A longitudinal test of impulsivity and depression pathways to early binge eating onset

Objective: The very early engagement in bulimic behaviors, such as binge eating, may be influenced by factors that dispose individuals to impulsive action as well as by factors that dispose individuals to depressive symptomatology. Using a longitudinal design, we conducted the first test of the simultaneous operation of both risk factors as children transition from elementary to middle school. Method In a sample of 1,906 children, we assessed risk for impulsive action (negative urgency, which is the tendency to act rashly when distressed, and eating expectancies, which are learned anticipations that eating will alleviate negative mood) and risk for depression (negative affect and depressive symptomatology) and binge eating behavior at three time points using a longitudinal design: the end of fifth grade (last year of elementary school: T0), the beginning of sixth grade (first year of middle school: T1), and the end of sixth grade (T2). Results Both the impulsive action and depression pathways predicted very early engagement in binge eating: each accounted for variance beyond the other. Mediation tests found that T1 eating expectancies mediated the predictive influence of T0 negative urgency on T2 binge eating (z=2.45, p<.01) and that T1 depressive symptoms mediated the influence of T0 negative affect on T2 binge eating (z=2.04, p<.05). Discussion In children, elevated levels of both negative urgency and negative affect predict early binge eating. This finding has important clinical implications because there are different interventions for the two different risk processes.