Abstract
It is important to understand the psychological factors that underlie heightened eating restraint, which represents a risk factor for various types of dysfunction, including eating disorders. This study tested the hypothesis that eating restraint will be predicted by fear of fatness in a manner that is moderated by avoidance of fatness, with such predictive capacity being most evident in those who exhibit elevated avoidance of fatness. Seventy nine participants varying in eating restraint took part in the study. Fear of fatness was measured using an Implicit Association Test, and avoidance of fatness was measured using an Approach-Avoidance Task. The data supported the hypothesis under test. The avoidance of fatness measure moderated the association between the fear of fatness measure and the measure of eating restraint. Specifically, fear of fatness was associated with increased eating restraint only when avoidance of fatness was elevated. It is suggested that these findings not only illuminate the psychological basis of individual differences in eating restraint, but also may inform the development of novel therapeutic interventions for dysfunctional eating restraint.
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References
Ackard, D. M., Croll, J. K., & Kearney-Cooke, A. (2002). Dieting frequency among college females: Association with disordered eating, body image, and related psychological problems. Journal of Psychosomatic research,52(3), 129–136. https://doi.org/10.1016/S0022-3999(01)00269-0.
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.
Allen, K. B., Allen, B., Austin, K. E., Waldron, J. C., & Ollendick, T. H. (2015). Synchrony-desychrony in the tripartite model of fear: Predicting treatment outcome in clinically phobic children. Behavior Research and Therapy,71, 54–64. https://doi.org/10.1016/j.brat/2015.05.009.
Australian Bureau of Statistics. (2018, August 30). Sample size calculator. Retrieved from https://www.abs.gov.au/websitedbs/d3310114.nsf/home/sample+size+calculator.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology,51(6), 1173–1182. https://doi.org/10.1037/0022-3514.51.6.1173.
Berg, K. C., Peterson, C. B., Frazier, P., & Crox, S. J. (2012). Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: A systematic review of the literature. International Journal of Eating Disorders,45(3), 428–438. https://doi.org/10.1002/eat.20931.
Blanton, H., Jaccard, J., Gonzales, P. M., & Christie, C. (2006). Decoding the implicit association test: Implications for criterion prediction. Journal of Experimental Social Psychology,42(2), 192–212. https://doi.org/10.1016/j.jesp.2005.07.003.
Bögels, S. M., & Mansell, W. (2004). Attention processes in the maintenance and treatment of social phobia: hypervigilance, avoidance and self-focused attention. Clinical Psychology Review,24(7), 827–856. https://doi.org/10.1016/j.cpr.2004.06.005.
Brand, P. A., Rothblum, E. D., & Solomon, L. J. (1992). A comparison of lesbians, gay men, and heterosexuals on weight and restrained eating. International Journal of Eating Disorders,11(3), 253–259. https://doi.org/10.1002/1098-108X(199204)11:3%3c253:AID-EAT2260110308%3e3.0.CO;2-J.
Brugman, E., Meulmeester, J. F., Spee-van der Wekke, A., Beuker, R. J., Zaadstra, B. M., Radder, J. J., et al. (1997). Dieting, weight and health in adolescents in the Netherlands. International Journal of Obesity,21(1), 54–60. https://doi.org/10.1038/sj.ijo.0800363.
Brunch, H. (1973). Eating disorders. New York: Basic Books.
Byrne, B. M. (2010). Structural equation modeling with AMOS: Basic concepts, applications, and programming. New York: Routledge.
Calzo, J. P., Sonneville, K. R., Haines, J., Blood, E. A., Field, A. E., & Austin, S. B. (2012). The development of associations among BMI, body dissatisfaction, and weight and shape concern in adolescent boys and girls. Journal of Adolescent Health,51(5), 517–523. https://doi.org/10.1016/j.jadohealth.2012.02.021.
Chen, M., & Bargh, J. A. (1999). Consequences of automatic evaluation: Immediate behavioral predispositions to approach or avoid the stimulus. Personality and Social Psychology Bulletin,25(2), 215–224. https://doi.org/10.1177/0146167299025002007.
Chernyak, Y., & Lowe, M. R. (2010). Motivations for dieting: Drive for thinness is different from drive for objective thinness. Journal of Abnormal Psychology,119(2), 276–281. https://doi.org/10.1037/a0018398.
Dalley, S. E., & Buunk, A. P. (2009). “Thinspiration” vs. “fear of fat” Using prototypes to predict frequent weight-loss dieting in females. Appetite,52(1), 217–221. https://doi.org/10.1016/j.appet.2008.09.019.
Dalley, S. E., Toffanin, P., & Pollet, T. E. (2012). Dietary restraint in college women: Fear of an imperfect fat self is stronger than hope of a perfect self. Body Image,9(4), 441–447. https://doi.org/10.1016/j.bodyim.2012.06.005.
Dondzilo, L., Rieger, E., Palermo, R., Byrne, S., & Bell, J. (2017). The mediating role of rumination in the relation between attentional bias towards thin female bodies and eating disorder symptomatology. PLoS ONE,12(5), e0177870. https://doi.org/10.1371/journal.pone.0177870.
Fairburn, C. G., & Beglin, S. J. (2008). Eating disorder examination questionnaire. In C. G. Fairburn (Ed.), Cognitive behavior therapy and eating disorders (pp. 309–313). New York: Guilford Press.
Fairburn, C. G., & Cooper, P. J. (1982). Self-induced vomiting and bulimia nervosa: An undetected problem. British Medical Journal,284, 1153–1155. https://doi.org/10.1136/bmj.284.6323.1153.
Fairburn, C. G., Wilson, G. T., & Schleimer, K. (1993). Binge eating: Nature, assessment, and treatment. New York: Guilford Press.
Fiedler, K., Messner, C., & Bluemke, M. (2010). Unresolved problems with the “I”, the “A”, and the “T”: A logical and psychometric critique of the Implicit Association Test (IAT). European Review of Social Psychology,17(1), 74–147. https://doi.org/10.1080/1046328060068124.
French, S. A., & Jeffery, R. W. (1994). Consequences of dieting to lose weight: Effects on physical and mental health. Health Psychology,13(3), 195. https://doi.org/10.1037/0278-6133.13.3.195.
French, S. A., Story, M., Downes, B., Resnick, M. D., & Blum, R. W. (1995). Frequent dieting among adolescents: Psychosocial and health behavior correlates. American journal of public health,85(5), 695–701. https://doi.org/10.2105/AJPH.85.5.695.
Friedrich, R. J. (1982). In defence of multiplicative terms in multiple regression equations. American Journal of Political Science,26(4), 797–833. https://doi.org/10.2307/2110973.
Gleaves, D. H., Brown, J. D., & Warren, C. S. (2004). The continuity/discontinuity models of eating disorders: A review of the literature and implications for assessment, treatment, and prevention. Behavior Modification,28(6), 739–762. https://doi.org/10.1177/0145445503259859.
Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998). Measuring individual differences in implicit cognition: The implicit association test. Journal of Personality and Social Psychology,74, 1464–1480. https://doi.org/10.1037/0022-3515.74.6.1464.
Greenwald, A. G., Nosek, B. A., & Banaji, M. R. (2003). Understanding and using the implicit association test I: An improved scoring algorithm. Journal of Personality and Social Psychology,85, 197–216. https://doi.org/10.1037/0022-3514.85.2.197.
Hair, J., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate data analysis (7th ed.). Upper Saddle River, NJ: Pearson Educational International.
Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., et al. (2004). Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record, 54(4), 553–578.
Heatherton, T. F., Herman, C. P., Polivy, J., King, G. A., & McGree, S. T. (1988). The (mis)measurement of restraint: An analysis of conceptual and psychometric issues. Journal of Abnormal Psychology, 97(1), 19–28.
Hendren, R. L., Barber, J. K., & Sigafoos, A. (1986). Eating-disorders symptoms in a nonclinical populations: A study of female adolescents in two private schools. Journal of the American Academy of Child Psychiatry,25(6), 836–840. https://doi.org/10.1016/S0002-7138(09)60203-X.
Herman, C. P., & Mack, D. (1975). Restrained and unrestrained eating. Journal of Personality,43(4), 647–660. https://doi.org/10.1111/j.1467-6494.1975.tb00727.x.
Hudson, J. I., Hiripi, E., Pope, H. D., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry,61(3), 348–358. https://doi.org/10.1016/j.biopsych.2006.03.040
IBM Corp. Released. (2013). IBM SPSS statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.
Izquierdo, A., Plessow, F., Becker, K. R., Mancuso, C. J., Slattery, M., Murray, H. B., et al. (2018). Implicit attitudes toward dieting and thinness distinguish fat-phobic and non-fat-phobic anorexia nervoas from avoidant/restrictive food intake disorder in adolescents. International Journal of Eating Disorders,52(4), 419–427. https://doi.org/10.1002/eat.22981.
Kashdan, T. B., & Kane, J. Q. (2011). Post-traumatic distress and the presence of post-traumatic growth and meaning in life: Experiential avoidance as a moderator. Personality and individual differences,50(10), 84–89. https://doi.org/10.1016/j.paid/2010.08.028.
Kenardy, J., Brown, W. J., & Vogt, E. (2001). Dieting and health in young Australian women. European Eating Disorders Review,9(4), 242–254. https://doi.org/10.1002/erv.388.
King, M. F., & Bruner, G. C. (2000). Social desirability bias: A neglected aspect of validity testing. Psychology and Marketing,17(2), 79–103. https://doi.org/10.1002/(SICI)1520-6793(200002)17:2%3c79:AID-MAR2%3e3.0.CO;2-0.
Kollei, I., Lukas, C. A., Loeber, S., & Berking, M. (2017). An app-based blended intervention to reduce body dissatisfaction: A randomised controlled pilot study. Journal of Consulting and Clinical Psychology,85(11), 1104–1108. https://doi.org/10.1037/ccp0000246.
Krijn, M., Emmelkamp, P. M., Olafsson, R. P., & Biemond, R. (2004). Virtual reality exposure therapy of anxiety disorders: A review. Clinical Psychology Review,24(3), 259–281. https://doi.org/10.1016/j.cpr.2004.04.001.
Laessle, R. G., Tuschl, R. J., Kotthaus, B. C., & Prike, K. M. (1989). A comparison of the validity of three scales for the assessment of dietary restraint. Journal of Abnormal Psychology,98(4), 504. https://doi.org/10.1037/0021-843X.98.4.504.
Marsh, A. A., Ambady, N., & Kleck, R. E. (2005). The effects of fear and anger facial expressions on approach- and avoidance-related behaviors. Emotion,5(1), 119–124. https://doi.org/10.1037/1528-3542.5.1.119.
Marshall, C., Lengyel, C., & Utioh, A. (2012). Body dissatisfaction: Among middle-aged and older women. Canadian Journal of Dietetic Practice and Research,73(2), 241. https://doi.org/10.3148/73.2.2012.e241.
Mauler, B. I., Hamm, A. O., Wike, A. I., & Tuschen-Caffier, B. (2006). Affect regulation and food intake in bulimia nervosa: Emotional responding to food cues after deprivation and subsequent eating. Journal of Abnormal Psychology,115(3), 567–579. https://doi.org/10.1037/0021-843X.115.3.567.
Miller, N. E. (2008). Conflict, displacements, learned drives and theory. Piscataway, NJ: Transaction Publishers.
Mogg, K., Bradley, B. P., Field, M., & De Houwer, J. (2003). Eye movements to smoking-related pictures in smokers: Relationship between attentional biases and implicit and explicit measures of stimulus valence. Addiction,98(6), 825–836. https://doi.org/10.1046/j.1360-0443.2003.00392.x.
Mond, J. M., Myers, T. C., Crosby, R. D., Hay, P. J., Rogers, B., Morgan, J. F., et al. (2008). Screening for eating disorders in primary care: EDE-Q versus SCOFF. Behavior Research Therapy,46(5), 612–622. https://doi.org/10.1016/j.brat.2008.02.003.
Mowrer, O. H. (1939). A stimulus-response analysis of anxiety and its role as a reinforcing agent. Psychological Review,46(6), 553. https://doi.org/10.1037/h0054288.
Mowrer, O. (1960). Learning theory and behavior. New York: Wiley.
Musher-Eizenman, D. R., Holub, S. C., Hauser, J. C., & Young, K. M. (2007). The relationship between parents’ anti-fat attitudes and restrictive feeding. Obesity,15(8), 2095–2102. https://doi.org/10.1038/oby.2007.249.
Mussap, A. J. (2006). Reinforcement sensitivity theory (RST) and body change behavior in males. Personality and Individual Differences,40(4), 841–852. https://doi.org/10.1016/j.paid.2005.08.013.
Mussap, A. J. (2007). Motivational processes associated with unhealthy body change attitudes and behaviors. Eating Behaviors,8(3), 423–428. https://doi.org/10.1016/j.eatbeh.2006.12.001.
Neely, J. H. (1991). Semantic priming effects in visual word recognition: A selective review of current findings and theories. In D. Besner & G. Humphreys (Eds.), Basic processes in reading: Visual word recognition (pp. 264–336). Hillsdale, NJ: Erlbaum.
Opdyke, D., Williford, J. S., & North, M. (1995). Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia. American Journal of Psychiatry,152(4), 626–628. https://doi.org/10.1176/ajp.152.4.626.
Patton, G., Johnson-Sabine, E., Wood, K., Mann, A., & Wakeling, A. (1990). Abnormal eating attitudes in London schoolgirls—A prospective epidemiological study: outcome at twelve month follow-up. Psychological medicine,20(2), 383–394. https://doi.org/10.1017/S00332917000177000.
Rachman, S., & Hodgson, R. (1974). Synchrony and desynchrony in fear and avoidance. Behavior Research and Therapy,12(4), 311–318. https://doi.org/10.1016/0005-7967(74)90005-9.
Rieger, E., Dolan, A., Thomas, B., & Bell, J. (2017). The effect of interpersonal rejection on attentional biases regarding thin-ideal and non-thin images: The moderating role of body weight-and shape-based self-worth. Body Image,22, 78–86. https://doi.org/10.1016/j.bodyim.2017.06.002.
Rinck, M., & Becker, E. S. (2007). Approach and avoidance in fear of spiders. Journal of Behaivour Therapy and Experimental Psychiatry,38(2), 105–120. https://doi.org/10.1016/j.jbtep.2006.10.001.
Robinson, B., Bacon, L. C., & O'Reilly, J. (1993). Fat phobia: Measuring, understanding, and changing anti-fat attitudes. International Journal of Eating Disorders,14(4), 467–480. https://doi.org/10.1002/1098-108X.
Rothbaum, B. O., Hodges, L., Alarcon, R., Ready, D., Shahar, F., Graap, J., et al. (1999). Virtual reality exposure therapy for PTSD Vietnam veterans: A case study. Journal of Traumatic Stress,12(2), 263–271. https://doi.org/10.1023/A:1024772308758.
Rothbaum, B. O., & Schwartz, A. C. (2002). Exposure therapy for posttraumatic stress disorders. American Journal of psychotherapy,56(1), 59–75.
Rosen, J. C., Leitenberg, H., Fondacaro, K. M., Gross, J., & Willmuth, J. (1985). Standardised test meals in assessment of eating behaviour in bulimia nervosa: Consumption of feared foods when vomiting is prevented. International Journal of Eating Disorders,4(1), 59–70. https://doi.org/10.1002/1098-108X.
Ruderman, A. J., & Besbeas, M. (1992). Psychological characteristics of dieters and bulimics. Journal of abnormal psychology,101(3), 383–390. https://doi.org/10.1037/0021-843X.101.3.383.
Salkovskis, P. M., Clark, D. M., Hackmann, A., Wells, A., & Gelder, M. A. (1999). An experimental investigation of the role of safety-seeking behaviors in the maintenance of panic disorder with agoraphobia. Behavior Research and Therapy,37(6), 559–574. https://doi.org/10.1016/S0005-7967(98)00153.
Serdula, M. K., Collins, E., Williamson, D. F., Anda, R. F., Pamuk, E., & Byers, T. E. (1993). Weight control practices of US adolescents and adults. Annals of Internal Medicine,119(7), 667–671. https://doi.org/10.7326/0003-4819-119-7_Part_2-199310011-00008.
Shehu, J., Mokgwathi, M., Faros, A., & Moruisi, M. (2016). Obesogenic slurs: How pervasive fat-shaming undermines the battle against juvenile obesity. African Journal for Physical Activity and Health Sciences,22(41), 952–964.
Slater, A., & Tiggemann, M. (2011). Gender differences in adolescent sport participation, teasing, self-objectification and body image concerns. Journal of Adolescence,34(2), 455–463. https://doi.org/10.1016/j.adolescence.2010.06.007.
Solarz, A. (1960). Latency of instrumental responses as a function of compatibility with the meaning of eliciting verbal signs. Journal of Experimental Psychology,59(4), 239–245. https://doi.org/10.1037/h0047274.
Sutton, R. M., & Farrall, S. (2005). Gender, socially desirable responding and the fear of crime: Are women really more anxious about crime? British Journal of Criminology,45, 212–224. https://doi.org/10.1093/bjc/azh084.
Stice, E., Presnell, K., Groesz, L., & Shaw, H., (2005). Effects of a weight maintenance diet on bulimic symptoms: An experimental test of the dietary restraint theory. Health Psychology,24(4), 402–412. https://doi.org/10.1037/0278-6133.24.4.402.
Striegel-Moore, R. H., Rosselli, F., Perrin, N., DeBar, L., Wilson, G. T., May, A., et al. (2009). Gender difference in the prevalence of eating disorder symptoms. International Journal of Eating Disorders,42(5), 471–474. https://doi.org/10.1002/eat.20625.
Striegel-Moore, R. H., Tucker, N., & Hsu, J. (1990). Body image dissatisfaction and disordered eating in lesbian college students. International Journal of Eating Disorders,9(5), 493–500. https://doi.org/10.1002/1098-108X(199009)9:5%3c493:AID-EAT2260090504%3e3.0.CO;2-C.
Vartanian, L. R., Herman, C. P., & Polivy, J. (2005). Implicit and explicit attitudes toward fatness and thinness: The role of the internalization of societal standards. Body image,2(4), 373–381. https://doi.org/10.1016/j.bodyim.2005.08.002.
Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993). The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Poster session presented at the annual meeting of the International Society for Traumatic Stress Studies; San Antonio, TX.
White, M. A., Kohlmaier, J. R., Varnado-Sullivan, P., & Williamson, D. A. (2003). Racial/ethnic differences in weight concerns: Protective and risk factors for the development of eating disorders and obesity among adolescent females. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity,8(1), 20–25. https://doi.org/10.1177/0044118X08328006.
Wiers, R. W., Eberl, C., Rinck, M., Becker, E. S., & Lindenmeyer, J. (2011). Retraining automatic action tendencies changes alcoholic patients’ approach bias for alcohol and improves treatment outcome. Psychological science,22(4), 490–497. https://doi.org/10.1177/0956797611400615.
Wiers, R. W., Rinck, M., Dictus, M., & Van den Wildenberg, E. (2009). Relatively strong automatic appetitive action-tendencies in male carriers of the OPRM1 G-allele. Genes, Brain and Behavior,8(1), 101–106. https://doi.org/10.1111/j.1601-183X.2008.00454.x.
Wilson, C. P. (1982). The fear of being fat and anorexia nervosa. International Journal of Psychoanalytic Psychotherapy,9, 233–255.
Woud, M. L., Anschutz, D. J., Van Strien, T., & Becker, E. S. (2011). Measuring thinspiration and fear of fat indirectly: A matter of approach and avoidance. Appetite,56(2), 451–455. https://doi.org/10.1016/j.appet.2010.12.012.
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MacLeod, J.S., MacLeod, C., Dondzilo, L. et al. The Role of Fear of Fatness and Avoidance of Fatness in Predicting Eating Restraint. Cogn Ther Res 44, 196–207 (2020). https://doi.org/10.1007/s10608-019-10052-9
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DOI: https://doi.org/10.1007/s10608-019-10052-9