O'Loghlen Elyse, Galligan Roslyn, Grant Sharon
Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
Appetite. 2023 Apr 1;183:106479. doi: 10.1016/j.appet.2023.106479. Epub 2023 Feb 2.
Binge eating within binge-eating disorder (BED) is a behaviour widely understood as a response to dietary restraint and emotion dysregulation. However, qualitative literature suggests that a wider range of functions of binge eating exist, with associations between functions of binge eating and adverse childhood experiences highlighted across this research. The present study sought to develop a scale to measure a wide range of functions of binge eating within BED. A secondary aim was to examine the relationship between these functions and adverse childhood experiences (ACEs).
The researchers developed an initial item pool for the Functions of Binge Eating Scale (FBES) and invited experts within the eating disorder (ED) field (n = 22) to review the items. The refined item pool was administered online to adults with self-reported binge eating symptoms (N = 882), along with related measures to establish scale validity.
Exploratory and confirmatory factor analyses produced an eight-factor structure (emotion regulation, hedonic hunger, compensatory eating, numbness/dissociation, emotion expression, self-punishment, control, self-protection). The scale demonstrated good internal reliability and adequate construct and predictive validity. Results also showed that functions theoretically related to childhood maltreatment were predicted by ACEs.
Findings extend our understanding of the range of functions of binge eating experienced in BED. Additionally, findings indicate that type of adverse childhood experience predicts functions of binge eating. Initial validation of the FBES suggests that functions of binge eating are wider than previously understood. Accordingly, clinicians are encouraged to explore and target more complex processes which might perpetuate binge-eating behaviour.
暴食症（BED）中的暴饮暴食行为被广泛认为是对饮食限制和情绪失调的一种反应。然而，定性文献表明，暴饮暴食存在更广泛的功能，并且在这项研究中强调了暴饮暴食功能与童年不良经历之间的关联。本研究旨在开发一种量表，以测量BED中暴饮暴食的多种功能。第二个目的是研究这些功能与童年不良经历（ACEs）之间的关系。
研究人员为暴饮暴食功能量表（FBES）编制了一个初始项目池，并邀请饮食失调（ED）领域的专家（n = 22）对这些项目进行评审。经过完善的项目池被在线施测于有自我报告暴饮暴食症状的成年人（N = 882），同时施测相关量表以确定该量表的效度。
探索性和验证性因素分析产生了一个八因素结构（情绪调节、享乐性饥饿、补偿性进食、麻木/解离、情绪表达、自我惩罚、控制、自我保护）。该量表显示出良好的内部信度以及足够的结构效度和预测效度。结果还表明，ACEs可以预测理论上与童年虐待相关的功能。
研究结果扩展了我们对BED中暴饮暴食功能范围的理解。此外，研究结果表明童年不良经历的类型可以预测暴饮暴食的功能。FBES的初步验证表明，暴饮暴食的功能比之前所理解的更为广泛。因此，鼓励临床医生探索并针对可能使暴饮暴食行为持续存在的更复杂过程。
