The acquired preparedness model of risk for binge eating disorder: Integrating nonspecific and specific risk processes

Risk for binge eating disorder (BED) involves both nonspecific factors (those increasing risk for multiple disorders) and specific factors (those unique to BED). The authors decompose the disorder by examining examples of both types of constructs. In particular, they argue that BED, bulimia nervosa, problem drinking, problem gambling, smoking, and risky sex are all caused, in part, by a disposition to engage in rash actions when experiencing intense emotions. This disposition is called urgency. They provide evidence that, among high urgency individuals, the particular expression of rash action (such as binge eating) is a function of learning events specific to the disorder. In this way, they present an etiologic model that integrates nonspecific and specific contributors to risk. They describe the risk model in detail, including its microgenetic, neurotransmitter, brain system, personality, and learning components. They also contrast BED with both bulimia nervosa and anorexia nervosa, by describing dimensions of dysfunction for the latter two disorders that are not present in BED. Their theory involves both differentiation (of BED from other eating disorders) and integration (between BED and other urgencybased disorders).