Expectancies regarding food and emotion regulation in patients with Binge Eating Disorder

Negative mood states influence eating disordered behaviors in subjects with
Binge Eating Disorder (BED). A link exists between emotional disturbances or
negative emotional states and binge eating behaviors (Grilo & Shiffman, 1994).
Although mood is worse overall for women with Binge Eating Disorder (BED), mood
is especially poor before binge episodes (Greeno, Wing, & Shiffman, 2000).
Furthermore, depressive disorders are the most prevalent lifetime diagnosis in
individuals with Binge Eating Disorder (Dingemans, Spinhoven, & Van Furth,
2007). In our previous study (Dingemans, Martijn, Jansen, & van Furth, 2007)
the role of negative emotions on binge eating in 66 patients with Binge Eating
Disorder (BED) was investigated. Mood worsened during the mood induction and
elevated back to baseline during the taste task. We hypothesized that
overeating might serve as a mean to repair one*s negative mood because people
give priority to affect regulation as Tice at al also suggested in their
studies (Tice, Bratslavsky, & Baumeister, 2001). Other studies also found
support for the fact that binge eating (temporarily) decreases the level of
negative emotions. Negative affect is reported to change over the course of
binge eating. Eating makes them feel better or makes them have less intense
negative emotions. Sad people often indulge in fattening snacks because they
believe that eating repairs their mood (Tice et al., 2001). Performance, and
especially continuous attempts at self-control, are strongly guided by people*s
expectations and cognitions about how self-control operates (Martijn, Tenbult,
Merckelbach, Dreezens, & de Vries, 2002). People tend to abandon or violate
their normal self-regulatory efforts because they give priority to affect
regulation. It might be hypothesized that they expect that fattening foods
improve their mood. In for example advertisements of the food industry a link
is often made between food and positive emotions. An example is the recently
launched media campaign by Mars® called *Mars gives you ernergy* in which the
name *Mars®* is temporarily replaced by *happy*, *love*or *feel good* on the
wrapper of the well-known chocolate bar. Frequent exposure to these kinds of
messages in the media or elsewhere might influence people*s expectancies
regarding food and mood. The expectancy learning theory (Smith, Simmons,
Flory, Annus, & Hill, 2007) postulates that one forms expectancies for the
consequences of various behaviors as a result of one*s learning history. These
expectancies influence one*s future behavioral choices. One*s expectancies for
the consequences of a given behavior are a summary of one*s learning history
and are thus the cognitive mechanisms by which prior learning leads to
subsequent behavior. The expectancy that eating helps alleviate affect might
predict increases in binge eating (Stice, 2001). Expectancies are thought to be
the mechanism by which prior learning influences behavior. Binge eating is
thought to result from extreme expectancies (Smith et al., 2007). Bulimic
patients have higher expectations that eating will help them regulate their
negative affect than anorexic patients and healthy controls (Hohlstein, Smith,
& Atlas, 1998) (Smith et al., 2007).
The results in our previous experimental study also showed that there is a
positive relation between depressive symptoms and caloric intake after a
negative mood induction. Individuals with BED who had severe depressive
symptoms consumed more calories than individuals who had no or mild depressive
symptoms. Furthermore, severely depressed BED patients who reported more
negative mood changes during the film fragment and those who reported more
positive mood change during the taste task had a higher caloric intake.
The results from our previous study only indicated that there is a positive
correlation between mood changes after the taste task and caloric intake. It
might be hypothesized that patients with Binge Eating Disorder engage in binge
eating because they expect that high calorie food alleviate their negative
mood.

The aim of the present study is to test whether there is a causal relationship
between expectancies regarding the effect of eating on mood, changes in mood
and actual caloric intake. In order to test whether there is a causal
relationship between expectancies and increased caloric intake, one must show
that expectancy modification produces changes in caloric intake. We hypothesize
that patients with BED overeat significantly more after a negative mood
induction compared to a positive mood induction.

The hypothesis that there is a causal relationship between expectancies
regarding the effect of eating on mood, changes in mood and actual caloric
intake will be tested in a 2 (Food-mood repair: expectancy confirmation versus
expectancy disconfirmation) by 2 (Mood induction: positive versus negative)
between-subjects design.

In the present study 80 participants will be randomly assigned to one of four
conditions:
1. A condition in which the expectancies that eating helps alleviate negative
mood are confirmed. This will be followed by a negative mood induction.
2. A condition in which the expectancies that eating helps alleviate negative
mood are disconfirmed. They receive information about food that states that
food will not alleviate their mood. The relation between eating and mood
alleviating will be disconfirmed. This will be followed by a negative mood
induction.
3. A condition in which the expectancies that eating helps alleviate negative
mood are confirmed followed by a positive mood induction.
4. A condition in which the expectancies that eating helps alleviate negative
mood are disconfirmed, followed by a positive mood induction.
Subsequently all participants are subjected to a taste task in which they have
to taste different kinds of food (chocolate, potato chips, cake and marsh
mellow).

Not applicable