Optimizing prediction of binge eating episodes : a comparison approach to test alternative conceptualizations of the affect regulation model

Abstract

Background : Although a wealth of studies have tested the link between negative mood states and likelihood of a subsequent binge eating episode, the assumption that this relationship follows a typical linear dose&ndash;response pattern (i.e., that risk of a binge episode increases in proportion to level of negative mood) has not been challenged. The present study demonstrates the applicability of an alternative, non-linear conceptualization of this relationship, in which the strength of association between negative mood and probability of a binge episode increases above a threshold value for the mood variable relative to the slope below this threshold value (threshold dose response model). Methods : A sample of 93 women aged 18 to 40 completed an online survey at random intervals seven times per day for a period of one week. Participants self-reported their current mood state and whether they had recently engaged in an eating episode symptomatic of a binge. Results : As hypothesized, the threshold approach was a better predictor than the linear dose&ndash;response modeling of likelihood of a binge episode. The superiority of the threshold approach was found even at low levels of negative mood (3 out of 10, with higher scores reflecting more&nbsp; negative mood). Additionally, severity of negative mood beyond this threshold value appears to be useful for predicting time to onset of a binge episode. Conclusions : Present findings suggest that simple dose&ndash;response formulations for the association between&nbsp; negative mood and onset of binge episodes miss vital aspects of this relationship. Most&nbsp; notably, the impact of mood on binge eating appears to depend on whether a threshold value&nbsp; of negative mood has been breached, and elevation in mood beyond this point may be useful&nbsp; for clinicians and researchers to identify time to onset. <br /