klomek et al, 2007; Koutek et al, 2016), although the differential effects found among the other classes (e.g., poor self ‐ image and suicidality , weight loss and fasting , and suicidality only ) suggest distinct mechanisms in how developmental risk factors may relate to suicidality and DEB. Consistent with previous research, the associations found in this study highlight that emotion dysregulation, impulsivity, and maladaptive coping may represent common pathways linking suicidality and DEB (Goschke, 2014; Muehlenkamp et al, 2012; Pompili & Laghi, 2018; Vanzhula et al, 2020). The emergence of these overlapping behaviors and pathways indicates a strong need for interventions starting in childhood, including monitoring of core behaviors and symptoms that may escalate and persist across development (Christian et al, 2020).…”

Section: Discussionsupporting

confidence: 91%

Leveraging general risk surveillance to reduce suicide in early adolescents: Associations between suicidality, disordered eating, and other developmental risk factors

Hunt

Levinson

Peiper

2021

Suicide & Life Threat Behav

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Objective Suicide is a leading cause of death in early adolescents (i.e., children ages 11–14), underscoring the need for a more complex understanding of suicidality in youth. Syndemics framework posits that the overlap of multiple maladaptive behaviors (or risk factors) produces worse health outcomes compared to each behavior alone. The use of this framework in preventing suicide necessitates that identification of developmental risk factors that occur in tandem to suicide (e.g., disordered eating behaviors and substance use) may be important for intervening on those at greatest risk of suicide. Method The present study uses latent class analysis (LCA) to evaluate the relationship between suicidality and disordered eating behaviors in early adolescence, and associations with other developmental risk factors in an epidemiological sample of middle school students (N = 3,811). Results Lifetime prevalence ranged from 6.8% to 18.2% for suicidality, and 5.3%–48.7% for disordered eating behavior. Our final model identified six independent classes, and each class had differential associations with several additional developmental risk factors. Conclusion By pinpointing specific classes of individuals who may be at risk for multiple developmental risk factors, our results have important implications for public health intervention and prevention efforts for a wide range of adolescent risk behaviors, including suicidality.

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Section: Discussionsupporting

confidence: 91%

Leveraging general risk surveillance to reduce suicide in early adolescents: Associations between suicidality, disordered eating, and other developmental risk factors

Hunt

Levinson

Peiper

2021

Suicide & Life Threat Behav

Self Cite

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“…The finding for adolescents that using avoidance to cope at baseline was predictive of restricting behaviour at EOT is consistent with previous research showing coping through avoidance to be a potential maintaining factor of EDs (Vanzhula et al., 2020). Individuals may avoid exposing themselves to feared situations (e.g., a calorically dense meal for fear of gaining weight), which then may strengthen this fear.…”

Section: Discussionsupporting

confidence: 90%

Motivation to recover for adolescent and adult eating disorder patients in residential treatment

Manwaring¹,

Blalock

Grange

et al. 2021

Euro Eating Disorders Rev

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Objective This study aimed to assess how baseline motivation to recover impacts eating disorder (ED) and comorbid symptoms at end‐of‐treatment (EOT) for adolescents and adults in inpatient/residential treatment. Method Two hundred and three adolescent (M = 15.90) and 395 adult (M = 25.45) patients with a Diagnostic Statistical Manual, 5th edition ED diagnosis completed the Decisional Balance Scale (DBS) at baseline, and psychosocial measures (ED symptoms, anxiety, depression, obsessive–compulsive disorder symptoms), and %body mass index (kg/m2; BMI) or median %BMI (for adolescents) at baseline and EOT. Results The DBS Avoidance Coping and Burdens subscales at baseline were significantly lower for adolescents than adults (p < 0.001), whereas the DBS Benefits subscale at baseline did not significantly differ between subsamples (p = 0.06). Motivation to recover via DBS subscales was a more reliable predictor of EOT outcomes for both ED and comorbid psychopathology in adults (significant predictor in 19 of 54 total analyses, and 4 significant associations post‐Bonferroni correction) than adolescents (significant predictor in 5 of 54 total analyses, and 1 significant association post‐Bonferroni correction). Conclusions Baseline motivation to recover may be an important predictor of outcome for adult patients in inpatient/residential treatment but does not appear associated with outcomes for adolescent patients.

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“…Negative affect (NA) is important in the onset and maintenance of EDs. Longitudinal studies have found that NA predicts the development of EDs, and many ED symptoms are used as coping strategies for NA (Vannucci et al, 2015; Vanzhula et al, 2020). For example, binge eating has been posited as a behavior used to escape from NA (Heatherton & Baumeister, 1991), and restrictive eating has been linked to the reduction of NA (Engel et al, 2005; Lavender et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Network investigation of eating disorder symptoms and positive and negative affect in a clinical eating disorder sample

Wong

Christian

Hunt

et al. 2021

Intl J Eating Disorders

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Objective Growing literature suggests that emotions influence the maintenance of eating disorder (ED) symptoms. However, most research has studied the relationship between ED symptoms and affect broadly (i.e., negative affect [NA], positive affect [PA]), rather than examining models comprised of multiple specific affective states (e.g., upset, proud). Method The current study (N = 196 individuals with EDs) used network analysis to examine the most interconnected (i.e., central) NA and PA states in EDs and test the complex associations between specific NA, PA, and ED symptoms. We estimated two networks: one with affective states only and another with affective states and ED symptoms. Results Feeling distressed, afraid, attentive, and determined were the most central symptoms in the affect‐only network. ED symptoms related to overvaluation of weight and shape, including affect‐based ED symptoms (i.e., guilt about eating), were central in the network of affect and ED symptoms. Guilt about eating and shame were central bridge symptoms across affect and ED symptom clusters, meaning that they were each strongly connected across clusters, and may represent important pathways among affect and ED symptoms. Discussion Limitations include the cross‐sectional and between‐person nature of these analyses, from which we cannot derive causal or within‐persons processes. Clinical interventions that target central and bridge symptoms (e.g., fear, shame) may disrupt the reinforcing cycle of NA in EDs that may contribute to ED behaviors. Future research should examine relationships among affective states and ED symptoms in longitudinal and intraindividual network models to develop more effective treatments for EDs.

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Avoidance coping during mealtimes predicts higher eating disorder symptoms

Cited by 26 publications

References 36 publications

Leveraging general risk surveillance to reduce suicide in early adolescents: Associations between suicidality, disordered eating, and other developmental risk factors

Leveraging general risk surveillance to reduce suicide in early adolescents: Associations between suicidality, disordered eating, and other developmental risk factors

Motivation to recover for adolescent and adult eating disorder patients in residential treatment

Network investigation of eating disorder symptoms and positive and negative affect in a clinical eating disorder sample

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