The dual-pathway model of binge eating: Is there a need for modification?

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

“…In addition to the cross-sectional studies above, six longitudinal studies have assessed the model (Allen, Byrne, & McLean, 2012;Dakanalis et al, 2014;Puccio, Kalathas, Fuller-Tyszkiewicz, & Krug, 2016;Salafia & Gondoli, 2011;Sehm & Warschburger, 2017;Stice et al, 1998). These longitudinal studies provided support for the majority of the paths proposed by the DPM; for example, all studies reported a significant effect of dietary restraint on the respective measure of disorder eating symptoms that were utilized.…”

“…Despite these findings, this group of longitudinal studies omitted the following variables: pressure to be FIGURE 1 Visual conceptualization of the dual pathway model. BMI: body mass index; Thin Ideal: thin ideal internalization; Body Diss: body dissatisfaction; Bulimia: bulimic symptoms thin (Allen et al, 2012;Dakanalis et al, 2014;Sehm & Warschburger, 2017) and thin ideal internalization (e.g., Allen et al, 2012;Dakanalis et al, 2014;Salafia & Gondoli, 2011;Sehm & Warschburger, 2017). Further, in two of the studies (Dakanalis et al, 2014;Puccio, Kalathas, et al, 2016), the variable BMI was utilized as a covariate (as opposed to a predictor), such that all variables in the model were regressed onto BMI, hence confounding the relative influence of BMI on the model.…”

“…They found that internalization of the thin ideal and body dissatisfaction were bidirectionally related, as were depressive affect and disordered eating. By contrast, Sehm and Warschburger () found no evidence to support bidirectional relationships over a 20‐month time lag between body dissatisfaction, restrained eating, negative affect, and binge‐eating symptoms. Indeed, unlike other studies into the DPM (Dakanalis et al, ), Sehm and Warschburger () found no evidence to support any paths that predicted binge‐eating symptoms.…”

“…By contrast, Sehm and Warschburger () found no evidence to support bidirectional relationships over a 20‐month time lag between body dissatisfaction, restrained eating, negative affect, and binge‐eating symptoms. Indeed, unlike other studies into the DPM (Dakanalis et al, ), Sehm and Warschburger () found no evidence to support any paths that predicted binge‐eating symptoms. Sehm and Warschburger () speculated that past longitudinal studies might have found significant effects for paths that predicted their disordered eating construct because such studies assessed shorter (e.g., a time lag of less than approximately 2 years), opposed to longer, time lags.…”

“…This raises the possibility that the DPM might be better conceptualized as having bidirectional feedback loops between specific paths (e.g., between the depression‐bulimic symptoms). In line with this view, two studies (Bradford & Petrie, ; Sehm & Warschburger, ) have tested for longitudinal bidirectional associations between constructs in the DPM. Bradford and Petrie () tested for bidirectional links between internalization of the thin ideal and body dissatisfaction, depressive affect and body dissatisfaction, and depressive affect and disordered eating over a 6‐month time period.…”