Profiling motives behind hedonic eating. Preliminary validation of the Palatable Eating Motives Scale.

The purpose of this study was to validate a new scale designed to measure individual motives for eating tasty foods and determine if any specific motive(s) are associated with obesity. The "Palatable Eating Motives Scale" (PEMS) is a self-report measure adapted from the Drinking Motives Questionnaire Revised (DMQ-R). N=150 racially-diverse college students (mean age: 24.4, BMI: 16-51kg/m(2)) were administered the PEMS along with the Binge-Eating Scale (BES) and the Yale Food Addiction Scale (YFAS) to test for convergent and incremental validity and the Sensitivity to Punishment and Reward Questionnaire (SPSRQ) for discriminant validity. The PEMS identified four motives for eating tasty food, the same ones found with the DMQ-R for alcohol intake: Social, Conformity, Enhancement, and Coping motives. The scales had good convergent validity with BES and YFAS scores but discriminated from the broader motivational constructs of inhibition and activation measured by the SPSRQ. Of the PEMS motives, Coping (eating tasty food to deal with problems and negative feelings) accounted for unique variance in BMI, and added to variance in BMI contributed by BES scores, showing incremental validity. YFAS scores did not contribute to BMI after controlling for binge-eating. Coping subscale scores were also significantly higher (p<0.001) among the severely obese (BMI>40). Motives behind palatable food intake are not homogenous and should be considered in personalized weight-loss strategies in future studies. In normal weight individuals, knowing one's dominant motive for eating tasty foods may help promote healthier food choices in times and places where they are most vulnerable to do otherwise.

Motives for eating tasty foods associated with binge-eating. Results from a student and a weight-loss seeking population.

The aim of this study was to use the Palatable Eating Motives Scale (PEMS) to determine if and what motives for eating tasty foods (e.g., junk food, fast food, and desserts) are associated with binge-eating in two diverse populations. BMI and scores on the PEMS, Yale Food Addiction Scale (YFAS), and Binge-eating Scale (BES) were obtained from 247 undergraduates at the University of Alabama at Birmingham (UAB) and 249 weight-loss seeking patients at the UAB EatRight program. Regression analyses revealed that eating tasty foods to forget worries and problems and help alleviate negative feelings (i.e., the 4-item Coping motive) was associated with binge-eating independently of any variance in BES scores due to sex, age, ethnicity, BMI, other PEMS motives, and YFAS scores in both students (R² = .57) and patients (R² = .55). Coping also was associated with higher BMI in students (p < 0.01), and in patients despite their truncated BMI range (p < 0.05). Among students, the motives Conformity and Reward Enhancement were also independently associated with binge-eating. For this younger sample with a greater range of BES scores, eating for these motives, but not for Social ones, may indicate early maladaptive eating habits that could later develop into disorders characterized by binge-eating if predisposing factors are present. Thus, identifying one's tasty food motive or motives can potentially be used to thwart the development of BED and obesity, especially if the motive is Coping. Identifying one's PEMS motives should also help personalize conventional treatments for binge-eating and obesity toward improved outcomes.

Impaired ventilatory response to carbon dioxide in patients with chronic renal failure: implications for the intensive care unit.

OBJECTIVES: To compare aspects of ventilatory control and the susceptibility to depressant drugs between patients with chronic renal failure and normal volunteers. DESIGN: Prospective, controlled study. SETTING: Pulmonary function laboratory of a university hospital. PATIENTS: Six patients with chronic renal failure requiring hemodialysis and ten normal, control subjects. INTERVENTIONS: Ventilatory responses to breathing CO2 were studied using a rebreathing method. The effects of triazolam (0.5 mg orally) and meperidine (1 mg/kg, subcutaneously) on these measurements were also studied. MEASUREMENTS AND MAIN RESULTS: Dialysis patients showed definite impairment in the ventilatory response to CO2, which could not be accounted for by differences in respiratory mechanics, muscle strength, or acid-base status. Meperidine impaired ventilatory responses in control subjects and in renal patients, while triazolam had little effect on either group. The effect of the drugs was not proportionately greater in dialysis patients than in control subjects. CONCLUSIONS: Chronic renal failure results in a poorly responsive ventilatory control system, which may make renal failure patients more difficult to wean from mechanical ventilation. Theoretically, these patients may be more vulnerable to disturbances in blood gas homeostasis and subsequent respiratory arrest than other patients in an unmonitored environment.

Psychotropic drug use in Sydney nursing homes.

OBJECTIVE: To determine the pattern of use of psychotropic drugs in Sydney nursing homes. DESIGN: Survey of data from medical records of residents and interviews with residents and staff. SETTING: Central Sydney Health Area, June to December 1993. PARTICIPANTS: All residents of 46 of the 47 nursing homes in the western sector of the health area. MAIN OUTCOME MEASURES: Psychotropic drugs used regularly or as required. Degree of cognitive impairment and depression rated on interview with residents, using Mini-Mental State Examination and Geriatric Depression Scale. Behavioural disturbances reported by staff. RESULTS: Most residents (58.9%) were taking one or more psychotropic drugs regularly and another 7% were prescribed these drugs as required. Neuroleptics were taken regularly by 27.4% and as required by a further 1.4% (at least one dose in the previous four weeks), but doses were equivalent to more than 100 mg/day of chlorpromazine for only 8.8%. Neuroleptics were more likely to be given to residents with greater cognitive impairment and more disturbed behaviour. Other psychotropic drugs in regular use were: benzodiazepines (32.3%); hypnotics (26.6%); antidepressants (15.6%); and anxiolytics (8.6%). At least half of antidepressant doses were subtherapeutic. Of 874 residents who responded to a depression questionnaire, 30% scored as significantly depressed; one-third of these were taking antidepressants. CONCLUSIONS: The percentage of residents in Central Sydney nursing homes who were taking neuroleptics, hypnotics or anxiolytics is among the highest reported from geriatric institutions around the world. Prescribing practices in Australian nursing homes need to be reviewed.