Emotional impulsivity drives subthreshold binge-eating in a cross-sectional sample of female students.
Authors: Vuillier, L. and Oakley, B.
Binge-eating is amongst the most commonly reported subthreshold eating disordered behaviour, affecting ~13% of female students. Evidence from full-threshold eating disorders suggests that emotional impulsivity, or ‘negative urgency’, is significantly associated with binge-eating. Nevertheless, the factors associated with subthreshold binge-eating in the student population remain under-investigated, despite its high prevalence and adverse consequences. Moreover, many studies rely on self-report measures of negative urgency, which may be inappropriate given the difficulties with emotional awareness and reporting identified in individuals with eating disordered behaviour. 70 female students without an eating disorder were recruited. The frequency of subthreshold binge-eating behaviour over the past 28 days was recorded. We administered widely validated questionnaires to measure alexithymia, emotion dysregulation and impulsivity. Finally, we administered a novel laboratory-based behavioural go-no-go task, with an emotional context, to index negative urgency. 40% of our sample reported subthreshold binge-eating in the past 28 days. Participants who reported binge-eating had significantly higher scores for self-reported alexithymia (p=1.20e-3, effect size r=0.39) and impulsivity (p=2.09e-5, r=0.51), and lower scores for impulse control in response to emotion (p=3.90e-4, r=0.42), as compared to students who never binged. Most notably, greater negative urgency, as assessed by our behavioural go-no-go task, was a unique predictor of higher binge-eating frequency (β=0.33; p=0.01; 95% CI for β [0.06; 0.43]), an effect maintained even after controlling for depression symptoms and eating concerns. Our findings demonstrate that emotionally-driven impulsive traits are significantly associated with subthreshold binge-eating in female students. Interventions that promote enhanced attention to one’s current emotional state and effective emotion regulation strategies are promising for managing binge-eating in the student population. We also validated a novel behavioural measure of negative urgency. This behavioural paradigm could be adapted for neuroimaging studies to identify neurological processes underpinning subthreshold binge-eating behaviours and what distinguishes them from full-threshold binge-eating.