Dynamic relations between interpersonal stressors, affective states, and binge eating in adolescent girls - Project Summary/Abstract Binge-spectrum eating disorders (BSEDs; e.g., bulimia nervosa and binge eating disorder) are serious mental health disorders that are prevalent among adolescents. The defining feature and primary treatment target for BSEDs is recurrent episodes of binge eating (BE; i.e., overeating while experiencing a loss of control over one’s eating). Despite a need to intervene on BE during adolescence to reduce long-lasting deleterious psychosocial and physical health outcomes, outcomes from existing treatments are suboptimal, possibly because the maintenance factors of BE during adolescence are poorly understood and available treatments may not effectively target the most potent mechanisms. Thus, research is urgently needed to identify novel mechanisms of adolescent BE to advance the development of interventions. Adolescence is a period characterized by significant social and emotional change. Consequently, adolescents display heightened sensitivity to social evaluation, and the quality of adolescent social relationships is robustly linked to mental health outcomes. Adolescence is also a critical period for socioemotional learning and the development of abilities to regulate negative affect, which is theorized to maintain BE. Thus, one theory of BE that may be particularly relevant during adolescence is the interpersonal model, which proposes that interpersonal stressors predict BE, and this relationship is mediated by increases in negative affect. Harnessing digital assessment tools and advanced statistical methods has the potential to examine the interpersonal model and identify intervention targets by: 1) Testing the interpersonal model on a momentary level in adolescents’ natural environments to uncover temporal relations between interpersonal stressors, affective states, and adolescent BE and reveal opportune moments for support; 2) Exploring heterogeneity within the interpersonal model based on key individual characteristics (i.e., dietary restraint and emotion regulation) to inform the development of personalized interventions; and 3) Exploring how specific types of interpersonal stressors (e.g., peer rejection, parental conflict) and affective states (e.g., anger, embarrassment) may differentially contribute to BE within the interpersonal model, which could serve to refine theories of adolescent BE and inform tailored intervention approaches. The proposed study will employ ecological momentary assessment (EMA) to examine temporal relations between interpersonal stressors, affective states, and BE among 30 adolescent (ages 14-18) girls with BSEDs. We will test the prospective effects of experiencing an interpersonal stressor on BE and examine the mediating role of negative affect. We will also examine if the strength of the relationships between interpersonal stressors, negative affect, and BE varies based on dietary restraint and emotion regulation. Exploratory analyses will examine the relative temporal effects of specific types of interpersonal stressors and specific affective states on BE. This study has the potential to significantly advance understanding of mechanisms of adolescent BE and inform the development of novel, real-time interventions.
