Metacognitions about desire thinking predict the severity of binge eating in a sample of Italian women

  • Marcantonio M. SpadaEmail author
  • Gabriele Caselli
  • Bruce A. Fernie
  • Ana V. Nikčević
  • Giovanni M. Ruggiero
  • Fabio Boccaletti
  • Giulia Dallari
  • Sandra Sassaroli
Original Article


In this study, our principal aim was to investigate whether metacognitions about desire thinking predict the severity of binge eating in women and, if so, whether this relationship is independent of age, self-reported body mass index (BMI), negative affect, irrational food beliefs and craving. One hundred and four women, consisting of 32 consecutive patients with binge eating disorder undergoing initial assessment for cognitive therapy for eating disorders, 39 moderate binge eaters, and 33 non-binge eaters (both from the general population), completed the following measures: Self-reported BMI, Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, General Craving Scale, Metacognitions about Desire Thinking Questionnaire, and Binge Eating Scale. A series of Spearman’s rho correlation analyses revealed that self-reported BMI, anxiety, depression, irrational food beliefs, craving, and all three factors of the metacognitions about desire thinking questionnaire were significantly associated with the severity of binge eating. A stepwise regression analysis identified self-reported BMI, craving, and negative metacognitions about desire thinking as significant predictors of the severity of binge eating. These results, taken together, highlight the possible role of metacognitions about desire thinking in predicting the severity of binge eating. The clinical implications of these findings are discussed.


Binge eating Binge eating disorder Craving Irrational food beliefs Metacognitions about desire thinking Negative affect, self-reported body mass index 



Author BAF receives salary support from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre and Dementia Research Unit at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

Ethical approval for this study was granted by Studi Cognitivi, Milan, Italy. All participants were informed that data provided in the study would be treated in the strictest confidence and that participation was entirely voluntary.

Informed consent

All participants provided informed consent.


  1. 1.
    American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (Fifth Edition)Google Scholar
  2. 2.
    Andres A, Saldana C (2014) Body dissatisfaction and dietary restraint influence binge eating behavior. Nutr Res 34:944–950. doi: 10.1016/j.nutres.2014.09.003;32 CrossRefPubMedGoogle Scholar
  3. 3.
    Arnow B, Kenardy J, Agras WS (1992) Binge eating among the obese: a descriptive study. J Behav Med 15:155–170. doi: 10.1007/BF00848323 CrossRefPubMedGoogle Scholar
  4. 4.
    Brown TA, Keel PK (2012) Current and emerging directions in the treatment of eating disorders. Subst Abuse 6:33–61. doi: 10.4137/SART.S7864 PubMedPubMedCentralGoogle Scholar
  5. 5.
    Caselli G, Ferla M, Mezzaluna C, Rovetto F, Spada MM (2012) Desire thinking across the continuum of drinking behaviour. Eur Addict Res 18:64–69. doi: 10.1159/000333601 CrossRefPubMedGoogle Scholar
  6. 6.
    Caselli G, Nikčević A, Fiore F, Mezzaluna C, Spada MM (2012) Desire thinking across the continuum of nicotine dependence. Addict Res Theory 20:382–388. doi: 10.3109/16066359.2011.644842 CrossRefGoogle Scholar
  7. 7.
    Caselli G, Soliani M, Spada MM (2013) The effect of desire thinking on craving: an experimental investigation. Psychol Addict Behav 27:301–306. doi: 10.1037/a0027981 CrossRefPubMedGoogle Scholar
  8. 8.
    Caselli G, Spada MM (2010) Metacognitions in desire thinking: a preliminary investigation. Behav Cogn Psychother 38:629–637. doi: 10.1017/S1352465810000317 CrossRefPubMedGoogle Scholar
  9. 9.
    Caselli G, Spada MM (2011) The Desire Thinking Questionnaire: development and psychometric properties. Addict Behav 36:1061–1067. doi: 10.1016/j.addbeh.2011.06.013 CrossRefPubMedGoogle Scholar
  10. 10.
    Caselli G, Spada MM (2013) The Metacognitions about Desire Thinking Questionnaire: development and psychometric properties. J Clin Psychol 69:1284–1298. doi: 10.1002/jclp.21999 CrossRefPubMedGoogle Scholar
  11. 11.
    Caselli G, Spada MM (2015) Desire thinking: what is it and what drives it? Addict Behav 44:71–79. doi: 10.1016/j.addbeh.2014.07.021 CrossRefPubMedGoogle Scholar
  12. 12.
    Celio A, Wilfley D, Crow S, Mitchell J, Walsh B (2004) A Comparison of the Binge Eating Scale, Questionnaire for Eating and Weight Patterns-Revised, and Eating Disorder Examination Questionnaire with Instructions with the Eating Disorder Examination in the Assessment of Binge Eating Disorder and its Symptoms. Int J Eat Disord 36:434–444. doi: 10.1002/eat.20057 CrossRefPubMedGoogle Scholar
  13. 13.
    Cooper MJ, Grocutt E, Deepak K, Bailey E (2007) Metacognition in anorexia nervosa, dieting and non-dieting controls: a preliminary investigation. Br J Clin Psychol 46:113–117. doi: 10.1348/014466506X115245 CrossRefPubMedGoogle Scholar
  14. 14.
    Costantini M, Musso M, Viterbori P, Bonci F, Del Mastro L, Garrone O, Venturini M, Morasso G (1999) Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale. Support Care Cancer 7:121–127. doi: 10.1007/s005200050241 CrossRefPubMedGoogle Scholar
  15. 15.
    Deaver C, Miltenberger R, Smyth J, Meidinger A, Crosby R (2003) An evaluation of affect and binge eating. Behav Modif 27:578–599. doi: 10.1177/0145445503255571 CrossRefPubMedGoogle Scholar
  16. 16.
    Di Bernardo M, Barciulli E, Ricca V, Mannucci E, Moretti S, Cabras PL, Rotella CM (1998) Validazione della versione italiana della Binge Eating Scle in pazienti obesi. Minerva Psichiatr 39:125–130Google Scholar
  17. 17.
    Fairburn CG, Cooper Z, Shafran R (2008) Enhanced cognitive behavior therapy for eating disorders: the core protocol. In: Fairburn CG (ed) Cognitive behavior therapy and eating disorders. Guilford Press, New York, pp 47–193Google Scholar
  18. 18.
    Fernie BA, Caselli G, Giustina L, Donato G, Marcotriggiani A, Spada MM (2014) Desire thinking as a predictor of gambling. Addict Behav 39:793–796. doi: 10.1016/j.addbeh.2014.01.010 CrossRefPubMedGoogle Scholar
  19. 19.
    Flannery BA, Volpicelli JR, Pettinati HM (1999) Psychometric properties of the Penn Alcohol Craving Scale. Alcohol Clin Exp Res 23:1289–1295. doi: 10.1111/j.1530-0277.1999.tb04349.x CrossRefPubMedGoogle Scholar
  20. 20.
    Gormally J, Black S, Daston S, Rardin D (1982) The assessment of binge eating severity among obese persons. Addict Behav 7:47–55. doi: 10.1016/0306-4603(82)90024-7 CrossRefPubMedGoogle Scholar
  21. 21.
    Greeno CG, Wing RR, Shiffman S (2000) Binge antecedents in obese women with and with out binge eating disorder. J Consult Clin Psycohol 68:95–102. doi: 10.1037/0022-006X.68.1.95 CrossRefGoogle Scholar
  22. 22.
    Heatherton TF, Baumeister RF (1991) Binge eating as escape from self-awareness. Psychol Bull 110:86–108. doi: 10.1037/0033-2909.110.1.86 CrossRefPubMedGoogle Scholar
  23. 23.
    Holmes M, Fuller-Tyszkiewicz M, Skouteris H, Broadbent J (2015) Understanding the link between body image and binge eating: a model comparison approach. Eat Weight Disord 20:81–89. doi: 10.1007/s40519-014-0141-4 CrossRefPubMedGoogle Scholar
  24. 24.
    Kavanagh DJ, Andrade J, May J (2005) Imaginary relish and exquisite torture: the elaborated intrusion theory of desire. Psychol Rev 112:446–467. doi: 10.1037/0033-295X.112.2.446 CrossRefPubMedGoogle Scholar
  25. 25.
    Kessler RC, Berglund PA, Chiu Wai Tat, Deitz AC, Hudson JI, Shahly V, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Benjet C, Bruffaerts R, de Girolamo G, de Graaf R, Haro JM, Kovess-Masfety V, O’Neill S, Posada-Villa J, Sasu C, Scott K, Viana MC, Xavier M (2013) The prevalence and correlates of binge eating disorder in the WHO World Mental Health Surveys. Biol Psychiatry 73:904–914. doi: 10.1016/j.biopsych.2012.11.020 CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Lavender JM, De Young KP, Anderson DA (2011) Eating Disorders Examination Questionnaire (EDE-Q): norms for undergraduate men. Eat Behav 11:119–121. doi: 10.1016/j.eatbeh.2009.09.005 CrossRefGoogle Scholar
  27. 27.
    Leehr EJ, Krohmer K, Schag K, Dresler T, Zipfel S, Giel KE (2015) Emotion regulation model in binge eating disorder and obesity. A systematic review. Neurosci Biobehav Rev 49:125–134. doi: 10.1016/j.neubiorev CrossRefPubMedGoogle Scholar
  28. 28.
    Luce KH, Crowther JH, Pole M (2008) Eating Disorder Examination Questionnaire (EDE-Q): norms for undergraduate women. Int J Eat Disord, 273–276. doi: 10.1002/eat.20504
  29. 29.
    May J, Andrade J, Panabokke N, Kavanagh D (2004) Images of desire: cognitive models of craving. Memory 12:447–461. doi: 10.1080/09658210444000061 CrossRefPubMedGoogle Scholar
  30. 30.
    May J, Andrade J, Panabokke N, Kavanagh D (2010) Visualspacial tasks suppress craving for cigarettes. Behav Res Ther 48:476–485. doi: 10.1016/j.brat.2010.02.001 CrossRefPubMedGoogle Scholar
  31. 31.
    McDermott CJ, Rushford N (2011) Dysfunctional metacognitions in anorexia nervosa. Eat Weight Disord 16:49–55. doi: 10.1007/BF03327521 CrossRefGoogle Scholar
  32. 32.
    Meno C, Hannum J, Espelage D, Douglas L (2008) Familial and individual variables as predictors of dieting concerns and binge eating in college females. Eat Behav 9:91–101. doi: 10.1016/j.eatbeh.2007.06.002 CrossRefPubMedGoogle Scholar
  33. 33.
    Mykletun A, Stordal E, Dahl AA (2001) Hospital Anxiety and Depression Scale: factor structure, item analyses and internal consistency. Br J Psychiatry 179:540–544. doi: 10.1192/bjp.179.6.540 CrossRefPubMedGoogle Scholar
  34. 34.
    Olstad S, Solem S, Hjemdal O, Hagen R (2015) Metacognition in eating disorders: comparison of women with eating disorders, self-reported history of eating disorders or psychiatric problems, and health controls. Eat Behav 16:17–22. doi: 10.1016/j.eatbeh.2014.10.019 CrossRefPubMedGoogle Scholar
  35. 35.
    Osberg TM, Eggert M (2012) Direct and indirect effects of stress on bulimic symptoms and BMI: the mediating role of irrational food beliefs. Eat Behav 13:54–57. doi: 10.1016/j.eatbeh.2011.09.008 CrossRefPubMedGoogle Scholar
  36. 36.
    Osberg TM, Poland D, Aguayo G, MacDougall S (2008) The Irrational Food Beliefs Scale: development and validation. Eat Behav 9:25–40. doi: 10.1016/j.eatbeh.2007.02.001 CrossRefPubMedGoogle Scholar
  37. 37.
    Polivy J, Herman CP (1993) Etiology of binge eating: psychological mechanisms. In: Fairburn Christopher G, Wilson Terence G (eds) Binge eating: nature, assessment and treatment. Guilford Press, New York, pp 173–205Google Scholar
  38. 38.
    Saules K, Collings A, Hoodin F, Angelella N, Alschuler K, Ivezaj V et al (2009) The contributions of weight problem perception, BMI, gender, mood, and smoking status to binge eating among college students. Eat Behav 10:1–9. doi: 10.1016/j.eatbeh.2008.07.010 CrossRefPubMedGoogle Scholar
  39. 39.
    Spada MM, Caselli G, Fernie BA, Manfredi C, Boccaletti F, Dallari G, Gandini F, Pinna E, Ruggiero GM, Sassaroli S (2015) Desire thinking: a risk factor for binge eating? Eat Behav 18:48–53. doi: 10.1016/j.eatbeh.2015.03.013 CrossRefPubMedGoogle Scholar
  40. 40.
    Spada MM, Caselli G, Nikčević AV, Wells A (2015) Metacognition in addictive behaviors. Addict Behav 44:9–15. doi: 10.1016/j.addbeh.2014.08.002 CrossRefPubMedGoogle Scholar
  41. 41.
    Spada MM, Caselli G, Slaifer M, Nikčević AV, Sassaroli S (2014) Desire Thinking as a predictor of problematic Internet use. Soc Sci Comput Rev 32:474–483. doi: 10.1177/0894439313511318 CrossRefGoogle Scholar
  42. 42.
    Spada MM, Caselli G, Wells A (2013) A triphasic metacognitive formulation of problem drinking. Clin Psychol Psychother 20:494–500. doi: 10.1002/cpp.1791 CrossRefPubMedGoogle Scholar
  43. 43.
    Spoor ST, Stice E, Bekker MH, Van Strien T, Croon MA, Van Heck G (2006) Relations between dietary restraint, depressive symptoms, and binge eating: a longitudinal study. Int J Eat Disord 39:700–707. doi: 10.1002/eat.20283 CrossRefPubMedGoogle Scholar
  44. 44.
    Striegel RH, Bedrosian R, Wang C, Schwartz S (2012) Why men should be included in research on binge eating: results from a comparison of psychosocial impairment in men and women. Int J Eat Disord 45:233–240. doi: 10.1002/eat.20962 CrossRefPubMedGoogle Scholar
  45. 45.
    Telch CF, Pratt EM, Niego SH (1998) Obese women with binge eating disorders define the term binge. Int J Eat Disord 24:313–317. doi: 10.1002/(SICI)1098-108X(199811)24:3<313:AID-EAT9>3.0.CO;2-P CrossRefPubMedGoogle Scholar
  46. 46.
    Wang WC, Worsley A, Cunningham EG (2009) Social ideological influences on food consumption, physical activity, and BMI. Appetite 53:288–296. doi: 10.1016/j.appet.2009.07.004 CrossRefPubMedGoogle Scholar
  47. 47.
    Wells A (1995) Worry and the incubation of intrusive images following stress. Behav Res Ther 33:579–583. doi: 10.1016/0005-7967(94)00087-Z CrossRefPubMedGoogle Scholar
  48. 48.
    Wells A (2000) Emotional disorders and metacognition: innovative cognitive therapy. Wiley, ChichesterGoogle Scholar
  49. 49.
    Wells A (2009) Metacognitive therapy for anxiety and depression. Guilford Press, New YorkGoogle Scholar
  50. 50.
    Wells A (2013) Advances in Metacognitive Therapy. Int J Cogn Ther 6:186–201. doi: 10.1521/ijct.2013.6.2.186 CrossRefGoogle Scholar
  51. 51.
    Wiser S, Telch CF (1999) Dialectical behavior therapy for binge eating disorder. J Clin Psychol 55:755–768. doi: 10.1002/(SICI)1097-4679(199906)55:6<755:AID-JCLP8>3.0.CO;2-R CrossRefPubMedGoogle Scholar
  52. 52.
    Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67:361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Marcantonio M. Spada
    • 1
    Email author
  • Gabriele Caselli
    • 1
    • 2
    • 7
  • Bruce A. Fernie
    • 3
    • 4
  • Ana V. Nikčević
    • 5
  • Giovanni M. Ruggiero
    • 2
  • Fabio Boccaletti
    • 2
  • Giulia Dallari
    • 6
  • Sandra Sassaroli
    • 2
  1. 1.Division of Psychology, School of Applied SciencesLondon South Bank UniversityLondonUK
  2. 2.Studi CognitiviMilanItaly
  3. 3.Department of Psychology, Institute of PsychiatryKing’s College LondonLondonUK
  4. 4.CASCAID, South London and Maudsley NHS Foundation TrustLondonUK
  5. 5.Department of PsychologyKingston UniversityKingston upon ThamesUK
  6. 6.University of PaviaPaviaItaly
  7. 7.Sigmund Freud UniversityMilanItaly

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