(PS2-D80) Mental Health Correlates of Self-diagnosed Food Sensitivity

Data from the U.S. Food and Drug Administration Food Safety Survey demonstrate that a growing number of individuals are reporting perceived food allergies (e.g., milk, fruit, shellfish) that are not diagnosed by medical providers. Individuals presenting to mental health settings for disordered eating, anxiety, and depression often report GI complaints. It is possible that individuals with these mental health concerns are hypersensitive to physiological cues and may be misattributing normal variations in gastrointestinal (GI) sensations to food sensitivities. The current study compared levels of psychopathology and visceral sensitivity (i.e., hypersensitivity to GI sensations such as bloating) among individuals reporting undiagnosed food sensitivity to 1) individuals with diagnosed medical disorders impacting the GI tract and 2) individuals without any food sensitivity or GI concerns.

A total of 591 university students (53% women; MBMI = 24.33) self-reported disordered eating behaviors (Eating Pathology Symptom Index), anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), visceral sensitivity (Visceral Sensitivity Index), perceived food sensitivity or medical disorder impacting the GI tract and whether this was diagnosed by a medical provider, and demographic information. Six Kruskal-Wallis non-parametric tests were used to examined differences in median mental health (restricting, binge eating, cognitive restraint, anxiety, depression) and visceral sensitivity scores across three groups (no sensitivity/disorder, undiagnosed food sensitivity, and diagnosed GI disorder). Significant tests were followed by pairwise comparisons to examine which groups differed. A chi-square test compared proportions of individuals reporting purging behaviors (presence/absence) across the three groups. The Benjamini-Hochberg procedure for false discovery rate was applied to control for multiple comparisons.

The Kruskal-Wallis tests showed significant differences of small to medium effects between groups for restricting (η2 = .015), anxiety (η2 = .034), depression (η2 = .040), and visceral sensitivity (η2 = .074; ps < .007). Compared to the no sensitivity/disorder group, the GI disorder group reported more restricting; no other differences were observed for disordered eating variables. Compared to the no sensitivity/disorder group, individuals self-reporting food sensitivities reported more anxiety and depression and higher visceral sensitivity. Compared to the GI disorder group, individuals self-reporting food sensitivities reported lower visceral sensitivity, but did not significantly differ on any mental health concerns (e.g., anxiety, depression, disordered eating). Findings are preliminary and should be replicated, but suggest that both individuals perceiving food sensitivity and those with diagnosed GI disorders may benefit from mental health referral and intervention. Cognitive behavioral interventions may target maladaptive cognitions and anxiety associated with GI sensations. Longitudinal investigation may provide insight as to whether onset of psychological disorders (e.g., depression, anxiety) precedes perceived food sensitivity or vice versa.