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Exploring risk factors of food and alcohol disturbance (FAD) in U.S. college students

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

Current research examining mental health and history of childhood trauma as risk factors of food and alcohol disturbance (FAD) is limited. College students may be at greater risk to engage in FAD behaviors because of the common co-occurrence of alcohol misuse and disordered eating behaviors within college populations. Therefore, the current study examined anxiety, depression, and adverse childhood experiences as possible risk factors of FAD behaviors in a college student sample.

Methods

Two-hundred and seven undergraduate students from a large Midwest university completed a cross-sectional survey assessing history of adverse childhood experiences, depressive symptoms, anxiety symptoms, FAD behaviors, and frequency of alcohol use.

Results

Current symptoms of generalized anxiety were significantly associated with engagement in FAD behaviors (Alcohol Effects subscale, β = 0.13, F(1, 204) = 4.10, p = 0.04; Bulimia subscale, β = 0.17, F(1, 204) = 6.19, p = 0.01; Diet and Exercise subscale, β = 0.19, F(1, 204) = 9.05, p < 0.01). Adverse childhood experiences were associated with engagement in FAD behaviors (Alcohol Effects subscale, β = 0.14, F(1, 204) = 4.27, p = 0.04). Current depressive symptoms were not significantly associated with FAD behaviors.

Conclusions

Study findings suggest that students who experience greater current symptoms of anxiety are at a greater risk to engage in FAD behaviors. Further understanding the role of anxiety in the development and maintenance of FAD behaviors may provide clinically useful information for the prevention and treatment of FAD behaviors. These findings highlight the need for further research to examine psychological distress as a risk factor for engagement in FAD behaviors longitudinally, in a larger, more diverse study sample.

Level of evidence

Level V, cross-sectional descriptive study.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not Applicable.

References

  1. Hunt TK, Forbush KT (2016) Is “drunkorexia” an eating disorder, substance use disorder, or both? Eat Behav 22:40–45. https://doi.org/10.1016/j.eatbeh.2016.03.034

    Article  PubMed  Google Scholar 

  2. Choquette EM, Rancourt D, Kevin Thompson J (2018) From fad to fad: a theoretical formulation and proposed name change for “drunkorexia” to food and alcohol disturbance (fad). Int J Eat Disord 51(8):831–834. https://doi.org/10.1002/eat.22926

    Article  PubMed  Google Scholar 

  3. Horváth Z, Román N, Elekes Z, Griffiths MD, Demetrovics Z, Urbán R (2020) Alcohol consumption and risk for feeding and eating disorders in adolescence: the mediating role of drinking motives. Addict behav 107:106431

    Article  Google Scholar 

  4. Rahal CJ, Bryant JB, Darkes J, Menzel JE, Thompson JK (2012) Development and validation of the compensatory eating and behaviors in response to alcohol consumption scale (CEBRACS). Eat Behav 13(2):83–87. https://doi.org/10.1016/j.eatbeh.2011.11.001

    Article  PubMed  Google Scholar 

  5. Bryant JB, Darkes J, Rahal C (2012) College students’ compensatory eating and behaviors in response to alcohol consumption. J Am Coll Health 60(5):350–356. https://doi.org/10.1080/07448481.2011.630702

    Article  PubMed  Google Scholar 

  6. Burke SC, Cremeens J, Vail-Smith K, Woolsey C (2010) Drunkorexia: Calorie restriction prior to alcohol consumption among college freshmen. J Alcohol Drug Educ 54(2): 17–34. Retrieved from https://search.proquest.com/docview/748830032?accountid=2909

  7. Griffin BL, Vogt KS (2021) Drunkorexia: is it really “just” a university lifestyle choice? Eat Weight Disord 26:2021–2031. https://doi.org/10.1007/s40519-020-01051-x

    Article  PubMed  Google Scholar 

  8. Palermo M, Choquette EM, Ahlich E, Rancourt D (2020) Food and alcohol disturbance by athlete status: the roles of drive for thinness, drive for muscularity, and sex. J Am Coll Health. https://doi.org/10.1080/07448481.2020.1713791

    Article  PubMed  Google Scholar 

  9. Choquette EM, Ordaz DL, Melioli T, Delage B, Chabrol H, Rodgers R, Thompson JK (2018) Food and alcohol disturbance (FAD) in the U.S. and France: nationality and gender effects and relations to drive for thinness and alcohol use. Eat Behav 31:113–119. https://doi.org/10.1016/j.eatbeh.2018.09.002

    Article  PubMed  Google Scholar 

  10. Marengo SM, Klibert J, Langhinrichsen-Rohling J, Warren J, Smalley KB (2019) The relationship of early maladaptive schemas and anticipated risky behaviors in college students. J Adult Dev 26:190–200. https://doi.org/10.1007/s10804-018-9313-1

    Article  Google Scholar 

  11. Perryman M, Barnard M, Reysen R (2018) College students’ disordered eating, substance use, and body satisfaction. Coll Stud J 52(4):516–522

    Google Scholar 

  12. Arria AM, Caldeira KM, Allen HK, Bugbee BA, Vincent KB, O’Grady KE (2017) Prevalence and incidence of drug use among college students: an 8-year longitudinal analysis. Am J Drug Alcohol Abuse 43(6):711–718. https://doi.org/10.1080/00952990.2017.1310219

    Article  PubMed  PubMed Central  Google Scholar 

  13. Borsari B, Carey KB (2001) Peer influences on college drinking: a review of the research. J Subst Abuse 13(4):391–424. https://doi.org/10.1016/S0899-3289(01)00098-0

    Article  CAS  PubMed  Google Scholar 

  14. Krieger H, Young CM, Anthenien AM, Neighbors C (2018) The epidemiology of binge drinking among college-age individuals in the United States. Alcohol Res 39(1):23–30

    PubMed  PubMed Central  Google Scholar 

  15. Gropper SS, Simmons KP, Gaines A, Drawdy K, Saunders D, Ulrich P, Connell LJ (2009) The freshman 15—a closer look. J Am Coll Health 58(3):223–231. https://doi.org/10.1080/07448480903295334

    Article  PubMed  Google Scholar 

  16. Hoffman DJ, Policastro P, Quick V, Lee SK (2006) Changes in body weight and fat mass of men and women in the first year of college: a study of the" freshman 15". J Am Coll Health 55(1):41–46. https://doi.org/10.3200/JACH.55.1.41-46

    Article  PubMed  Google Scholar 

  17. Roosen KM, Mills JS (2015) Exploring the motives and mental health correlates of intentional food restriction prior to alcohol use in university students. J Health Psychol 20(6):875–886. https://doi.org/10.1177/1359105315573436

    Article  PubMed  Google Scholar 

  18. Borsari B, Murphy JG, Barnett NP (2007) Predictors of alcohol use during the first year of college: implications for prevention. Addict Behav 32(10):2062–2086. https://doi.org/10.1016/j.addbeh.2007.01.017

    Article  PubMed  PubMed Central  Google Scholar 

  19. Giles SM, Champion H, Sutfin EL, Mccoy TP, Wagoner K (2009) Calorie restriction on drinking days: an examination of drinking consequences among college students. J Am Coll Health 57(6):603–610. https://doi.org/10.3200/jach.57.6.603-610

    Article  PubMed  PubMed Central  Google Scholar 

  20. Neighbors C, Lee CM, Lewis MA, Fossos N, Larimer ME (2007) Are social norms the best predictor of outcomes among heavy-drinking college students? J Stud Alcohol Drugs 68(4):556–565. https://doi.org/10.15288/jsad.2007.68.556

    Article  PubMed  Google Scholar 

  21. Talbott LL, Martin RJ, Usdan SL, Leeper JD, Umstattd MR, Cremeens JL, Geiger BF (2008) Drinking likelihood, alcohol problems, and peer influence among first-year college students. Am J Drug Alcohol Abuse 34(4):433–440. https://doi.org/10.1080/00952990802122655

    Article  PubMed  Google Scholar 

  22. Lupi M, Martinotti G, Giannantonio MD (2017) Drunkorexia: an emerging trend in young adults. Eat Weight Disord 22(4):619–622. https://doi.org/10.1007/s40519-017-0429-2

    Article  PubMed  Google Scholar 

  23. Mersky J, Topitzes J, Reynolds A (2013) Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: a cohort study of an urban, minority sample in the US. Child Abuse Negl 37(11):917–925. https://doi.org/10.1016/j.chiabu.2013.07.011

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Speranza M, Atger F, Corcos M, Loas G, Guilbaud O, Stéphan P, Perez-Diaz F, Halfon O, Venisse JL, Bizouard, P, Lang F, Flament M, Jeammet P (2003) Depressive psychopathology and adverse childhood experiences in eating disorders. Eur Psychiatry 18(8):377–383. https://doi.org/10.1016/j.eurpsy.2003.04.001

    Article  PubMed  Google Scholar 

  25. Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, Jones L, Dunne MP (2017) The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health 2(8):e356. https://doi.org/10.1016/s2468-2667(17)30118-4

    Article  PubMed  Google Scholar 

  26. Rothman EF, Dejong W, Palfai T, Saitz R (2008) Relationship of age of first drink to alcohol-related consequences among college students with unhealthy alcohol use. Subst Abus 29(1):33–41. https://doi.org/10.1300/j465v29n01_05

    Article  PubMed  Google Scholar 

  27. Smyth JM, Heron KE, Wonderlich SA, Crosby RD, Thompson KM (2008) The influence of reported trauma and adverse events on eating disturbance in young adults. Int J Eat Disord 41(3):195–202. https://doi.org/10.1002/eat.20490

    Article  PubMed  Google Scholar 

  28. Deboer LB, Smits JAJ (2013) Anxiety and disordered eating. Cognit Ther Res 37(5):887–889. https://doi.org/10.1007/s10608-013-9565-9

    Article  PubMed  PubMed Central  Google Scholar 

  29. Godart NT, Flament MF, Perdereau F, Jeammet P (2002) Comorbidity between eating disorders and anxiety disorders: a review. Int J Eat Disord 32(3):253–270. https://doi.org/10.1002/eat.10096

    Article  CAS  PubMed  Google Scholar 

  30. Kushner M, Abrams K, Borchardt C (2000) The relationship between anxiety disorders and alcohol use disorders a review of major perspectives and findings. Clin Psychol Rev 20(2):149–171. https://doi.org/10.1016/s0272-7358(99)00027-6

    Article  CAS  PubMed  Google Scholar 

  31. Dawson DA, Grant BF, Stinson FS, Chou PS (2005) Psychopathology associated with drinking and alcohol use disorders in the college and general adult populations. Drug Alcohol Depend 77(2):139–150. https://doi.org/10.1016/j.drugalcdep.2004.07.012

    Article  PubMed  Google Scholar 

  32. Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK (1990) Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA 264(19):2511–2518. https://doi.org/10.1001/jama.264.19.2511

    Article  CAS  PubMed  Google Scholar 

  33. Santos M, Richards CS, Bleckley MK (2007) Comorbidity between depression and disordered eating in adolescents. Eat Behav 8(4):440–449. https://doi.org/10.1016/j.eatbeh.2007.03.005

    Article  PubMed  Google Scholar 

  34. Gilles DM, Turk CL, Fresco DM (2006) Social anxiety, alcohol expectancies, and self-efficacy as predictors of heavy drinking in college students. Addict Behav 31(3):388–398. https://doi.org/10.1016/j.addbeh.2005.05.020

    Article  PubMed  Google Scholar 

  35. Schry AR, White SW (2013) Understanding the relationship between social anxiety and alcohol use in college students: a meta-analysis. Addict Behav 38(11):2690–2706. https://doi.org/10.1016/j.addbeh.2013.06.014

    Article  PubMed  Google Scholar 

  36. Terlecki M, Ecker A, Buckner J (2014) Drinking context influences the association between social anxiety and drinking problems in undergraduates. Psychol Addict Behav 28(2):545–552. https://doi.org/10.1037/e520702015-013

    Article  PubMed  PubMed Central  Google Scholar 

  37. Laghi F, Pompili S, Bianchi D, Lonigro A, Baiocco R (2020) Exploring the association between psychological distress and drunkorexia behaviors in non-clinical adolescents: the moderating role of emotional dysregulation. Eat Weight Disord. https://doi.org/10.1007/s40519-020-00912-9

    Article  PubMed  Google Scholar 

  38. Kelly-Weeder S (2011) Binge drinking and disordered eating in college students. J Am Assoc Nurse Pract 23(1):33–41. https://doi.org/10.1111/j.1745-7599.2010.00568.x

    Article  Google Scholar 

  39. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med 14(4):245–258. https://doi.org/10.1016/s0749-3797(98)00017-8

    Article  CAS  PubMed  Google Scholar 

  40. Adverse Childhood Experiences International Questionnaire (2018) ACE-IQ. Retrieved from https://www.who.int/violence_injury_prevention/violence/activities/adverse_childhood_experiences/en/

  41. Murphy A, Steele M, Dube SR, Bate J, Bonuck K, Meissner P, Goldman H, Steele H (2014) Adverse childhood experiences (ACEs) questionnaire and adult attachment interview (AAI): implications for parent child relationships. Child Abuse Negl 38(2):224–233. https://doi.org/10.1016/j.chiabu.2013.09.004

    Article  PubMed  Google Scholar 

  42. Spitzer RL, Kroenke K, Williams JB, Löwe B (2006) A brief measure for assessing generalized anxiety disorder. Arch Intern Med 166(10):1092. https://doi.org/10.1001/archinte.166.10.1092

    Article  PubMed  Google Scholar 

  43. Williams N (2014) The GAD-7 questionnaire. Occup Med 64(3):224–224

    Article  Google Scholar 

  44. Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, Herzberg PY (2008) Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Med Care 46(3):266–274. https://doi.org/10.1097/mlr.0b013e318160d093

    Article  PubMed  Google Scholar 

  45. Radloff LS (1977) The CES-D Scale. Appl Psychol Meas 1(3):385–401. https://doi.org/10.1177/014662167700100306

    Article  Google Scholar 

  46. Roberts RE, Lewinsohn PM, Seeley JR (1991) Screening for adolescent depression: a comparison of depression scales. J Am Acad Child Psy 30(1):58–66. https://doi.org/10.1192/bjp.141.1.45

    Article  CAS  Google Scholar 

  47. Rushton JL, Forcier M, Schectman RM (2002) Epidemiology of depressive symptoms in the national longitudinal study of adolescent health. J Am Acad Child Psy 41(2):199–205. https://doi.org/10.1097/00004583-200202000-00014

    Article  Google Scholar 

  48. Choquette EM (2017) A Psychometric Evaluation of the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS). Graduate Theses and Dissertations

  49. D’Zurilla TJ, Sheedy CF (1991) Relation between social problem-solving ability and subsequent level of psychological stress in college students. J Pers Soc Psychol 61(5):841–846

    Article  CAS  Google Scholar 

  50. Grossbard JR, Lee CM, Neighbors C, Larimer ME (2008) Body image concerns and contingent self-esteem in male and female college students. Sex Roles 60(3–4):198–207. https://doi.org/10.1007/s11199-008-9535-y

    Article  PubMed  PubMed Central  Google Scholar 

  51. Hoffman DJ, Policastro P, Quick V, Lee S (2006) Changes in body weight and fat mass of men and women in the first year of college: a study of the “Freshman 15.” J Am Coll Health 55(1):41–46. https://doi.org/10.3200/jach.55.1.41-46

    Article  PubMed  Google Scholar 

  52. Rothman EF, Bernstein J, Strunin L (2010) Why might adverse childhood experiences lead to underage drinking among US youth? Findings from an emergency department-based qualitative pilot study. Subst Use Misuse 45(13):2281–2290. https://doi.org/10.3109/10826084.2010.482369

    Article  PubMed  Google Scholar 

  53. Maguire-Jack K, Lanier P, Lombardi B (2020) Investigating racial differences in clusters of adverse childhood experiences. Am J Orthopsychiatry 90(1):106–114. https://doi.org/10.1037/ort0000405

    Article  PubMed  Google Scholar 

  54. Sacks V, Murphey D (2018). The prevalence of adverse childhood experiences, nationally, by state, and by race/ethnicity. Child Trends: 1–20

  55. Stahl SM (2002) The psychopharmacology of energy and fatigue. J Clin Psychiatry 63(1):7–8. https://doi.org/10.4088/jcp.v63n0102

    Article  PubMed  Google Scholar 

  56. Gillen MM, Markey CN, Markey PM (2012) An examination of dieting behaviors among adults: links with depression. Eat Behav 13(2):88–93. https://doi.org/10.1016/j.eatbeh.2011.11.014

    Article  PubMed  Google Scholar 

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Funding

This work was supported by funding from the National Center for Advancing Translational Sciences of the NIH through grant support for the Center for Clinical and Translational Science and Training (1UL1TR001425-01).

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Authors and Affiliations

  1. Department of Psychology, University of Cincinnati, Edwards One, 45 W. Corry Blvd, Cincinnati, OH, 45221, USA

    Taylor Gates & Cathleen Odar Stough

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Contributions

Taylor Gates and Cathleen Odar Stough designed the study and wrote the protocol. Taylor Gates conducted literature searches and provided summaries of previous research studies. Taylor Gates and Cathleen Odar Stough conducted the statistical analyses. Taylor Gates wrote the first draft of the manuscript and Cathleen Odar Stough contributed to and approved the final manuscript. TG: Conceptualization, Methodology, Formal analyses, Investigation, Writing—original draft, Writing—review & editing. COS: Conceptualization, Methodology, Investigation, Writing—review & editing, Supervision.

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Correspondence to Taylor Gates.

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All authors declare no conflicts of interest.

Ethical approval

The questionnaire and methodology for this study was approved by the Institutional Review Board (IRB) of the University of Cincinnati (Ethics Approval Number: IRB Registration #: 00000180 FWA #: 000003152).

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Informed consent was obtained from all individual participants included in the study.

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Informed consent for publication and dissemination of results was obtained from all individual participants included in the study.

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Gates, T., Odar Stough, C. Exploring risk factors of food and alcohol disturbance (FAD) in U.S. college students. Eat Weight Disord 27, 1739–1749 (2022). https://doi.org/10.1007/s40519-021-01313-2

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