TY - JOUR
T1 - Ecological momentary assessment of stressful events and negative affect in bulimia nervosa
AU - Goldschmidt, Andrea B.
AU - Wonderlich, Stephen A.
AU - Crosby, Ross D.
AU - Engel, Scott G.
AU - Lavender, Jason M.
AU - Peterson, Carol B.
AU - Crow, Scott J.
AU - Cao, Li
AU - Mitchell, James E.
PY - 2014/2
Y1 - 2014/2
N2 - Objective: Negative affect precedes binge eating and purging in bulimia nervosa (BN), but little is known about factors that precipitate negative affect in relation to these behaviors. We aimed to assess the temporal relation among stressful events, negative affect, and bulimic events in the natural environment using ecological momentary assessment. Method: A total of 133 women with current BN recorded their mood, eating behavior, and the occurrence of stressful events every day for 2 weeks. Multilevel structural equation mediation models evaluated the relations among Time 1 stress measures (i.e., interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal), Time 2 negative affect, and Time 2 binge eating and purging, controlling for Time 1 negative affect. Results: Increases in negative affect from Time 1 to Time 2 significantly mediated the relations between Time 1 interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal and Time 2 binge eating and purging. When modeled simultaneously, confidence intervals for interpersonal stressors, general daily hassles, and stress appraisal did not overlap, suggesting that each had a distinct impact on negative affect in relation to binge eating and purging. Conclusions: Our findings indicate that stress precedes the occurrence of bulimic behaviors and that increases in negative affect following stressful events mediate this relation. Results suggest that stress and subsequent negative affect may function as maintenance factors for bulimic behaviors and should be targeted in treatment.
AB - Objective: Negative affect precedes binge eating and purging in bulimia nervosa (BN), but little is known about factors that precipitate negative affect in relation to these behaviors. We aimed to assess the temporal relation among stressful events, negative affect, and bulimic events in the natural environment using ecological momentary assessment. Method: A total of 133 women with current BN recorded their mood, eating behavior, and the occurrence of stressful events every day for 2 weeks. Multilevel structural equation mediation models evaluated the relations among Time 1 stress measures (i.e., interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal), Time 2 negative affect, and Time 2 binge eating and purging, controlling for Time 1 negative affect. Results: Increases in negative affect from Time 1 to Time 2 significantly mediated the relations between Time 1 interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal and Time 2 binge eating and purging. When modeled simultaneously, confidence intervals for interpersonal stressors, general daily hassles, and stress appraisal did not overlap, suggesting that each had a distinct impact on negative affect in relation to binge eating and purging. Conclusions: Our findings indicate that stress precedes the occurrence of bulimic behaviors and that increases in negative affect following stressful events mediate this relation. Results suggest that stress and subsequent negative affect may function as maintenance factors for bulimic behaviors and should be targeted in treatment.
KW - binge eating
KW - bulimia nervosa
KW - ecological momentary assessment
KW - negative affect
KW - stress
UR - http://www.scopus.com/inward/record.url?scp=84893749481&partnerID=8YFLogxK
U2 - 10.1037/a0034974
DO - 10.1037/a0034974
M3 - Article
C2 - 24219182
AN - SCOPUS:84893749481
SN - 0022-006X
VL - 82
SP - 30
EP - 39
JO - Journal of Consulting and Clinical Psychology
JF - Journal of Consulting and Clinical Psychology
IS - 1
ER -