(PS1-A17) A Longitudinal Test of Alcohol Problems and Binge Eating: The Moderating Role of Shame

Binge eating (the experience of consuming an objectively large amount of food while experiencing a simultaneous loss of control) frequently co-occurs with problematic alcohol use (consumption of alcohol likely to lead to physical or psychosocial harm). Shame (a self-conscious emotion characterized by an evaluation of the core self as irreparably flawed) is a transdiagnostic, prospective risk factor for both problematic alcohol use and binge eating. Limited research has examined (1) the temporal relationship between problematic alcohol use and binge eating, and (2) the potential additive effect of shame in risk models that include problematic alcohol use and binge eating. It may be the case that higher levels of shame increase the likelihood that problematic alcohol use and binge eating co-occur over time. Such a test is particularly important in college women, who are at high-risk for both alcohol use and binge eating and may be especially prone to shame in response to such behaviors.

We tested this conceptual model in a sample of 302 college women (71.9% white; mean (SD) age at baseline = 18.45 (0.88) years) at two time points: August (baseline) and eight months later in April (follow-up). Two linear regression models with interaction terms were developed to evaluate the prospective, bidirectional relationship between problematic alcohol use and binge eating while examining moderation by shame. We controlled for relevant covariates including guilt, a self-conscious emotion characterized by negative feelings about one's behavior, rather than one's core self. Guilt is distinct from, but overlaps conceptually with, shame. We also controlled for negative affect, a general dimension of subjective distress. Negative affect is distinct from, but can co-occur with, shame.

Baseline problematic alcohol use (β = 0.13, p < .05) and baseline shame (β = 0.29, p < .001) independently predicted increases in follow-up binge eating, controlling for baseline binge eating, guilt, negative affect, and negative urgency. Additionally, the influence of baseline problematic alcohol use on follow-up binge eating was stronger at higher levels of baseline shame (β = 0.14, p < .01). The reciprocal relationship was not significant: baseline binge eating and shame did not predict follow-up problematic alcohol use independently or in conjunction with each other (all p's > .05). Baseline guilt and negative affect were not significant predictors of follow-up binge eating, but baseline negative affect negatively predicted follow-up alcohol use.

Results provide support for (1) problematic alcohol use as a prospective risk factor for increased binge eating and (2) the additive impact of elevated shame on the relationship between problematic alcohol use and binge eating, perhaps particularly among college women. Findings highlight the potential for interventions targeting shame and problematic alcohol use to reduce or prevent future binge eating among college women. Candidate interventions include those that seek to increase self-compassion, given evidence that self-compassion-focused exercises predict decreases in shame across clinical and non-clinical populations.