Understanding Loss of Control Eating Through the Lens of Expectancies and Reinforcement Sensitization

Psychiatry. 2024 Oct 28:1-16. doi: 10.1080/00332747.2024.2403664. Online ahead of print.

Abstract

Objective: Prior research has indicated that outcome expectancies, sensitivity to punishment, and sensitivity to reward may predict harmful health behaviors concurrently, including disordered eating. Loss-of-control eating (LOCE), feeling unable to resist eating or stop once one has started, is associated with expectancies that eating alleviates negative affect (NA reduction expectancies) and expectancies that eating is rewarding (reward expectancies).

Method: A survey battery was administered examining LOCE pathology, sensitivity to punishment, sensitivity to reward, and eating expectancies to a sample of 1660 adults in the United States (Mage = 39.24 (14.51), 73.86% assigned female at birth). It was hypothesized that sensitivity to punishment would have a potentiating effect on the relationship between NA reduction expectancies and LOCE (a two-way interactive effect). This relationship was theorized to be moderated by the effect of reward sensitivity (a three-way interactive effect), as reward sensitivity has been found to interact with punishment sensitivity. Similarly, reward expectancies on LOCE were thought to be potentiated by sensitivity to reward (a two-way interactive effect) and this relationship was also thought to be influenced by sensitivity to punishment (a three-way interactive effect).

Results: Hypotheses were partially supported. Sensitivity to punishment significantly moderated a two-way interactive relationship between reward sensitivity and reward expectancies on LOCE, attenuating this two-way interaction at low sensitivity to punishment. Similarly, the interaction between sensitivity to punishment and NA reduction expectancies on LOCE was only significant when reward sensitivity was low or at its mean.

Conclusion: Sensitivity to punishment and sensitivity to reward evince nuanced interactions with each other and eating expectancies to predict LOCE. Findings have treatment implications for cognitive interventions in LOCE.