Alexander Rice1,2, Jason M Lavender3,4,5, Lisa M Shank1,2,6,7,8, M K Higgins Neyland1,2,6, Bethelhem Markos1,2, Hannah Repke1,2, Hannah Haynes1,2,7, Julia Gallagher-Teske1,2, Natasha A Schvey7,8, Tracy Sbrocco8, Denise E Wilfley9, Brian Ford10, Caitlin B Ford11, Sarah Jorgensen12, Jack A Yanovski7, Mark Haigney1,6, David A Klein10, Jeffrey Quinlan12, Marian Tanofsky-Kraff1,6,7,8. 1. Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA. 2. The Metis Foundation, San Antonio, TX, USA. 3. Military Cardiovascular Outcomes Research (MiCOR) Program, Uniformed Services University of the Health Sciences (USU) and the Metis Foundation, Bethesda, MD, USA. jason.lavender.ctr@usuhs.edu. 4. The Metis Foundation, San Antonio, TX, USA. jason.lavender.ctr@usuhs.edu. 5. Department of Medicine, USU, Bethesda, MD, USA. jason.lavender.ctr@usuhs.edu. 6. Department of Medicine, USU, Bethesda, MD, USA. 7. Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, 10 Center Drive, Bethesda, MD, USA. 8. Department of Medical and Clinical Psychology, USU, Bethesda, MD, USA. 9. Washington University School of Medicine, St. Louis, MO, USA. 10. Department of Family Medicine, USU, Bethesda, MD, USA. 11. Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA. 12. Department of Family Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Abstract
PURPOSE: Evidence suggests that difficulties identifying and describing one's feelings, core components of alexithymia, are associated with attitudinal and behavioral symptoms of disordered eating; depressive symptoms also may underlie these associations. Specifically, research indicates that alexithymia is positively related to depressive symptoms, which in turn may promote both disordered-eating attitudes and certain disinhibited-eating behaviors (e.g., emotional eating). Findings also suggest that military-dependent youth with high weight may exhibit elevated depressive symptoms and disordered eating. As such, understanding associations among alexithymia, depressive symptoms, and disordered eating is particularly relevant for this vulnerable population. METHODS: We examined 149 adolescent military dependents (14.4 ± 1.6y; 55.0% female; 20.0% non-Hispanic Black; BMIz: 1.9 ± 0.4) at high risk for binge-eating disorder and obesity in adulthood. Participants completed questionnaires assessing two components of alexithymia (difficulty identifying feelings [DIF] and difficulty describing feelings [DDF]), depressive symptoms, emotional eating, and trait anxiety; disordered-eating attitudes were assessed via semi-structured interview. RESULTS: A series of regression-based models examined indirect relationships of DIF and DDF with disordered-eating attitudes and emotional eating through depressive symptoms. Bootstrapped 95% confidence intervals revealed a significant indirect path from each of the alexithymia components to disordered-eating attitudes via depressive symptoms; indirect paths to emotional eating were non-significant. CONCLUSION: Results support the salience of depressive symptoms in the relationship between alexithymia and disordered-eating attitudes. Future research should utilize prospective designs and explore direct and indirect associations of alexithymia with other disordered-eating behaviors. LEVEL OF EVIDENCE: Level III, evidence obtained from a well-designed cohort study.
PURPOSE: Evidence suggests that difficulties identifying and describing one's feelings, core components of alexithymia, are associated with attitudinal and behavioral symptoms of disordered eating; depressive symptoms also may underlie these associations. Specifically, research indicates that alexithymia is positively related to depressive symptoms, which in turn may promote both disordered-eating attitudes and certain disinhibited-eating behaviors (e.g., emotional eating). Findings also suggest that military-dependent youth with high weight may exhibit elevated depressive symptoms and disordered eating. As such, understanding associations among alexithymia, depressive symptoms, and disordered eating is particularly relevant for this vulnerable population. METHODS: We examined 149 adolescent military dependents (14.4 ± 1.6y; 55.0% female; 20.0% non-Hispanic Black; BMIz: 1.9 ± 0.4) at high risk for binge-eating disorder and obesity in adulthood. Participants completed questionnaires assessing two components of alexithymia (difficulty identifying feelings [DIF] and difficulty describing feelings [DDF]), depressive symptoms, emotional eating, and trait anxiety; disordered-eating attitudes were assessed via semi-structured interview. RESULTS: A series of regression-based models examined indirect relationships of DIF and DDF with disordered-eating attitudes and emotional eating through depressive symptoms. Bootstrapped 95% confidence intervals revealed a significant indirect path from each of the alexithymia components to disordered-eating attitudes via depressive symptoms; indirect paths to emotional eating were non-significant. CONCLUSION: Results support the salience of depressive symptoms in the relationship between alexithymia and disordered-eating attitudes. Future research should utilize prospective designs and explore direct and indirect associations of alexithymia with other disordered-eating behaviors. LEVEL OF EVIDENCE: Level III, evidence obtained from a well-designed cohort study.