Date of Award

12-2008

Level of Access Assigned by Author

Open-Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Advisor

Sandra T. Sigmon

Second Committee Member

Jeffrey E. Hecker

Third Committee Member

Geoffrey L. Thorpe

Abstract

[In lieu of Abstract, excerpt from Conclusion of Examining the Role of Stress in Binge Eating Disorder]:

Results from the present study support growing evidence which demonstrates that stress can negatively impact binge eating. However, given the paucity of research examining these variables in clinical samples of individuals diagnosed with BED, additional research is warranted. Therefore, future studies should continue to recruit clinical samples utilizing clinical interviews. Research is also needed to further explore the relationship between cortisol and binge eating in individuals diagnosed with BED. Interestingly, individuals diagnosed with BED perceived the stress task (and situations in general) as more stressful than individuals in the control group despite the fact that there were no significant differences between cortisol levels. Individuals diagnosed with BED had a different experience even though there were no differences in cortisol. Therefore, it is important for future studies to focus on the relationship between cortisol and perceived stress. Given that many studies, including the current study, have found a relationship between binge eating and negative emotions (e.g., anxiety, depression) future research should extend these findings by focusing on other negative emotions, such as shame as another possible avenue to better understand BED processes. Although there were interesting results when looking at within group changes in cortisol, the current findings have to be viewed cautiously. Future research utilizing larger samples and an actual consumption of food component after the stress task may be able to address several limitations of the current study. In addition, there are other biological markers of stress (e.g., DHEA, ACTH, etc) that may be more pertinent to BED and could be examined in addition to cortisol. Although aspects of the interactive model of binge eating (Cattanach & Rodin, 1988) were supported in the current study (e.g., greater negative affect and perceived stress, increased desire to binge eat after stress, and the use of maladaptive coping styles by individuals diagnosed with BED), the methodology of the study did not permit a thorough test of the model. For example, level of control and social support were not assessed in the current study. Similarly, in a test of the interactive model (Cattanach et al., 1988), only urge to binge eat was assessed after individuals went through stressful tasks. It remains to be seen if the interactive model can account for actual binges in individuals with BED. In addition, certain aspects of the escape from awareness model (Heatherton & Baumeister, 1991) and affect regulation models of bingeing (e.g., Kenardy et al., 1996) were supported in the current study. Incomplete tests of the models and commonalities between them make it difficult to provide definitive support for any one model of BED. In addition, the models were all proposed for bingeing associated with BN, not BED. Further research is needed to specify which components of the models apply to BED. Future research should also focus on perceived stress given that the current study found no significant difference in the quantity of stressful events reported by groups. Taking into account perceived stress is also important when administering treatments for individuals diagnosed with BED. Given the current results, it may be more effective to focus on helping an individual perceive situations differently as opposed to (or in addition to) just reducing the number of stressors in their lives. Therefore, treatment such as Cognitive-Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) may be particularly helpful with this population. If an individual diagnosed with BED perceives situations as more stressful, then targeting only a reduction in quantity of stressful events, without addressing the client’s beliefs about the stressors will not likely result in significant improvements. Instead, engaging in the meaning attributed to the stressor through cognitive restructuring or cognitive defusion may be an important aspect of treatment.

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