Browsing by Author "von Ranson, Kristin M."
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Item Body image disturbance partially explains eating-related psychosocial impairment in food addiction(Elsevier, 2021) Lacroix, Emilie; von Ranson, Kristin M.Background This study aimed to explore the association of food addiction (FA) with eating-related psychosocial impairment and examine the extent to which this association was explained directly by FA symptoms themselves, versus through body image disturbance. Materials and methods Participants (356 university students and 544 crowdsourced adults) completed self-report measures of FA (Yale Food Addiction Scale; YFAS 2.0), psychosocial impairment (Clinical Impairment Assessment; CIA 3.0), and body image disturbance (Eating Disorders Examination Questionnaire; EDE-Q 6.0), and reported their body mass index (BMI) and gender. Results Endorsement of distress and/or impairment on the YFAS corresponded to ratings on the CIA. Structural equation models indicated the relationship between FA and eating-related psychosocial impairment was partially mediated by body image disturbance. The indirect effect of body image disturbance explained more variance in eating-related psychosocial impairment than did YFAS scores themselves. Neither BMI nor gender significantly moderated any direct or indirect pathways from food addiction to psychosocial impairment. Conclusions Food addiction is associated with clinical impairment in men and women across the weight spectrum. A large portion of psychosocial impairment associated with food addiction may be explained by body image disturbance. Due to its role in explaining psychosocial impairment, body image disturbance warrants increased attention in FA research.Item Conceptualizing addictive-like eating: A qualitative analysis(Elsevier, 2019-06) Paterson, Carley; Lacroix, Emilie; von Ranson, Kristin M.Debates regarding addictive-like eating have generated several conceptualizations of this construct. Qualitative research helps ensure that conceptualizations capture how individuals may experience addictive-like eating. In this study, we conducted semi-structured interviews with ten participants who identified themselves as addicted to food, or to food and eating, to determine how they conceptualized their addictive-like eating. Using thematic analysis, we identified four themes: (1) Social Environment, describing how past and present social environments affected addictive-like eating; (2) Situational Cues, encompassing situational contributions to addictive-like eating; (3) Persistent Cognitions, including preoccupation with food and loss of control; and (4) Impact of Weight, encompassing weight gain and its perceived impact on health, body image, and distress. Participants described properties specific to their preferred foods, as well as environmental and cognitive factors contributing to addictive-like eating. These descriptions were not completely captured by either the substance-based “food addiction” or behavioural “eating addiction” frameworks, though characteristics consistent with both were present. Further, existing scales of addictive-like eating do not assess the impact of social and situational cues, suggesting a need for new or revised measures. We propose a working definition of addictive-like eating that incorporates the characteristics described.Item Evaluating an abbreviated three-factor version of the Eating Disorder Examination Questionnaire in three samples(Elsevier, 2018-11) Tobin, Leah N.; Lacroix, Emilie; von Ranson, Kristin M.A brief, three-factor structure for the Eating Disorder Examination-Questionnaire (EDE-Q) has been identified that has stronger psychometric properties than the original four-factor EDE-Q structure. However, there is a need for independent replication of the brief version in different samples, and examination of how comparable the brief version is in women and men of diverse ages. This study compared factor structure fit and other psychometric properties between the original and brief versions in three independent samples of adults to evaluate the reliability and validity of this brief version. It also examined measurement invariance across gender in a middle-aged community sample. Participants included university women (N = 659), university women and men (N = 358), and crowdsourced community women and men (N = 544). Across samples, compared to the original version the brief version demonstrated greater internal consistency, somewhat less item overlap, and superior model fit in confirmatory factor analyses, although some fit indices fell below recommended cut-offs. Separate confirmatory factor analyses of the brief version in community women and men suggested the brief version may better fit community men than women, and measurement invariance across gender for the brief version was not supported for the community sample. This independent replication supports the factorial validity of the brief version in three samples of students and crowdsourced community adults, and highlights the importance of further examination of the psychometric properties of this brief three-factor version across gender and age categories, among others sample characteristics.Item Lived Experience and Defining Addictive-Like Eating: a Synthesis of Qualitative Research(Springer, 2020) Lacroix, Emilie; von Ranson, Kristin M.Purpose of Review Addictive-like eating has engendered much controversy, in part because it has been ill-defined. Qualitative research has described individuals’ experiences and definitions of addictive-like eating, providing insights about its central features. The aim of the present review was to synthesize the latest qualitative research on addictive-like eating, to identify features that are common across individuals’ experiences. We sought to understand how people with lived experience of addictive-like eating define and conceptualize this phenomenon, to answer the question, “What is addictive-like eating?” We conducted this review using qualitative meta-synthesis methodology. Searches of four databases identified 13 English-language qualitative studies of addictive-like eating or food addiction. After assessing research quality, we retained seven articles focused on lived experiences and definitions of addictive-like eating or food addiction, published between 2014 and 2019. Recent Findings Themes identified included, in order of descending frequency and prominence in representation within lived experiences, loss of control over eating, psychological and functional preoccupation, emotional eating and shame, health- and weight-related distress, consequences of addictive-like eating, and role of context and food environment. Overall, we observed only modest alignment between lived experiences of addictive-like eating and DSM-5 substance use disorder criteria. Summary Lived experiences and views of addictive-like eating differ substantially and meaningfully from substance use disorder criteria and related measures. We propose a working definition of addictive-like eating for use in future study of this construct, and, particularly, scale development efforts that adequately represent the breadth, depth, and weighting of addictive-like eating features.Item Moving beyond the “eating addiction” versus “food addiction” debate: Comment on Schulte et al. (2017)(Elsevier, 2018) Lacroix, Emilie; Tavares, Hermano; von Ranson, Kristin M.In a recent commentary, Schulte et al. (2017) argued that addictive-like eating should be conceptualized as a substance use disorder rather than a behavioural addiction, and noted that many parallels that Hebebrand et al. (2014) drew between addictive-like eating and behavioural addictions apply likewise to substance use disorders. However, we argue that many of the arguments advanced by Schulte et al. (2017) in support of a substance-based food addiction model, including the important role played by ingested substances, are nonspecific. That is, these arguments apply equally well to behavioural addictions and other mental disorders, notably eating disorders, which raises the question of whether the phenomenon of addictive-like eating is encompassed by existing eating disorder diagnoses. Similarities between addictive-like eating and substance use, no matter how compelling, do not ensure the validity or clinical utility of a substance-based food addiction model and should not drive the conceptualization of addictive-like eating. The present commentary discusses problems with Schulte et al.’s (2017) arguments for substance-based food addiction, and draws attention to alternative conceptualizations of addictive-like eating which risk being overlooked when this conversation is framed as a dichotomous debate between the food and eating addiction models.Item Prevalence of social, cognitive, and emotional impairment among individuals with food addiction(Springer, 2020) Lacroix, Emilie; von Ranson, Kristin M.Purpose The clinical utility of the construct of food addiction has been heavily debated. Though food addiction has been associated with psychosocial impairment in clinical samples, it is critical to examine these associations in non-clinical samples, to obtain unbiased evidence regarding this phenomenon’s clinical significance. It is also unknown which types of impairment are most common in food addiction. This observational study explored the association of self-reported food addiction with impairment in the domains of social, cognitive, and emotional functioning. Methods Participants (356 university students and 544 adults recruited through Mechanical Turk) completed the Yale Food Addiction Scale 2.0 and Clinical Impairment Assessment 3.0 questionnaire, as well as measures of emotional eating, reward-driven eating, binge eating, and general disordered eating. Results Food addiction scores showed large correlations with emotional (r = 0.55, 0.57), social (r = 0.56, 0.59), and cognitive impairment (r = 0.58, 0.53) in the student and Mechanical Turk samples, respectively. The most common difficulties endorsed were emotional (e.g., feeling ashamed or critical of oneself, upset, or worried due to one’s eating habits), followed by social and cognitive. Conclusion Food addiction was strongly associated with psychosocial impairment in two non-clinical samples, suggesting this phenomenon merits further investigation. We found substantial associations of food addiction with emotional as well as social and cognitive impairment.Item Scope and ethics of psychologists’ use of client testimonials on professional websites(American Psychological Association, 2018) Lacroix, Emilie; Dobson, Keith S.; von Ranson, Kristin M.Background: Testimonials are statements on behalf of current or former clients that may comment on the abilities, qualifications, or personal characteristics of a health care provider, or attest to outcomes experienced after receipt of services. Although the use of client testimonials in promotional materials is prohibited by both the Canadian Psychological Association Practice Guidelines and by guidelines or legislation in a majority of provinces, a portion of registered psychologists’ professional websites may still display client testimonials or link to third-party provider rating sites (e.g., RateMDs.com, Yelp.ca). With little oversight by governing bodies, the scope of this practice is unknown. This article examines how often testimonials appear on the websites of Canadian psychologists and group practices, and discusses ethical guidelines and issues surrounding this practice. Method: We examined the professional websites of practicing registered psychologists (N = 433) selected from the provincial directories of five provinces (Alberta, British Columbia, Ontario, Manitoba, and Quebec). Results: Of sampled websites, 4.2% included client testimonials, 1.2% explicitly solicited testimonials, and 1.4% included links to external provider rating websites. Of the testimonials displayed on psychologists’ websites, 38.9% contained potentially identifying information. Conclusions: Client testimonials are used by psychologists in Canada despite national guidelines against this practice. Although clients who provide anonymous testimonials are unlikely to be harmed by this practice, there is still a risk of harm occurring. Furthermore, because testimonials represent a highly biased source of information, their use may reflect poorly on the psychology profession.Item “There is no way to avoid the first bite”: A qualitative investigation of addictive-like eating in treatment-seeking Brazilian women and men(Elsevier, 2019-02) Emilie Lacroix, Emilie; Edgar Oliveira, Edgar; Saldanha de Castro, Juliana; Cabral, Janice Rico; Tavares, Hermano; von Ranson, Kristin M.There has been polarizing debate on addictive-like eating in recent years. To move toward valid definition and measurement of this construct, qualitative research describing individuals' experiences is needed. The present study explored how Brazilian men and women define and experience addictive-like eating. Interviews were conducted with 7 men and 8 women (Mage = 46.6 years, MBMI = 35.43 kg/m2) seeking treatment for addictive-like eating. Thematic analysis of interviews identified three saturated, overarching themes describing participants’ conceptualizations of the (1) characteristics, (2) causal factors, and (3) consequences of addictive-like eating. Lack of control was a key characteristic of addictive-like eating described by all participants. A causal factor which most participants described was emotional eating. Consequences included emotional, interpersonal, occupational, and health-related impairments which appeared primarily related to weight gain, rather than to the pattern of addictive-like eating itself. These results are largely consistent with those of previous qualitative studies. Importantly, the symptoms described by our participants and in previous qualitative studies may be inadequately captured by existing self-report questionnaires designed to assess addictive-like eating. To address this potential limitation, we provide recommendations for assessing the full range of possible addictive-like eating symptoms.