Mariantonietta Fabbricatore

The association among food addiction, binge eating severity and psychopathology in obese and overweight patients attending low-energy-diet therapy.

Several studies have shown that food addiction (FA) is strongly related with psychopathology. However, this relationship may be partly mediated by the presence and severity of binge eating. The aim of the current study was to assess the strength of the association between FA and psychopathology, and whether this relationship was mediated by the presence and severity of binge eating. Participants were 112 patients seeking weight loss interventions. All the participants were administered the Yale Food Addiction Scale (YFAS), The Symptom Check list-90-R (SCL-90), and the Binge Eating Scale (BES). Thirty-eight (33.9%) individuals were diagnosed as having FA. FA severity was strongly associated with binge eating, whereas both FA and binge eating were positively and moderately associated with psychopathology. A mediational model analyzing direct and indirect (through the mediating role of binge eating) effects of FA on psychopathology indicated that the relation between FA and psychopathology was fully mediated by the severity of binge eating. This finding suggests that FA may contribute to the development of psychopathology through its effect on binge eating.

Food Cravings Questionnaire–Trait (FCQ–T) Discriminates Between Obese and Overweight Patients With and Without Binge Eating Tendencies: The Italian Version of the FCQ–T

Food craving (FC) might play an important role in the course of eating disorders and obesity. The question of its measurement has particular importance in relation to the dramatic growth in obesity rates and its relevance for public health. The aim of this study was to investigate the psychometric properties of the Italian version of the Food Cravings Questionnaire–Trait (FCQ–T) in overweight and obese patients who were attending weight loss programs, and its efficiency in discriminating patients with binge eating. Participants were 497 (411 women, 86 men) overweight and obese patients in treatment with low-energy diet therapy. We used structural equation modeling to compare 3 factor models tested in previous studies (a 6-factor model, an 8-factor model, and a 9-factor model), which indicated that the 9-factor model has a better fit over the competing models. The FCQ–T had good internal consistency (Cronbachs α of.96 for the total score, and between.76 and.92 for subfactors), and was able to discriminate patients with clinical-level binge eating from those with probable and without binge eating with an efficiency of.74 (sensitivity =.64, specificity =.78). FCQ–T scores were sensitive to changes associated with treatment only for patients who started dietary restriction between the baseline and the follow-up assessment, but not for patients who were already observing dietary restrictions at the time of the baseline assessment. These results suggest that the FCQ–T could be a potentially useful measure for the screening of binge eating problems in overweight and obese patients while in treatment.

Childhood trauma in obese and overweight women with food addiction and clinical-level of binge eating

Childhood trauma (CT) is considered a major risk factor for several disorders as well as for the development of eating psychopathology and adult obesity. The main aims of the present study were to assess in overweight and obese women: (i) the independent association between CT and food addiction (FA), and (ii) CT in patients with both FA and clinical-level of binge eating (BE), versus patients who only engage in FA or BE. Participants were 301 overweight and obese women seeking low-energy-diet therapy. All of the patients were administered self-report measures investigating FA, BE, CT, anxiety and depressive symptoms. CT severity was moderately and positively associated with both FA (r=0.37; p<0.001) and BE (r=0.36; p<0.001) severity. The association between FA and CT remained significant after controlling for potential confounding variables. Furthermore, compared to patients without dysfunctional eating patterns, the co-occurrence of FA and BE was associated with more severe CT as well as with more severe psychopathology (i.e., anxiety and depressive symptoms) and higher BMI. Our results suggest that clinicians should carefully assess the presence of CT in individuals who report dysfunctional eating patterns in order to develop treatment approaches specifically for obese and overweight patients with a history of CT.

Gender differences in food craving among overweight and obese patients attending low energy diet therapy: a matched case–control study

This case–control study examined gender differences in food craving among a sample of overweight and obese patients attending low energy diet therapy. To disentangle the specific role of gender from the role of confounders, we paired groups for BMI, age and severity of binge eating as assed by the Binge Eating Scale (BES). The participants were 73 pairs of patients who were attending low energy diet therapy. All the participants were administered the State and Trait Food Cravings Questionnaire, trait version (FCQ-T) and the BES. Female patients had higher mean scores on six out of nine dimensions of the FCQ-T. When controlling for the effect of other variables, obese and overweight female patients were 1.1 times more likely to report higher anticipation of relief of negative states and feelings from eating than their male pairs. Obese and overweight female patients experience more cravings for food than their male pairs despite comparable severity of binge eating and obesity suggesting the need for tailored interventions.

[Food Addiction: definizione, misurazione e prevalenza in soggetti sani e in pazienti con disturbi del comportamento alimentare].

The construct of “Food Addiction” (FA) has been introduced in the last decades to better understand abnormal eating patterns in obese and overweight people and in patients with Eating Disorders (EDs). Despite a substantial parallelism between drug addiction and FA, there is still no agreement in considering FA an independent ED or a useful convincing concept. Therefore, the purpose of this review is to aggregate available data, in order to increase knowledge about: 1) definition, measurement and general features of FA; 2) prevalence of FA in clinical and non-clinical samples. Available data suggest that FA seems to be a transnosografic construct and exists in all EDs, with higher prevalence in Bulimia Nervosa. Although the discussion on the autonomous diagnosis of FA within EDs remains open, studies have reported that comorbidity between FA and other EDs is associated with worse clinical conditions and symptoms, justifying, as a result, the usefulness of assessing and treating this condition.

Emotion Regulation and Mentalization in People at Risk for Food Addiction

ABSTRACT Researchers investigated the association among food addiction, difficulties in emotion regulation, and mentalization deficits in a sample of 322 Italian adults from the general population. All participants were administered the Italian versions of the Yale Food Addiction Scale (I-YFAS), the Difficulties in Emotion Regulation Scale, the Mentalization Questionnaire, the Binge Eating Scale, and the Michigan Alcohol Screening Test. Of respondents, 7.1% reported high food-addiction symptoms (ie, 3 or more symptoms of food addiction on the I-YFAS). In bivariate analyses, high food-addiction symptoms were associated with more difficulties in emotion regulation and mentalization deficits. In the multivariate analysis, high food-addiction symptoms remained independently associated with mentalization deficits, but not with difficulties in emotion regulation. Our data suggest that mentalization may play an important role in food addiction by making it difficult for an individual to understand his or her own inner mental states as well as the mental states of others, especially when powerful emotions arise.

Factor Structure of the Binge Eating Scale in a Large Sample of Obese and Overweight Patients Attending Low Energy Diet Therapy.

In the present study, we evaluated the dimensionality and psychometric properties of the Italian version of the Binge Eating Scale (BES) in a 669 (127 men and 542 women) obese and overweight patients seeking weight loss treatment. All participants were administered the Italian version of the BES. Fit statistics for the alternative SEM models demonstrated that both the one-factor and competing two-factor models had a comparable fit to the data. Thus, we selected the one-factor model as the most parsimonious. The BES had good internal consistency reliability (α = 0.89) with a moderate mean inter-item correlation (rii  = 0.34). Given that we were not able to clearly determine the best model among the competing two-factor models and a comparable fit of these models with the one-factor model, we have suggested that the one-factor model is the best fitting model describing the dimensionality of the BES.

Alterations of EEG functional connectivity in resting state obese and overweight patients with binge eating disorder: A preliminary report

Alterations in brain functional connectivity have been detected in patients with eating disorders, but have not been studied in binge eating disorder (BED). We have investigated electroencephalographic (EEG) functional connectivity in thirteen overweight and obese patients with BED and thirteen overweight and obese patients without BED during RS condition. EEG analyzes were conducted by means of the exact Low Resolution Electric Tomography software (eLORETA). Compared to patients without BED, patients with BED demonstrated an increase of lagged phase synchronization in the beta frequency band among the cortical areas explored by FC1-T3 (left superior frontal gyrus-left middle temporal gyrus), T5-O1 (left inferior temporal gyrus-left middle occipital gyrus), and C4-O1 (right postcentral gyrus-left middle occipital gyrus) electrodes (T=4.861, p<0.05). EEG connectivity values were also significantly related to binge eating symptomatology after controlling for depressive symptoms. Our results may reflect the impairment of frontal control network and visual processing networks, which lead patients with BED to be more vulnerable to food cues and lack of control with regards to over eating.

Health-related quality of life and its association with alexithymia and difficulties in emotion regulation in patients with psoriasis

BACKGROUND Health-related quality of life (HRQoL) in psoriasis patients could be negatively affected by medical (e.g., obesity) and psychological (e.g., depression, anxiety, and alexithymia) conditions the presence of which suggests difficulties in understanding and regulating inner states and emotions. Thus, the aim of this study was to investigate HRQoL and its association with obesity and difficulties in understanding and regulating inner states and emotions in patients with psoriasis. A second objective was to examine whether the presence of difficulties in understanding and regulating inner states and emotions may mediate the association between psoriasis and poor HRQoL. METHOD One hundred adult outpatients and 97 healthy controls were administered a checklist assessing major socio-demographic variables, and measures of HRQoL, difficulties in emotion regulation, alexithymia, anxiety, depression, and food craving. RESULTS Psoriasis patients (compared to controls) reported more frequently obesity, alexithymia, anxiety, depression and food craving, and reported lower scores on the mental and physical components of HRQoL. A mediation model, with mental health as the dependent variable, indicated significant direct and indirect (through BMI, difficulties in emotion regulation, anxiety, depression, and food craving) effects of psoriasis on the quality of life, so that psoriasis was associated with worse mental health. A second mediation model with physical health as dependent variable indicated only a significant indirect effect (through BMI and depression) of psoriasis on the quality of life. CONCLUSIONS Psoriasis is characterized by poor HRQoL and the presence of difficulties in understanding and regulating inner states and emotions. In patients with psoriasis the possible influence of food craving on abnormal eating habits should be carefully assessed.

Difficulties in emotion regulation and personal distress in young adults with social anxiety

BACKGROUND The aim of this study was to assess the association between social anxiety and difficulties in emotion regulation in a sample of Italian young adults. METHODS Our convenience sample was composed of 298 Italian young adults (184 women and 114 men) aged 18-34 years. Participants were administered the Interaction Anxiousness Scale (IAS), the Audience Anxiousness Scale (AAS), the Difficulties in Emotion Regulation Scale (DERS), and the Interpersonal Reactivity Index (IRI). A Two Step cluster analysis was used to group subjects according to their level of social anxiety. RESULTS The cluster analysis indicated a two-cluster solution. The first cluster included 163 young adults with higher scores on the AAS and the IAS than those included in cluster 2 (n=135). A generalized linear model with groups as dependent variable indicated that people with higher social anxiety (compared to those with lower social anxiety) have higher scores on the dimension personal distress of the IRI (p<0.01), and on the DERS non acceptance of negative emotions (p<0.001) and lack of emotional clarity (p<0.05). CONCLUSIONS The results are consistent with models of psychopathology, which hypothesize that people who cannot deal effectively with their emotions may develop depressive and anxious disorders.