Food approach and avoidance craving: A partial test of the Ambivalence Model of Craving.

Accumulating evidence from both cross-sectional and cue-reactivity studies supports the application of the Ambivalence Model of Craving (AMC) from the substance use literature to food craving. The focus of this extant work has been on the association between the two dimensions of food craving (approach and avoidance) and disordered eating behaviors. The present study extended existing validity data by investigating approach and avoidance food craving profiles and their associations with 1) disordered eating behaviors and 2) thinness/restriction and eating expectancies - a risk factor for disordered eating that is explicitly described by the AMC. It was anticipated that food craving profiles would parallel those defined by the AMC (i.e., approach oriented, avoidance oriented, ambivalent, indifferent) and that profiles defined by high avoidance food craving would be higher in compensatory behaviors, restricting behaviors, and thinness/restriction expectancies, while those defined by high approach food craving would be higher in binge eating and eating expectancies. A sample of 407 undergraduate students (54% female, 47% non-Hispanic White; Mage = 21 years) reported demographics, food craving disordered eating behaviors, and thinness/restriction and eating expectancies via an anonymous online survey. Latent profile analysis was used to test hypotheses. Hypotheses were partially supported. Four profiles were identified, but similar levels of approach and avoidance food craving were observed in each profile, with the intensity of the cravings increasing across the four profiles. Endorsement of disordered eating behaviors and expectancies also increased in intensity across the profiles. Findings suggest an additive, rather than interactive, effect of food craving.

Psychological resilience, emotional symptoms, and recovery duration in adolescent sport-related concussion.

OBJECTIVE: This study aimed to explore the relation between resilience, emotional changes following injury, and recovery duration in sport-related concussion. METHODS: Thirty-one high school student-athletes (ages 14-18) with sports-related injuries (concussion, n = 17 orthopedic injury, n = 14) were recruited from a pediatric sports medicine clinic. Participants completed self-report resilience ratings and self- and parent-reported post-concussion symptoms as part of a neuropsychological test battery. Hierarchical regression analyses examined predictors of recovery duration, including: (1) injury group and sex, (2) self- and parent-reported emotional symptom changes, and (3) resilience score. RESULTS: Injury group and sex alone were not predictors of recovery duration (p = .60). When parent and patient reported emotional response to injury were added to the analysis, 35% of the variance in length of recovery was explained, making the model statistically significant (F (2.26) = 3.57, p = .019). Including resilience did not reach statistical significance (p = .443). Post hoc analysis revealed parent-report of emotional changes was significantly associated with recovery duration t(31) = 3.16, p < .01), while self-report was not (p = .54). CONCLUSIONS: Parent-reported emotional change plays a pivotal role in predicting recovery length among adolescents recovering from sport-related concussion and orthopedic injury. These pilot findings highlight the significance of caregiver input in the clinical exam and emphasize the potential for acute interventions supporting psychological resources to enhance recovery outcomes across adolescent sport-related injuries.

Food for thought: Examining the relationship between low calorie density foods in Instagram feeds and disordered eating symptoms among undergraduate women.

BACKGROUND: Ample studies have tested how viewing bodies on social media impacts eating disorder symptoms; however, the relationship between viewing food images on social media and disordered eating remains understudied. This study investigated whether viewing images of healthy, palatable food on Instagram impacted disordered eating attitudes across two samples of undergraduate women. METHODS: This pre-registered online study was conducted at two sites. Participants identifying as female (study 1 n = 222; study 2 n = 214) were randomly assigned to view one of two Instagram feeds - either a feed featuring low calorie, aesthetically pleasing foods or a control condition featuring travel images. Participants completed state measures of disordered eating intentions, self-esteem, and body image before and after viewing the feeds. RESULTS: A main effect of condition on disordered eating intentions was found at the Midwestern site, but not the Southeastern site. CONCLUSIONS: Viewing healthy palatable food images on Instagram could increase risk for disordered eating behaviors among college females. If findings are replicated, individuals vulnerable to disordered eating may benefit from removing these types of feeds from their social media. Further research is needed to determine whether other forms of visual content on Instagram may be associated with disordered eating.

Testing the interaction of thinness/restriction and negative affect reduction expectancies on disordered eating behavior.

OBJECTIVE: Thinness/restriction expectancies (i.e., perceived rewards from thinness/dietary restriction) and negative affect reduction expectancies (i.e., beliefs that eating will reduce negative emotions) are associated with disordered eating, but have largely been studied in isolation despite evidence that individuals can endorse these expectancies simultaneously. Guided by the goal conflict model, we hypothesized that for individuals reporting high levels of one type of expectancy, stronger endorsement of the second expectancy category would be associated with more dietary restriction, binge eating, and compensatory behaviors. A secondary aim included testing an adapted goal conflict model. DESIGN: Interaction effects were tested using multiple linear and negative binomial regressions. Exploratory indirect effect models tested the adapted goal conflict model. Given gender differences, hypotheses were tested separately by gender. MEASURES: Participants (N = 406, 54.2% female, non-Hispanic White = 68.8%, Mage = 20.99, MBMI = 25.05) completed measures of thinness/restriction expectancies, negative affect expectancies, dietary restriction, binge eating, and compensatory behaviors (e.g., purging, laxative/diuretic use, compensatory exercise). RESULTS: No statistically significant interaction of thinness/restriction and negative affect expectancies on disordered eating was observed for either the male or female sample. Main effects models revealed consistent findings across subsamples. Greater thinness/restriction expectancies were associated with more dietary restriction, binge eating, and compensatory behaviors. Greater negative affect reduction expectancies were associated with more binge eating. Exploratory indirect effect models yielded significant effects of each expectancy category on disordered eating. CONCLUSION: Expectancies may be independent risk factors for disordered eating. Disordered eating prevention and intervention efforts may benefit from explicitly targeting thinness/restriction and negative affect expectancies.

Intrinsic and extrinsic motivations as moderators of the association between exercise frequency and exercise behavior.

PURPOSE: Motivations underlying exercise may contribute to the extent to which exercise is maladaptive, independent of exercise frequency. Extrinsic and intrinsic exercise motivation may independently moderate associations between exercise frequency and 1) compulsive and 2) healthy exercise. It was expected that among individuals with high extrinsic motivation, greater exercise frequency would be associated with more compulsive exercise, whereas among individuals with high intrinsic motivation, greater exercise frequency would be associated with more healthy exercise. METHODS: A total of 446 university students (50.9% female; 67.0% White) completed measures of intrinsic and extrinsic exercise motivations, exercise frequency, compulsive exercise, and healthy exercise. Intrinsic and extrinsic motivations for exercise were entered as simultaneous independent moderators of the associations between exercise frequency and 1) compulsive exercise and 2) healthy exercise in multiple linear regressions. RESULTS: Moderation effects of exercise motivation were not supported for compulsive exercise. Only main effects of frequency (b = 0.04, p < 0.01) and extrinsic motivation (b = 0.27, p < 0.01) were observed. Intrinsic motivation moderated the association between frequency and healthy exercise (b = -0.02, p = 0.03). Among individuals with lower intrinsic motivation, greater frequency was related to more healthy exercise. This association was significantly weaker among individuals with high intrinsic motivation. CONCLUSION: Consistent with theory and extant work, extrinsic motivation was associated with compulsive exercise, while intrinsic motivation was associated with healthy exercise. Clinically, assessing the extent to which exercise is intrinsically or extrinsically motivated may help identify whether individuals may be more likely to engage in compulsive versus healthy exercise. Results support the importance of exploring the exercise motivations as predictors of compulsive and healthy exercise. LEVEL OF EVIDENCE: Level V, Descriptive Cross-Sectional Study.

Examining the impact of weight bias on the association between exercise identity and maladaptive exercise behaviors.

OBJECTIVE: Though exercise behaviors are typically viewed as health-promoting, certain forms of exercise (i.e., excessive exercise, unhealthy muscle-building behaviors) are considered maladaptive and are associated with negative physical and psychological outcomes. Psychosocial factors may put people at greater risk for engaging in maladaptive exercise. Based on deviance regulation theory, weight bias was examined as a potential moderator of the association between exercise identity and both excessive exercise and muscle-building behaviors. DESIGN: The current study is a secondary analysis of a larger data set investigating associations between athletic identity, exercise behaviors, and disordered eating behaviors. Hypotheses were examined using moderation testing in multiple linear regression. MAIN OUTCOME MEASURES: Participants (N = 225, 50.2% female) completed the Eating Pathology Symptoms Inventory as a measure of maladaptive exercise. RESULTS: Controlling for sex, age, athlete status, and body mass index, weight bias moderated the association between exercise identity and both excessive exercise and muscle-building behaviors. Among individuals with high exercise identity, higher weight bias was associated with increased maladaptive exercise behaviors. CONCLUSION: Individuals with higher exercise identity and higher weight bias may be at greatest risk of engaging in maladaptive exercise. Preventive interventions for maladaptive exercise behaviors may consider targeting exercise identity and weight bias.