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Brief report self-control in relation to problem drinking and symptoms of disordered eating
Addictive Behaviors, Vol. 24, No. 3, pp. 439–442, 1999 Copyright © 1999 Elsevier Science Ltd Printed in the USA. All rights reserved 0306-4603/99/$–see front matter
Pergamon
PII S0306-4603(98)00056-2
BRIEF REPORT SELF-CONTROL IN RELATION TO PROBLEM DRINKING AND SYMPTOMS OF DISORDERED EATING TERESA PELUSO,* LINA A. RICCIARDELLI,* and ROBERT J. WILLIAMS† *Deakin University; and † Charles Sturt University
Abstract — The present study investigated problem drinking and symptoms of disordered eating in relation to (a) restrained drinking and eating, and (b) cognitive self-control. One hundred and ninety-eight high school students (97 males and 101 females; mean age 5 16.45 years) completed questionnaires that assessed problem drinking, symptoms of disordered eating, restrained eating and drinking, and cognitive self-control. Using principal components analysis, three factors with eigenvalues greater than 1 were found to summarize the interrelationships among the examined measures. For both sexes, the first two factors primarily reflected problem drinking and restrained drinking, and problem eating and restrained eating, respectively. The third factor reflected a more general problem with control underlying aspects of both problem drinking and problem eating. © 1999 Elsevier Science Ltd
An increasing number of studies have highlighted the co-morbidity between eating disorders and alcohol abuse (see Holderness, Brooks-Gunn, & Warren, 1994, for a review). Consistent with recent reviews of the literature with adult samples, Wiederman and Pryor (1996) have shown that approximately one-third of adolescent girls with bulimia nervosa smoked tobacco, used marijuana, and were drinking alcohol at least weekly. Evidence suggests that the observed co-morbidity between eating and drinking problems in clinical populations also holds in nonclinical samples of adolescent boys and girls (e.g., Krahn et al., 1996). Although much research has focused on establishing the relationship between eating and drinking, and describing the extent of the co-morbidity, little empirical research has investigated the possible mechanisms underlying this relationship. The research model most relevant to the present study, first proposed by Southwick and Steele (1987) and recently developed more fully by Baumeister and Heatherton (1996), suggests a common process reflecting misregulation. Misregulation refers to active efforts to exert control over oneself that are ineffective or counterproductive (Baumeister & Heatherton, 1996). Although, Southwick and Steele (1987) found no evidence for the co-morbidity between symptoms of disordered eating and problem drinking, they did find that individuals who had a restrained consummatory style in both eating and drinking also scored lower on general measures of self-control. Patterns of restrained eating and restrained drinking primarily involve high levels of cognitive and emotional preoccupation about controlling one’s behavior. As restraint involves high levels of cognitive and emotional preoccupation about one’s consummatory intake, more may be learned about the relationships between drinking and eating problems by examining these consummatory problems in relation to cognitive measures of self-control. Specifically, the present study was designed to Requests for reprints should be sent to Lina A. Ricciardelli, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, 3125, Australia; E-mail: [email protected] 439
440
T. PELUSO et al.
examine and summarize the nature of the interrelationships among problem drinking and symptoms of disordered eating; restrained drinking and eating; and cognitive selfcontrol. M E T H O D
Participants were 198 high school students (97 males and 101 females) from three public high schools in Melbourne, Australia. The mean age of the males and the females was 16.32 (SD 5 .98) and 16.52 (SD 5 1.01) years, respectively. Participation in the study was voluntary, but both parental and student consent was obtained before students were administered questionnaires. Subjects completed questionnaires anonymously during their class-time. These took between 30 to 40 min to complete. Subjects completed the questionnaire items in the following order: demographic data (age, sex, height, and weight); Eating Restraint (Herman & Mack, 1975); Drive for Thinness, Bulimia and Body Dissatisfaction subscales from the Eating Disorder Inventory–2 (Garner, 1991); Cognitive Self-Control (Rohde, Lewinsohn, Tilson, & Seeley, 1990); Action Control/Cognitive Preoccupation (Kuhl, 1994); alcohol consumption; Adolescent Drinking Index (Harrell & Wirtz, 1989); and two drinking restraint scales, Cognitive Emotional Preoccupation and Cognitive Behavioral Control (Collins & Lapp, 1992). R E S U L T S
A N D
D I S C U S S I O N
Reported drinking levels were high for both sexes. The reported average number of drinks per session (M 5 5.61 and SD 5 5.83 for males; M 5 4.43 and SD 5 4.45 for females) is well above the recommended safe levels. Consistent with these high levels of drinking, one-third of the young men (32%) and close to one-quarter of the young women (17.7%) scored above the cutoff score of 16, indicative of problem drinking (Harrell & Wirtz, 1989). The 94th percentile (1.6 SD above the mean) on the Drive for Thinness subscale as recommended by Garner (1991) was used as the cutoff score, indicative of problem eating. Twenty-three percent of the females and 2.1% of the males were found to score above this cutoff point. Estimates of co-morbidity between drinking and eating problems were also calculated. Thirty-five percent of the young women who were classified as problem drinkers were also classified as problem eaters. This is very similar to the figure of 36.4% reported by Striegel-Moore and Huydic (1993) in a study of adolescent girls. Only 4.8% of the young men who scored within the problem drinking range were found to have eating problems. However, this is not an unexpected value as so few males score within the problem eating range. A principal component analysis using varimax rotation was conducted to summarize the relationships among the employed variables. The measure of sampling adequacy (Kaiser-Meyer-Olkin) for our sample of males (.65) and females (.71) was found to be good, and for both males and females three factors with eigenvalues greater than 1 described the interrelationships, as shown in Table 1. For both sexes, the first two factors primarily reflect problem drinking and problem eating behaviors. Moreover, consistent with an expanding body of research, both the problem-drinking and problem-eating factors were characterized by high restraint (Collins & Lapp, 1992).
Problem drinking and disordered eating
441
Table 1. Principal component analysis for males and females Males Factor I: Drinking Number of standard drinks per occasion Frequency of drinking Adolescent Drinking Index Cognitive Emotional Preoccupation (Drinking) Cognitive Behavioral (Drinking) Drive for Thinness Bulimia Body Dissatisfaction Eating Restraint Cognitive Self-Control Action Control/Cognitive Preoccupation Explained variance (%)
Factor II: Eating
Females Factor III: Control
Factor I: Eating
Factor II: Drinking
Factor III: Control
.67
2.23
.37
2.01
.74
2.16
.79 .89
.08 .00
2.06 2.19
.17 .13
.76 .89
2.06 .18
.83
.22
2.10
.01
.66
.45
.31
.40
.15
.17
.17
.81
.02 2.10 .16 .03 2.14
.90 .47 .76 .70 .13
2.10 .36 2.09 .23 .78
.88 .54 .80 .85 2.20
.20 .24 .22 .05 2.31
.11 .42 2.17 2.02 .54
.17
2.54
.47
2.51
.28
2.08
26.6
22.5
11.2
32.0
18.7
12.3
For both sexes the third factor reflected a more general problem, with control underlying aspects of both problem drinking and problem eating. For males, the third factor had moderate loadings on Bulimia, quantity of drinking, Cognitive Self-Control, and Action Control/Cognitive Preoccupation. The factor is primarily reflecting a struggle with control in that it describes individuals who are high on cognitive self-control (i.e., they are cognitively preoccupied with controlling their behavior) but who are also reporting higher action-orientated behavior (i.e., they are actively engaged in attempts to control their behavior). This pattern of control is an unsuccessful one as it is linked to both increased bulimic behaviors and higher levels of drinking. For females, the third factor had moderate loadings on Bulimia, restrained drinking and Cognitive Self-Control. This factor, is somewhat similar to the males’ Factor III in that it is reflecting a struggle with self-control underlying both drinking and eating. But unlike the males’ Factor III, this factor for the females is dominated by a high loading on Cognitive Behavioral Control, which measures actual attempts at controlling drinking. The factor also describes young women who are highly preoccupied with their drinking and who are cognitively preoccupied with more general aspects of their behavior. Moreover, as with the males’ Factor III, this pattern of control can be described as an unsuccessful one as it is linked to high levels of bulimic behaviors. This struggle with control characterized by Factor III for the males and females equates closely with Baumeister and Heatherton’s (1996) notion of misregulation. Future research needs to investigate further problematic styles of control in relation to problem drinking and disordered eating. Many of the recent studies have focused almost exclusively on establishing or estimating the extent of the relationship between drinking and eating problems but few studies have investigated the dimensions underlying this relationship. R E F E R E N C E S Baumeister, R. F., & Heatherton, T. F. (1996). Self-regulation failure: An overview. Psychological Inquiry, 7, 1–15.
442
T. PELUSO et al.
Collins, R. L., & Lapp, W. M. (1992). The Temptation and Restraint Inventory for measuring drinking restraint. British Journal of Addiction, 87, 625–633. Garner, D. M. (1991). The Eating Disorder Inventory–2: Professional Manual. Odessa, FL: Psychological Assessment Resources. Harrell, A. V., & Wirtz, P. W. (1989). Adolescent Drinking Index: Professional manual. Odessa, FL: Psychological Assessment Resources. Herman, C., & Mack, D. (1975). Restrained and unrestrained eating. Journal of Personality, 43, 647–660. Holderness, C. C., Brooks-Gunn, J., & Warren, M. P. (1994). Co-morbidity of eating disorders and substance abuse: Review of the literature. International Journal of Eating Disorders, 16, 1–34. Krahn, D., Piper, D., King, M., Olson, L., Kurth, C., & Moberg, D. P. (1996). Dieting in sixth grade predicts alcohol use in ninth grade. Journal of Substance Abuse, 8, 293–301. Kuhl, J. (1994). Action versus state orientation: Psychometric properties of the Action Control Scale (ACS90). In J. Kuhl & J. Beckmann (Eds.), Volition and personality (pp. 47–58). Seattle: Hogrefe & Huber Publishers. Rohde, P., Lewinsohn, P. M., Tilson, M., & Seeley, J. R. (1990). Dimensionality of coping and its relation to depression. Journal and Personality and Social Psychology, 58, 499–511. Southwick, L., & Steele, C. M. (1987). Restrained drinking: Personality correlates of a control scale. The Journal of Drug Issues, 17, 349–358. Striegel-Moore, R. H., & Huydic, E. S. (1993). Problem drinking and symptoms of disordered eating in female high school students. International Journal of Eating Disorders, 14, 417–425. Wiederman, M. W., & Pryor, T. (1996). Substance sue and impulsive behaviors among adolescent with eating disorders. Addictive Behaviors, 21, 269–272.
Pergamon
PII S0306-4603(98)00056-2
BRIEF REPORT SELF-CONTROL IN RELATION TO PROBLEM DRINKING AND SYMPTOMS OF DISORDERED EATING TERESA PELUSO,* LINA A. RICCIARDELLI,* and ROBERT J. WILLIAMS† *Deakin University; and † Charles Sturt University
Abstract — The present study investigated problem drinking and symptoms of disordered eating in relation to (a) restrained drinking and eating, and (b) cognitive self-control. One hundred and ninety-eight high school students (97 males and 101 females; mean age 5 16.45 years) completed questionnaires that assessed problem drinking, symptoms of disordered eating, restrained eating and drinking, and cognitive self-control. Using principal components analysis, three factors with eigenvalues greater than 1 were found to summarize the interrelationships among the examined measures. For both sexes, the first two factors primarily reflected problem drinking and restrained drinking, and problem eating and restrained eating, respectively. The third factor reflected a more general problem with control underlying aspects of both problem drinking and problem eating. © 1999 Elsevier Science Ltd
An increasing number of studies have highlighted the co-morbidity between eating disorders and alcohol abuse (see Holderness, Brooks-Gunn, & Warren, 1994, for a review). Consistent with recent reviews of the literature with adult samples, Wiederman and Pryor (1996) have shown that approximately one-third of adolescent girls with bulimia nervosa smoked tobacco, used marijuana, and were drinking alcohol at least weekly. Evidence suggests that the observed co-morbidity between eating and drinking problems in clinical populations also holds in nonclinical samples of adolescent boys and girls (e.g., Krahn et al., 1996). Although much research has focused on establishing the relationship between eating and drinking, and describing the extent of the co-morbidity, little empirical research has investigated the possible mechanisms underlying this relationship. The research model most relevant to the present study, first proposed by Southwick and Steele (1987) and recently developed more fully by Baumeister and Heatherton (1996), suggests a common process reflecting misregulation. Misregulation refers to active efforts to exert control over oneself that are ineffective or counterproductive (Baumeister & Heatherton, 1996). Although, Southwick and Steele (1987) found no evidence for the co-morbidity between symptoms of disordered eating and problem drinking, they did find that individuals who had a restrained consummatory style in both eating and drinking also scored lower on general measures of self-control. Patterns of restrained eating and restrained drinking primarily involve high levels of cognitive and emotional preoccupation about controlling one’s behavior. As restraint involves high levels of cognitive and emotional preoccupation about one’s consummatory intake, more may be learned about the relationships between drinking and eating problems by examining these consummatory problems in relation to cognitive measures of self-control. Specifically, the present study was designed to Requests for reprints should be sent to Lina A. Ricciardelli, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, 3125, Australia; E-mail: [email protected] 439
440
T. PELUSO et al.
examine and summarize the nature of the interrelationships among problem drinking and symptoms of disordered eating; restrained drinking and eating; and cognitive selfcontrol. M E T H O D
Participants were 198 high school students (97 males and 101 females) from three public high schools in Melbourne, Australia. The mean age of the males and the females was 16.32 (SD 5 .98) and 16.52 (SD 5 1.01) years, respectively. Participation in the study was voluntary, but both parental and student consent was obtained before students were administered questionnaires. Subjects completed questionnaires anonymously during their class-time. These took between 30 to 40 min to complete. Subjects completed the questionnaire items in the following order: demographic data (age, sex, height, and weight); Eating Restraint (Herman & Mack, 1975); Drive for Thinness, Bulimia and Body Dissatisfaction subscales from the Eating Disorder Inventory–2 (Garner, 1991); Cognitive Self-Control (Rohde, Lewinsohn, Tilson, & Seeley, 1990); Action Control/Cognitive Preoccupation (Kuhl, 1994); alcohol consumption; Adolescent Drinking Index (Harrell & Wirtz, 1989); and two drinking restraint scales, Cognitive Emotional Preoccupation and Cognitive Behavioral Control (Collins & Lapp, 1992). R E S U L T S
A N D
D I S C U S S I O N
Reported drinking levels were high for both sexes. The reported average number of drinks per session (M 5 5.61 and SD 5 5.83 for males; M 5 4.43 and SD 5 4.45 for females) is well above the recommended safe levels. Consistent with these high levels of drinking, one-third of the young men (32%) and close to one-quarter of the young women (17.7%) scored above the cutoff score of 16, indicative of problem drinking (Harrell & Wirtz, 1989). The 94th percentile (1.6 SD above the mean) on the Drive for Thinness subscale as recommended by Garner (1991) was used as the cutoff score, indicative of problem eating. Twenty-three percent of the females and 2.1% of the males were found to score above this cutoff point. Estimates of co-morbidity between drinking and eating problems were also calculated. Thirty-five percent of the young women who were classified as problem drinkers were also classified as problem eaters. This is very similar to the figure of 36.4% reported by Striegel-Moore and Huydic (1993) in a study of adolescent girls. Only 4.8% of the young men who scored within the problem drinking range were found to have eating problems. However, this is not an unexpected value as so few males score within the problem eating range. A principal component analysis using varimax rotation was conducted to summarize the relationships among the employed variables. The measure of sampling adequacy (Kaiser-Meyer-Olkin) for our sample of males (.65) and females (.71) was found to be good, and for both males and females three factors with eigenvalues greater than 1 described the interrelationships, as shown in Table 1. For both sexes, the first two factors primarily reflect problem drinking and problem eating behaviors. Moreover, consistent with an expanding body of research, both the problem-drinking and problem-eating factors were characterized by high restraint (Collins & Lapp, 1992).
Problem drinking and disordered eating
441
Table 1. Principal component analysis for males and females Males Factor I: Drinking Number of standard drinks per occasion Frequency of drinking Adolescent Drinking Index Cognitive Emotional Preoccupation (Drinking) Cognitive Behavioral (Drinking) Drive for Thinness Bulimia Body Dissatisfaction Eating Restraint Cognitive Self-Control Action Control/Cognitive Preoccupation Explained variance (%)
Factor II: Eating
Females Factor III: Control
Factor I: Eating
Factor II: Drinking
Factor III: Control
.67
2.23
.37
2.01
.74
2.16
.79 .89
.08 .00
2.06 2.19
.17 .13
.76 .89
2.06 .18
.83
.22
2.10
.01
.66
.45
.31
.40
.15
.17
.17
.81
.02 2.10 .16 .03 2.14
.90 .47 .76 .70 .13
2.10 .36 2.09 .23 .78
.88 .54 .80 .85 2.20
.20 .24 .22 .05 2.31
.11 .42 2.17 2.02 .54
.17
2.54
.47
2.51
.28
2.08
26.6
22.5
11.2
32.0
18.7
12.3
For both sexes the third factor reflected a more general problem, with control underlying aspects of both problem drinking and problem eating. For males, the third factor had moderate loadings on Bulimia, quantity of drinking, Cognitive Self-Control, and Action Control/Cognitive Preoccupation. The factor is primarily reflecting a struggle with control in that it describes individuals who are high on cognitive self-control (i.e., they are cognitively preoccupied with controlling their behavior) but who are also reporting higher action-orientated behavior (i.e., they are actively engaged in attempts to control their behavior). This pattern of control is an unsuccessful one as it is linked to both increased bulimic behaviors and higher levels of drinking. For females, the third factor had moderate loadings on Bulimia, restrained drinking and Cognitive Self-Control. This factor, is somewhat similar to the males’ Factor III in that it is reflecting a struggle with self-control underlying both drinking and eating. But unlike the males’ Factor III, this factor for the females is dominated by a high loading on Cognitive Behavioral Control, which measures actual attempts at controlling drinking. The factor also describes young women who are highly preoccupied with their drinking and who are cognitively preoccupied with more general aspects of their behavior. Moreover, as with the males’ Factor III, this pattern of control can be described as an unsuccessful one as it is linked to high levels of bulimic behaviors. This struggle with control characterized by Factor III for the males and females equates closely with Baumeister and Heatherton’s (1996) notion of misregulation. Future research needs to investigate further problematic styles of control in relation to problem drinking and disordered eating. Many of the recent studies have focused almost exclusively on establishing or estimating the extent of the relationship between drinking and eating problems but few studies have investigated the dimensions underlying this relationship. R E F E R E N C E S Baumeister, R. F., & Heatherton, T. F. (1996). Self-regulation failure: An overview. Psychological Inquiry, 7, 1–15.
442
T. PELUSO et al.
Collins, R. L., & Lapp, W. M. (1992). The Temptation and Restraint Inventory for measuring drinking restraint. British Journal of Addiction, 87, 625–633. Garner, D. M. (1991). The Eating Disorder Inventory–2: Professional Manual. Odessa, FL: Psychological Assessment Resources. Harrell, A. V., & Wirtz, P. W. (1989). Adolescent Drinking Index: Professional manual. Odessa, FL: Psychological Assessment Resources. Herman, C., & Mack, D. (1975). Restrained and unrestrained eating. Journal of Personality, 43, 647–660. Holderness, C. C., Brooks-Gunn, J., & Warren, M. P. (1994). Co-morbidity of eating disorders and substance abuse: Review of the literature. International Journal of Eating Disorders, 16, 1–34. Krahn, D., Piper, D., King, M., Olson, L., Kurth, C., & Moberg, D. P. (1996). Dieting in sixth grade predicts alcohol use in ninth grade. Journal of Substance Abuse, 8, 293–301. Kuhl, J. (1994). Action versus state orientation: Psychometric properties of the Action Control Scale (ACS90). In J. Kuhl & J. Beckmann (Eds.), Volition and personality (pp. 47–58). Seattle: Hogrefe & Huber Publishers. Rohde, P., Lewinsohn, P. M., Tilson, M., & Seeley, J. R. (1990). Dimensionality of coping and its relation to depression. Journal and Personality and Social Psychology, 58, 499–511. Southwick, L., & Steele, C. M. (1987). Restrained drinking: Personality correlates of a control scale. The Journal of Drug Issues, 17, 349–358. Striegel-Moore, R. H., & Huydic, E. S. (1993). Problem drinking and symptoms of disordered eating in female high school students. International Journal of Eating Disorders, 14, 417–425. Wiederman, M. W., & Pryor, T. (1996). Substance sue and impulsive behaviors among adolescent with eating disorders. Addictive Behaviors, 21, 269–272.