Jennifer S. Mills

Components of attentional bias for food cues among restrained eaters

The study aimed to investigate attentional bias for food cues among restrained eaters. In particular, the roles of speeded detection (enhanced orientation of attention toward food stimuli) and slowed disengagement (trouble disengaging attention from food stimuli) were examined. Participants were 78 female undergraduate students aged 18-25 years, classified as restrained (N=38) or unrestrained eaters (N=40). Attentional bias was assessed by a visual search task which required participants to locate the position of an odd-one-out target word in a matrix of 19 distractor words. Restrained eaters were disproportionately faster than unrestrained eaters to detect a food word within a neutral matrix compared to a neutral word within a neutral distractor matrix. Restrained eaters were also disproportionately faster, rather than slower, than unrestrained eaters to detect a neutral word within a food matrix compared to a neutral word within a neutral distractor matrix. Thus restrained eaters show a heightened vigilance for food cues, but no slower disengagement from such cues.

In Perfect Harmony: Synchronizing the Self to Activated Social Categories

The self-concept is one of the main organizing constructs in the behavioral sciences because it influences how people interpret their environment, the choices they make, whether and how they initiate action, and the pursuit of specific goals. Because belonging to social groups and feeling interconnected is critical to human survival, the authors propose that people spontaneously change their working self-concept so that they are more similar to salient social categories. Specifically, 4 studies investigated whether activating a variety of social categories (i.e., jocks, hippies, the overweight, Blacks, and Asians) increased associations between the self and the target category. Whereas Studies 1 and 2 focused on associations between stereotypic traits and the self, Studies 3 and 4 examined self-perceptions and self-categorizations, respectively. The results provide consistent evidence that following social category priming, people synchronized the self to the activated category. Furthermore, the findings indicate that factors that influence category activation, such as social goals, and factors that induce a focus on the interconnectedness of the self, such as an interdependent vs. independent self-construal, can impact this process. The implications of changes to the working self-concept for intergroup relations are discussed.

Body Checking Induces an Attentional Bias for Body-Related Cues

OBJECTIVE Theoretical models suggest that body checking is linked to biased cognitive processing. However, this link has not been investigated in any systematic way. The present study examined the influence of body checking on attentional bias for body-related cues by manipulating body checking behaviors in nonclinical participants. METHOD 66 women were randomly assigned to one of three conditions: body checking, body exposure, or control. A body visual search task was used to measure attentional bias. RESULTS Participants in the body checking condition showed speeded detection of body-related information compared to participants in the exposure and control conditions. No evidence was found for increased distraction by body-related information. Furthermore, participants in the body checking condition reported more body dissatisfaction after the manipulation than participants in the body exposure and control conditions. DISCUSSION These results are the first to experimentally establish the link between body checking and attentional bias toward body-related cues.

Binge eating in bariatric surgery candidates: The role of insecure attachment and emotion regulation.

Binge eating has a high prevalence among bariatric patients and is associated with post-surgical weight gain. This study examined the potential mediating role of emotion regulation difficulties in the relation between attachment insecurity and binge eating among this population. Participants were 1388 adult pre-bariatric surgery candidates from an accredited bariatric surgery assessment centre in Toronto, Ontario. Participants completed measures of psychological functioning, including attachment style and emotion regulation. Mediation analyses revealed that difficulties with emotion regulation mediated a positive association between insecure-anxious attachment and binge eating. An insecure-avoidant attachment was found to have a non-significant association with binge eating when examining the total effect. However, when difficulties with emotion regulation were controlled for in the model to examine its role as a mediator, this association became significant, and emotion regulation difficulties also mediated the relationship between attachment avoidance and binge eating. These findings suggest that difficulties in emotion regulation may be an important clinical issue to address in order to reduce binge eating in adult bariatric surgery candidates.

Exploring the motives and mental health correlates of intentional food restriction prior to alcohol use in university students.

This study explored the prevalence of and motivations behind ‘drunkorexia’ – restricting food intake prior to drinking alcohol. For both male and female university students (N = 3409), intentionally changing eating behaviour prior to drinking alcohol was common practice (46%). Analyses performed on a targeted sample of women (n = 226) revealed that food restriction prior to alcohol use was associated with greater symptomology than eating more food. Those who restrict eating prior to drinking to avoid weight gain scored higher on measures of disordered eating, whereas those who restrict to get intoxicated faster scored higher on measures of alcohol abuse.

Correlates, causes, and consequences of fat talk: A review.

Fat talk is a term used to describe self-disparaging remarks made to other people about ones weight or body. Fat talk has been both causally and correlationally linked to a number of negative body image-related variables including low body esteem, body dissatisfaction, drive for thinness, body-related cognitive distortions, and perceived sociocultural pressure to be thin. As such, body image researchers and clinicians would benefit from increased awareness of the current literature concerning fat talk. A narrative synthesis approach is used to summarize all research containing the keywords fat talk, body talk, or weight talk that was published from 1994 to 2014 inclusive. The measures used to study fat talk, outcomes and correlates associated with fat talk, theories that may help explain these findings, and the purpose served by fat talk are reviewed and discussed. In addition, directions for future research on fat talk, including intervention strategies, are examined.

The natural course of eating pathology in female university students.

This study investigated the natural course of eating pathology in a sample of female university students. Seventy-nine students were recruited in their first month of the university, 24 of whom endorsed objective binge eating and inappropriate compensatory behaviors based on an initial screening interview. Testing sessions occurred every 6 months for the following 2 1/2 years and included the assessment of eating pathology, general psychopathology and well-being, weight, and exposure to psychological or psychiatric treatment. Data were analyzed using a mixed-effects linear regression model. Whereas general psychopathology decreased during the study, eating pathology was fairly stable. The symptomatic participants experienced significantly more weight fluctuations over the course of the study than did in the control participants. None of the symptomatic participants sought treatment for their eating and eating pathology showed little evidence of spontaneous remission. Larger, follow-up studies of changes to untreated eating pathology over time are recommended.

A randomized controlled trial of motivational interviewing + self-help versus psychoeducation + self-help for binge eating

OBJECTIVE Motivational Interviewing (MI) is a collaborative therapy that focuses on strengthening a persons internal motivation to change. Research suggests that MI may be helpful for treating binge eating; however, findings are limited and little is known about how MI for binge eating compares to active therapy controls. The present study aimed to build on current research by comparing MI as a prelude to self-help treatment for binge eating with psychoeducation as a prelude to self-help treatment for binge eating. METHOD Participants with full or subthreshold DSM-IV Binge Eating Disorder or nonpurging Bulimia Nervosa were randomly assigned to receive either 60 minutes of MI followed by a self-help manual (n = 24) or 60 minutes of psychoeducation followed by a self-help manual (n = 21). Questionnaires were completed pre- and postsession, and at 1 and 4 months postsession. RESULTS MI significantly increased readiness to change and confidence in ability to control binge eating, whereas psychoeducation did not. No group differences were found when changes in eating disorder attitudes and behaviors were examined. DISCUSSION MI offers benefits for increasing motivation and self-efficacy. However, it may not be a uniquely effective treatment approach for reducing binge eating.

A preliminary study of motivational interviewing as a prelude to intensive treatment for an eating disorder

BackgroundEngaging patients with an eating disorder in change is difficult and intensive treatment programs have high drop-out rates. The purpose of the study was to determine whether Motivational Interviewing (MI) in the form of a brief, pre-treatment intervention would be associated with higher completion rates in subsequent intensive treatment for an eating disorder.Thirty-two participants diagnosed with an eating disorder participated in the study. All participants were on the waitlist for admission to an intensive, hospital-based treatment program. Sixteen participants were randomly assigned to four individual sessions of MI that began prior to entrance into the treatment program (MI condition) and 16 participants were assigned to treatment as usual (control condition). The main outcome was completion of the intensive treatment program. Participants also completed self-report measures of motivation to change.ResultsParticipants in the MI condition were significantly more likely to complete intensive treatment (69% completion rate) than were those in the control condition (31%).ConclusionsMI can be a useful intervention to engage individuals with severe eating disorders prior to participation in intensive treatment. MI as a brief prelude to hospital-based treatment for an eating disorder may help to improve completion rates in such programs. Further research is required to determine the precise therapeutic mechanisms of change in MI.

A Randomized Controlled Trial of Motivational Interviewing plus Self-Help Versus Psychoeducation plus Self-Help for Binge Eating

OBJECTIVE Motivational Interviewing (MI) is a collaborative therapy that focuses on strengthening a persons internal motivation to change. Research suggests that MI may be helpful for treating binge eating; however, findings are limited and little is known about how MI for binge eating compares to active therapy controls. The present study aimed to build on current research by comparing MI as a prelude to self-help treatment for binge eating with psychoeducation as a prelude to self-help treatment for binge eating. METHOD Participants with full or subthreshold DSM-IV Binge Eating Disorder or nonpurging Bulimia Nervosa were randomly assigned to receive either 60 minutes of MI followed by a self-help manual (n = 24) or 60 minutes of psychoeducation followed by a self-help manual (n = 21). Questionnaires were completed pre- and postsession, and at 1 and 4 months postsession. RESULTS MI significantly increased readiness to change and confidence in ability to control binge eating, whereas psychoeducation did not. No group differences were found when changes in eating disorder attitudes and behaviors were examined. DISCUSSION MI offers benefits for increasing motivation and self-efficacy. However, it may not be a uniquely effective treatment approach for reducing binge eating.