Expectancies related to thinness, dietary restriction, eating, and alcohol consumption in women with bulimia nervosa

Abstract

Objective: To investigate behavior-outcome expectancies relating to thinness, dietary restriction, eating, and alcohol consumption in women with bulimia nervosa (BN).Method: Women with BN (N 5 29), women with BN and a co-morbid lifetime alcohol use disorder (AUD; N 5 18), and control women (N 5 24), completed interviews and questionnaires assessing eating-and alcohol-related symptoms, as well as questionnaires measuring expectancies relating to thinness, dietary restriction, eating, and alcohol consumption.Results: Compared with the control group, both bulimic groups reported greater positive expectancies relating to thinness, dietary restriction and eating; expectancy endorsements were also predictive of the severity of eating-related symptoms. Compared with the other groups, the bulimic group with comorbid lifetime AUD had elevated positive alcohol-related expectancies, and alcohol expectancy endorsements predicted severity of alcohol-related symptoms.Discussion: Women with BN endorsed more positive expectancies relating to thinness, dietary restriction, and eating, whereas women with BN and a lifetime comorbid AUD endorsed more positive alcohol expectancies. The results are consistent with expectancy theory in that positive expectancy endorsements were associated with symptom severity in a syndromespecific manner. Expectancies related to thinness, dietary restriction, eating, and alcohol consumption in women with BN V V C

Eating Expectancies in Relation to Eating Disorder Recovery

“…These results are in line with and extend previous research that has found eating disorder symptomatology to be associated with increased levels of negative reinforcement eating expectancies and decreased levels of positive reinforcement eating expectancies (Bruce, Mansour, & Steiger, 2009; Simmons, et al, 2002). Individuals in the fully recovered group endorsed lower levels of the expectancy that eating would lead to out of control feelings compared to those in the partial recovery and active eating disorder groups.…”

“…Meanwhile, the partially recovered group had similar expectancies as those with a current eating disorder in terms of linking eating to feeling out of control. This replicates previous findings, which found that endorsement of this expectation was tied with eating pathology (Bruce et al, 2009; Hohlstein et al, 1998). This finding further extends prior work by revealing that even among individuals who may look recovered (i.e., not underweight, no disordered eating), an expectancy that eating leads to, presumably aversive, out of control feelings may remain, perhaps represented among some as subjective binge eating (i.e., out-of-control eating episodes that are not objectively large).…”

“…For example, Hohlstein et al (1998) found that individuals with BN endorsed higher levels of the Eating Alleviates Boredom expectancy than those with AN, psychiatric controls, or non-psychiatric controls and that individuals with BN, psychiatric controls, and non-psychiatric controls endorsed higher levels of the Eating Enhances Cognitive Competence expectancy than those with AN. Further, Bruce et al (2009) found that while individuals with BN and controls exhibited similar levels of the Eating Enhances Cognitive Competency expectancy, individuals with BN endorsed higher levels of the Eating Alleviates Boredom expectancy than controls. The results of the current study, however, suggest that these two eating expectancies may not be as closely tied with eating disorder recovery as the other three expectancies measured by the EEI.…”

A risk and maintenance model for bulimia nervosa: From impulsive action to compulsive behavior.

“…Specifically, they endorse the eating expectancy at higher levels than do women with AN, normal controls, and psychiatric controls. They endorse the thinness expectancy at higher levels than do normal and psychiatric controls, and at similar levels as do women with AN (Bruce, Mansour, & Steiger, 2009; Hohlstein, Smith, & Atlas, 1998). Their strong expectations for reward from both eating and thinness is consistent with their engagement in extreme eating, dieting, and purging behaviors.…”

Research Review: Two pathways toward impulsive action: an integrative risk model for bulimic behavior in youth

“…These eating expectancies have been shown to correlate cross‐sectionally with symptom level in child (Combs et al., ; Pearson et al., ), adolescent (MacBrayer et al., ; Simmons et al., ) and adult samples (Hohlstein et al., ). Women with BN endorse eating expectancies more strongly than women with AN, normal controls, and psychiatric controls (Bruce, Mansour, & Steiger, ). Longitudinally, these expectancies predict binge eating, including binge eating onset, in longitudinal samples of adolescent girls (Pearson et al., ; Smith, Simmons et al., ) and college women (Fischer et al., ).…”