Dysphoric mood may explain the relation between sleep reactivity and binge eating but not purging.

Objective: This study investigated whether sleep reactivity (i.e., a propensity to experience sleep disturbances when stressed) relates to eating disorder behavioral symptoms indirectly through dysphoric mood in a sample of college students. Participants: One hundred and ninety-eight college students (51.5% female). Methods: Participants completed self-report measures of dysphoric mood, eating disorder behavioral symptoms, and sleep reactivity. Results: Higher sleep reactivity was associated with greater binge-eating symptoms indirectly through higher dysphoric mood. Higher sleep reactivity was associated with greater purging symptoms; however, this association was not explained by dysphoric mood. Conclusions: Findings support the relevance of sleep reactivity to binge eating and purging and suggest that sleep reactivity relates to binge-eating symptoms indirectly through dysphoric mood. If replicated in prospective data, targeting stress-induced sleep and mood disturbances in college students may reduce risk for binge eating.

Disordered eating in transgender and gender non-conforming youth: A comparison to community-based and clinical samples.

OBJECTIVE: This study investigates eating pathology in transgender and gender non-conforming (TGNC) youth compared to a community-based sample and individuals with eating disorders (EDs). METHOD: Participants (ages 13-21 years) included TGNC youth from a paediatric gender clinic (N = 97), a demographically matched community-based sample of cisgender males (N = 97) and cisgender females (N = 97), and treatment-seeking patients with EDs (N = 112). The Eating Disorder Examination Questionnaire (EDE-Q) was used to assess ED cognitions and behaviours. RESULTS: Transgender and gender non-conforming participants reported significantly higher EDE-Q global scores compared to the cisgender samples, but significantly lower than the ED sample. Transgender and gender non-conforming individuals reported a higher likelihood of objective binge episodes (OBEs) than the cisgender groups, albeit lower than youth with EDs. A substantial proportion of TGNC participants scored in elevated ranges on the EDE-Q global score (35% ≥ score of 3, 17% ≥ score of 4), significantly higher than cisgender males (0% ≥ score of 3, 0% ≥ score of 4) and females (9% ≥ score of 3, 3% ≥ score of 4). CONCLUSIONS: Findings indicate that TGNC youth exhibit increased ED cognitions and OBEs compared to cisgender samples, highlighting the need for screening and addressing ED symptoms in this population.

The role of habit in maintaining binge/purge behaviors: An ecological momentary assessment study.

OBJECTIVE: Individuals with eating disorders transdiagnostically engage in binge eating (BE) and/or purging, despite life-threatening consequences. Little is known about factors that contribute to the persistence of these behaviors. This study explored whether habitual control over binge/purge (B/P) spectrum behaviors contributes to symptom persistence and whether negative reinforcement via reductions in negative affect is less influential in maintaining B/P behaviors that are under habitual control and are persistent. METHOD: Women with BE and/or purging (N = 81) completed self-report measures assessing habit strength of BE and purging. Then, they completed a 14-day ecological momentary assessment (EMA) protocol during which they completed measures of negative affect, BE, and purging multiple times per day. RESULTS: Habitual control over purging was associated with a greater frequency of purging during the EMA period. However, habitual control over BE was not associated with the severity of loss of control eating or the frequency of BE episodes. Habitual control did not moderate temporal relations between negative affect and B/P behaviors during the EMA period. However, exploratory analyses revealed that individuals with a longer duration of BE and greater habitual control over BE showed a less pronounced reduction in negative affect following BE. DISCUSSION: Overall, these findings suggest that purging may be maintained by habitual stimulus-response learning. In addition, they support the possibility that reduction in negative affect may play a less prominent role in maintaining BE that is habitual and persistent. PUBLIC SIGNIFICANCE: This study investigated whether habit contributes to the persistence of symptoms in women with binge/purge spectrum behaviors and whether negative reinforcement via reductions in negative affect is less influential in maintaining binge/purge behaviors that are under habitual control. The findings suggest that purging may be maintained through habit. This supports the potential utility of habit reversal interventions to decrease habitual purging.

Reconceptualizing emotion regulation and coping strategy usage in eating disorders research: The utility of a regulatory flexibility framework.

Emotion regulation and coping strategies are often conceptualized in eating disorder (ED) research as inherently adaptive or maladaptive, and successful regulation is often defined as greater overall use of adaptive strategies. However, recent empirical work outside of the field of EDs challenges this categorical conceptualization of strategies, demonstrating that adaptiveness is determined by the ability to flexibly implement and adjust strategies based on contextual demands (i.e., regulatory flexibility). Despite evidence that emotion regulation and coping strategies are best conceptualized in terms of flexibility in the broader literature, few ED studies have adopted this model. We review the current conceptual framework of emotion regulation and coping strategies used in ED research and present regulatory flexibility as an alternative approach to conceptualizing these strategies. The lack of research on regulatory flexibility among individuals with EDs limits our understanding of the role of emotion regulation and coping difficulties in ED risk and maintenance. Adopting a regulatory flexibility model of strategies in EDs may extend knowledge of the role of emotion regulation difficulties in the development and maintenance of EDs. We highlight the potential utility of investigating regulatory flexibility and present recommendations for future research on regulatory flexibility in EDs. PUBLIC SIGNIFICANCE STATEMENT: Research on emotion regulation and coping strategy usage in eating disorders often view regulatory strategies as inherently adaptive or maladaptive. However, recent studies support defining strategies in terms of flexibility. Adopting a regulatory flexibility model of strategies in eating disorders research may advance knowledge of the role of emotion regulation difficulties in the development and maintenance of eating disorders, ultimately enhancing prevention and treatment efforts.

Disentangling the links between gastric emptying and binge eating v. purging in eating disorders using a case-control design.

BACKGROUND: Prior work supports delayed gastric emptying in anorexia nervosa and bulimia nervosa (BN) but not binge-eating disorder, suggesting that neither low body weight nor binge eating fully accounts for slowed gastric motility. Specifying a link between delayed gastric emptying and self-induced vomiting could offer new insights into the pathophysiology of purging disorder (PD). METHODS: Women (N = 95) recruited from the community meeting criteria for DSM-5 BN who purged (n = 26), BN with nonpurging compensatory behaviors (n = 18), PD (n = 25), or healthy control women (n = 26) completed assessments of gastric emptying, gut peptides, and subjective responses over the course of a standardized test meal under two conditions administered in a double-blind, crossover sequence: placebo and 10 mg of metoclopramide. RESULTS: Delayed gastric emptying was associated with purging with no main or moderating effects of binge eating in the placebo condition. Medication eliminated group differences in gastric emptying but did not alter group differences in reported gastrointestinal distress. Exploratory analyses revealed that medication caused increased postprandial PYY release, which predicted elevated gastrointestinal distress. CONCLUSIONS: Delayed gastric emptying demonstrates a specific association with purging behaviors. However, correcting disruptions in gastric emptying may exacerbate disruptions in gut peptide responses specifically linked to the presence of purging after normal amounts of food.

Accelerometer-Based Physical Activity and Shape and Weight Concerns Among Youth With Overweight and Obesity: A Pilot Exploratory Ecological Momentary Assessment Study.

Background: A bidirectional association between shape and weight concerns (SWC) and physical activity (PA) has been previously documented. This relationship may be particularly salient among youth with overweight/obesity, given that social marginalization of larger bodies has been associated with elevated SWC and barriers to PA. This pilot study explores reciprocal relationships between momentary SWC and accelerometer-assessed PA behavior. Methods: Youth with overweight/obesity (N = 17) participated in a 14-day ecological momentary assessment protocol, during which they were prompted to respond to questions about SWC several times per day. They also continuously wore Actiwatch 2 accelerometers to capture light and moderate-to-vigorous PA behavior. Results: Hierarchical linear modeling revealed a unidirectional association between SWC and PA, whereby after engaging in a higher duration of PA, participants reported lower SWC. SWC did not predict subsequent PA. Conclusion: The findings support a negative temporal relationship between PA and SWC. While further work is needed to replicate and extend these preliminary findings, they may suggest that PA acutely benefits SWC among youth with overweight and obesity.

PTSD symptoms as a potential mediator of associations between military sexual assault and disordered eating.

Despite increasing rates of sexual assault in the military and high rates of disordered eating and post-traumatic stress disorder (PTSD) among veterans, little is known about how these constructs are related. This study examined whether PTSD symptoms mediate the relation between military sexual assault and disordered eating among female veterans. United States female veterans (N = 98) completed self-report measures assessing military sexual assault, PTSD, and disordered eating. Results indicated that military sexual assault was associated with higher PTSD symptoms and disordered eating. PTSD symptoms did not mediate the relation between military sexual assault and overall levels of disordered eating. However, PTSD symptoms fully mediated the relation between military sexual assault and the Bulimia and Food Preoccupation subscale of the Eating Attitudes Test-26. Findings suggest that military sexual assault may contribute to the development of bulimia nervosa symptoms indirectly through PTSD symptoms. Thus, the findings do not support a global relationship between trauma and all facets of disordered eating, but demonstrate a relationship between PTSD and bulimia nervosa symptoms, with purging potentially functioning as an emotion regulation strategy. Future longitudinal studies are needed to establish temporal precedence of these associations.

Sleep reactivity is associated with social anxiety and disordered-eating behaviors in college students.

Objective: Investigate whether sleep reactivity was associated with social anxiety and disordered-eating behaviors in a college population. Participants: One hundred ninety-eight college-age men and women. Methods: Participants completed self-report measures of social anxiety, disordered-eating behaviors and sleep reactivity. Results: Sleep reactivity was associated with greater dietary restriction and purging, controlling for social anxiety but it was not associated with binge eating. Sleep reactivity was associated with elevated symptoms of social anxiety, controlling for disordered-eating behaviors. Conclusions: The results suggest that sleep reactivity represents a shared correlate of disordered-eating behaviors and social anxiety that may partially explain their co-occurrence. Interventions to help college students high in sleep reactivity effectively manage stress and regulate their sleep may aid in the prevention and treatment of social anxiety and disordered-eating behaviors.

The moderating role of sleep duration on momentary relations between negative affect and loss-of-control eating in children and adolescents.

OBJECTIVE: Loss-of-control (LOC) eating is associated with eating disorders and obesity, and thus it is imperative to understand its momentary risk factors in order to improve intervention efforts. Negative affect has been proposed as a momentary risk factor for LOC eating, but the evidence for its effects in children and adolescents is mixed. Short sleep duration (which is very common in youth), may be one variable that moderates the relation between negative affect and subsequent LOC eating. As such, we aimed to examine the moderating role of within-person sleep duration on the momentary relations between negative affect and subsequent LOC eating. METHOD: We recruited children (N = 30) with overweight/obesity ages 8-14, who completed a 2-week ecological momentary assessment protocol assessing negative affect and LOC eating several times per day, while also wearing a sleep actigraphy device and completing sleep diaries. RESULTS: Consistent with hypotheses, within-person sleep duration moderated the next-day momentary relation between within-person negative affect and LOC eating, such that shorter sleep duration strengthened the positive relation between negative affect and loss-of-control eating. CONCLUSIONS: Results suggest that, in children and adolescents, fluctuations in sleep duration may influence susceptibility to losing control over eating after experiencing negative affect. Future research should further investigate other metrics of sleep disturbance as they relate to emotion regulation and LOC eating. Such research will set the stage for augmenting paediatric interventions to better target maintenance factors for LOC eating.

Body dissatisfaction among ethnic subgroups of Latin women: An examination of acculturative stress and ethnic identity.

This study investigated (1) ethnic group differences in body dissatisfaction (BD) among specific Latina subgroups, (2) acculturative stress as a mediator between ethnic group and BD, and (3) ethnic identification as a moderator between 3a) ethnic group and BD and 3b) acculturative stress and BD. Mexican (n = 30), Puerto Rican (n = 31), Cuban (n = 29), and non-Hispanic, White (n = 30) women in the US completed self-report questionnaires. Group comparisons indicated Mexicans reported greater BD compared to Whites, while Puerto Ricans and Cubans did not differ from Whites. A significant indirect effect indicated that acculturative stress mediated the association between ethnic group and BD. Acculturative stress predicted BD at low and average levels of ethnic identification. Additionally, there were significant differences comparing Cubans to Mexicans and Puerto Ricans, which were dependent on ethnic identification. Thus, higher ethnic identification may serve as a protective factor for Cubans. Findings support separating subgroups of Latinas and that higher ethnic identification may protect against the development of BD in Latinas experiencing acculturative stress. Assessments and interventions should address acculturative stress since higher levels were associated with higher levels of BD, and the combination of ethnic group, acculturative stress, and ethnic identification may help explain differences in BD among Latinas.

Overweight preoccupation is associated with eating pathology in male collegiate athletes with body dissatisfaction.

PURPOSE: This study examined specific aspects of body dissatisfaction and drive for muscularity as correlates of eating pathology and explored sport confidence as a moderator of these associations in male collegiate athletes. METHOD: Ninety-three male collegiate athletes who endorsed body dissatisfaction and were enrolled in a body dissatisfaction intervention study completed baseline measures of appearance orientation, appearance evaluation, overweight preoccupation, muscularity-oriented attitudes and behaviors, eating pathology symptoms, and sport confidence. RESULTS: There were significant associations between overweight preoccupation and cognitive restraint, purging, binge eating, and excessive exercise, appearance orientation and cognitive restraint, negative appearance evaluation and restricting, muscularity-oriented attitudes and binge eating, and muscularity-oriented behaviors and excessive exercise. Low-to-moderate sport confidence moderated the association between muscularity-oriented behaviors and purging. CONCLUSION: Findings highlight a need for interventions targeting drive for muscularity and body dissatisfaction, especially overweight preoccupation, in male collegiate athletes. Findings additionally suggest a need to further examine the utility of sport confidence in prevention and intervention programs targeting eating pathology in larger samples of male athletes. LEVEL OF EVIDENCE: V, Cross-sectional descriptive study.

Typology of eating episodes in children and adolescents with overweight/obesity.

BACKGROUND: Research suggests that youth with overweight/obesity can be subtyped according to disinhibited eating tendencies. No research has attempted to subtype classes of eating episodes along sensational, psychological, and hedonic dimensions. METHODS: Youth (N = 39; 55% female) aged 8-14 y with overweight/obesity completed a 2-week ecological momentary assessment protocol in which they reported on all eating episodes and their sensational, environmental, affective, and interpersonal contexts. Latent profile analysis (LPA) was used to classify episodes based on loss of control (LOC) while eating, self-reported overeating, food palatability, hunger, and cravings. Classes were compared on affective, interpersonal, appearance-related, and environmental correlates using Wald chi-square tests. RESULTS: LPA identified three classes of eating episodes involving high levels of LOC/self-reported overeating ("binge-like" class), low levels of hunger ("eating-in-the-absence-of-hunger" class), and high hunger and cravings ("appetitive eating" class). Binge-like eating was associated with the highest levels of body dissatisfaction, interpersonal distress, and positive affect, and was most likely to occur in the after-school hours. CONCLUSIONS: Binge-like eating tends to occur in a psychological context relative to other types of eating episodes in youth with overweight/obesity. Future research should explore whether certain classes of eating episodes are associated with distinct weight trajectories over time.

Reducing eating disorder risk among male athletes: A randomized controlled trial investigating the male athlete body project.

OBJECTIVE: No study to date has investigated an intervention program for male athletes that targets eating disorder risk factors. The purpose of this study was to measure the effects of the Male Athlete Body Project (MABP), an adaptation of the Female Athlete Body Project on body dissatisfaction, drive for muscularity, body-ideal internalization, and muscle dysmorphia. METHOD: Participants were 79 male collegiate athletes who were randomized to the MABP (n = 39) or an assessment-only control condition (n = 40). All participants completed psychometrically validated measures at three time points: baseline, post-treatment (3 weeks after baseline for the control condition), and 1-month follow-up. RESULTS: Hierarchical Linear Modeling assessed differences between conditions across time. Interaction effects revealed that participation in the MABP improved satisfaction with specific body parts and reduced drive for muscularity and body-ideal internalization at post-treatment compared to a control group. Athletes in the MABP also reported increased body areas satisfaction and reductions in drive for muscularity at 1-month follow-up. Reductions in supplement use were observed at 1-month follow-up only. DISCUSSION: This study provides preliminary evidence of the efficacy of the MABP in reducing some eating disorder risk factors up to 1 month after the intervention; follow-up study considerations are discussed. CLINICAL TRIAL REGISTRATION NUMBER: NCT04077177 PUBLIC SIGNIFICANCE: This study highlights the importance of eating disorder and body image intervention efforts for male athletes. Findings suggest that male college athletes who attended a 3-session group intervention based on a well-established program for college women experienced an increase in satisfaction with specific body areas and a reduction in some eating disorder risk factors (e.g., drive for muscularity, supplement use, and body-ideal internalization) compared to a control group.

Gender differences in the relation between interpersonal stress and momentary shape and weight concerns in youth with overweight/obesity.

The purpose of this study was to examine relations between interpersonal stress and momentary shape and weight concerns among pre-adolescent and early adolescent boys and girls with overweight/obesity, using ecological momentary assessment (EMA). We also aimed to determine whether interpersonal stress was differentially related to shape/weight concerns in boys versus girls. Forty youth, ages 8-14 years (53% female), with overweight or obesity reported their state-level shape/weight concerns and negative affect and their recent interpersonal stress (i.e., stress experienced since the last EMA assessment) multiple times a day, for two weeks. Results indicated that interpersonal stress predicted shape/weight concerns in girls but was not related to shape/weight concerns in boys. At the between-person level, higher overall feelings of loneliness and social rejection and a higher overall desire for more friends predicted higher average levels of shape/weight concerns. At the within-person level, higher momentary ratings of loneliness, social rejection, and desire for more friends predicted lower shape/weight concerns. These data suggest that the tendency to experience interpersonal stress may be more detrimental to body satisfaction for girls with overweight/obesity than for boys with overweight/obesity. Interventions that focus on reducing interpersonal stress may be effective in ameliorating shape/weight concerns in girls with overweight/obesity.

Women of diverse sexual identities admit to eating disorder treatment with differential symptom severity but achieve similar clinical outcomes.

OBJECTIVE: Sexual minority (SM) women may be at increased risk for certain eating disorder (ED) symptoms and report distinct body image concerns compared to heterosexual women. However, it is unclear how such symptoms differ across sexual orientations in treatment-seeking women, or if there are differences in treatment outcomes. This study examined group differences in (1) ED symptomatology at admission in a disaggregated sample of SM and heterosexual women presenting for ED treatment and (2) treatment outcomes. METHODS: Adult women who admitted to higher levels of ED treatment across 48 locations of one treatment center between 2015 and 2018 completed self-report measures of ED symptomatology and quality of life (QOL) at admission and discharge. Participants identified their sexualities as heterosexual (n = 2,502, 80.2%), lesbian/gay (n = 134, 4.3%), bisexual (n = 270, 8.7%), "other" (n = 136, 4.4%), and unsure (n = 78, 2.5%). Objectives 1 and 2 were tested using one-way and repeated measures analyses of variance, respectively. RESULTS: Group differences at admission emerged between lesbian/gay and heterosexual, bisexual and heterosexual, and bisexual and "other"-identified women on preoccupation and restriction, fasting, self-induced vomiting, shape and weight concern, and QOL. Bisexual women, in particular, admitted with the highest severity and at younger ages compared to heterosexual women. Despite such differences, women across groups achieved similar treatment outcomes at discharge. DISCUSSION: Study findings underscore the importance of subgroup analyses of ED symptoms in SM women and have both clinical and research implications related to ED symptomatology in this population.

Nutrition knowledge moderates the association between perfectionism and shape/weight concerns.

Perfectionistic traits have been associated with stronger weight and diet concerns. Maladaptive perfectionism is tied to critical evaluation tendencies such as excessive concern about making mistakes, increasing one's risk for eating disorder pathology. Knowledge about healthy diet and nutrition may be one factor influencing associations between perfectionistic tendencies, as individuals with eating disorders may be more attuned to sources of nutrients. The current study examined whether nutrition knowledge moderates the association between one facet of perfectionism, concern over mistakes, and shape/weight concerns and the association between concern over mistakes and global eating pathology. College women (N = 122) completed questionnaires on disordered eating attitudes, nutrition knowledge, and perfectionism. Concern over mistakes was positively related to shape/weight concerns and global eating pathology. Nutrition knowledge significantly moderated the association between concerns over mistakes and shape/weight concerns, such that the association was stronger among those with higher levels of nutrition knowledge. Furthermore, nutrition knowledge displayed trend-level significance for the moderation of the association between concern over mistakes and global eating pathology. College women displaying high levels of concern over mistakes who are more informed about nutrition knowledge may be more vulnerable to developing concerns about body shape/weight and eating disorder pathology.

Eating pathology and depressive symptoms as predictors of excessive weight gain during pregnancy.

Excessive gestational weight gain is associated with negative outcomes and the identification of contributing psychosocial factors may be useful in prevention and intervention. Pregnant women (N = 70) completed self-report measures of eating pathology, depressive symptomatology, and gestational weight gain. Global eating pathology was positively associated with overvaluation of shape and weight, dietary restraint, frequency of binge eating, and depressive symptoms. Depressive symptoms significantly predicted excessive gestational weight gain, while global eating pathology predicted excessive gestational weight gain at a trend level. Results suggest that depressive symptoms more strongly predict excessive gestational weight gain than eating pathology.

Emotion regulation flexibility and disordered eating.

Research suggests that individuals with eating disorders use more putatively maladaptive emotion regulation strategies and fewer putatively adaptive strategies. However, there is growing theoretical and empirical support for the notion that the efficacy of emotion regulation strategies varies across situations. Thus, successful emotion regulation is characterized by the ability to flexibly choose between emotion regulation strategies in order to fit one's situational needs. Despite growing support for this conceptualization of successful emotion regulation, no research has investigated it in relation to disordered eating. Using the emotion regulation choice paradigm, this study investigated the association between emotion regulation flexibility and disordered eating. Women (N = 50) completed self-report questionnaires and a laboratory-based emotion regulation choice task to assess emotion regulation flexibility. Results indicated that lower emotion regulation flexibility was associated with more frequent purging and excessive exercise. Emotion regulation flexibility was not significantly associated with binge eating or overall eating disorder psychopathology. These findings suggest that individuals who engage in unhealthy compensatory behaviors exhibit reduced emotion regulation flexibility. If replicated in clinical samples, treatment for eating disorders characterized by compensatory behaviors may benefit from incorporating additional strategies to help people utilize emotion regulation strategies in a flexible, situationally appropriate manner.

Momentary associations between positive affect dimensions and dysregulated eating during puberty in a diverse sample of youth with overweight/obesity.

OBJECTIVE: The link between dysregulated positive affect and binge-eating behavior in youth with obesity is poorly understood. In addition, it is unclear how putative associations differ across developmental periods of rapid biological and emotional change, such as puberty, and in racial and ethnic minority youth, who are more likely to be overweight but are underrepresented in the literature. METHOD: This study used a 2-week ecological momentary assessment protocol to examine independent and interactive effects of positive affect intensity/instability, and pubertal stage on two components of binge-eating behavior, loss of control eating (LOCE), and overeating. RESULTS: Participants were 38 youth with overweight/obesity (ages 8-14 years; 78% African American/Hispanic). Positive affect instability was calculated using probability of acute change (PAC), representing the likelihood of extreme affective changes, and mean squared successive difference (MSSD), representing the average change in affect over successive recordings. There were no main effects of positive affect intensity on LOCE or overeating, but positive affect instability was negatively associated with overeating severity using both MSSD (p = .005) and PAC metrics (p = .001). However, moderation analyses including interactions with pubertal status revealed more extreme changes in positive affect (i.e., higher PAC) were related to greater overeating (p = .001) and LOCE severity (p = .043) in mid-late pubertal youth but not in pre-early pubertal youth. DISCUSSION: Pubertal status may influence the association between disruptions in positive affect and dysregulated eating in youth, and positive affect instability may be important to consider in order to understand the emotional correlates of binge eating in youth with overweight/obesity.

The interactive effects of parental self-efficacy and child eating styles in relation to naturalistically-assessed craving, overeating, and loss of control eating.

OBJECTIVE: Parental factors have been linked to weight-related outcomes in children, though less is known regarding the role of parental self-efficacy (PSE) for promoting healthy dietary behaviors (HDBs). This study examined associations between PSE for promoting HDBs and child reports of craving, overeating, and loss of control eating in daily life. The interactive effects of PSE and child eating style (emotional eating, external eating, and restraint) were also explored. METHOD: Thirty-eight youth (ages 8-14; 55.3% female) with overweight/obesity and their parents completed the Dutch Eating Behavior Questionnaire for Children (DEBQ-C) and Parental Self-Efficacy for Healthy Dietary and Physical Activity Behaviors Scale, respectively. Youth completed ecological momentary assessment (EMA) to report craving, overeating, and loss of control eating. RESULTS: Generalized estimating equations indicated no consistent main effects of PSE on EMA outcomes, but PSE interacted with DEBQ-C child eating styles to predict each EMA outcome. Among children of parents with lower PSE, (a) higher emotional eating was associated with greater overeating and loss of control eating; (b) higher external eating was associated with greater craving; and (c) higher restraint was associated with greater loss of control eating and craving. Conversely, these associations were attenuated among children of parents with higher PSE. DISCUSSION: Together findings suggest the interplay of child characteristics and PSE regarding children's eating behaviors warrants future investigation in the context of eating and weight disorders. In particular, further research is needed to examine the directionality of effects and mechanisms underlying these associations.