Elsevier

Appetite

Volume 45, Issue 3, December 2005, Pages 205-213
Appetite

Research Report
The Stice model of overeating: Tests in clinical and non-clinical samples

https://doi.org/10.1016/j.appet.2005.08.004Get rights and content

Abstract

The present study tested the dual pathway model of Stice [Stice, E (1994). A review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. Clinical Psychology Review, 14, 633–661 and Stice, E. (2001). A prospective test of the dual-pathway model of bulimic pathology: mediating effects of dieting and negative affect. Journal of Abnormal Psychology, 110, 124–135.] in a non-clinical sample of female adolescents and a clinical sample of female eating disorder patients. The model assumes that negative affect and restrained eating mediates the link between body dissatisfaction and overeating. We also tested an extended version of the model postulating that negative affect and overeating are not directly related, but indirectly through lack of interoceptive awareness and emotional eating. Structural equation modelling was used to test our models. First, in the two samples, body dissatisfaction and drive for thinness were associated with overeating/binge eating. In both clinical and adolescent sample, we found support for the negative affect pathway and not for the restraint pathway. Lack of interoceptive awareness and emotional eating appear to (partly) explain the association between negative affect and overeating. Emotional eating was much more strongly associated with overeating in the clinical than in the adolescent sample. In sum, we found substantial evidence for the negative affect pathway in the dual pathway model. The link between body dissatisfaction and overeating in this respect might be explained by the fact that negative affect, due to body dissatisfaction, is related to a lack of awareness of personal feelings and to eating when dealing with negative emotions, which on its turn is associated with overeating.

Section snippets

Female adolescents

A sample of 436 female adolescents had been obtained from six different schools in the eastern part of the Netherlands in various levels of education varying from lower vocational to pre-university education. They had a mean age of 15.6 years (SD=1.5) and a mean BMI (body mass index; weight/height×height) of 20.06 (SD=2.6). The questionnaire with the measures to study was administered under the supervision of both the teacher and the researcher after the students' parents had given their

Preliminary analyses

First of all, the correlation structures of the data obtained in the sample of female adolescents and the clinical sample were compared to analyse whether the non-clinical and clinical data should be analysed separately or in combination. A comparison between data of the clinical and non-clinical sample tested the hypothesis that both covariance matrices were calculated from random samples of one population. By testing this hypothesis with regard to the eight variables involved Body

Discussion

In the sample of female adolescents, the model by Stice (1994, 2001) fitted the data well and the extended model fitted the data even better. In the clinical sample, however, the initial model by Stice did not fit the data and only the extended, second model showed a satisfactory fit. In both samples there was strong support for a link between negative body image and restrained eating, but in neither of the samples support was found for a link between restrained eating and overeating/binge

Acknowledgements

Rutger Engels was supported by a fellowship of the Dutch Organization of Scientific Research during the preparation of this manuscript.

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