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Dynamic relations between interpersonal stressors, affective states, and binge eating in adolescent girls
Dissertation

Dynamic relations between interpersonal stressors, affective states, and binge eating in adolescent girls

Laura D'Adamo
Doctor of Philosophy (Ph.D.), Drexel University
May 2026
DOI:
https://doi.org/10.17918/00011361
pdf
DAdamo_Laura_20261.14 MB
PDF Embargoed Access, Embargo ends: 31 May 2027

Abstract

Background: Binge-spectrum eating disorders (BSEDs), characterized by recurrent binge eating, typically emerge during adolescence, a developmental period marked by heightened interpersonal sensitivity and the development of emotion regulation capabilities. The interpersonal model of binge eating posits that interpersonal stressors predict binge eating through elevations in negative affect, but this model has not been tested at the momentary level in clinical adolescent samples. In a sample of adolescent girls with BSEDs, this study used ecological momentary assessment (EMA) to evaluate whether interpersonal stressors prospectively predicted engagement in binge eating and whether negative affect mediated this relationship. We also tested whether between-person and day-level dietary restraint and emotion dysregulation amplified the interpersonal model pathways. Method: Adolescent girls with BSEDs (N = 48; M age = 18.1 ± 1.0) completed a 21-day EMA protocol during which they reported on interpersonal stressors, affect, and eating behavior five times/day in their natural environments. Bayesian dynamic structural equation modeling (DSEM) was used to evaluate whether experiencing an interpersonal stressor since the last survey was prospectively associated with binge eating (operationalized as both a binary event and an ordinal measure of loss-of-control eating intensity) at the next timepoint, and to test the mediating role of momentary negative affect. Between-person and day-level dietary restraint and emotion dysregulation were tested as moderators of these relationships. Results: Interpersonal stressors had an indirect effect on binge eating at the next survey through increased negative affect, consistent with full mediation (i.e., no evidence of a direct effect). Average levels of dietary restraint across the recording period moderated the interpersonal stressor-negative affect pathway, such that adolescents with higher average restraint showed greater affective reactivity to stressors. There were no day-level moderation effects, although there was a tentative main effect showing that higher daily restraint was associated with greater loss-of-control eating. Discussion: This study provided the first momentary-level evidence for the interpersonal model of binge eating in adolescents with BSEDs. Findings highlight interpersonal stressors as common triggers of emotional cascades into binge eating and negative affect as a key mechanism linking interpersonal stressors to binge eating. Results suggest that interventions targeting emotion regulation, interpersonal functioning, and dietary restraint may help disrupt this pathway and reduce vulnerability to binge eating among adolescents.

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