Functional assessment of restrictive eating: A three-study clinically heterogeneous and transdiagnostic investigation.
Functional assessment of restrictive eating: A three-study clinically heterogeneous and transdiagnostic investigation.
复制标题
DOI：
10.1037/abn0000700
复制
发表时间：
2021-10
影响因子：
4.6
通讯作者：
Haynos AF
中科院分区：
文献类型：
--
作者：
Wang SB;Fox KR;Boccagno C;Hooley JM;Mair P;Nock MK;Haynos AF
Restrictive eating is common and associated with negative psychological outcomes across the lifespan and eating disorder (ED) severity levels. Little is known about functional processes that maintain restriction, especially outside of narrow diagnostic categories (e.g., anorexia nervosa). Here, we extend research on operant four-function models (identifying automatic negative, automatic positive, social negative, and social positive reinforcement functions) that have previously been applied to nonsuicidal self-injury (NSSI), binge eating, and purging to restricting. We assessed restrictive eating functions in three samples: clinically heterogeneous adolescents (Study 1: N=457), transdiagnostic adults (Study 2: N=145), and adults with acute or recently weight-restored anorexia nervosa (Study 3: N=45). Study 1 indicated the four-function model was a good fit for restricting (RMSEA=0.06, TLI=0.88). This factor structure replicated in Study 2 (CFI=0.97, RMSEA=0.07, TLI=0.97, SRMR=0.09). Unlike NSSI, binge eating, and purging, which have been found to primarily serve automatic negative reinforcement functions, all three present studies found automatic positive reinforcement was most highly endorsed (by up to 85% of participants). In Studies 1 and 3, automatic functions were associated with poorer emotion regulation (ps<.05). In Study 1, social functions were associated with less social support (ps<.001). Across studies, automatic functions were associated with greater restriction ps<.05). Functions varied slightly by ED diagnosis. Across ED presentation, severity, and developmental stage, restrictive eating may be largely maintained by automatic positive reinforcement, with some variability across presentations. Continued examination of restrictive eating functions will establish processes that maintain restriction, allowing more precise treatment targeting for these problematic behaviors. Self-destructive behaviors have been found to be maintained via positive and negative reinforcement, with both automatic and social contingencies. The current series of studies extends this four-function model to restrictive eating, finding that unlike other self-destructive behaviors (e.g., nonsuicidal self-injury, binge eating, and purging, which all primarily serve automatic negative reinforcement), restrictive eating is primarily maintained by automatic positive reinforcement. Findings replicated across three separate samples varying by developmental stage, diagnosis, illness stage/severity, and administration method (online vs. in person).
Restrictive eating is common and associated with negative psychological outcomes across the lifespan and eating disorder (ED) severity levels. Little is known about functional processes that maintain restriction, especially outside of narrow diagnostic categories (e.g., anorexia nervosa). Here, we extend research on operant four-function models (identifying automatic negative, automatic positive, social negative, and social positive reinforcement functions) that have previously been applied to nonsuicidal self-injury (NSSI), binge eating, and purging to restricting. We assessed restrictive eating functions in three samples: clinically heterogeneous adolescents (Study 1: N=457), transdiagnostic adults (Study 2: N=145), and adults with acute or recently weight-restored anorexia nervosa (Study 3: N=45). Study 1 indicated the four-function model was a good fit for restricting (RMSEA=0.06, TLI=0.88). This factor structure replicated in Study 2 (CFI=0.97, RMSEA=0.07, TLI=0.97, SRMR=0.09). Unlike NSSI, binge eating, and purging, which have been found to primarily serve automatic negative reinforcement functions, all three present studies found automatic positive reinforcement was most highly endorsed (by up to 85% of participants). In Studies 1 and 3, automatic functions were associated with poorer emotion regulation (ps<.05). In Study 1, social functions were associated with less social support (ps<.001). Across studies, automatic functions were associated with greater restriction ps<.05). Functions varied slightly by ED diagnosis. Across ED presentation, severity, and developmental stage, restrictive eating may be largely maintained by automatic positive reinforcement, with some variability across presentations. Continued examination of restrictive eating functions will establish processes that maintain restriction, allowing more precise treatment targeting for these problematic behaviors. Self-destructive behaviors have been found to be maintained via positive and negative reinforcement, with both automatic and social contingencies. The current series of studies extends this four-function model to restrictive eating, finding that unlike other self-destructive behaviors (e.g., nonsuicidal self-injury, binge eating, and purging, which all primarily serve automatic negative reinforcement), restrictive eating is primarily maintained by automatic positive reinforcement. Findings replicated across three separate samples varying by developmental stage, diagnosis, illness stage/severity, and administration method (online vs. in person).
登录
查看更多内容
DOI：
10.1080/10705519909540118
发表时间：
1999-01-01
影响因子：
6
作者：
Hu, Li-tze;Bentler, Peter M.
通讯作者：
Bentler, Peter M.
影响因子：
3.7
作者：
Fox, Kathryn R.;O'Sullivan, Isabel M.;Hooley, Jill M.
通讯作者：
Hooley, Jill M.
影响因子：
5.5
作者：
Binford, RB;Le Grange, D;Jellar, CC
通讯作者：
Jellar, CC
影响因子：
5
作者：
Juarascio, Adrienne;Shaw, Jena;Lowe, Michael
通讯作者：
Lowe, Michael
影响因子：
4.8
作者：
Haynos AF;Hall LMJ;Lavender JM;Peterson CB;Crow SJ;Klimes-Dougan B;Cullen KR;Lim KO;Camchong J
通讯作者：
Camchong J