Tatjana van Strien

The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior

The development of the Dutch Eating Behaviour Questionnaire (DEBQ) with scales for restrained, emotional, and external eating is described. Factor analyses have shown that all items on restrained and external eating each have high loadings on one factor, but items on emotional eating have two dimensions, one dealing with eating in response to diffuse emotions, and the other with eating in response to clearly labelled emotions. The pattern of corrected item-total correlation coefficients and of the factors was very similar for various subsamples, which indicates a high degree of stability of dimensions on the eating behavior scales. The norms and Cronbachs alpha coefficients of the scales and also the Pearsons correlation coefficients to assess interrelationships between scales indicate that the scales have a high internal consistency and factorial validity. However, their external validity has yet to be investigated.

The predictive validity of the dutch restrained eating scale

The present study aims to determine the predictive validity of the 10-item Dutch Restrained Eating Scale. The ultimate criterion of restrained eating is the degree to which an individual eats less than he or she actually would like to eat. Since a study on both actual food consumption and restriction of food intake is very complicated, if not impossible, the difference between actual and desired intake of energy was studied indirectly, that is, from estimates of deviations from the required energy intake. The relationships were studied between restrained eating scores and the magnitude of the deviation from energy requirement, and between restrained eating scores and intake of fat and sugar, because restriction in intake of these may also reflect dietary restraint. About 20% of the variance of scores on the Restrained Eating Scale could be explained from these measures of food intake, which suggests that the Dutch Restrained Eating Scale has moderate to good predictive validity.

Relations between negative affect, coping and emotional eating

The study was designed to examine the relations between negative affect, coping, and emotional eating. It was tested whether emotion-oriented coping and avoidance distraction, alone or in interaction with negative affect, were related to increased levels of emotional eating. Participants were 125 eating-disordered women and 132 women representing a community population. Measures included the Positive and Negative Affectivity Schedule (PANAS), the Coping Inventory for Stressful Situations (CISS), and the Dutch Eating Behavior Questionnaire (DEBQ). Both emotion-oriented coping and avoidance distraction were related to emotional eating, while controlling for levels of negative affect. Negative affect did not have a unique contribution to emotional eating over and above emotion-oriented coping or avoidance distraction. The findings suggest that emotional eating is related to reliance on emotion-oriented coping and avoidance distraction in eating-disordered women as well as in relatively healthy women.

The Stice model of overeating: Tests in clinical and non-clinical samples

The present study tested the dual pathway model of Stice [. A review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. Clinical Psychology Review, 14, 633-661 and . A prospective test of the dual-pathway model of bulimic pathology: mediating effects of dieting and negative affect. Journal of Abnormal Psychology, 110, 124-135.] in a non-clinical sample of female adolescents and a clinical sample of female eating disorder patients. The model assumes that negative affect and restrained eating mediates the link between body dissatisfaction and overeating. We also tested an extended version of the model postulating that negative affect and overeating are not directly related, but indirectly through lack of interoceptive awareness and emotional eating. Structural equation modelling was used to test our models. First, in the two samples, body dissatisfaction and drive for thinness were associated with overeating/binge eating. In both clinical and adolescent sample, we found support for the negative affect pathway and not for the restraint pathway. Lack of interoceptive awareness and emotional eating appear to (partly) explain the association between negative affect and overeating. Emotional eating was much more strongly associated with overeating in the clinical than in the adolescent sample. In sum, we found substantial evidence for the negative affect pathway in the dual pathway model. The link between body dissatisfaction and overeating in this respect might be explained by the fact that negative affect, due to body dissatisfaction, is related to a lack of awareness of personal feelings and to eating when dealing with negative emotions, which on its turn is associated with overeating.

Tendency toward overeating and restraint as predictors of food consumption

Restrained eaters have repeatedly been found to overeat following a preload, which phenomenon is called the disinhibition effect. Remarkably, the disinhibition effect is only found when the restraint scale (RS) is used, and never when other measures of restraint, like the three-factor eating questionnaire (TFEQ) or the Dutch eating behavior questionnaire (DEBQ) are applied. Recent research has shown that tendency toward overeating appears to be a better predictor of food consumption than dietary restraint. The present study examines the predictive value of preload, tendency toward overeating and dietary restraint. An experiment was carried out with 209 female participants with the aim to evaluate whether the results of the study [Int J Eating Disorders 28 (2000) 333] are robust. In addition to the RS, the TFEQ and DEBQ were used to measure restraint and tendency toward overeating. Again, no disinhibition effect occurred, confirming the results of the previous study. Restraint, as measured by the three questionnaires, was not related to food consumption. In contrast, tendency toward overeating was significantly related to food consumption. Restraint theorys contentions that dieting leads to overeating might be valid for only some dieters, namely those with a high tendency toward overeating.

Possible pathways between depression, emotional and external eating. A structural equation model.

Emotional and external eating appear to co-occur and both have been shown to correlate to neuroticism, especially depression. However, there is evidence suggesting that emotional and external eating are independent constructs. In this study we revisited the relation between depression, emotional, and external eating. Using structural equation modelling, we examined whether depression, emotional and external eating are directly related and also indirectly related through the intervening concepts alexithymia and impulsivity. Participants were 549 females concerned about their weight. They filled out instruments on emotional and external eating, depression, alexithymia, and impulse regulation. The relational structure between the model variables was explored for one half of the participants and this solution was checked using the other half. Our data showed a moderate relationship between emotional and external eating. Depression was positively and directly associated with emotional eating, but not with external eating. In addition, depression was indirectly related to emotional eating through both alexithymia and impulsivity. A significant relation was found between impulsivity and external eating. Results suggest potential mediating pathways between depression and emotional eating, while no relation appeared to exist between depression and external eating. Emotional and external eating would appear to be different constructs.

Exposure to slim images in mass media: television commercials as reminders of restriction in restrained eaters

OBJECTIVE The aim of the present study was to explore the effects of exposure to slim images and diet-related products in commercials on actual food intake in relation to dietary restraint. DESIGN An experimental design was used, in which food intake was measured in 124 female students who watched either a sad or a neutral movie on television, which was interrupted by either commercials featuring slim models and diet products, or neutral commercials. Subsequently, participants filled out questionnaires on dietary restraint and any tendency toward overeating. MAIN OUTCOME VARIABLE Intake of snack food while watching television. RESULTS It was found that highly restrained students exposed to commercials with slim models and diet-related products ate less food, whereas less restrained eaters ate slightly more after seeing these commercials. CONCLUSION The findings suggest that restrained eaters confronted with diet products and slim images when watching television will be reminded of their restricted eating behavior and eat less. The present study provides support for the reinhibition theory of slim media images.

Construct validation of the Restraint Scale in normal-weight and overweight females.

The Restraint Scale (RS) is a widely used measure to assess restrained eating. The purpose of this study was to examine the construct validity of the RS in a sample of normal-weight (n=349) and overweight (n=409) females using confirmatory factor analyses of the RS in relation to other measures for dieting, overeating and body dissatisfaction. Following Laessle et al. [(1989a). A comparison of the validity of three scales for the assessment of dietary restraint. Journal of Abnormal Psychology, 98, 504-507], we assumed a three-factor structure: (1) overeating and disinhibitory eating, (2) dieting and restriction of food intake, and (3) body dissatisfaction and drive for thinness. Analyses revealed that the RS loaded significantly on all three factors for both samples, confirming its multifactorial structure. However, the RS appears to capture these constructs differently in overweight and normal-weight females such that the RS may overestimate restraint in overweight individuals. This may explain the greater effectiveness of the RS in predicting counter-regulation in normal-weight than in overweight samples of dieters.

Perceived parental control of food intake is related to external, restrained and emotional eating in 7-12-year-old boys and girls.

This study examined the prevalence of external, restrained and emotional eating and the relationship of these disturbed types of eating behaviours with perceived parental control of food intake (pressure to eat and restriction) in a group of 7- to 12-year-old boys and girls (n = 596). External eating turned out to be the most prevalent disturbed eating behaviour for boys and girls, followed by restrained eating and emotional eating. Sex differences were found in external and restrained eating. For the boys, perceived pressure to eat was positively related to emotional and external eating. For both sexes, perceived restriction to eat was negatively related to emotional and external eating and positively related to restrained eating. This led to the conclusion that perceived pressure to eat has a disruptive effect on a childs self-regulating mechanism of food intake, particularly so for boys, whereas perceived restriction can also have a positive effect.

Moderation of distress-induced eating by emotional eating scores.

Earlier studies assessing the possible moderator effect of self-reported emotional eating on the relation between stress and actual food intake have obtained mixed results. The null findings in some of these studies might be attributed to misclassification of participants due to the use of the median splits and/or insufficient participants with extreme scores. The objective of the two current studies was to test whether it is possible to predict distress-induced eating with a self-report emotional eating scale by using extreme scorers. In study 1 (n=45) we used a between-subjects design and emotional eating was assessed after food intake during a negative or a neutral mood (induced by a movie). In study 2 (n=47) we used a within-subjects design and emotional eating was assessed well before food intake, which occurred after a control or stress task (Trier Social Stress Task). The main outcome measure was actual food intake. In both studies self-reported emotional eating significantly moderated the relation between distress and food intake. As expected, low emotional eaters ate less during the sad movie or after stress than during the neutral movie or after the control task, whereas high emotional eaters ate more. No such moderator effect was found for emotional eating in the entire sample (n=124) of study 1 using the median-split procedure or the full range of emotional eating scores. We conclude that it is possible to predict distress-induced food intake using self-reports of emotional eating provided that the participants have sufficiently extreme emotional eating scores.