Insecure attachment, negative affectivity, alexithymia, level of emotional awareness, and body image disturbance as predictors of binge eating severity in women who binge

This study examined a model for predicting binge eating grounded in attachment theory. Binge eating was conceptualized as a means for regulating aversive emotional arousal and was theoretically linked with each of the predictor variables in a developmental trajectory beginning with insecure attachment. Anxious attachment, avoidant attachment, negative affectivity, alexithymia, level of emotional awareness, and body image disturbance were entered in a hierarchical regression model for three separate outcome measures of binge eating: objective binge eating, emotional overeating, and eating concerns.; The participants were 290 adult women who responded to an Internet advertisement for a paid research study on binge eating and who endorsed at least one episode of binge eating during the past 6 months. Participants were excluded if they purged on average two or more times per week or if they were presently engaged in any form of psychological treatment or support group. The Internet-based survey was designed to assess the predictor variables with the following measures: The Revised Experiences in Close Relationships Scale (ECR-R); Revised NEO Personality Inventory NEO PI-R) Neuroticism scale; Twenty-item Toronto Alexithymia Scale (TAS-20); Levels of Emotional Awareness Scale (LEAS); and Body Shape Questionnaire (BSQ). The outcome variables were measured with the Eating Disorder Examination Questionnaire (EDE-Q Item 15 and EDE-Q Eating Concern subscale) and the Emotional Overeating Questionnaire (EOQ).; The regression model accounted substantially and significantly for the variability in outcome measures for objective binge eating, eating concerns, and emotional overeating. Anxious attachment and negative affectivity were key underlying factors in body image disturbance, which in turn was the strongest predictor of the three binge eating outcome measures. Body mass index contributed to body image disturbance but added minimally to the overall ability of the model to predict binge eating outcomes. High levels of distress and body image disturbance were associated with even sub-clinical frequencies of binge eating and were evident throughout the range of body weight from normal to obese. The results of this study support inclusion of Binge Eating Disorder (BED) as a discrete DSM eating disorder diagnosis and suggest that body image disturbance be included in the diagnostic criteria for BED.; Key words. Binge Eating, Eating Disorders, Obesity, Emotion Regulation, Anxious Attachment, Avoidant Attachment, Negative Affectivity, Alexithymia, Emotional Awareness, Body Image Disturbance, Body Mass Index, Binge Eating Disorder, Emotional Overeating, Eating Concerns.