Claus Vögele

Food cravings discriminate differentially between successful and unsuccessful dieters and non-dieters. Validation of the Food Cravings Questionnaires in German☆

Food cravings have been strongly associated with triggering food consumption. However, definitions and measurements of food cravings are heterogeneous. Therefore, Cepeda-Benito and colleagues (2000) have suggested the Food Cravings Questionnaires (FCQs) to measure food cravings as a multidimensional construct at trait- and state-level. In the current study, we validated a German version of the FCQs in an online study (N=616). The factor structure of the state and trait versions could partially be replicated, but yielded fewer than the originally proposed factors. Internal consistencies of both versions were very good (Cronbachs α>.90), whereas retest reliability of the state version was expectedly lower than that of the trait version. Construct validity of the trait version (FCQ-T) was demonstrated by high correlations with related eating behavior questionnaires and low correlations with questionnaires unrelated to eating. Most importantly, FCQ-T-subscales were able to discriminate between successful and unsuccessful dieters and non-dieters. Validity of the state version was supported by positive relations with food deprivation and current negative affect. Taken together, the German version of the FCQs has good psychometric properties. Moreover, this study provided first evidence that distinct dimensions of food cravings are differentially related to success and failure in dieting.

ARTiiFACT: a tool for heart rate artifact processing and heart rate variability analysis.

The importance of appropriate handling of artifacts in interbeat interval (IBI) data must not be underestimated. Even a single artifact may cause unreliable heart rate variability (HRV) results. Thus, a robust artifact detection algorithm and the option for manual intervention by the researcher form key components for confident HRV analysis. Here, we present ARTiiFACT, a software tool for processing electrocardiogram and IBI data. Both automated and manual artifact detection and correction are available in a graphical user interface. In addition, ARTiiFACT includes time- and frequency-based HRV analyses and descriptive statistics, thus offering the basic tools for HRV analysis. Notably, all program steps can be executed separately and allow for data export, thus offering high flexibility and interoperability with a whole range of applications.

Individual differences in the perception of bodily sensations: the role of trait anxiety and coping style.

Thirty young women participated in an experiment in which heart rate, blood pressure, respiration rate, skin conductance level and palmar sweat index were monitored at rest and during the administration of mental arithmetic, mirror drawing and cold pressor tasks. The accuracy of perception of somatic states was estimated by calculating within-subject correlations between four bodily sensations (racing heart, high blood pressure, shortness of breath and sweaty hands) and corresponding physiological parameters, assessed on eight occasions during the experiment. The accuracy of heart rate perception was highest, with a mean correlation between actual heart rate and ratings of racing heart of 0.76 and 66% of participants showing significant within-subject effects. The mean accuracy was 0.55 for systolic blood pressure, 0.48 for respiration rate, 0.47 for skin conductance level, and 0.64 for palmar sweat index. Accurate perception across physiological parameters did not cluster within individuals, and was not dependent on the range either of physiological changes or sensation ratings. Trait anxiety was not significantly associated with accuracy of somatic perception. Subjects with high trait anxiety reported larger increases in shortness of breath during tasks than did low anxious subjects, but this was not reflected in objective physiological measures. Information-seeking coping style, indexed by the monitoring scale of the Miller Behavioral Style Scale, was related to the accuracy of perception of skin conductance level and heart rate. The use of within-subject correlational strategies for assessing individual differences in perception of bodily states is discussed.

Evidence-based recommendations for the development of obesity prevention programs targeted at preschool children

The ToyBox intervention was developed using an evidence‐based approach, using the findings of four reviews. These reviews included three critical and narrative reviews of educational strategies and psychological approaches explaining young childrens acquisition and formation of energy‐balance related behaviours, and the management of these behaviours, and also a systematic review of behavioural models underpinning school‐based interventions in preschool and school settings for the prevention of obesity in children aged 4–6 years.

Effects of prolonged and repeated body image exposure in binge-eating disorder.

OBJECTIVE The purpose of the present study was to investigate psychological mechanisms associated with prolonged and repeated body image exposure. METHOD In an experimental design, 30 female volunteers diagnosed with binge-eating disorder (BED) (DSM-IV) and 30 non-eating-disordered controls (NC) were exposed to their physical appearance in a mirror. The confrontation procedure was guided by a standardized interview manual and took place on two separate days. Self-reported mood, appearance self-esteem, and frequency of negative cognitions were assessed repeatedly throughout the experiment. RESULTS During body image exposure sessions, binge-eating-disordered individuals showed significantly lower mood than controls while appearance self-esteem was diminished in both groups. During the second body image exposure session, higher levels of mood and appearance self-esteem were observed in both groups, and negative cognitions occurred less frequently. CONCLUSION Results are discussed with regard to the therapeutic use of body image exposure.

Psychological and Physiological Reactivity to Stress: An Experimental Study on Bulimic Patients, Restrained Eaters and Controls

Background: Binge eating behavior in bulimic patients is thought to play a crucial role in the regulation of psychophysiological arousal in stressful situations. Previous results suggest that interpersonal stress and achievement challenge are perceived as particularly stressful by bulimic individuals. It is not clear, however, whether bulimic individuals respond to stress with an increased desire to binge, and whether this increase is accompanied by higher psychophysiological reactivity compared to healthy controls. Methods: Twenty-seven patients with bulimia nervosa (DSM-IV), 27 restrained eaters, and 27 controls participated in two experimental sessions in which continuous measures of heart rate, blood pressure, respiration rate, and electrodermal activity were monitored under conditions of achievement challenge (mental arithmetic, Stroop test) and interpersonal stress provoking feelings of loneliness and social rejection (film, imagery task). Ratings of desire to binge, negative mood, and hunger were obtained between experimental trials. Groups were matched for age and body mass index. Results: There was a marked difference in subjective ratings during interpersonal stress. Bulimic patients responded to the imagery task with increases in both desire to binge and hunger, whereas restrained eaters and controls showed no change. There were no substantial group differences in psychophysiological reactivity. Conclusions: The dissociation between emotional responses and physiological activation may have important therapeutic implications.

Psychological responses to body shape exposure in patients with bulimia nervosa.

One of the unresolved issues regarding research on bulimia nervosa concerns the question as to how patients diagnosed with bulimia nervosa respond to body image exposure. In addition, it remains unclear whether there are differential responses associated with different exposure techniques (e.g. in vivo exposure vs. exposure by visualization). The aim of the present study was to investigate psychological responses to body image exposure. Twenty participants diagnosed with bulimia nervosa (DSM IV) and twenty non-eating disordered individuals were exposed to their body image using a video recording (video confrontation). In addition, they were asked to imagine and describe the appearance of their body (imagery task). Results indicate that self-reported negative emotions increased in response to both, video confrontation and imagery task, in the clinical as well as in the control group. Furthermore, video confrontation led to more pronounced group differences than exposure by visualization (imagery task). Participants diagnosed with bulimia nervosa took less time to describe their waist, hips and bottom compared to non-eating disturbed controls. This last result could be interpreted in terms of avoidance behavior and other mechanisms during body image exposure.

A narrative review of psychological and educational strategies applied to young children's eating behaviours aimed at reducing obesity risk

Strategies to reduce risk of obesity by influencing preschool childrens eating behaviour are reviewed. The studies are placed in the context of relevant psychological processes, including inherited and acquired preferences, and behavioural traits, such as food neophobia, ‘enjoyment of food’ and ‘satiety responsiveness’. These are important influences on how children respond to feeding practices, as well as predictors of obesity risk. Nevertheless, in young children, food environment and experience are especially important for establishing eating habits and food preferences. Providing information to parents, or to children, on healthy feeding is insufficient. Acceptance of healthy foods can be encouraged by five to ten repeated tastes. Recent evidence suggests rewarding healthy eating can be successful, even for verbal praise alone, but that palatable foods should not be used as rewards for eating. Intake of healthier foods can be promoted by increasing portion size, especially in the beginning of the meal. Parental strategies of pressuring to eat and restriction do not appear to be causally linked to obesity, but are instead primarily responses to childrens eating tendencies and weight. Moderate rather than frequent restriction may improve healthy eating in children. Actively positive social modelling by adults and peers can be effective in encouraging healthier eating.

Anger suppression, reactivity and hypertension risk: Gender makes a difference

The present study investigated gender-related differences in cardiovascular reactivity and the role of anger inhibition and risk for future hypertension.Tonic blood pressure served as an index of hypertension risk. Twenty-eight female and 26 male college students with high and low normal blood pressure were recruited on the basis of their mean arterial pressure. Continuous measures of heart rate and blood pressure were taken while participants carried out a series of behavioral manoeuvres including mental arithmetic, interpersonal challenge, a frustrating psychomotor test, and the cold pressor test. Participants also completed inventories assessing trait anxiety, trait anger, anger expression, and Type A.The results are in concordance with previous findings and show higher cardiovascular reactivity in men than in women and in subjects at risk for hypertension. Within the male group, a combination of hypertension risk and anger suppression led to the highest reactivity, whereas in female subjects, differences in anger-in had no effect on reactivity. The implications of these results are discussed in light of sex differences in cardiovascular morbidity and mortality.

Mental disorders in chronic obstructive pulmonary disease (COPD).

Recent research using questionnaire measures has demonstrated high prevalence rates of mental disorders in chronic obstructive pulmonary disease (COPD). However, clinical interviews and clinical rather than healthy control groups have rarely been employed. The aim of the present study was to assess mental disorders in patients with COPD with advanced methodology, to identify moderating factors explaining mental co-morbidities and to compare results with a clinical control group without COPD. A standardized clinical interview (F-DIPS) and a range of questionnaires were used to assess mental disorders, perceived physical symptoms and cognitions in 20 hospitalized patients with mild-to-moderate COPD (mean FEV(1)/VC (%)=61.3). Results were compared with a hospitalized clinical control group without pulmonary dysfunction (CCG; N=20). Results showed that 55% of patients with COPD received a diagnosis of a mental disorder compared to 30% of CCG patients. All principal mental diagnoses in the COPD group were anxiety disorders (especially Panic Disorder with Agoraphobia), while CCG patients received a wider range of diagnoses (anxiety, pain, alcohol abuse). There was no systematic association between anxiety levels and respiratory function in the whole COPD group, but a positive correlation between anxiety levels and perceived physical symptoms (p<0.001) as well as negative cognitions (p<0.001 and p<0.05, respectively) for COPD patients with anxiety disorder (N=11). The present results confirm the high prevalence rate of anxiety in patients with COPD and suggest further that anxiety in COPD patients may be mediated by cognitive processes. These findings are discussed in terms of their implications for treatment.