Negative urgency and the dual pathway model of bulimic symptoms: A longitudinal analysis

Abstract

Objective This study extends the dual pathway model (DPM) of bulimic symptoms by considering the bidirectional effects amongst symptoms of depression, dietary restraint, and bulimia. We also assessed the influence of negative urgency, a personality construct associated with bulimic symptoms, on the DPM. Method Participants were 244 females (Mage = 23.77 years) from the general community. Variables pertinent to the DPM as well as negative urgency were assessed at baseline, and symptoms of depression, dietary restraint, and bulimia were reassessed at 1‐month follow‐up. Results Excellent model fit was obtained once modifications were made to the DPM and the extended model that included negative urgency. Cross‐sectional paths replicated the DPM as hypothesized, with the exception that time 1 (T1) body mass index failed to predict T1 body dissatisfaction. Although no bidirectional effects were observed, T1 depression predicted dietary restraint at time 2 (T2). Negative urgency was shown to provide incremental predictive utility of T1 pressure to be thin, T1 body dissatisfaction, and T1 and T2 depression. Conclusion Findings lend support to the DPM and suggest that depression might be a risk factor for later dietary restraint. The results are also consistent with the notion that negative urgency may be an independent risk factor for symptoms of bulimia. However, short‐term longitudinal effects of these putative risk factors require further evaluation.

Drive for thinness provides an alternative, more meaningful, severity indicator than the DSM‐5 severity indices for eating disorders

“…It might be related to the fact that, for these ED sub-types, negative affect could have been an important additional severity indicator not considered in the current study. This observation is in line with Stice's dual pathway model for bulimic symptoms (Puccio, Fuller-Tyszkiewicz, Buck, & Krug, 2019;Stice, Shaw, & Nemeroff, 1998), which specifies dietary restraint, a proxy for DT, and negative affect as key variables. It is also in line with various taxometric studies that have continuously revealed a pure 'dietary', and a mixed 'dietarydepressive', sub-type in BN (Chen & Le Grange, 2007;Grilo, 2004), and BED (Grilo, Masheb, & Wilson, 2001).…”

“…Our findings also agree with the broader impulsivity literature in EDs. These studies have shown that impulsive behaviours are linked to ED symptom severity (Mallorqui-Bague et al, 2020;Todisco et al, 2020;Waxman, 2009;Puccio et al, 2019) and a poorer prognosis (Aguera et al, 2017;Fischer, Peterson, & McCarthy, 2013). Our conclusion is, therefore, that, in the absence of sufficient and robust evidence, caution should be exercised regarding conclusive statements suggestive of the validity of the DSM-5 severity specifiers.…”

A multimodal MRI study of the neural mechanisms of emotion regulation impairment in women with obesity

“…Other work has implicated a failure to engage the vmPFC with loss-of-control eating in overweight and obese girls in response to distress, suggesting that perturbations in such neural circuits may lead to overeating in order to cope with negative affect 43 . More recent research using stress induction, food cues and ecological momentary assessment found that changes in activation in the vmPFC significantly moderated the relationship of affect to binge eating 44 , thereby lending support to models positing negative urgency as being a risk factor for bulimic symptoms 45 .…”

Binge eating behavior in a sample of Lebanese Adolescents: Correlates and Binge Eating Scale validation

“…Higher depression and body dissatisfaction were significantly associated with more BE, in line with previous studies in adolescents [ 51 – 53 ]; this association with BE could be partially explained by the severity of BD in the individual, which was found to severely affect and predict depression [ 54 ]. In addition, this association could be the result of a reciprocal relationship between depression and BE with one factor being the cause or result of the other [ 55 , 56 ], while some studies suggested the possibility of them sharing common risk factors [ 57 , 58 ]. For example, feeling worthless could be a shared basis for the development and maintenance of depression, and the root for the perceived sense of shame with regard to body self-evaluation [ 55 ].…”