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The Correlational Relationship Between Binge Eating and Depression: A Meta-Analytic Review

The Correlational Relationship Between Binge Eating and Depression: A Meta-Analytic Review. Susan Himes, Liuqin Yang, & Tovah Yanover University of South Florida November 25, 2005. Why is Binge Eating Important?.

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The Correlational Relationship Between Binge Eating and Depression: A Meta-Analytic Review

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  1. The Correlational Relationship Between Binge Eating and Depression: A Meta-Analytic Review Susan Himes, Liuqin Yang, & Tovah Yanover University of South Florida November 25, 2005

  2. Why is Binge Eating Important? • Binge eating disturbance is considered to be a significant clinical problem because it is associated with depression, anxiety, and other psychopathology (Womble, 2001). • In addition to the negative psychological correlates of bingeing, binge eating is a risk factor for obesity and weight gain (McGuire et al., 1999; Stice et al., 1999; Stice, Presnell, & Spangler, 2002).

  3. What is Binge Eating and Which Populations are Prone to Binges? • The American Psychiatric Association (1994) defines binge eating as the consumption of a large amount of food within a discrete period of time, accompanied by perceived loss of control. • Binge eating behavior has been observed in both clinical eating disordered groups and nonclinical samples (Bruce & Agras, 1992; Fairburn, Hay, & Welch, 1993.); however, binge eating behavior is commonly found among obese and bulimic populations.

  4. What is the Relationship Between Binge Eating and Depression? • Previous studies have found that binge eating disorder is associated with a greater lifetime risk for major depression (Marcus et al., 1990; Yanovski et al., 1993). • Binge eaters display higher levels of current depression (Telch & Agras, 1996). • Stice (2002) found that depressive symptoms predicted an increased risk for binge eating onset in adolescent girls.

  5. What is the Relationship Between Binge Eating and Negative Affect? • Although not every binge episode occurs within the context of depression, negative affect or negative mood state frequently predicts the initiation of a binge (Stice & Agras, 1998; Arnow, Kenardy, and Agras, 1995). • Stice (1998) found that negative affect predicted binge eating in adolescent girls, although this effect was not observed in adult women (Vogeltanz-Holm et al., 2000). • There is also experimental evidence that negative affect inductions result in elevated caloric intake among adult dieters, and that negative mood states tend to precede binge eating episodes among individuals with bulimia nervosa and binge eating disorder (BED; Cools, Schotte, & McNally, 1992; Davis, Freeman, Garner, 1988; Greeno, Winge, & Shiffman, 2000).

  6. Affect Regulation Model (Stice, 2005) • The affect regulation model suggests that individuals in a negative mood state eat in an effort to provide comfort or distraction from negative emotions. • Individuals with disturbances in serotonin regulation (which characterize depression) may consume excessive amounts of carbohydrate-rich foods in an effort to regulate their serotonin levels (Wurtman et al., 1985). • Dietary or pharmacological serotonin administration leads to normalized eating and decreased depression (Ciarella, Ciarella, Graziani, & Mirante, 1991; Lieberman, Wutmasn, & Chew, 1986). • Evidence for the Affect Regulation Model: • Depression has predicted future increases in weight in adults (Hoppa & Hallstrom, 1981; McGuire et al., 1999) and future increases in body mass and onset of obesity in adolescents (Goodman & Whitaker, 2002; Pine, Goldstein, Wolk, & Weissman, 2001). • In a large sample of adolescent girls, Stice (2005) found for each additional depressive symptom reported, there was more than a fourfold increase in risk for obesity onset.

  7. Strength of the Relationship Between Binge Eating and Depression • Only a few studies addressed the strength of the relationship between bingeing and depression. • In 1993, Berkowitz, Stunkard, and Stallings found that depression was related to the severity of binge eating in treatment seeking obese female adolescents. • Greenberg and Harvey (1996) found that severity of binge eating was significantly correlated with the coexistence of high levels of depression and dietary restraint. • Isnard (2003) found a strong significant positive relationship between binge eating severity and level of depression among obese adolescents seeking treatment. • Streigel-Moore et al. (1998) found that, in an obese population, subjects with subthreshold BED and overeaters tended to show higher levels of depressive traits than the non-binge eating control group, indicating a continuum of increasing depression risk with increasing binge eating.

  8. Which Samples Have a Stronger Relationship Between Bingeing and Depression? • Clinical samples measuring the relationship between depression and bingeing diagnostic status have consistently found that obese bingers experience higher rates of depression than obese non-bingers (Stice & Telch, 1998, Streigel-Moore et al, 1998). • Among eating disordered samples, higher levels of depression have been reported in bulimia samples than in binge eating disorder samples (Crow et al., 1996; Raymond et al., 1995). • In contrast, Peterson et al. (1998) found no differences in depression between BED purgers and BED non-purgers.

  9. Aims of the Current Meta-Analysis • Despite the number of studies examining the relationship between mood state and binge eating, the results have not been reviewed and analyzed using meta-analytic procedures. • The primary aim of the current meta-analysis is to clarify the magnitude of the relationship between depression/depressive symptoms and binge eating behavior. • The secondary aim of this meta-analysis is to test for the moderator sample type, to identify whether the relationship between binge eating and depression is stronger in some populations (obese) than in others (eating disorder samples).

  10. Method • Literature search • PsycINFO and PubMed • Binge and depression askeywords • Studies between 1994 and 2005 • 332 studies in PsycINFO and 343 in PubMed • Inclusion criteria • Binge eating and depression were operationalized clearly and measured. • Zero-order correlation was reported. • Only 10 studies were identified.

  11. Method (Cont’) • Coding and inter-rater reliability • Seven characteristics were coded • Categorical variables (Kappa): Research setting, sample type, participants’ gender and p-values of effect sizes • Continuous variables (ICC): Sample size and effect size • Procedure • Measurement error, not corrected • Barebones analysis, Schmidt and Hunter’s • Moderator analysis, Hedges & Olkin’s Q

  12. Results • Inter-rater reliability (Table 2) • All the Kappa values are equal to 1 except for coding of research setting. • Both ICCs are over .99 for continuous study characteristics. • Relationship between binge eating and depression (Table 4) • Estimated average of rho is .34.

  13. Results (Cont’) • Moderator analysis • Telch et al. (1994) was excluded • Six from obese samples and 6 from others • Q-test indicated overall heterogeneity (Q(11) = 28.33, p < .001) • The test of our moderator, ns (Q(1) = 0.72, p=.396)

  14. Summary • Meta-analysis revealed a significant, positive relationship between binge eating and depression. • The data were heterogeneous, but diagnosis did not significantly moderate the relationship.

  15. Moderation • Two possible reasons that diagnosis was not a significant moderator • It isn’t and future research should find one that is. • It is but we hade too few studies (12 effect sizes) to see it.

  16. Implications • Findings consistent with affect regulation model • But the data are cross-sectional • Of interest is the reciprocal relationship between these constructs

  17. Limitations • Small k • Inclusion of published studies

  18. Future Research • More studies so that we can re-examine diagnosis as a moderator • More studies to look at other potential moderators • Participant age • Participant gender

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