Skip to main content

Advertisement

SpringerLink
Log in

The Effects of Comorbid Disordered Eating Behaviours on Outcomes at Follow-up from Residential Substance Use Disorder Treatment: a Latent Class Approach

  • Original Article
  • Published:
International Journal of Mental Health and Addiction Aims and scope Submit manuscript

Abstract  

Comorbid eating disorders’ (EDs) rates among individuals with substance use disorders (SUD) are higher than the general population and present challenges for recovery. This study aims to examine recovery outcomes and psychological distress of individuals at 3 months post-discharge from residential SUD treatment. In a sample of 615 individuals in residential treatment for SUD, latent class analysis was conducted based on gender and disordered eating symptoms at baseline. Using general linear regression, controlling for recovery indicator at baseline, differences between the three identified classes in recovery indicators at 3 months post-discharge were examined. Class 1 (63.4%) was primarily male, with few ED symptoms; class 2 (24.7%) reported weight concerns and was mainly female; class 3 (11.9%) reported high rates of ED symptoms and mixed gender. Class 3 had significantly higher psychological distress than other classes. Findings suggest few differences in recovery outcomes by ED symptoms and gender, following discharge; however, mental health differences remain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed. ed.).

  • Anstine, D., & Grinenko, D. (2000). Rapid screening for disordered eating in college-aged females in the primary care setting. J Adolesc Health, 26(5), 338–342.

    Article  CAS  Google Scholar 

  • Berlin, K. S., Williams, N. A., & Gilber, R. P. (2014). An introduction to latent variable mixture modeling (part 1): Overview and cross-sectional latent class and latent profile analysis. Journal of Pediatric Psychology, 39(2), 174–187.

    Article  Google Scholar 

  • Brownell, K. D., & Walsh, B. T. (2017). Eating disorders and obesity: A comprehensive handbook. Guilford Publications.

  • Bulik, C. M., Klump, K. L., Thornton, L., Kaplan, A. S., Devlin, B., Fichter, M. M., Halmi, K. A., Strober, M., Woodside, D. B., Crow, S., & Mitchell, J. E. (2004). Alcohol use disorder comorbidity in eating disorders: A multicenter study. The Journal of clinical psychiatry, 65(7), 1000–1006. http://psycnet.apa.org/doi/10.4088/JCP.v65n0718.

    Article  Google Scholar 

  • Burns, L., Teesson, M., & O’Neill, K. (2005). The impact of comorbid anxiety and depression on alcohol treatment outcomes. Addiction, 100(6), 787–796.

    Article  Google Scholar 

  • Burrows, T., Skinner, J., McKenna, R., & Rollo, M. (2017). Food addiction, binge eating disorder, and obesity: Is there a relationship? Behavioral Sciences, 7(3), 54.

    Article  Google Scholar 

  • Callaly, T., Trauer, T., Munro, L., & Whelan, G. (2001). Prevalence of psychiatric disorder in a methadone maintenance population. Australian & New Zealand Journal of Psychiatry, 35(5), 601–605.

    Article  CAS  Google Scholar 

  • Calugi, S., El Ghoch, M., Conti, M., & Dalle Grave, R. (2018). 2018/06/01/). Preoccupation with shape or weight, fear of weight gain, feeling fat and treatment outcomes in patients with anorexia nervosa: A longitudinal study. Behaviour Research and Therapy, 105, 63–68. https://doi.org/10.1016/j.brat.2018.04.001

    Article  Google Scholar 

  • Calzo, J. P., Horton, N. J., Sonneville, K. R., Swanson, S. A., Crosby, R. D., Micali, N., Eddy, K. T., & Field, A. E. (2016). Male eating disorder symptom patterns and health correlates from 13 to 26 years of age. Journal of the American Academy of Child & Adolescent Psychiatry, 55(8), 693–700. e692.

    Article  Google Scholar 

  • Canan, F., Karaca, S., Sogucak, S., Gecici, O., & Kuloglu, M. (2017). Eating disorders and food addiction in men with heroin use disorder: A controlled study. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 22(2), 249–257. https://doi.org/10.1007/s40519-017-0378-9

    Article  Google Scholar 

  • Carr, M. M., & Grilo, C. M. (2020). Examining heterogeneity of binge-eating disorder using latent class analysis. Journal of Psychiatric Research, 130, 194–200.

    Article  Google Scholar 

  • CASA. (2003). Food for Thought: Substance Abuse and Eating Disroders. http://www.casacolumbia.org/templates/Publications_Reports.aspx

  • Cotton, M., Ball, C., & Robinson, P. (2003). Four simple questions can help screen for eating disorders. Journal of General Internal Medicine, 18(1), 53–56.

    Article  Google Scholar 

  • Deane, F. P., Wootoon, D. J., Chsu, C. I., & Kelly, P. J. (2012). Predicting dropout in the first 3 months of 12-step residential drug and alcohol treatment in an Australian sample. Journal of Studies on Alcohol and Drugs, 73(2), 216–225.

    Article  Google Scholar 

  • Erga, A. H., Hønsi, A., Anda-Ågotnes, L. G., Nesvåg, S., Hesse, M., & Hagen, E. (2021). Trajectories of psychological distress during recovery from polysubstance use disorder. Addiction Research & Theory, 29(1), 64–71.

    Article  Google Scholar 

  • Foster, K. T., Li, N., McClure, E. A., Sonne, S. C., & Gray, K. M. (2016). Gender differences in internalizing symptoms and suicide risk among men and women seeking treatment for cannabis use disorder from late adolescence to middle adulthood. Journal of Substance Abuse Treatment, 66, 16–22.

    Article  Google Scholar 

  • Freund, K. M., Graham, S. M., Lesky, L. G., & Moskowitz, M. A. (1993). Detection of bulimia in a primary care setting. J Gen Intern Med, 8(5), 236–242.

    Article  CAS  Google Scholar 

  • Gearhardt, A. N., White, M. A., & Potenza, M. N. (2011). Binge eating disorder and food addiction. Current Drug Abuse Reviews, 4(3), 201–207.

    Article  Google Scholar 

  • Grossbard, J. R., Lee, C. M., Neighbors, C., & Larimer, M. E. (2009). Body image concerns and contingent self-esteem in male and female college students. Sex Roles, 60(3), 198–207.

    Article  Google Scholar 

  • Grotzkyj‐Giorgi, M. (2009). Nutrition and addiction—Can dietary changes assist with recovery? Drugs and Alcohol Today.

  • Harrison, A. N., James Bateman, C. C., Younger-Coleman, N. O., Williams, M. C., Rocke, K. D., Clato-Day Scarlett, S. C., & Chang, S. M. (2020). Disordered eating behaviours and attitudes among adolescents in a middle-income country. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 25(6), 1727–1737.

    Article  Google Scholar 

  • Harrop, E. N., & Marlatt, G. A. (2010). The comorbidity of substance use disorders and eating disorders in women: Prevalence, etiology, and treatment. Addictive Behaviors, 35(5), 392–398. https://doi.org/10.1016/j.addbeh.2009.12.016

    Article  Google Scholar 

  • Hayes, A. F. (2013). Mediation, moderation, and conditional process analysis: A regression-based approach. The Guilford Press.

  • Haynes, C. J., Deane, F. P., & Kelly, P. J. (2021). Suicidal ideation predicted by changes experienced from pre-treatment to 3-month postdischarge from residential substance use disorder treatment. Journal of Substance Abuse Treatment, 108542.

  • Holderness, C. C., Brooks-Gunn, J., & Warren, M. P. (1994). Co-morbidity of eating disorders and substance abuse review of the literature. International Journal of Eating Disorders, 16(1), 1–34.

    Article  CAS  Google Scholar 

  • Jeynes, K. D., & Gibson, E. L. (2017). The importance of nutrition in aiding recovery from substance use disorders: A review. Drug and Alcohol Dependence, 179, 229–239.

    Article  Google Scholar 

  • Kalon, E., Hong, J., Tobin, C., & Schulte, T. (2016). Psychological and neurobiological correlates of food addiction. International Review of Neurobiology, 129, 85–110.

    Article  CAS  Google Scholar 

  • Keel, P. K., Fichter, M., Quadflieg, N., &, et al. (2004). Application of a latent class analysis to empirically define eating disorder phenotypes. Archives of General Psychiatry, 61(2), 192–200. https://doi.org/10.1001/archpsyc.61.2.192

    Article  Google Scholar 

  • Kelly, P. J., Robinson, L. D., Baker, A. L., Deane, F. P., McKetin, R., Hudson, S., & Keane, C. (2017). Polysubstance use in treatment seekers who inject amphetamine: Drug use profiles, injecting practices and quality of life. Addictive Behaviors, 71, 25–30.

    Article  Google Scholar 

  • Laudet, A. B. (2011). The case for considering quality of life in addiction research and clinical practice. Addiction science & clinical practice, 6(1), 44–55. https://pubmed.ncbi.nlm.nih.gov/22003421.

    Google Scholar 

  • Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343.

    Article  CAS  Google Scholar 

  • Lubman, D. I., Allen, N. B., Rogers, N., Cementon, E., & Bonomo, Y. (2007). The impact of co-occurring mood and anxiety disorders among substance-abusing youth. Journal of Affective Disorders, 103(1–3), 105–112.

    Article  Google Scholar 

  • Manzato, E. (2019). Eating disorders and disordered eating behaviors in males: A challenging topic. Eating and Weight Disorders, 24(4), 651–652.

    Article  Google Scholar 

  • Marsh, H. W., Lüdtke, O., Trautwein, U., & Morin, A. J. (2009). Classical latent profile analysis of academic self-concept dimensions: Synergy of person-and variable-centered approaches to theoretical models of self-concept. Structural Equation Modeling: A Multidisciplinary Journal, 16(2), 191–225.

    Article  Google Scholar 

  • McGaffin, B. J., Deane, F. P., Kelly, P. J., & Ciarrochi, J. (2015). Flourishing, languishing and moderate mental health: Prevalence and change in mental health during recovery from drug and alcohol problems. Addiction Research & Theory, 23(5), 351–360.

    Article  Google Scholar 

  • McHugh, R. K., Votaw, V. R., Sugarman, D. E., & Greenfield, S. F. (2018). Sex and gender differences in substance use disorders. Clinical Psychology Review, 66, 12–23.

    Article  Google Scholar 

  • McLellan, A. T., Cacciola, J. C., Rikoon, S. H., Carise, D., & Alterman, A. I. (2006). The Addiction Severity Index at 25: Origins, contributions and transitions [Review]. American Journal on Addictions, 15(2), 113–124. https://doi.org/10.1080/10550490500528316

    Article  Google Scholar 

  • Measelle, J. R., Stice, E., & Hogansen, J. M. (2006). Developmental trajectories of co-occurring depressive, eating, antisocial, and substance abuse problems in female adolescents. J Abnorm Psychol, 115(3), 524–538. https://doi.org/10.1037/0021-843X.115.3.524

    Article  Google Scholar 

  • Mills, K., Deady, M., Proudfoot, H., Sannibale, C., Teesson, M., Mattick, R., & Burns, L. (2009). Guidelines on the management of co-occurring alcohol and other drug and mental health conditions in alcohol and other drug treatment settings. National Drug and Alcohol Research Centre.

    Google Scholar 

  • Mo, C., & Deane, F. P. (2016). Reductions in craving and negative affect predict 3-month post-discharge alcohol use following residential treatment. International Journal of Mental Health and Addiction, 14(5), 761–774.

    Article  Google Scholar 

  • Mo, C., Deane, F. P., Lyons, G. C., & Kelly, P. J. (2013). Factor analysis and validity of a short six-item version of the Desires for Alcohol Questionnaire. Journal of Substance Abuse Treatment, 44(5), 557–564.

    Article  Google Scholar 

  • Mond, J., Mitchison, D., & Hay, P. (2014). Prevalence and implications of eating disordered behavior in men. In L. Cohn & R. Lemberg (Eds.), Current Findings on Males with Eating Disorders. Routledge.

  • Moss, H. B., Chen, C. M., & Yi, H.-Y. (2007). Subtypes of alcohol dependence in a nationally representative sample. Drug and Alcohol Dependence, 91(2–3), 149–158.

    Article  Google Scholar 

  • Posavac, S. S., & Posavac, H. D. (2002). Predictors of women’s concern with body weight: The roles of perceived self-media ideal discrepancies and self-esteem. Eating Disorders, 10(2), 153–160.

    Article  Google Scholar 

  • Robinson, L. D., Kelly, P. J., Deane, F. P., & Reis, S. L. (2019). Exploring the relationships between eating disorders and mental health in women attending residential substance use treatment. Journal of Dual Diagnosis, 15(4), 270–280.

    Article  Google Scholar 

  • Robinson, L. D., Kelly, P. J., Larance, B., Griffiths, S., & Deane, F. P. (2021). Eating disorder behaviours and substance use in women attending treatment for substance use disorders: a latent class analysis. Int J Mental Health and Addiction.

  • Sherman, B. J., McRae-Clark, A. L., Baker, N. L., Sonne, S. C., Killeen, T. K., Cloud, K., & Gray, K. M. (2017). Gender differences among treatment-seeking adults with cannabis use disorder: Clinical profiles of women and men enrolled in the achieving cannabis cessation—Evaluating N-acetylcysteine treatment (ACCENT) study. The American Journal on Addictions, 26(2), 136–144.

    Article  Google Scholar 

  • Sklar, S. M., & Turner, N. E. (1999). A brief measure for the assessment of coping self-efficacy among alcohol and other drug users. Addiction, 94(5), 723–729.

    Article  CAS  Google Scholar 

  • Strother, E., Lemberg, R., Stanford, S. C., & Turberville, D. (2012). Eating disorders in men: Underdiagnosed, undertreated, and misunderstood. Eating Disorders, 20(5), 346–355.

    Article  Google Scholar 

  • Sweeting, H., Walker, L., MacLean, A., Patterson, C., Räisänen, U., & Hunt, K. (2015). Prevalence of eating disorders in males: A review of rates reported in academic research and UK mass media. International journal of men's health, 14(2).

  • Thapliyal, P., Hay, P., & Conti, J. (2018). Role of gender in the treatment experiences of people with an eating disorder: a metasynthesis. Journal of eating disorders, 6(1), 18. https://doi.org/10.1186/s40337-018-0207-1

    Article  Google Scholar 

  • Thorsteinsdottir, G., & Ulfarsdottir, L. (2008). Eating disorders in college students in Iceland. The European Journal of Psychiatry, 22(2), 107–115.

    Article  Google Scholar 

  • Tracey, E. M., Laudet, A. B., Min, M. O., Kim, H., Brown, S., Kyoung Jun, M., & Singer, L. (2012). Prospective patterns and correlates of quality of life among women in substance abuse treatment. Drug and Alcohol Dependence, 124(3), 242–249.

    Article  Google Scholar 

  • Turner, B., & Deane, F. P. (2016). Length of stay as a predictor of reliable change in psychological recovery and well being following residential substance abuse treatment. Therapeutic Communities: The International Journal of Therapeutic Communities.

  • Wahler, E. A., & Otis, M. D. (2014). Social stress, economic hardship, and psychological distress as predictors of sustained abstinence from substance use after treatment. Substance Use & Misuse, 49(13), 1820–1832.

    Article  Google Scholar 

  • Warren, C. S., Lindsay, A. R., White, E. K., Claudat, K., & Velasquez, S. C. (2013). Weight-related concerns related to drug use for women in substance abuse treatment: Prevalence and relationships with eating pathology. J Subst Abuse Treat, 44(5), 494–501. https://doi.org/10.1016/j.jsat.2012.08.222

    Article  Google Scholar 

  • Weltzin, T. E., Cornella-Carlson, T., Fitzpatrick, M. E., Kennington, B., Bean, P., & Jefferies, C. (2012). Treatment issues and outcomes for males with eating disorders. Eating Disorders, 20(5), 444–459.

    Article  Google Scholar 

  • Zhang, J., Wang, Y., Wu, C., & He, J. (2022). The relationship between emotional intelligence and eating disorders or disordered eating behaviors: A meta-analysis. Personality and Individual Differences, 185, 111239.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of the Arts, Humanities and Social Sciences, Centre for Health Psychology Research, University of Wollongong, Wollongong, NSW, 2522, Australia

    Laura D. Robinson & Frank P. Deane

  2. Faculty of the Arts, Humanities and Social Sciences, School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia

    Laura D. Robinson & Frank P. Deane

Authors
  1. Laura D. Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Frank P. Deane
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Laura D. Robinson.

Ethics declarations

Ethics Approval and Consent to Participate

The questionnaire and methodology for this study was approved by the Human Research Ethics committee of the University of Wollongong (Ethics approval number: HE12/428).

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Robinson, L.D., Deane, F.P. The Effects of Comorbid Disordered Eating Behaviours on Outcomes at Follow-up from Residential Substance Use Disorder Treatment: a Latent Class Approach. Int J Ment Health Addiction (2022). https://doi.org/10.1007/s11469-022-00975-y

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11469-022-00975-y

Keywords

Search

Navigation