Exploring the contributions of affective constructs and interoceptive awareness to feeling fat
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity - Tập 27 - Trang 3533-3541 - 2022
Tóm tắt
Feeling fat, a subjective feeling of being overweight that does not always correspond to actual body weight, is commonly reported in patients with an eating disorder. Research suggests that feeling fat relates to deficits in interoceptive awareness, the perception and integration of signals related to body states. Relatedly, recent work has linked feeling fat to affective constructs, such as depressive symptoms and guilt. The current study explores the unique relationships between feeling fat, self-reported, and objective IA, guilt, alexithymia, and depressive symptoms. Female undergraduates (N = 128) completed the 11th item of the Eating Disorder Examination Questionnaire, the Toronto Alexithymia Scale, the Guilt subscale of the Positive and Negative Affect Schedule, and the Beck Depression Inventory-II. Participants also completed two IA measures: a heartbeat perception task and the Multidimensional Assessment of Interoceptive Awareness. All collected measures explained 56% of the variability in feeling fat. Depressive symptoms, self-reported IA, and BMI accounted for significant variability in feeling fat. Relative weights analyses revealed that depressive symptoms accounted for the most variability in feeling fat (19%). This finding remained significant after controlling for BMI, which also accounted for significant variability in feeling fat (25%). Our results replicate previous findings that depressive symptoms relate significantly to feeling fat and extend this work by incorporating the role of interoceptive awareness, guilt, and alexithymia. Endorsement of feeling fat during an intake assessment may alert clinicians to assess for depressive symptoms, and focusing on depressive symptoms in treatment may improve feeling fat. Level I Evidence obtained from an experimental study.
Tài liệu tham khảo
Kaye WH, Bulik CM (2021) Treatment of patients with anorexia nervosa in the USA crisis in care. JAMA Psychiat. https://doi.org/10.1001/jamapsychiatry.2020.4796
Mitchell JE, Peterson CB (2020) Anorexia nervosa. N Engl J Med 382(14):1343–1351. https://doi.org/10.1056/NEJMcp1803175
Sakaluk JK, Williams AJ, Kilshaw RE, Rhyner KT (2019) Evaluating the evidential value of empirically supported psychological treatments (ESTs) a meta-scientific review. J Abnormal Psy 128(6):500
Fairburn C (2008) Cognitive behavior therapy and eating disorders. The Guilford Press
Cooper MJ, Deepak K, Grocutt E, Bailey E (2007) The experience of ‘feeling fat’ in women with anorexia nervosa, dieting and non-dieting women: an exploratory study. Eur Eat Disord Rev: Professional J Eat Disord Ass 15(5):366–372. https://doi.org/10.1002/erv.785
Striegel-Moore R, McAvay G, Rodin J (1986) Psychological and behavioral correlates of feeling fat in women. Int J Eat Disord 5(5):935–947. https://doi.org/10.1002/1098-108X(198607)5:5%3c935::AID-EAT2260050514%3e3.0.CO;2-0
Calugi S, El Ghoch M, Conti M, Dalle Grave R (2018) Preoccupation with shape or weight, fear of weight gain, feeling fat and treatment outcomes in patients with anorexia nervosa: a longitudinal study. Behav Res Ther 105:63–68. https://doi.org/10.1016/j.brat.2018.04.001
Jansen W, van de Looij-Jansen PM, de Wilde EJ, Brug J (2008) Feeling fat rather than being fat may be associated with psychological well-being in young Dutch adolescents. J Adolesc Health 42(2):128–136. https://doi.org/10.1016/j.jadohealth.2007.07.015
Mehak A, Racine SE (2020) Understanding “feeling fat” and its underlying mechanisms: The importance of multimethod measurement. Int J Eat Disord 53(9):1400–1404. https://doi.org/10.1002/eat.23336
Linardon J, Phillipou A, Castle D, Newton R, Harrison P, Cistullo LL, Brennan L (2018) Feeling fat in eating disorders: testing the unique relationships between feeling fat and measures of disordered eating in anorexia nervosa and bulimia nervosa. Body Image 25:163–167. https://doi.org/10.1016/j.bodyim.2018.04.001
Mehak A, Racine SE (2021) ‘Feeling fat’ is associated with specific eating disorder symptom dimensions in young men and women. Eat Weight Disord-Stud Anorexia, Bulimia Obesity. https://doi.org/10.1007/s40519-020-01074-4
Powell AL, Thelen MH (1996) Emotions and cognitions associated with bingeing and weight control behavior in bulimia. J Psychosom Res 40(3):317–328. https://doi.org/10.1016/0022-3999(95)00641-9
Khalsa SS, Adolphs R, Cameron OG, Critchley HD, Davenport PW, Feinstein JS, Zucker N (2018) Interoception and mental health: a roadmap. Bio psy: cognitive neuroscie and neuro 3(6):501–513. https://doi.org/10.1016/j.bpsc.2017.12.004
Boswell JF, Anderson LM, Anderson DA (2015) Integration of interoceptive exposure in eating disorder treatment. Clin Psychol Sci Pract 22(2):194. https://doi.org/10.1111/cpsp.12103
Levinson CA, Williams BM, Christian C (2020) What are the emotions underlying feeling fat and fear of weight gain? J Affect Disord 277:146–152. https://doi.org/10.1016/j.jad.2020.08.012
Santel S, Baving L, Krauel K, Münte TF, Rotte M (2006) Hunger and satiety in anorexia nervosa: fMRI during cognitive processing of food pictures. Brain Res 1114(1):138–148. https://doi.org/10.1016/j.brainres.2006.07.045
Brown TA, Berner LA, Jones MD, Reilly EE, Cusack A, Anderson LK, Wierenga CE (2017) Psychometric evaluation and norms for the multidimensional assessment of interoceptive awareness (MAIA) in a clinical eating disorders sample. Eur Eat Disord Rev 25(5):411–416. https://doi.org/10.1002/erv.2532
Fassino S, Piero A, Garmaglia C, Abbate-Daga G (2004) Clinical, psychopathological and personality correlates of interoceptive awareness in anorexia nervosa, bulimia nervosa, and obesity. Psychopathology 37(4):168174. https://doi.org/10.1159/000079420
Herbert B, Blechert J, Hautzinger M, Matthias E, Herbert C (2013) Intuitive eating is associated with interoceptive sensitivity. Eff Body Mass I Appetite 70:22–30. https://doi.org/10.1016/j.appet.2013.06.082
Pink AE, Williams C, Lee M, Young HA, Harrison S, Davies AE, Price M (2021) Manipulating the sensation of feeling fat: the role of alexithymia, interoceptive sensibility and perfectionism. Physiol Behav. https://doi.org/10.1016/j.physbeh.2021.113501
Berg KC, Crosby RD, Cao L, Peterson CB, Engel SG, Mitchell JE, Wonderlich SA (2013) Facets of negative affect prior to and following binge-only, purge-only, and binge/purge events in women with bulimia nervosa. J Abnorm Psychol 122(1):111. https://doi.org/10.1037/a0029703
Engelberg MJ, Steiger H, Gauvin L, Wonderlich SA (2007) Binge antecedents in bulimic syndromes: an examination of dissociation and negative affect. Int J Eat Disord 40(6):531–536. https://doi.org/10.1002/eat.20399
Haedt-Matt AA, Keel PK (2015) Affect regulation and purging: an ecological momentary assessment study in purging disorder. J Abnorm Psychol 124(2):399. https://doi.org/10.1037/a0038815
Lavender JM, Utzinger LM, Cao L, Wonderlich SA, Engel SG, Mitchell JE, Crosby RD (2016) Reciprocal associations between negative affect, binge eating, and purging in the natural environment in women with bulimia nervosa. J Abnorm Psychol 125(3):381. https://doi.org/10.1037/abn0000135
Spoor ST, Stice E, Bekker MH, Van Strien T, Croon MA, Van Heck GL (2006) Relations between dietary restraint, depressive symptoms, and binge eating: a longitudinal study. Int J Eat Disord 39(8):700–707. https://doi.org/10.1002/eat.20283
Hendryx MS, Haviland MG, Shaw DG (1991) Dimensions of alexithymia and their relationships to anxiety and depression. J Per Ass 56(2):227–237. https://doi.org/10.1207/s15327752jpa5602_4
Andersen AE (2000) How I Practice” Responding to the phrase “I feel fat. Eat Disord 8(2):167–169. https://doi.org/10.1080/10640260008251223
Anderson, L. M. (2017). Does What You Think You Feel, Impact What You Actually Eat? An Examination of Alexithymia, Interoceptive Awareness, and Loss of Control Eating in Young Women [Unpublished doctoral dissertation]. State University of New York at Albany
Stice E, Telch CF, Rizvi SL (2000) Development and validation of the Eating Disorder Diagnostic Scale: a brief self-report measure of anorexia, bulimia, and binge-eating disorder. Psychol Assess 12(2):123–131. https://doi.org/10.1037//1040-3590.12.2.123
Fairburn CG, Beglin SJ (2008) Cognitive behavior therapy and eating disorders. Guilford Press, New York
Mehling WE, Price C, Daubenmier JJ, Acree M, Bartmess E, Stewart A (2012) The multidimensional assessment of interoceptive awareness (MAIA). PLoS ONE 7(11):e48230
Schandry R (1981) Heart beat perception and emotional experience. Psychophysiology 18:483–488. https://doi.org/10.1111/j.1469-8986.1981.tb02486.x
Watson, D., & Clark, L. A. (1994). The PANAS-X: Manual for the Positive and Negative Affect Schedule-Expanded Form. Ames: The University of Iowa. Retrieved from: http://ir.uiowa.edu/psychology_pubs/11/.
Beck AT, Steer RA, Brown GK (1996) Manual for the beck depression inventory-II. Psychological Corporation, San Antonio
Steer RA, Ball R, Ranieri WF, Beck AT (1997) Further evidence for the construct validity of the beck depression inventory-II with psychiatric outpatients. Psychol Rep 80(2):443–446. https://doi.org/10.2466/pr0.1997.80.2.443
Bagby RM, Parker JDA, Taylor GJ (1994) The twenty-item toronto alexithymia scale-i. item selection and cross-validation of the factor structure. J Psychosom Res 38:23–32. https://doi.org/10.1016/0022-3999(94)90005-1
Braun MT, Oswald FL (2011) Exploratory regression analysis: a tool for selecting models and determining predictor importance. Behavioral Research 43:311–339. https://doi.org/10.3758/s13428-010-0046-8
Tonidandel S, LeBreton JM (2014) RWA-Web – a free, comprehensive, web-based, and user-friendly tool for relative weight analysis. J Bus Psychol 30(2):207–216. https://doi.org/10.1007/s10869-014-9351-z
Garfinkel SN, Seth AK, Barrett AB, Suzuki K, Critchley HD (2015) Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness. Biol Psychol 104:65–74. https://doi.org/10.1016/j.biopsycho.2014.11.004
Khalsa SS, Rudrauf D, Damasio AR, Davidson RJ, Lutz A, Tranel D (2008) Interoceptive awareness in experienced meditators. Psychophysiology 45(4):671–677. https://doi.org/10.1111/j.1469-8986.2008.00666.x
Klabunde M, Acheson DT, Boutelle KN, Matthews SC, Kaye WH (2013) Interoceptive sensitivity deficits in women recovered from bulimia nervosa. Eat Behav 14(4):488–492. https://doi.org/10.1016/j.eatbeh.2013.08.002
Pollatos O, Kurz A-L, Albrecht J, Schreder T, Kleemann AM, Schopf V, Schandry R (2008) Reduced perception of bodily signals in anorexia nervosa. Eat Behav 9(4):381–388. https://doi.org/10.1016/j.eatbeh.2008.02.001
Harshaw C (2015) Interoceptive dysfunction: toward an integrated framework for understanding somatic and affective disturbance in depression. Psychol Bull 141(2):311. https://doi.org/10.1037/a0038101
Jordan J, Joyce PR, Carter FA, Horn J, McIntosh VV, Luty SE, Bulik CM (2008) Specific and nonspecific comorbidity in anorexia nervosa. Int J Eat Disord 41(1):47–56. https://doi.org/10.1002/eat.20463
Herbert BM, Muth ER, Pollatos O, Herbert C (2012) Interoception across modalities: on the relationship between cardiac awareness and the sensitivity for gastric functions. PLoS ONE 7(5):e36646. https://doi.org/10.1371/journal.pone.0036646
Kerr KL, Moseman SE, Avery JA, Bodurka J, Zucker NL, Simmons WK (2016) Altered insula activity during visceral interoception in weight-restored patients with anorexia nervosa. Neuropsychopharmacology 41(2):521–528. https://doi.org/10.1038/npp.2015.174
Mayeli, A., Al Zoubi, O., White, E. J., Chappelle, S., Kuplicki, R., Smith, R.and Khalsa, S. S. (2021). Neural indicators of human gut feelings. bioRxiv. https://doi.org/10.1101/2021.02.11.430867
Van Dyck Z, Vögele C, Blechert J, Lutz AP, Schulz A, Herbert BM (2016) The water load test as a measure of gastric interoception: Development of a two-stage protocol and application to a healthy female population. PLoS ONE 11(9):e0163574. https://doi.org/10.1371/journal.pone.016357