RISK FACTORS OF EMOTIONAL EATING IN UNDERGRADUATES
by
ALAN Y HO
Submitted in partial fulfillment of the requirements
for the degree of Doctor of Philosophy
Dissertation Adviser: Dr. Anastasia Dimitropoulos
Department of Psychological Sciences
CASE WESTERN RESERVE UNIVERSITY
August, 2014
CASE WESTERN RESERVE UNIVERSITY
SCHOOL OF GRADUATE STUDIES
We hereby approve the thesis/dissertation of
Alan Y Ho
Candidate for the Doctor of Philosophy degree *.
Committee Chair
Anastasia Dimitropolous
Committee Member
Heath Demaree
Committee Member
Elizabeth Short
Committee Member
Eileen Anderson-Fye
Date of Defense
May 12, 2014
*We also certify that written approval has been obtained for any proprietary material
contained therein.
1
Table of Contents
List of Tables ………………………………………………………………………
2
List of Figures ……………………………………………………………………..
3
Abstract ……………………………………………………………………………
4
Introduction ………………………………………………………………………..
6
Methods …………………………………………………………………………… 38
Results …………………………………………………………………………….. 43
Discussion ………………………………………………………………………… 49
Tables ……………………………………………………………………………... 66
Appendices …………………………………………………………………………. 77
References ………………………………………………………………………… 85
2
List of Tables
Table 1 – Sample Descriptives ...……………………………………………….....
66
Table 2 - Medications Taken in Past 30 Days from Participants in Study ……….
67
Table 3 – The COPE Subscales as used in the Current Study ……………………..
67
Table 4 – Normality ……………………………………………………………….
68
Table 5 – Non-Normal Variables Log Transformation ………………………….
68
Table 6 – Gender Independent T-tests ……………………………………………..
69
Table 7 – Coping Styles and Parental Bonding ……………………………………
70
Table 8 – Coping Styles and Adjustment to College ………………………………
70
Table 9 – Parental Bonding and Emotional Eating Correlation ……………………
71
Table 10 – Coping and Emotional Eating Correlation M + F ………………………
72
Table 11 – Coping and Emotional Eating Correlation, Male ………………………
72
Table 12 – Coping and Emotional Eating Correlation, Female ……………………
73
Table 13 – Asian vs. White Independent T-Test ……………………………………
74
Table 14 – Regression Coefficients …………………………………………………
75
Table 15 – Multiple Linear Regression Model Summary ………………………….
75
3
List of Figures
Figure 1 – Hypothesized Model ……………………………………………………. 36
Figure 2 – Male (M), Female (F), and Male + Female (T) correlation results of
hypothesized model …………………………………………………………………. 76
4
Risk Factors of Emotional Eating among Undergraduates
Abstract
By
ALAN Y HO
While food quenches one’s hunger, it also assuages feelings. When food is eaten
to satisfy one’s feelings instead of satisfying hunger, it results in emotional eating which
is associated with negative consequences such as increased risk for heart disease,
symptoms of anxiety and depression, and increased risk of obesity. This study examined
the risk factors of emotional eating in hopes of giving clinicians a better understanding on
how to prevent or lesson emotional eating. There are a myriad of risk factors to
emotional eating. Studying emotional eating is complex because it is influenced by many
factors such as food preferences, genetics, culture, psychology, and the social and
physical environment. Thus, there are many more risk factors than what is being studied
here. However, this study attempts to add to the existing psychology literature in
emotional eating. Using survey assessments, this study examined whether parental
bonding was associated with emotional eating in non-clinical college students who lived
among their peers instead of their family. Furthermore, this study investigated whether
one’s level of adjustment to college was associated with emotional eating. In addition, an
attempt to replicate previous associations between coping style, one’s transition to
college, and parental bonding was performed using measures that allowed for more
detailed analysis and in order to use these variables as predictors in a multiple regression.
Results indicated that perceived parental bonding and level of adjustment to college had
5
no meaningful association with emotional eating. However, gender and race differences
in emotional eating were identified. Additionally, gender, race, avoidance coping and
socially-supported coping predicted 27% of the variance seen in emotional eating
suggesting that in order to curb emotional eating, therapy should concentrate on learning
effective coping styles. In addition, this study may also help clinicians and dieticians
alike better understand the risks that lead to emotional eating.
6
Introduction
Emotional states and situations can have a monumental effect on eating behavior
that goes beyond our physiological need for food. Geliebter and Aversa (2003) define
emotional eating as food intake that is triggered by strong emotions, both negative and
positive, rather than to our internal hunger cues. The hot fudge sundae that you choose to
eat after a depressing day or for a celebration is not necessarily due to hunger or your
need to fulfill your daily recommended nutrient intake, but because it soothes you or
makes you feel happier. Across cultures, food is used for celebrations such as weddings,
birthdays, or after a sporting win and thus, it is likely that positive affect and food intake
are related through associative learning (Patel & Schlundt, 2001). Likewise, the stress of
final exams may lead someone to indulge in a pint of Ben & Jerry’s ice cream. Eating a
small amount of sweet foods has been shown to improve negative mood states
immediately, albeit temporarily (Macht & Mueller, 2007). Eating in response to an
emotional state is convenient because food surrounds us and is an intricate part of our
celebrations from holidays to personal milestones, our social life, business meetings, and
even our mourning. This is something not observed in other animals and why researchers
believe eating is more than just replenishing our energy (McGrew & Feistner, 1992).
However, eating in response to emotions and not internal hunger cues, is
associated with negative consequences. Emotional eating has been associated with
psychopathology including symptoms of anxiety and depression (Goossens, Braet, Van
Vlierberghe, & Mels, 2009; Heaven, Mulligan, Merrilees, Woods, & Fairooz, 2001),
negative self-concept and feelings of physical incompetence (Braet & Van Strien, 1997),
7
difficulties in interpersonal relationships and sexuality (Van Strien, Schippers, & Cox,
1995), overeating (Wardle et al., 1992), and bulimic behaviors (Waller & Osman, 1998).
In addition, emotional eating has been linked with elevated consumption of high-calorie
and high fat foods (Oliver, Wardle, & Gibson, 2000; Wallis & Hetherington, 2004),
increased risk of obesity (Sung, Lee, Song, Lee, & Lee, 2010), and poor weight loss
outcomes (Elfhag & Rossner, 2005). Overconsumption of high-calorie and high fat foods
and being overweight or obese is associated with pathological changes in the body which
increases the risk for many chronic diseases such as heart disease, type 2 diabetes, and
stroke (Lean, Hans, & Seidell, 1998).
Even if emotional eating is not associated with obesity, poor dietary behaviors
such as eating food that are high in saturated fat have been linked to poor cardiovascular
health (Hermansen, 2000). The body runs on fuel in the form of nutrients from food and
if the fuel put into the body is not healthy, the body cannot function at peak performance
(Nantz, Rowe, Nieves, & Percival, 2006). For the body to function to the best of its
ability, essential nutrients such as vitamins, proteins, and minerals are necessary (Lane,
Magno, Lane, Chan, Hoyt, & Greenfield, 2008). Healthy food contains vitamins the
body requires to function optimally such as Vitamins A, B, C, and D (Lane et al., 2008).
Foods such as spinach and carrots contain a healthy amount of vitamin A, which
contributes to healthy skin and hair and healthy vision (Chapman, 2012). Fruits such as
oranges and grapefruit contain vitamin C, which increases one’s immune system and aids
in iron absorption (Nantz et al., 2006). Foods such as chicken, beef, pork, and fish
contain protein and vitamin B which are important for optimal brain performance and
lean muscle mass (Feng, 2012). Calcium, a mineral, aids in bone strength and is found in
8
foods such as milk and cheese (Lutz et al., 2012). These essential nutrients are found
sparingly, if at all, in unhealthy foods even though sweet desserts or salty chips may
satisfy one’s hunger.
Food intake characterized by high levels of saturated fat and processed sugar is
negatively associated with high density lipoprotein (HDL) cholesterol and positively
associated with levels of total cholesterol, blood sugar levels, and increased systolic
blood pressure (van Dam, Grievinik, Ocke, & Feskens, 2003). HDL reduces plaque in
the arteries and is considered “good” lipoproteins (van Dam et al., 2003). While there are
certain risk factors for sub-optimal health that cannot be altered such as heredity and
increasing age, eating behavior and obesity is a risk factor that can be changed (Brown &
Roberts, 2012). Thus, a look into the risk factors of emotional eating, which is linked to
an increase in the likelihood of poor dietary behaviors, is important as it is a behavior that
can be modified.
Self-Regulation
Researchers have suggested that emotional eating is a learned response (Bruch,
1973; Galloway, Farrow, & Martz., 2010); this response is believed to have emerged in
adolescence in association with depressive feelings and inadequate parenting (Ouwen,
Van Strien, & van Leeuwe, 2009; Snoek, Engels, & Janssens, 2007; Van Strien, Snoek,
van der Zwaluw, & Engels, 2010). In a recent study, Galloway and researchers (2010)
investigated how feeding practices used in childhood relate to eating behaviors and
weight status in early adulthood. College students’ and their parents’ retrospective
reports on child feeding practices when the students were in middle school were
examined. Parents have significant control over the intake and selection of foods their
9
child consumes as Galloway and researchers (2010) found a significant positive
correlation between the recollected use of controlling child feeding practices and current
emotional eating among college students. Moreover, in both males and females, parents’
recollections of using controlling feeding practices were positively correlated with BMI.
Unfortunately, parents’ use of controlling feeding practices is linked to poorer selfregulation of food intake in their children (Constanza & Woody, 1985). For example,
due to social rule, meals are usually eaten at certain times and the selection of foods for
the meal is either bought or made by the parents. With picky eaters who are underweight,
a parent may encourage or demand the child to eat more food and to eat more calorie
dense foods. With a child that is overweight, the parent may restrict the child from eating
certain types of foods. Experimental findings show that restrictive feeding practices
increase the likelihood of eating in the absence of hunger (Birch, Fisher, & Davison,
2003). Likewise, a parent may pressure the child to eat healthier foods. However, when
a child is pressured to eat a type of food (usually healthy food), the child is more likely to
report a greater dislike for that particular food later on in life (Galloway, Fiorito, Francis,
& Birch, 2006; Johnson & Birch, 1994). While done with good intention, pressuring a
child to eat interferes with the child’s natural ability to self-regulate (Johnson and Birch,
1994).
The process of self-regulation develops over one’s lifespan. Poor self-regulation
begins early in the lifespan at a time when food is the only accessible method to aid the
individual's ability to self-regulate (Baker & Hoerger, 2012). At first, a child relies on
the primary caregiver to manage and soothe their emotions. A child who is given treats
after an accomplishment may grow up using treats as a reward. Likewise, a child who is
10
given ice cream as a way to stop crying may learn to link ice cream with feelings of
comfort. However, over the years, most individuals learn additional ways to manage
their emotions in other ways such as distracting themselves, talking to others, or framing
their situations in a more positive way (Ventura & Birch, 2008). This maturation is not
only learned but is also biological. Neurological changes, while constant, are much more
rapid when puberty occurs. Magnetic Resonance Imaging (MRI) studies of the brain
have shown that maturation tends to occur from the back of the brain to the front of the
brain (Sowell et al., 2003). As a result, the prefrontal cortex, a region of the brain thought
to be essential for managing attention and inhibiting thoughts and behaviors, is the last to
develop (Shaw et al., 2008; Sowell et al., 2003). Teens have less white matter in the
frontal lobes of their brains when compared to adults (Giedd et al., 1999 Sowell et al.,
2003). With more myelin, comes the growth of important brain connections, allowing for
better flow of information between brain regions. Children will tend to have poorer selfregulation because of immaturity of the brain (McRae et al., 2012) and may therefore be
more likely to throw food tantrums, emotionally eat, and overeat. However, the ability to
successfully self-regulate requires not only the proper maturation of the brain but also
proper parenting. Effective parenting includes developing and clarifying clear
expectations on how to behave, staying calm in the midst of turmoil when the child
becomes upset, consistently following through with positive and negative consequences,
and being a positive role model (Lopez, 2004). Without the proper parenting, adults may
not properly learn to use more sophisticated ways to manage their emotions such as
problem solving or meditation. For some individuals, their ability to self-regulate remain
less than optimal. Unfortunately, poor self-regulation likely contributes to a number of
11
unhealthy behaviors as individuals seek and consume tasty and unhealthy food in order to
feel an immediate sense of gratification (Galloway et al., 2006; Johnson & Birch, 1994).
Effects of Stress on Eating Behavior
Emotional eating has also been found to occur in people with poor coping skills
(Ouwens, Van Strien, & Van Leeuwe, 2009). According to Lazarus and Folkman (1984),
coping is the cognitive and behavioral efforts to manage internal and external demands
created by a stressful situation. In Lazarus and Fokman’s (1984) transactional model of
stress, the primary appraisal refers to the initial perception about a stressor and whether it
is judged to be positive (eustress) or negative (distress). In general, when individuals
view an event as threatening, they experience distress; however, when individuals view
an event as challenging, they experience eustress. The secondary appraisal refers to the
coping responses the individual draws on. Access to physical resources (e.g. health and
energy), social (e.g. family and friends), psychological (e.g. self-esteem), and material
resources (e.g. money) affects ones’ coping responses. The more resources an individual
has, the better they will be able to cope.
Lazarus and Folkman (1987) also identified two ways of reducing distress:
either problem-focused coping or emotion-focused coping. In problem-focused coping,
individuals engage in a problem-solving behavior designed to eliminate or reduce the
origin of the stress. For example, if an individual is experiencing stress at home with the
family, this individual can devise a strategy such as scheduling family counseling to
reduce or eliminate the stressful situation. The number of daily stressors, while possibly
small in magnitude, has been associated with lowered mood in college students (Wolf,
Elston, & Kissling, 1989). Moreover, the accumulation of daily stressors can develop
12
into major stresses and increase anxiety and depression (Holahan, Moos, Holahan,
Brennan, & Schutte, 2005). Thus, problem-focused coping appears to be effective
because its goal is to remove the stressor.
On the other hand, in emotion-focused coping, an individual experiencing stress
at home will try to control the symptoms of stress such as talking to a friend who might
provide sympathy. Emotion-focused coping incorporates a diverse number of coping
styles and has shown to be both adaptive and maladaptive (Billings & Moos, 1984;
Bouteyre, Maurel, & Bernaud., 2007; Penland, Masten, Zelhart, Fournet, & Callahan,
2000; Wigndaele et al., 2007). Coping strategies that focus on negative emotions and
thoughts increase psychological distress (e.g. venting of emotions and rumination)
whereas coping strategies that regulate emotion (e.g. seeking social support) seem to
reduce distress. In Billings and Moos’s (1984) study, the researchers analyzed the
relationship between coping styles and depressive symptoms in 424 men and women
undergoing treatment for depression. The results indicated that patients who focused on
negative emotions had greater dysfunction while depressed patients who engaged in
affect-regulation experienced less severe depressive symptoms. Mixed findings have
been found in university samples regarding the adaptiveness of venting one’s emotions.
Bouteyre et al. (2007) showed a positive association between venting of emotions and
depressive symptoms in first year psychology students whereas Penland et al. (2000)
found that venting of emotions was an adaptive coping strategy and this coping style
decreased depressive symptoms.
On the other hand, an emotion-focused coping strategy, seeking social support,
has consistently shown to be adaptive and to be associated with decreased psychological
13
distress (Crocket et al. 2007; Wijndaele et al., 2007). Wijndaele et al. (2007) studied the
relationship between emotion-focused coping and psychological distress and found that
in the general population, individuals who regularly received social support had lower
levels of anxiety and depressive symptoms. Likewise, Crocket et al. (2007) found that
seeking social support was an effective coping strategy for university students
experiencing high levels of stress. This negative association between seeking social
support and psychological distress has also been supported by other researchers
(Bouteyre et al., 2007; Penland et al., 2000).
The effectiveness of emotion-focused coping varies because it incorporates more
than one coping style. Coping styles that regulate emotion are adaptive because they
prevent people from dwelling on their negative emotions and ensure that the individual
takes steps to resolve the negativity (Carver, Scjeier, & Weintraub, 1989). For instance,
seeking social support is effective because it encourages the individual to seek advice
from others to engage and solve problems (Bouteyre et al., 2007). Conversely, emotionfocused strategies that focus on negative emotions are maladaptive because it requires the
individual to focus on negative emotions rather than methods of removing them (Billings
& Moos, 1984).
A third type of coping is avoidance-oriented coping such as engaging in a
substitute task or seeking a diversionary activity (Endler & Parker, 1994) such as drug
use to avoid stress. Studies have shown that while avoidance-oriented coping strategies
may be effective in the short term (Miller, Brody, & Summerton, 1988), they may
contribute to negative long term consequences such as poor health because this strategy
only delays dealing with the stressor (Cronkite & Moos, 1994). Clinically depressed
14
patients experience less improvement and greater dysfunction over time when engaging
in avoidant coping (Billings & Moos, 1984). Similarly, in a ten year longitudinal study,
Holahan et al. (2005) found that avoidant coping is positively correlated with depressive
symptoms. In this longitudinal study, the researchers examined how coping styles were
correlated with life stressors and depressive symptoms four years later and ten years later.
Holahan and researchers found that individuals who engaged in avoidant coping styles at
baseline were more likely to experience stressors four years later and to have depressive
symptoms ten years later. This is most likely because avoidant coping styles fail to
remove the stressor (Holahan et al., 2005).
In summary, the type of coping style used is associated with psychological
distress. Problem-focused coping is negatively associated with stress, anxiety, and
depression while avoidant-focused coping is positively associated with increased health
problems. The association between emotion focused coping and psychological distress is
mixed (Billings & Moos, 1984; Carver et al., 1989). In addition to the findings that the
effectiveness of emotion-focused coping varies because it incorporates more than one
coping style, recent studies (Litman, 2006; Tennen, Affleck, & Armeli, 2000) found that
because problem-solving coping and emotion-focused coping often occur together
depending on the unique experience, evaluating coping styles using problem-focused and
emotion-focused coping is not ideal (Litman, 2006). While there is a high degree of
overlap among problem and emotion focused scales, previous research has consistently
identified factors that characterize coping with or without the assistance of social support
(Baqutayan, 2011; Litman, 2006; Tennen, Affleck, & Armeli, 2000). Two studies
evaluating the dimensionality of the COPE inventory (Carver, et al., 1989) found that
15
these 3 factors best differentiates the unique coping styles: self-sufficient, sociallysupported, and avoidant-coping (Litman, 2006). In addition, self-sufficient coping and
socially-supported coping both are positively correlated with approach oriented behavior
(dealing with either the problem or related emotions) while avoidant coping is correlated
with avoidance oriented behavior (ignoring or withdrawing from the stressor; Litman,
2006).
During stressful periods, eating behavior may change and some people cope with
stress by indulging in emotional eating (Epel et al., 2004; Ozier et al., 2008; Timmerman
& Acton, 2001). Emotional eating, according to psychosomatic theory, is an atypical
response to distress; the typical response is loss of appetite due to inhibition of gastric
muscles (Gold & Chrousos., 2002). Timmerman and Acton (2001) examined the
relationship between basic need satisfaction based on Maslow’s hierarchy (1943) (i.e.,
physiological, safety/security, love/belonging, esteem/self-esteem, and self-actualization)
and emotional eating through questionnaires received from adults at a professional
conference. Timmerman and Acton (2001) hypothesized that because a lack of basic
needs according to Maslow’s hierarchy functions as a stressor, the more an individual
lacks in basic needs, the more likely these individuals will engage in emotional eating to
substitute for their need. Using the Basic Need Satisfaction Inventory (BNSI) to access
basic need satisfaction, Timmerman and Acton (2001) found a strong negative correlation
(r = -.49; p < .001) to the Emotional Eating Scale (EES); the lower the level of basic need
satisfaction (lower on Maslow’s hierarchy pyramid), the more likely one would engage in
emotional eating (Timmerman & Acton, 2001).
16
Stress can also change an individuals’ preference for foods as people under stress
prefer sweet and fatty foods, sugary drinks, and alcoholic beverages independent of
gender and or whether one is on a diet or not (Dallman, 2010; Pagoto et al., 2009;
Rutters, Nieuwenhuizen, Lemmens, Born, & Westerterp-Plantega, 2009). Unfortunately,
unhealthy foods and beverages such as these are most often eaten at times between meals
because of their savory or sweet taste and their convenience. In addition, stress also
changes the type of food consumed during a meal. Oliver and Wardle (1999)
administered a self-report questionnaire to college students and found that meal-type
foods, fruits and vegetables, were consistently reported to be consumed less under
stressful conditions. Likewise, Epel et al. (2001) also found through their experiment that
women who had high cortisol levels in response to stress ate more sweet high fatty foods
than did women who did not have a high cortisol response to stress. However, it is
unclear in this study whether women who tended to eat sweet fatty foods had a biological
predisposition to higher cortisol levels.
However, not everyone responds to stress in the same manner. Previous research
has found that stress produces differential effects on eating depending on the type of
eating behavior (restrained eating, unrestrained eating, and emotional eating) the
individual displays (Herman & Polivy, 1983; Zellner at al., 2006). One type of consumer
is the restrained eater. Even though these individuals often feel hungry, think about food,
and are readily tempted by the sight or smell of food, they consciously attempt to control
their impulse to eat in order to maintain or lose body weight (Herman & Polivy, 1983).
In contrast, nondieters tend to be unrestrained eaters. Unrestrained eaters do not
constantly try to control their food intake and do not feel guilty when they overeat
17
(Herman & Polivy, 1983). Zellner et al. (2006) performed two experiments to investigate
whether food selection changes under stress. In the first experiment undergraduate
female students were split into two groups: a stressed group and a no-stress group. The
stressed group received a list of 10 unsolvable anagrams while the no-stress group
received a list of 10 solvable anagrams. While performing the anagrams, four bowls of
snacks containing M&Ms, grapes, potato chips, and peanuts were left on the table for the
subjects to eat as a “thank you” for their participation in the experiment. The researchers
concluded that stress caused changes in food choice away from healthy low fat food
(grapes) to less healthy high fat food (M&Ms). In the second part of the experiment,
Zellner et al (2006) found that not only did more females than males reported greater
food consumption when stressed, but that of the women who increased their food intake
due to stress, 71% were restrained eaters as opposed to women who undereat or who
don’t change the amount they eat when stressed. The foods that these women report
overeating (high caloric and high fat foods) when stressed are typically foods they
normally avoid for weight-loss or health reasons; women who are stressed and eat these
foods though report that it made them feel better.
Similarly, both restrained eaters and emotional eaters have been found to consume
more energy and fat under stressful conditions, particularly those involving ego-threat or
negative self-referent information, negative information about the self (Heatherton,
Herman, & Polivy, 1991; Polivy & Herman, 1999; Oliver et al., 2000). According to
Heatherton and Baumeister (1991), this behavior may be an attempt to escape or shift
attention away from the aversive and threatening stimuli. Thus, instead of focusing on
the negative, the attention is now shifted toward the immediate comforting stimulus of
18
food. Conversely, the intake of unrestrained and non-emotional eaters tends to stay the
same, or even decrease under stress, which may be associated with the autonomic
correlates of stress (Wallis & Hetherington, 2009). When under stress, the fight-or-flight
response takes over and activates the body: heart rate accelerates, blood pressure rises,
and blood rushes to the muscles instead of the stomach (Friedman, 1992). It is also clear
that there is a greater prevalence of restrained eating and emotional and situational
susceptibility to eat in females than in males and that restrained males are more
successful at maintaining or losing weight than restrained females (Drapeau.et al., 2003).
For example, in women, a high restraint behavior tended to promote weight gain whereas
in men, it had the opposite effect (Drapeau et al., 2003). Although someone with high
restraint eating behavior will intend to limit food intake and to choose lower calorie foods
to promote weight loss or prevent weight gain, once one “gives in to” these desires, all
restraint may be abandoned. These results suggest that while eating behaviors are
associated with body weight changes, how these changes are expressed differs between
men and women.
Real time stressful circumstances, such as examinations (e.g. exams in college) or
periods of high workload from a job, can provide a predictable context in which to study
food intake as it is related to stress. Such studies have found that times of high workloads
are associated with greater energy and fat intake (McCann, Warnick, & Knopp, 1990), or
higher fat, sugar and total energy intake. In McCann, Warnick, and Knopp’s (1990)
study, the subjects were employees who processed grants submitted by investigators at
the University of Washington to funding agencies. Thus, due to the nature of this work,
workloads tend to be cyclical. During high workload, not only was there greater energy
19
and fat intake, but these period were also associated with elevated cholesterol levels
measured through blood samples. However, in other research, increased energy intake
during high workload was found only in people who were restrained eaters (Wardle,
Steptoe, Oliver, & Lipsey, 2000). Among students, exams or high workload have also
been associated with higher energy intake too (Pollard, Steptoe, Canaan, Davies, &
Wardle, 1995) or less healthy diets (Weidner, Kohlmann, Dotzauer, & Burns, 1996).
Macht, Haupt, and Ellgring (2005) explored whether eating functioned to alleviate
stress, distract people from stressful emotions, or to relax individuals experiencing stressinduced emotions. The researcher, using a sample of college students, obtained selfreported emotions and eating behaviors from the students. The students were then split
into two groups: one group was given an exam and the other group (control) was not
given an exam. Two points in time were used: 1) well in advance of the exam date - 3 to
4 weeks before the date of the exam (baseline) and 2) just before the exam date - 3 to 4
days prior to the exam date. According to the self reports, students taking exams 3 days
before the test reported increased feelings of tension, fear, and stress compared to the
control group and they reported that they ate to distract themselves from these feelings
rather than eating to feel better or to relax. However, in a separate study, Oliver, Wardle,
and Gibson (2000) found that stress (threat of public speaking) did not alter overall intake
of a buffet meal. Despite this, stressed emotional eaters ate more sweet high-fat foods
(chocolate and cake), and a more energy-dense meal, than either unstressed emotional
eaters or non-emotional eaters. In addition, Epel, Lapidus, McEwen, and Brownell
(2001), found that emotional eaters may be more susceptible to effects of stress: women
who ate more from a selection of snack foods after a stressful task also showed the
20
greatest release of the stress-sensitive hormone, cortisol and more stress-induced negative
affect. Cortisol has been termed “the stress hormone” because it is secreted in higher
levels during the body’s response to a stressor (Epel et al., 2001). In addition, these high
reactors also showed a preference for sweet foods. It seems that emotional eaters may be
more likely to experience mood disturbance when challenged and to seek comfort from
food during stress-induced negative affect.
Neuroscience of Eating Behavior
There is increasing evidence that certain individuals are prone to develop
maladaptive patterns of behavior such as an addiction to food that is similar to abuse of
drugs such as heroin, methamphetamine, cocaine, ecstasy and alcohol (Gold, Graham,
Cocores, & Nixon, 2009). Drug addiction results from the hijacking of neurobiological
pathways that have evolved in humans as a way to regulate reward, motivation, decisionmaking, and learning and memory (Wang, Vokow, Thanos, & Fowler, 2009). One of
these pathways is known as the dopaminergic pathway which includes areas of the brain
such as the ventral tegmental area (VTA), the nucleus accumbens, and the frontal cortex
(Lingford-Hughes & Nutt, 2003). Considerable evidence indicates that activation of
these pathways tends to reinforce behavior such that organisms quickly learn behaviors
that activate this system (Lingoford-Hughes & Nutt, 2003). For example,
methamphetamine is one of the fastest growing illicit drug in the world especially among
youth as the drug produces an intense euphoria which often leads to numerous sex- and
drug-related risk behaviors and negative health outcomes (Fast, Kerr, Wood, & Small,
2014). Methamphetamine acts on the dopaminergic pathway and mimics the
neurotransmitter dopamine, tricking the brain and its dopamine transporters to take in
21
methamphetamine into the cell. The excess dopamine in the cell forces the dopamine
transporters to act in reverse by pushing the dopamine out of the cell and into the synaptic
cleft (Wang et al., 2009). As a result, the excess dopamine in the synaptic cleft binds
again and again to the postsynaptic receptors giving the user a feeling of intense pleasure
and exhilaration. Drug-seeking behavior is motivated and reinforced by the high
associated with the sudden increase in dopamine within the dopaminergic reward
pathway of the brain (Gold et al., 2009).
The effects of dopamine, however, are not confined to just drugs, but also to
gambling, sex, and eating addiction. Patients with Parkinson’s disease, a disease
characterized by deficiencies in dopaminergic neurotransmission, are usually given LDOPA, a drug that is the precursor to dopamine and readily passes the blood brain
barrier. A side effect of taking L-DOPA is the increase in developing behavioral
addictions such as addictions to gambling, sex, and eating (Dagher & Robbins, 2009).
Mounting evidence suggest that an addiction to food also significantly increases levels of
dopamine, in addition to serotonin in the brain creating a temporary elevation of mood
(Gold et al., 2009). When one eats a food high in carbohydrates, insulin gets released
which breaks the carbohydrates down and increases blood concentration of glucose
which is either used by the body or stored by the body cells (Gold et al., 2009). Insulin
also indirectly increases the concentration of tryptophan, the precursor for serotonin, in
the brain. This can lead to increased amounts of serotonin in the brain which temporarily
elevates mood (Gold et al., 2009). According to Kenneth Blum’s Reward Deficiency
Syndrome (Blum et al., 2006), one seeks out substances that balances ones’ biochemical
levels. For example, if one has a low serotonin level, one may seek out substances, such
22
as food, that raise serotonin levels. High carbohydrate and high sugar foods are examples
of foods that temporarily raise serotonin levels (Gold et al., 2009).
Blum also concluded in a study that glucose cravings are caused by a lack of
dopamine receptors in the brain (Blum et al., 2006). In animal models of obesity,
dopamine activity is reduced in the tuberoinfundibular pathway that projects to the
hypothalamus (Pijl, 2003). However, when treated with dopamine agonists, it reverses
the obesity presumably by activating dopamine D1 and D2 receptors (Pijl, 2003). In
humans, brain imaging studies show reductions in dopamine D2 receptors in the striatum
of obese individuals (Wang et al., 2001). This finding is similar to the reductions
reported in drug addicted individuals (Wang et al., 2001). In addition, for obese
individuals, high-calorie food cues show a sustained response in brain regions implicated
in reward and addiction even after eating (Dimitropoulos, Tkach, Ho, & Kennedy, 2012).
Likewise, imaging studies have also found abnormalities in the prefrontal cortex in obese
individuals (Dimitropoulos et al., 2012; Wang, et al., 2009). When food-related stimuli
are presented to individuals, the orbital frontal cortex (OFC) is activated along with
reports of increased cravings (Wang et al., 2009). Similarly, increased OFC activation
and increased cravings are reported when drug-related stimuli are presented to addicts
(Volkow & Fowler, 2000).
Emotional Eating and Weight
According to the US Centers for Disease Control and Prevention (CDC), the
current American society has been described as obesogenic where people live in
environments that promote overeating, eating unhealthy food, and physical inactivity
(Center for Disease Control & Prevention, [CDC], 2014). An estimated 65% of US
23
adults are currently either overweight or obese (Flegal, Carroll, Ogeden, & Johnson,
2002) defined as body mass index (BMI; calculated as kg/m2) greater than or equal to 25.
The abundant availability and aggressive marketing of food, the increased use of
sedentary technological gadgets for enjoyment, and the commonplace use of motorized
transportation results in extra consumption of food and a decline in physical activity
(Lake & Townshend, 2006; Swinburn, Egger, & Raza, 1999). In addition, evolution has
favored genetic adaptations that allow humans to survive in periods of food shortages so
that humans tend to overeat in times of food surplus and can rapidly lay down fat
(Bryant, King, & Blundell, 2008; Van Strien, Herman, & Verheijden, 2009). There may
be selective pressure supporting opportunistic eating as over the course of millions of
years this opportunistic eating behavior led to the individual’s survival. However, in the
current obesogenic environment seen in the western world today, opportunistic eating is a
counterproductive behavior that provides a positive energy balance, cardiovascular
disease and shorter life span, weight gain, and increased likelihood of obesity.
Emotional eating and eating due to the obesogenic environment may be
counteracted by imposing cognitive restraint on food intake. A review on the long-term
effectiveness of diets by Mann et al (2007) concluded that diets are not the long-term
answer. A problem with dietary restraint is that the body has trouble distinguishing
between food shortage and a self-imposed food restriction (Goldsmith, et al., 2010;
Polivy & Herman, 1985). As a result, the body may act as if it is in starvation mode
which increases feelings of hunger and slows down the metabolism. This may explain
the difficulties in losing weight. However, the addition of physical activity has been
found to be beneficial to maintaining a healthy body weight (Van Baak, 1999). Physical
24
activity increases caloric expenditure and metabolic rate and has also been associated
with lower depressive symptomatology, decreased feelings of tension, and a greater
emotional well-being (Amenesi & Whitaker, 2008; Dunn, Trevedi, Kampert, Clark &
Chambliss, 2005). In a recent web-based questionnaire study, emotional eating was
positively correlated with weight gain (Koenders & van Strien, 2011). In addition, there
was a negative correlation between physical activity and emotional eating. More
importantly, a high level of sporting (three sports activities or more per week in the
summer and winter) was related to weight loss and non-emotional eating.
However, despite the dangers of an obesogenic environment, not everyone
becomes overweight or obese. Susceptibility to increased body weight can be attributed
to many factors ranging from genetics, physiological, behavioral and psychological
(Blundell et al., 2005). A number of studies have focused on the psychological tendency
of emotional eating and its association to obesity (de Lauzon-Guillain et al., 2006;
Geliebter & Aversa, 2003; Keskitalo et al., 2008; Van Strien, Frijters, Roosen, KnuimanHijl, & Dafers, 1985). The association between obesity and emotional eating has yielded
uneven results as some studies have found a positive association between higher weight
status and emotional eating (Blair, Lewis, & Booth, 1990; Konttinen, Haukkala, SarlioLahteenkorva, Silventoinen & Jousilahti, 2009; Koenders & Van Strien, 2011; Van Strien
et al., 1985) while other studies have found no association (Abramson & Wunderlich,
1972; Allison & Heshka, 1993; Fitzgibbon, Stolley, & Kirschenbaum, 1993).
Because emotional eating negatively affects health whether it leads to obesity or
not, Macht (1999) specifically looked at emotional eating in healthy weight adults.
Macht (1999), using a self-report study of non-clinical sample of males and females,
25
investigated the influences of emotions (anger, fear, sadness, and joy) in healthy weight
adults. Individuals completed a questionnaire of 33 items for each emotion and Macht
(1999) found that different emotions led to different eating behaviors. A factor analysis
of the 33 item answers yielded four factors of eating which were labeled 1) eating due to
hunger feelings, 2) impulsive eating (eating fast and carelessly) 3) sensory eating (eating
intense and flavorful foods) and 4) hedonic eating (eating due to its pleasantness). Macht
(1999) found that impulsive and sensory eating occurred more often during anger than
during other emotions. On the other hand, hedonic eating occurred more often during joy
than during other emotions. In addition, women reported higher tendencies of impulsive
and sensory eating than men during anger and sadness. This study shows that emotional
eating is present not only in overweight and obese individuals, but also in healthy weight
individuals. Moreover, there are different eating behavior patterns in relation to different
emotional states.
We live in an obesogenic environment where the presence of food is ubiquitous.
It does not help, as far as our weight and health is concerned, that our genetic adaptations
favor us to overeat in times of food surplus. Unlike hundreds of years ago, food is more
easily obtained when we feel a need to eat. Studies have examined whether there is an
association between emotional eating and BMI and the results are inconclusive.
Emotional eating can have negative health consequences and occurs in both healthy
weight and overweight individuals.
Psychopathology
When negative emotions are felt, a loss of appetite and reduction of food intake
are the natural physiological responses (Herman & Polivy, 1984; Schacter, Goldman, &
26
Gordon, 1968). However, when an increase in food intake is seen in response to a
negative emotion, it is considered an unnatural response (Heatherton, Herman, & Polivy,
1991). Emotional eating has been identified as a possible factor triggering binge eating
in bulimia nervosa (BN) (Engelberg, Steiger, Gauvin, & Wonderlich, 2007; Van Strien,
Schippers, & Cox, 1995), binge eating disorder (BED) (Dingemans, Martign, Jansen, &
van Furth, 2009; Eldregde & Agras, 1996; Pinaquy, Chabrol, Simon, Louvet, & Barbe,
2003; Masheb & Grilo, 2006; Stein, Kennardy, Wiseman, Dounchism, Arnow, &
Wilfley, 2007), and anorexia nervosa (AN) (Ricca et al., 2012). In fact, binge eating
and/or purge behavior appears to be precipitated by negative affect (Masheb & Grilo,
2006). These behaviors are seen as attempts to cope with negative affect by providing
short term comfort (Smythet al., 2007; Wild et al., 2007). BN is characterized by
episodic patterns of binge eating accompanied by a sense of loss of control and a strong
desire to be thin. With BN, there may be compensatory behaviors such as vomiting and
accompanied by little weight loss or even weight gain (Goldbloom & Garfinkel, 1993).
BED identifies overweight or obese patients who present with recurrent eating of an
unusually large amount of food during a short period of time and who do not engage in
the typical compensatory behaviors of bulimia nervosa (Devling, Walsh, Spitzer & Hasin,
1992). AN is characterized by self-imposed starvation due to a relentless pursuit of
thinness and fear of being fat (Goldbloom & Garfinkel, 1993). Besides the physical
health consequences associated with an eating disorder, psychological concerns such as
phobias (Carter & Bewell-Weiss, 2011), obsessive compulsive disorder (Starcevic &
Brakoulias, 2014), dysphoria (Johnson & Larson, 1982), and isolation from other people
(Halmi et al., 1991) are of concern.
27
A recent study examined whether there are differences in emotion regulation
deficits among people with eating disorders compared to control participants (Svaldi,
Griepenstroh, Tuschen-caffier, & Ehring, 2012). All three eating disorder groups (BD,
BED, and AN) reported significantly higher levels of emotion intensity, lower acceptance
of emotions, less emotional awareness and clarity, and more emotional regulation
difficulties than the healthy control group. Patients with eating disorders are unable to
differentiate and regulate their emotional states (Bydlowski et al., 2002). Whether
disturbances in regulating their emotions is the cause of eating disorders or is a
personality trait is not yet fully understood (Bydlowski et al., 2002). Similarly, because
these eating disorders are due in part to emotional states and a loss of control, Ricca and
researchers (2012) investigated whether there was significantly more emotional eating
among the disordered groups (BD, BED, and AN) compared to a healthy control group
using the Emotional Eating Scale (EES) self assessment. Findings indicated there were
no significant differences among the three disordered groups (BD, BED, and AN), yet, all
of the patients showed significantly higher EES scores compared to health controls.
Research into the psychological well-being of normal weight female adults finds
that female adults often show similar psychological symptoms to patients with an eating
disorder. In a self-report study of 127 normal weight female adults, high levels of
emotional eating were associated with low psychological well-being, low self-esteem,
body image vulnerability, and feelings of inadequacy (Lindeman & Stark, 2001); these
symptoms are the same ones seen in underlying eating disorders. In turn, an inability to
regulate high negative affect is related to the development of depressive disorders and
psychopathology (Kovacs, Joormann, & Gotlib, 2008). Emotional eating is also related
28
to emotional processing disturbances such as higher levels of alexithymia – inability to
identify and express emotions (Van Strien, 2006), higher levels of anhedonia (Keranen,
Rasinaho, Hakko, Savolainen, & Lindeman, 2010), decreased emotional clarity (Larsen,
Van Strien, Eisinga, & Engles, 2006), lower attention to emotion (Moon & Berenbaum,
2009), and poor interoceptive awareness (Ouwens et al., 2009) in the non-clinical
population. Interoceptive awareness is defined as sensitivity to stimuli originating from
within the body (Sim & Zeman., 2004).
Likewise, in the clinical population, Sim and Zeman (2004) found poor
interoceptive awareness in patients who suffered from bulimia nervosa. Van Strien,
Engels, Leeuwe, and Snoek (2005) found that emotional eating and interoceptive
awareness account for a significant proportion of the relationship between negative affect
and overeating in a study of clinical and nonclinical female adolescents. Rommel et al.
(2012) found that obese women exhibited deficits in emotional awareness and used
emotional eating as an emotion regulation strategy significantly more than controls. The
authors also showed that paternal and maternal overprotection negatively correlated with
obese individuals’ level of emotional awareness and that emotional awareness was also
negatively correlated with their level of emotional eating.
Whether it is an individual with an eating disorder or whether it is an individual
who engages in high levels of emotional eating, both show similar characteristics such as
low psychological well-being and feelings of inadequacy. Poor interoceptive awareness,
poor emotional regulation, and low psychological well-being are all common associations
with abnormal eating.
29
Parenting and Emotional Eating
Research on parenting practices reveal that there is a link between parents who
minimize their child’s emotional expression or punish them for expressing negative
emotions and a child that tends to be more emotionally reactive and less able to regulate
their emotions; these children are more likely to use escape tactics such as avoiding the
situation all together to deal with emotional distress (Fabes, Leonard, Kupanoff, &
Martin, 2001). Likewise, studies have found a link between parenting styles and
emotional eating in children and adolescents (Schuetzmann, Richter-Appelt, SchulteMarkwort, & Schimmelmann., 2008; Snoek, Engels, Jansens, & Van Strien., 2007;
Topham et al., 2011). Topham and researchers (2011) found that among 6 to 8 year olds,
emotional eating was negatively correlated with authoritative parenting style (high
warmth and high control). Besides lower levels of emotional eating, there was also a link
between authoritative parents and children with greater self-discipline and more
emotional maturity (Baumrind, 1991). Likewise, Snoek et al. (2007) found that
adolescents who reported less maternal support, more maternal psychological control
(psychological manipulative strategies to control ones’ behavior), and less maternal
behavioral control (control on whereabouts and activities) were associated with higher
levels of emotional eating.
Similarly, a few studies have found an association between parenting and
emotional processing disturbances (De Panfilis, Rabbaglio, Rossi, Zita, & Maggini.,
2003; Fukunishi, 1998). De Panfilis and researchers (2003) found that among eating
disordered outpatients, alexithymia, was predicted by lower levels of maternal care.
Specifically, the TAS-20 (Toronto Alexithymia Scale) total score, a 20-item instrument
30
that is one of the most commonly used measures of alexithymia, and the ‘difficulty in
describing feelings’ subscale of the TAS-20 were significantly correlated to low maternal
care. Examples of high maternal caregiving behavior are responding promptly,
accurately, and consistently to an infant’s signals and consistently having face-to-face
interaction with the child. Similarly, Fukunishi (1998) found that in college students,
difficulty identifying feelings and difficulty describing feelings not only were associated
with abnormal eating attitudes, but were also associated with a lack of maternal care. In a
recent study, Rommel and researchers (2012) investigated the impact of emotional
awareness and parental bonding on emotional eating in obese women who sought
treatment for obesity. Parental bonding is the emotional connection that the parent feels
for the child. The authors found that paternal and maternal overprotection was negatively
associated with obese patients’ levels of emotional awareness. In turn, emotional
awareness was negatively associated with emotional eating.
Thus, research has found an association between emotional eating and emotions
in children at an early age and parental care. Low maternal care is associated with
individuals having difficulties identifying and describing their feelings and leads to
increased abnormal eating behavior (De Panfilis et al, 2003; Fukunishi, 1998). In
addition, research has found that an authoritative parenting style is negatively correlated
with emotional eating in children. However, what is unknown is whether or not parental
bonding is associated with emotional eating in a non-clinical university sample of healthy
young adults.
31
Parental Bonding and Coping
Transitional periods require considerable adaptation to psychosocial and
environmental changes. The transition to early adulthood is especially pronounced
among young adults entering a university where the separation from family, loss of
familiar social support, and academic demands are obstacles that young adults need to
overcome. The ability to overcome these challenges requires factors such as an
individuals’ ability to cope with these challenges; the ability to cope with these obstacles
determines their well-being and success in college. The ability to cope seems to be
derived from the bonding with the individuals’ parents (Adlaf, Gliksman, Demers, &
Newton-Taylor, 2001). The development of a secure relationship between child and
parent impacts the child’s interaction with the environment such as exploring and
discovering his surroundings, development of skills, and self-confidence (Ainsworth,
1985). The more secure a child feels, the more likely the child is to explore the
surroundings and thus, develop the skills and independence to take on challenges.
Matheson and researchers (2005) found that maternal bonding was associated with an
increased likelihood to use problem solving, active distraction, and social-support seeking
and less likely to use less adaptive emotion-focused strategies (e.g. rumination, blame) or
a passive resignation of failure (Matheson et al., 2005). Ultimately, the strength of this
relationship may determine how well a young adult overcomes challenges during
transitional periods.
Coping and Transition to College
Because college is often a time of adjustment and newfound independence,
college students must draw upon coping strategies to deal with their experience of stress.
32
Individuals who have acquired good skills in coping with new situations tend to have less
difficulty making the transition into college because coping is a mechanism that reduces
stress (Tinto, 1993). In addition, coping is also an attempt to alter events or
circumstances that are threatening or challenging by making them less so (Smith & Renk,
2007). For example, coping with a challenging course in college may require a student to
attend office hours and change the way studying is managed. Aspinwall and Taylor
(1992) found that coping strategies used by students significantly predicted their
adjustment in college. Active coping, behavioral or psychological responses that change
the nature of the stressor itself or how one thinks about it, was found to have positive and
direct effect on college adjustment as compared to avoidant coping which showed a
negative effect on college adjustment. Active coping predicted better adjustment to
college. Similarly, Leong, Bonz, and Zachar (1997) also found that active coping
predicted academic adjustment as well as personal-emotional adjustment, how a student
is feeling psychologically and physically. The impact of coping on college adjustment is
also supported by research that investigated the effects of coping styles on incoming
medical students (Park & Adler, 2003). This study reported students’ coping styles was
related to students’ psychological well-being and that escape-avoidance coping was
related to lower levels of psychological well-being. In addition, positive reappraisal and
planful problem solving were related to higher levels of psychological well-being. These
findings are consistent with Dyson and Renk’s (2006) result that found frequent use of
escape-avoidance coping among freshman was related to higher levels of depression.
Studies have also shown that students’ coping significantly predicted their
academic achievement in terms of grade point average (GPA; Baker & Siryk, 1984;
33
Sennett, Finchilescu, Gibson, & Strauss, 2003). Moreover, Hackett, Betz, Casas, and
Rocha-Singh (1992) reported significant positive relationships between coping and
students’ college GPA. Likewise, studies have also shown that among psychological
dispositions of coping strategies, perceived academic control, and self-esteem, coping
strategies had the most effect on students’ GPAs (Clifton, Perry, Stubbs, & Roberts,
2004). Similarly, DeBerard, Spielman, and Julka (2004) found that escape-avoidance
coping was negatively correlated with academic achievement. Coping styles not only
affect an individuals’ academic performance, but also a young adults’ well-being.
Transition to College as a Unique Stressor
Leaving the comforts of home and going away to college is a significant
development in a persons’ life, one that entails varying levels of adjustment difficulties.
For example, students are typically away from parental guidance and free to eat whatever
they want. There are many temptations such as piling on portions of food at the dining
hall and eating sugary and salty snacks whenever students want. Students also tend to
exercise less after high school because students are busy with the adjustment to college,
with class, homework, and socializing (Racette, Deusinger, Strube, Highstein, &
Deusinger, 2005). Alcohol use and drug use may also begin or increase without parental
guidance (Racette, et al. 2005). All of the changes in one’s life may result in greater
stress. The cumulative result is sometimes termed the “Freshman 15” by the popular
press; a term used to describe the average weight gain, 15 pounds, freshmen put on their
first year of college (Holm-Denoma, Joiner, Vohs, & Heatherton, 2008). However, a
recent study found that the “Freshman 15” may be a myth as the average college student
gains only 2.5 to 3.5 pounds in their first year (Zagorsky & Smith, 2011). Furthermore,
34
the study indicated that college students only gained an additional half-pound than noncollege students of the same age and the only factor that increased weight gain was heavy
drinking.
However, research has shown that the better adjusted students (both psychological
and physical well-being) are less likely to report experiencing stress (Montgomery &
Haemmerlie, 2001) and to seek help from counseling or the campus psychological
service centers (Beyers & Goossens, 2002). In addition, students that score higher on the
personal-emotional adjustment score within the Student Adaptation to College
Questionnaire (SACQ) report fewer health visits to the doctor and fewer absences from
class due to illness (Beyers & Goossens, 2002). Striegel-Moore, Silberstein, Frensch,
and Rodin (1989) reported that upon completion of their freshman year of college, a
significant number of females reported an increase in eating disorder symptomatology
including binge eating (14.6% increase) and a negative feeling regarding weight (22.9%
increase). While it is known that poor adjustment to the stresses of college has negative
consequences ranging from depression to eating disorders, it is not known whether the
level of college adjustment contributes to the negative effects of emotional eating.
Emotional eating may be inappropriately used as a coping strategy among poorly
adjusted students. In the absence of appropriate coping strategies in college, emotional
eating may persist into adulthood and be a precursor to obesity, eating disorders, or
psychopathology. Thus, examining the association between college adjustment and
emotional eating is warranted.
Aims and Hypothesis
35
The study of emotional eating is complex as it is influenced by many factors from
food preferences, genetics, and the social and physical environment (Desmet &
Schifferstein, 2008; Levitan & Davis, 2010). With many variables to consider, the study
of emotional eating still requires much research and careful study. This study examined
the contribution of coping style, parental bonding, and college adjustment to emotional
eating. To date, studies have not examined the association of these variables together
with respect to emotional eating. One goal was made to replicate previous associations
between coping style, stress, and parental bonding. In reference to coping style, this
study attempted to study coping style using 3 factors that recent research has suggested to
best differentiate the unique coping styles: self-sufficient, socially-supported, and
avoidant-coping (Litman, 2006) Moreover,the current research investigated an
unexplored area of psychology and examined the relationship between parental bonding
and emotional eating in a non-clinical young adult population who live among their peers
instead of their family. Individuals form many different relationships over the course of
the life span, but the relationship between parent and child is among the most important
(Steinberg, 2001). Studies have shown that parenting affects the emotional response of
young children, including emotional eating. Moreover, research has shown that low
maternal care is associated with greater risk of alexithymia and poor interoceptive
awareness in clinical samples. However, while research suggests a link between
parenting and emotional eating in children, it is unknown whether parental bonding has a
lasting influence on emotional eating in college students living away from their parents.
College is a unique time period in ones’ life span with possible stress due to demands
from classes, the responsibility of being on one’s own, relationships, decisions about
36
whether to take part in alcohol or substance use, possible financial responsibilities, and
trying to figure out how to balance everything. Thus, this study examined whether an
individuals’ ability to adjust to college is associated with emotional eating where students
have more access to when, what, and how much food they eat. Lastly, measures typically
used to assess emotional eating such as the Dutch Eating Behaviour Questionnaire
(DEBQ) and Emotional Eating Scale (EES) do not assess positive emotions as a trigger
(Evers, Adriaanse, de Ridder, & de Witt Huberts., 2013). Thus, this study incorporated
an exploratory positive emotion subscale, EES Positive, as emotional eating studies have
emphasized negative emotions rather than positive emotions (Evers et al., 2013). It is
important to examine positive emotions, in addition to negative emotions, because it is
known that across cultures, food is used for celebrations and as a way of socialization
(Patel & Schlundt, 2001; Wansink, 2004). Thus, the possible link between overeating
and eating in response to positive emotions should be examined.
The hypothesized model (Figure 1) is diagramed below:
37
The primary aims of this study was to investigate the relationships among emotional
eating, student adaptation to college, coping style, and parental bonding in college
students.
1. To confirm whether parental bonding in childhood was associated with type of
coping style used in college. Specifically, whether the level of care and the level
of independence a parent gives a child would be correlated with a type of coping
style. It was hypothesized that: (a) Avoidant coping styles would be negatively
associated with care score (high score = warmth, low score = coldness) and
positively associated protection score (high score = control, low score =
independence); (b) Self-sufficient and Socially-supported coping would be
positively associated with care score and negatively associated with protection
score.
2. To confirm whether the type of coping style (Self-sufficient, Socially-supported,
and Avoidant coping) used in college students would be associated with their
level of adjustment to college. It was hypothesized that: (a) students who use
avoidant coping styles would have a poorer adjustment to college. On the other
hand, students who use self-sufficient and socially-supported coping would have
higher levels of college adjustment.
3. To examine whether parental bonding would be associated with emotional eating.
In particular, it was hypothesized that: (a) students with cold (low care) parents
that were overprotective (high overprotection score) would be more likely to
emotionally eat (b) students with warm (high care) parents that allowed for their
38
independence (low overprotection score) would be negatively associated with
emotional eating.
4. To examine whether the level of adjustment to college would be associated with
emotional eating. It was hypothesized that students with a higher level of
adjustment to college would have lower levels of emotional eating.
5. To examine whether coping style, student adaptation to college, and parental
bonding would have an additive effect in explaining emotional eating. It was
predicted increases in avoidant coping, poorer parental bonding, and poorer
adaptation to college would result in greater emotional eating than the degree of
emotional eating associated with each predictor alone would indicate.
Method
Participants
Participants were undergraduate students recruited from Case Western Reserve
University’s psychology research pool and from fliers displayed across the university
campus. Students who participated in the research as a Psychology 101 student received
course credit. Participants who were not part of the subject pool were entered into a
drawing for a $100 Visa gift card and the winner was contacted and mailed the reward.
An informed consent waiver was obtained prior to study participation. Participants must
have been able to read and understand English. In addition, students who lived at home
with their parents and those who were on psychological medications that would
significantly affect their eating behavior were excluded from the study.
39
245 students responded to the advertisements. Participants who met one or more
of the following were not included in the study: did not consent to the study, failed to
confirm that there wasn’t a chance they were pregnant, indicated that they were on
medication(s) that would significantly affect their eating behavior, did not complete at
least 90% of the survey, were under 18 years of age, lived at home, failed to complete
90% of the survey, or were extreme outliers and were determined that the individuals did
not fill out the survey in good faith were deleted from the final database used for analysis.
72 participants out of 245 (29.4%) were not included in the study due to one or more of
the above exclusion criteria. Of the 72 subjects not used in the study, 31 individuals
listed having taken an anti-depressant and/or anti-anxiety medication within the past 30
days. Because these medications have been known to affect eating behavior by reducing
appetite (Haenisch & Bonisch, 2011; Kintscher, 2012), it is important to not include these
participants in this study. The resulting full dataset used for analysis had one hundred
seventy three participants (n = 173; Table 1). Demographic characteristics including
medication reported are displayed in Tables 1 and 2.
Measures
The Emotional Eating Scale (EES: Arnow, Kenardy, & Agras, 1995) is a 25 item scale
with three factors: anger/frustration, anxiety, and depression. Participants indicate on a
5-point Likert scale ranging from a 0 “no desire to eat” to a 4 “an overwhelming urge to
eat”, to what extent each emotional descriptor (e.g., lonely, nervous, frustrated, etc…)
leads them to experience an urge to eat. The 3 subscales were derived from research in
which anger/frustration, anxiety, and depression accounted for 95% of the emotional
states preceding binge eating episodes in obese binge eaters (Arnow et al., 1995). The
40
EES demonstrated good reliability and validity (Arnow et al., 1995) and coefficient
alphas for this study were 0.89 and 0.85 for the anger and anxiety subscales. Three
additional positive items were added to the EES solely for exploratory purposes since
positive emotions have been largely neglected: Attentive, in love, and content. No
cutoffs exist for classifying emotional eating. Scores range from 0 to 44 on EES
Frustration, 0 to 36 on EES Anxiety, 0 to 20 on EES Depression, 0 to 100 on EES Total,
and 0 to 12 for the exploratory subscale of EES Positive. The EES Total does not include
the exploratory subscale of EES Positive.
The Student Adaptation to College questionnaire (SACQ: Baker & Siryk, 1989) is a 67
item measure designed to assess how well students adapt to the demands of their college
experience. The level of adjustment items are ranked on a 9-point scale that ranges 1
“applies very closely to me” to 9 “doesn’t apply to me at all.” The 4 subscales include
academic adjustment (e.g. ‘Has well-defined academic goals’, ‘has trouble concentrating
when studying’), social adjustment (e.g. ‘fits in well with college environment’, ‘has
several close social ties’, ‘gets along well with roommates’), personal-emotional
adjustment (e.g. ‘being independent has not been easy’, ‘is not sleeping well’, ‘worries a
lot about college expenses’), and institutional attachment (e.g. ‘is pleased about attending
this college’). Scores range from 24 to 216 on academic adjustment, 20 to 180 for social
adjustment, 15 to 135 on personal-emotional adjustment, 15 to 135 for attachment and 67
to 603 on the full scale score. The SACQ has good internal consistency, reliability, and
criterion-related validity. Cronbach’s alpha values range from 0.77 for the personalemotional adjustment subscale to 0.95 for the full scale score (Baker & Siryk, 1989).
41
The COPE Inventory (Carver et al., 1989) is a measurement of coping style which
contains 15 subscales measured with a four-point Likert scale. The 15 subscales are
active coping, planning, positive reframing, acceptance, humor, religion, using emotional
support, using instrumental support, self-distraction, denial, venting, substance use,
behavioral disengagement, mental disengagement, and self-blame. Each item in a
subscale was measured using a frequency scale of (1) never, (2) seldom (3) often and (4)
always. Thus, each item has a minimum score of 1 and a maximum score of 4. The
COPE has good reliability (alpha = .45 - .60) and test re-test scores (r=.45 - .86) over an
eight week period in a university sample (Carver et al., 1989).
The COPE was chosen as the coping measure for this study because it assesses a
broader variety of coping-styles. Carver et al. (1989) factored the individual COPE scale
scores and identified four dimensions: problem-focused coping, emotion-focused coping,
social-support, and avoidant-coping. However, recent studies have found that emotion
and problem focused scales have a high degree of overlap as individuals may use both
kinds of strategies depending on the situation (Tennen, Affleck, & Armeli, 2000). In
addition, studies have found some items to weakly correlate with the original scales and a
hierarchical factor structure with a number of primary factors loading on to a few secondorder factors suggesting that the factor structure warrants further examination (Litman,
2006; Lyne & Roger, 2000). Within the COPE, Litman (2006) found three factors that
provided the most stable factor structure: Self-sufficient coping, socially-supported
coping, and avoidant-coping. Scores range from 8 to 32 on the self-sufficient factor, 4 to
16 on the avoidant-coping factor, and 3 to 12 on the socially-supported factor. These
three factors will be used in this study (Table 3).
42
The Parental Bonding Inventory (PBI; Parker, Tupling & Brown, 1979) is a widely used
and well validated self-report questionnaire that consists of two (father and mother) 25item self-report questionnaires that assess parental bonding along two dimensions: care
factor and over-protection factor. There are 12 care factor items and 13 over-protection
factor items with each item scored from 0 to 3. Scores range from 0 to 36 for the care
dimension and 0 to 39 for the over-protection dimension. The PBI asks the responder to
evaluate the relationship between their parents and themselves from the first 16 years of
their childhood. High scores on care suggest a parent who was warm and understand and
low scores reflect a parent who was cold and rejecting. A high score on control reflects
over-protection and a low score reflects a parent allowing independence. The PBI is
reliable over time regardless of current mood state (Wilhelm, Niven, Parker, & HadziPavlovic, 2005).
Procedure
Individuals were notified through the Psychology 101 online research tracking
system, http://case.sona-systems.com/ and via posters throughout the university.
Participating in research provides students an opportunity to be acquainted with
psychological research. Once an individual had voluntarily signed up to participate in the
research through the online experiment tracking system, the SONA system automatically
sent the individuals a link to the study. The first screen before any questions were to be
answered was the approved consent notice where participants either accepted or rejected
consent. After completion of the survey, which should have taken no more than 30
minutes to complete, research credit for the student was recorded. Once this was done,
data was divided into 2 databases: one with the answers to the questions and one with
43
identifying information such as name and e-mail. Separating the information into two
databases ensured confidentiality.
Results
Missing Data
For participants with less than 10% of data missing (N=173), subscales on all
measures with missing value(s) were not used except the Student Adaptation to College
Questionnaire (SACQ). The SACQ had specific directions as to replacing missing
values. Prorated values were used by substituting the mean of the responses for the
subscale on which the missing item appeared. If an item appeared on only one subscale,
this prorated value from the subscale was used for the Full Scale as well. If items were
missing for items that appeared on more than one subscale, three different means had to
be calculated – two based on the subscales and one based on the Full Scale.
Outliers
In order to identify outliers in interval level variables and ordinal level variables,
all of the scores for a variable were converted to standard scores. A case was defined as
an outlier if its standard score was ±3.0 or beyond the mean (Jarrell, 1994). Analysis
performed with and without the outliers were the same in terms of the number and
specific variables that were significant and meaningful. In the analysis of outliers, it was
found that two subjects consistently had outlier scores on the majority of the measures.
Thus, these two subjects were deleted from the final dataset.
44
Normality
To test whether or not the data was normally distributed, z-scores for skewness
and kurtosis were calculated (Table 4). For small samples (n < 50), if absolute z-scores
for either skewness or kurtosis were larger than 1.96, then the distribution of the sample
was considered non-normal (West, Finch, and Curran, 1995). However, since this study
had a medium sized sample (50 < n <300), an absolute z-value over 3.29 was considered
a non-normal distribution (West et al., 1995). Variables with skewness z-values and
kurtosis z-values of between -3.29 and +3.29 were considered normally distributed.
The following variables were considered non-normally distributed: Maternal
Care, SACQ Social, SACQ Attach, COPE Avoid. Thus, log transformations were
performed on these variables. Since Maternal Care and SACQ Attach variables had a
negative skew, a reflection of the data was done in addition to the subsequent log
transformation. The subsequent skewness and kurtosis values after the transformations
are depicted in Table 5 and subsequently used in the data analysis.
Data Analysis
Data analysis was carried out using the IBM SPSS statistical software program
(version 21.0) (SPSS 2012). The data was examined for accuracy of input and outliers.
Accuracy of input was examined through a 20% data reliability check; no errors were
found. A description of the study sample is given in Table 1.
Before correlations were performed, independent samples t-tests were conducted
to test for sex differences of emotional eating and other variables of interest.
Significance level was set at p < 0.05. This significance level was set at the standard
45
level because the purpose of performing the independent samples t-test was to explore the
possibility of sex differences. If possible sex differences were found, then correlational
analysis would be performed within each gender group and also for full group with both
genders included. Independent sample t-tests were performed to check for gender
differences (Table 6). Males rated their mothers as significantly more controlling in
comparison to females. The following gender differences were also found with higher
scores in females compared to males: EES Frustration, EES Depression, EES Total,
SACQ Full Scale, SACQ Academic, SACQ Attach, COPE Social, Mother Care, and
Father Care (Table 6).
Significance levels for Pearson correlations were set at a more stringent level of p
< 0.01 with r > 0.3 considered significant. With results from independent samples t-tests
possibly signaling sex differences (Table 6), Pearson correlations were run within gender
groups and for the full group.
The significance level for the multiple regression was set at p < 0.05. Mean and
standard deviations were calculated for continuous data and frequencies were computed
for categorical variables. Preliminary correlational analysis between emotional eating
and demographic characteristics (e.g. gender) were conducted to determine whether these
variables needed to be include as covariates in the regression analysis. Tolerance values
for each predictor was used as a check for multicollinearity. The tolerance value is an
indication of the percent of variance in the predictor that cannot be accounted for by the
other predictors. Thus, a small value, values less than 0.10, indicates that a predictor is
redundant. Tolerance values were high, above 0.845, for variables entered into the
multiple regression indicating no multicollinearity issues.
46
Hypothesis 1: (a) Higher levels of avoidant coping styles will be negatively associated
with lower degrees of perceived warmth and positively associated with perceived
parental control. (b) Higher levels of self-sufficient and socially supported coping will be
positively associated with a greater degree of perceived parental warmth and negatively
associated with perceived parental control.
As hypothesis 1a predicted, there was a negative association between avoidant
coping and perceived parental warmth and a positive association between avoidant
coping and parental control (Table 7). However, this link was only found in perceived
paternal care. Perceived paternal warmth was negatively associated with the use of
avoidant coping (r = -0.30, p = 0.0001) and perceived paternal control was positively
associated with the use of avoidant coping (r = 0.44, p = 0.0001).
For hypothesis 1b, correlation analysis did not indicate a significant relationship
between any of the Parental Bonding Inventory subscales with perceived parental care
(Table 7).
Hypothesis 2: (a) A higher use of avoidant coping styles will result in poorer adjustment
to college (lower SACQ scores). (b) On the other hand, a higher use of self-sufficient and
socially-supported coping styles will be positively associated with higher levels of college
adjustment.
2a. Hypothesis 2a was not supported as correlational analysis did not indicate a
significant relationship between avoidant coping and any of the subscales for the Student
Adaptation College Questionnaire (Table 8).
47
2b. Likewise, hypothesis 2b was also not supported as results did not indicate a
significant relationship between self-sufficient and socially-supported coping with any of
the subscales for the Student Adaptation College Questionnaire (Table 8).
Hypothesis 3: (a) Students that perceive their parents to be cold (low care score) and
overprotective (high overprotection score) would be more likely to emotionally eat (b)
Students that perceive their parents to be warm (high care) parents that allowed for their
independence (low overprotection score) will have lower levels of emotional eating.
Hypothesis 3 was not supported as correlational analysis did not indicate a
significant relationship between any of the subscale scores of perceived parental bonding
and emotional eating.
Hypothesis 4: A higher level of adjustment to college will be negatively associated with
emotional eating.
Correlation analysis did not indicate a significant association between any of the
subscales scores or total score of adjustment to college and scores of emotional eating
(Table 9).
Exploratory Analysis
Before hypothesis 5 was analyzed, an exploratory analysis was performed to see
which additional independent variables may be factors in emotional eating. Analysis of
the relationship between coping styles and emotional eating were found to be significant
(Table 10, 11, and 12). COPE Avoid was correlated with EES Total (M+F: r=0.34, p <
0.0001; F: r=0.32, p < 0.003; M: r=0.39, p < 0.001). Likewise, there was also an
association between COPE Avoid and EES Frustration (M+F: r=0.36, p < 0.0001; F:
48
r=0.35, p < 0.001; M: r=0.4, p < 0.001). In males only, high levels of avoidance coping
was positively associated with EES Anxiety (Table 11: M: r=0.32, p < 0.007).
A link between socially supported coping and emotional eating was also found.
There was a link between COPE Social and EES Depression (Table 9; M+F: r=0.3, p <
0.0001). In males only (Table 11), COPE Social was positively associated with EES
Total and EES Anxiety, r=0.33, p < 0.005 and r = 0.34, p < 0.004 respectively.
Hypothesis 5: Increases in avoidant coping, poorer perceived parental bonding, and
poorer adaptation to college will result in greater emotional eating than the degree of
emotional eating associated with each predictor alone would indicate.
A hierarchical linear regression was run to predict emotional eating from COPE
Social and COPE Avoid while controlling for sex and race. Independent t-test was used
to test for gender differences in emotional eating (Table 6). There was a significant
difference in EES Frustration [t(166)= -2.319, p = 0.022], EES Depression [t(170)= 3.477, p = 0.001], and EES Total [t(163)= -2.649, p = 0.009] with females emotionally
eating more than males across the groups. Results of a one-way ANOVA and a
subsequent independent t-test was used to test for possible group differences in emotional
eating across race (Table 14). Race was found to be significantly different with Asian
students emotionally eating significantly more than white students to anxiety [t(151)=
2.574, p = 0.011], frustration [t(148)= 2.599, p = 0.01], and total emotional eating
[t(145)= 2.581, p = 0.011]. Exploratory analysis also showed that Asian students engaged
in greater emotional eating than white students to positive emotions [t(149)=3.28 , p =
0.001]
49
This regression model significantly predicted total emotional eating, F(6, 141) =
10.083, p < 0.0001, R2 = 0.30 (Table 14, 15). The results of the multiple linear
regression suggests that a significant proportion of the total variation in emotional eating
was predicted by socially supported coping and avoidance coping, p < 0.05. According
to the R-squared, coefficient of determination, the independent variables explain 30% of
the variability of emotional eating. The adjusted R-square is an adjustment of the Rsquared that takes into account, penalizes, the addition of extraneous predictors to the
model. The adjusted R-squared indicates that 27% of the variance in the dependent
variable can be explained by gender, race, socially supported coping and avoidance
coping. Socially supported coping and avoidance coping added 15.9% of the variance
beyond sex and race.
Discussion
There are many risk factors of emotional eating because it is influenced by many
factors such as food preferences, genetics, culture, psychology, and the social and
physical environment. As a result of its complexity, it is almost impossible to study all of
the possible factors in one study. While complex, this study examined unique and
important factors that possibly were associated with emotional eating. Recent research
has suggested that instead of studying coping using emotion-focused, problem-focused,
and avoidance-oriented coping, the 3 factors that best differentiates the unique coping
styles are self-sufficient, socially-supported, and avoidant coping (Litman, 2006). In
addition, while research suggests a link between parenting and emotional eating in
children, it is unknown whether this link has a lasting influence in college students who
are living away from their parents and attempting to become independent. Lastly, while
50
studies have examined emotional eating in response to negative emotions, it was also
important to examine how positive emotions affect eating behavior because it is known
that food is also used for celebrations and as a way of socialization (Patel & Schlundt,
2001; Wansink, 2004). While there are many risk factors of emotional eating to consider,
this study attempted to examine a few possible factors that have yet to be examined.
The major findings reported here indicate socially supported coping and
avoidance coping are important contributors to emotional eating and this is mediated in
part through gender and race (Figure 2). One of the major correlational findings was that
there was a significant positive relationship between avoidance coping and emotional
eating, regardless of gender. More specifically, individuals who tend to use more
avoidance coping tended to rate themselves as emotionally eating in response to
frustration more often in both genders. This finding is in contrast to a recent online study
of female college undergraduates from Canada, in which avoidant coping was not found
to be associated with emotional eating (Raspopow, Matheson, Abizaid, & Anisman,
2013). Instead, emotion focused coping was found to be positively associated with
emotional eating. According to Raspopow et al. (2013), emotion focused coping may be
a way of diminishing the adverse effects that come with emotional coping such as
rumination and self-blame by self-medicating through eating and increasing positive
feelings. Ingestion of highly palatable foods promote the release of serotonin which
temporarily increases mood states (Christensen & Pettijohn, 2001). However, the results
from the present study suggest that there is a positive relationship between the use of
avoidance coping and emotional eating in both females and males. Unlike self-sufficient
coping and socially-supported coping, avoidance coping is a short term solution to
51
alleviate stress (Holahan et al., 2005) and emotional eating, likewise, may soothe
emotions temporarily but fail to permanently remove the stressor. Self-sufficient coping
and socially-supported coping both are positively correlated with approach oriented
behavior (dealing with either the problem or related emotions) while avoidant coping is
correlated with avoidance oriented behavior (ignoring or withdrawing from the stressor;
Litman, 2006). The present findings suggests that in both males and females, there is an
association between avoiding the stressor instead of actively fixing the problem and
temporarily alleviating stress by turning to emotional eating instead of actively trying to
fix the problem. Avoidance coping and emotional eating are similar in that both
temporarily increase mood. Interestingly, the present study also found that emotionally
eating to frustration was also positively associated with avoidance coping.
Frustration is an emotional state that varies from a mild annoyance to possibly an
intense rage. Frustration can be caused by both external and internal events such as being
annoyed at a specific coworker or feeling anger about personal problems. It may be
possible that there is a link between individuals that have a low tolerance to the emotion
of frustration and avoiding the problem at the core of the frustration by emotional eating
in response to the specific emotion as a temporary and immediate gratification. In
rational emotive therapy (RET; Ellis & Bernard, 1986), there is a concept, low-frustration
tolerance (LTF), which stems from an irrational immediate gratification belief that “life
should be easy and go the way I want. If not, it’s awful and I can’t stand it” (Wessler &
Wessler, 1983). Thus, there may be a link between individuals who tend to avoid the
problem as a method of not dealing with the negative feelings and seeking immediate
52
gratification – one being emotional eating. This may be a plausible explanation of the
positive relationship between emotionally eating to frustration and avoidance coping.
The idea of low-frustration tolerance is also known as discomfort anxiety and is
created by the distorted views of the individuals’ ability to put up with the discomfort. In
the present study, males who were more likely to use avoidance coping were also more
likely to emotionally eat in response to anxiety. Previous research suggests that there are
sex differences in brain connectivity and gender differences in which individuals
outwardly show their emotions. Ingalhalikar and researchers (2014), using diffusion
tensor imaging in a sample of 949 youths aged 8 – 22 years old found that male brains
have more connections within each hemisphere while female brains are more
interconnected between hemispheres. However, how this structural difference affects
behavior and emotion is still unknown as it leaves out culture, which shapes how one
thinks and how one uses the brain. For example, in a study of college students, females
were more likely than males to express happiness during a frustrating task as opposed to
a negative emotion (Chaplin, 2006). According to Keenan and Shaw (1997), girls are
socialized by parents and teachers to consider the impact of the expression of negative
emotions on others. Similarly, girls are more likely than boys to anticipate negative
reactions from others in response to their expression of negative emotions (Underwood,
1997). Society expects different attitudes and behaviors from males and females and as a
result, there is a tendency for boys and girls to be raised differently (Underwood, 1997).
In gender socialization, boys are raised to conform to the male gender role, and girls are
raised to conform to the female gender role. A gender role is a set of behaviors, attitudes,
and personality characteristics expected and encouraged of a person based on his or her
53
sex. Thus, there seems to be a unique positive relationship between avoidance coping
and emotional eating in response to anxiety in males only that is not seen in females that
is possibly due to gender socialization.
Another important finding was the positive correlation between sociallysupported coping and emotional eating in response to feeling depressed. This finding is
similar with the recent online study of female college undergraduates from Canada
(Raspopow et al., 2013) in which emotion focused coping was found to be positively
associated with emotional eating. Emotion focused coping involves reducing the
negative emotional responses such as depression and embarrassment. While the present
study did not explicitly examine the emotional coping factor because of the high degree
of overlap among problem and emotion focused scales (Litman, 2006), the subscale of
socially-supported coping, used in the current study includes a number of emotion based
coping strategies such as emotional social support and venting one’s emotions. The
present finding suggests that individuals who are more focused on dealing with stress
through social support and through reducing negative emotional responses are more
likely to use emotional eating as a method of temporarily reducing negative feelings.
Both socially-supported coping and emotional eating are centrally based on emotions
because emotions are at the center of social interactions among people. When an
individual is feeling the blues or lonely, self-medicating through eating increases
serotonin levels and mood. Likewise, seeking social support to reduce negative feelings
also increases an individual’s mood (Christensen & Pettijohn, 2001).
Specific to males, those who endorsed a greater use of socially-supported coping
also responded that they were more likely to emotionally eat, especially in response to
54
frustration. According to Littman (2006), socially-supported coping was significantly
and positively correlated with BAS Reward Responsiveness, a 5-item subscale of the BIS
(Behavioral Inhibition)/BAS (Behavioral Approach) scales (Carver & White, 1994) that
measures approach behavior. On the other hand, BIS measures inhibition or withdrawal
behavior (Fowles, 1993). Carver (2004) found in his study that self-reported Fun
Seeking (BAS subscale) predicted reports of greater frustration after frustrative
nonreward and self-reported Reward Responsiveness (BAS subscale) predicted reports of
greater anger. Approach behavior yields negative affect when progress is inadequate,
positive affect when progress exceeds criterion, and no affect when progress is acceptable
but no more or less (Affleck et al., 1998; Carver, 2004; Carver & Scheier, 1999;
Lawrence, Carver, & Scheier, 2002). Likewise, withdrawal behavior yields negative
affect when progress is inadequate, positive affect when progress exceeds criterion, and
no affect when progress is acceptable but no more or less (Carver, 2004). Thus, the
approach motivation can be responsible for negative affect such as frustration. Littman’s
(2006) research suggests a positive relation between socially-supported coping and BAS
and Carver’s (2004) study suggests a positive association between BAS and levels of
frustration. In turn, the present finding links socially-supported coping to emotional
eating in response to frustration in males suggesting that in response to frustration
possibly due to inadequate progress towards a goal, males may uniquely turn to social
support and emotional eating.
In addition to gender differences, race differences were also found. Asians
reported significantly higher levels of eating in response to frustration, anxiety, and
overall emotional eating compared to White college students. In exploratory analysis,
55
Asians also significantly ate more than Whites in response to positive emotions.
However, as displayed in Table 13, these findings should be treated with caution as the
mean scores for EES frustration (13.11 for Asians and 9.71 for Whites; range of 0 – 44),
EES anxiety (11.72 for Asians and 8.90 for Whites; range of 0 – 36), EES total (34.02 for
Asians and 26.50 for Whites; range of 0 – 100), and EES Positive (4.44 for Asians and
2.81 for Whites; range of 0-12) were below the median for their respective subscale
score.
While the prevalence of eating disorders in preindustrialized, non-Western
populations has generally been found to be lower than postindustrialized and Western
societies (Anderson-Fye & Becker, 2003), this prevalence seems to be increasing
(Chisuwa & O’Dea, 2010; Cummins & Lehman, 2007). The increase of eating disorders
in most non-Western societies might be due to the introduction of Western ideas such as
fashion and media (Cummins & Lehman, 2007). For example, in the past, the slimness
seen as a Western ideal for women would have been seen as possibly a sign of poverty in
a traditional Chinese society (Lee, 1991). This supports the belief that culture plays an
important role in the development of eating disorders, since their prevalence in Western
societies is high. However, there are questions as to whether eating disorders develop
differently in different cultures and whether health professionals identify eating disorders
properly in non-Western groups that may lead to an underestimation of the prevelance of
eating disorders in non-Western populations (Chisuwa & O’Dea, 2010; Cummins &
Lehman, 2007; Gordan, Perez, & Joiner, 2002; Makino, M., Tsuboi, K., & Dennerstein,
2004; Soh, Touyz, & Surgenor, 2006).
56
Eating disorder data on Asian countries show unique patterns that cannot be
generalized broadly to all Asian countries (Kuboki, Nomura, Ide, Suematsu, & Araki,
1996; Tsai, 2000). Prevelance rates of anorexia and bulimia nervosa in Japan and China
have been found to be lower than in Western nations (Lee, Hsu, & Wing, 1992; Tsai,
2000). On the other hand, South Korea has similar prevelance rates of eating pathology as
the United States (Lippincott & Hwang, 1999) although Korean Americans have been
found to have comparatively lower rates (Anderson-Fye & Becker, 2003; Ko and Cohen,
1998). Ko and Cohen (1998) explained that a possible reason for their finding is that
Korea has undergone rapid industrialization. Westernization of the native Koreans may
create more disordered eating attitudes compared to Korean Americans because of the
novelty and unfamiliarity of Western ideals. On the other hand, Korean Americans may
feel less pressure to diet (Ko & Cohen, 1998) with one possible explanation being that
Asians, in general, may feel less risk of obesity compared to their Caucasian peers (Sing,
1993). According to Tsai and researchers (1998), Asian female students in the U.S.
reported less body dissatisfaction than American students possibly due to their generally
smaller body size. Similarly, another study found that Chinese people living in Hong
Kong showed higher levels of body dissatisfaction and dieting than Chinese people living
in the US (Davis & Katzman, 1998). According to Chan, Ku, and Owens (2010), a
possible reason for this may be that with the spread of Western values, the Chinese
individuals living in Hong Kong experience Western standards determined in large part
to media ideals while Chinese individuals living in the US have direct experience of the
difference between media ideals and typical body size and shape of actual Westerners.
57
It is important to note that while this study collected data on race, there were no
further questions as to the country of origin or as to whether students were international
students or 1st generation Americans. At Case Western Reserve University, 8% of
undergraduates in 2012 were international students and 18% of the student body
population are Asian. For the fall semester of 2013, 4,661 students were enrolled from
96 different countries including 273 students from China, 3 students from Hong Kong, 18
students from India, 1 student from Japan, 48 students from the Republic of Korea, 1
student from Malaysia, 4 students from Taiwan, 2 students from Thailand, and 2 students
from Viet Nam. In the present study, 31.8% of the respondents were Asian and based on
demographic data from Case Western Reserve University, the majority of the sample
were most likely Chinese. While studies of eating disorders among Asian Americans are
sparse, it seems that higher levels of emotional eating in Asians compared to Whites is in
contrast to the limited studies that found greater disordered eating attitudes in Whites
than Asian Americans (Lucero, Hicks, Bramlette, Brassington, & Welter, 1992; Tsai et
al., 1998).
However, emotional eating in Asian college students may reflect a difference in
culturally appropriate behavior. The concept of the self is important in emotions.
Cultural constructions of the self can be categorized into the independent self and the
interdependent self (Markus & Kitayama, 1991). The independent self is formed in a
culture where individuality and independence are highly valued. On the other hand, the
interdependent self develops out of cultures that emphasize the interrelationships and
connections between members of the society. Individuals in this society are concerned
more with how thoughts and feelings affect social interactions with others. There is a
58
greater emphasis on the relationship instead of the individual’s internal thoughts and
feelings (Markus & Kitayama, 1991). In addition, previous studies have suggested that
there are cultural differences in emotional expression (Kitayama, 2002; Markus &
Kitayama, 1991; Miller, 2002). Western European values such as independence and selfassertion encourage open emotion expression unless in the face of social threats such as
embarrassment (Oyserman, Coon, & Kemmelmeier, 2002). On the other hand, Asian
values such as interdependence and harmony encourage suppression equally for selfprotective purposes and prosocial goals. For example, an individual may hide the joy
from beating an opponent at a competitive game rather than openly expressing their glee.
Gross and John (2003) found that minorities in the United States, including Asian
Americans, reported higher levels of emotional suppression than Caucasians.
Furthermore, the use of suppression was associated with negative emotions for Western
Europeans while suppression was more normative for Asians since it was often used
prosocially. As a result, rather than viewing emotional eating as a purely maladaptive
response to emotions, emotional eating may be a normative and accepted response to
emotions in the Asian culture. While it may be true that Asian Americans report higher
levels of emotional suppression than Caucasians, it may be possible that Asian
Americans express their emotions not through dancing, yelling, or screaming, but
expressing emotions through the love of food. A reflection of this may be seen at
restaurants where many Chinese dishes are meant to be shared while many items on an
American menu are meant to be ordered individually. Socializing and eating are tightly
connected and studies have shown that more food are eaten at meals with familiar and
friendly people because these people help make the meal more enjoyable (Wansink,
59
2004). Instead of giving hugs or kisses, buying, eating, and sharing food may serve as the
normal expression of emotion in Asian Americans.
Additionally, data for this study was collected mainly from Case Western Reserve
University which is located within 10 to 15 minutes from numerous Asian supermarkets,
Asian restaurants including dim sum, and Asian cafes that serve traditional Asian
pastries, bubble tea, and desserts. The convenience of Asian supermarkets allows Asian
populations the possibility of keeping the Asian tradition, especially as it pertains to food,
in their daily life. These Asian supermarkets provide traditional foods and special
seasonings such as whole roast duck, kimchi, mochi ice cream, and star anise that are
typically not found in other grocery stores. While acculturation is a multidimensional
process that is dynamic and complex (Satia, 2003; Satia et al., 2001), eating habits are
often one of the last traditions to change (Lee, Sobal, & Frongillo, 1999). While Korean
Americans and Chinese Americans tend to eat American breakfasts and lunches more
frequently than traditional meals, both groups tended to retain their traditional Korean
and Chinese meals, respectively, for dinner (Lee, Sobal, & Frongillo, 2000; Pan, Dixon,
Himburg, & Huffman, 1999). Moreover, for Korean Americans, eating Korean meals
had higher emotional attachment (Lee et al., 1999). With the convenience and abundance
of Asian restaurants, cafes, and groceries that provided traditional Asian meals and
snacks, Asian students at this particular university were potentially able to obtain
traditional foods that have a high emotional attachment that was in stark contrast to
American food. It may be possible that the Asian group in this study rated themselves as
emotionally eating more than their Caucasian counterparts because the dinner meal may
be a meal with high emotional attachment that is typically not seen in Caucasians on a
60
regular meal to meal basis. In addition, Asians may significantly eat more to positive
emotions than Whites because each trip to the Asian market and each traditional meal
that the Asians eat and/or make may have much greater emotional attachment due to the
greater difficulty, possibly, of attaining traditional Asian food from one’s foreign country
or when one is living at home with their family.
Another important finding in this study is that females were found to
significantly eat more to emotions than males. Females not only had higher general
levels of emotional eating compared to males, but also higher levels of eating in response
to frustration and depressed mood. The majority of emotional eating studies consist of a
female only sample (Nguyen-Rodriquez, Unger, & Spruijt-Metz., 2009). However, for
studies that include both genders, findings on sex differences have been mixed. Some
studies found females reporting higher levels of emotional eating than males (Braet et al.,
2008; Tanofsky-Kraff et al., 2007) while a number of studies failed to find any sex
differences in levels of emotional eating (Braet & van Strien, 1997; Caccialanza et al.,
2004; Nguyen-Rodriquez et al., 2009). Emotional eating has been identified as a factor
triggering binge eating in bulimia nervosa (BN) (Engelberg et al., 2007), binge eating
disorder (BED) (Dingemans et al., 2009; Pinaquy et al., 2003; Masheb & Grilo, 2006;
Stein et al., 2007), and anorexia nervosa (AN) (Ricca et al., 2012). All of these eating
disorders have a much greater prevalence in women than in men (Dingemans et al., 2009;
Ricca et al., 2012). Likewise, research into the psychological well-being of normal
weight female adults finds that females often show similar psychological symptoms to
patients with an eating disorder. In a self-report study of 127 normal weight female
adults, high levels of emotional eating were associated with low psychological well-
61
being, low self-esteem, body image vulnerability, and feelings of inadequacy (Lindeman
& Stark, 2001); these symptoms are the same ones seen in underlying eating disorders.
Based on the results of the present study, females may be more vulnerable to emotional
eating.
Lastly, findings from this study indicate that the greater the perceived warmth
of the individuals’ father growing up, the lesser the use of avoidant coping. Likewise,
individuals that perceived their father to be more controlling were more likely to use
greater amounts of avoidance coping. Parental bonding with the individuals’ parents
early in life is associated with the ability to cope supports the previous literature (Adlaf et
al., 2001). The development of a secure relationship between child and parent impacts
the child’s interaction with the environment such as exploring and discovering his
surroundings, development of skills, and self-confidence (Ainsworth, 1985).
Interestingly, in the present study, this relationship was only found in the perceived
parental bonding in fathers, not mothers. In a recent study (Kochanska & Kim, 2013),
researchers examined the effect of the parent child relationship and how this relationship
may be associated with aggressive, troubled, or negative emotional behavior in middle
childhood. A secure attachment with at least one parent was shown to be a protective
factor against negative behavior and that secure attachment with two parents did not add
a protective effect beyond the security of one (Kochanska & Kim, 2013). Furthermore, it
didn’t matter whether the secure attachment was with the mother or the father. This was
unique and according to the authors, this was likely due to the fact that fathers have just
recently become increasingly more involved in caregiving (Kochanska & Kim, 2013).
Thus, while prior studies (Main & Weston, 1981; Suess, Grossmann, & Sroufe, 1992)
62
found the primacy of the mother as the attachment figure, it is possible that the increased
involvement of fathers in caregiving has decreased this primacy effect.
In addition, the effects of parental bonding with the mother and the father may
have unique effects depending on age of the child. Maternal parental bonding may be
more influential during grade school years while paternal parental bonding may be more
influential during later years of independence. Some studies have indicated that
compared to mothers, fathers tend to fill the role of a playmate rather than a caregiver
role for their children (Cabrera, Tamis-LeMonda, Bradley, Hofferth, & Lamb, 2000). In
addition, studies have found that fathers are more likely than mothers to encourage risktaking and exploration in their children (Paquette, 2004). Thus, while the results of this
study found a link between individuals that perceived their father to be warm and less
controlling and the use of avoidance coping as a method of dealing with stress while at
college, there was not a significant and meaningful relationship between perceived
maternal bonding and coping style.
All in all, gender, race, socially supported coping, and avoidance coping
accounted for 30% of the explained variance in emotional eating. The R-square change
indicates that 15.9% of the variance in the dependent variable can be explained by
socially supported coping and avoidance coping. Avoidance coping and emotional eating
are similar in that both temporarily increase mood and both do not actively solve the root
of the stressor. In addition, socially supported coping encompasses many aspects of
emotional coping and thus, like emotionally eating, is based on reducing negative
emotion or increasing positive emotion. Perceived parental bonding and level of
adjustment to college were not predictors of emotional eating. However, the lack of a
63
significant finding may be due to the retrospective nature of the parental bonding report
or that emotional eating in college is influenced by other factors. While research
suggests a link between emotional eating and parenting style while the child and
adolescent are living at home (Schuetzmann et al., 2008; Snoek, et al., 2007; Topham et
al., 2011), results from the present study suggests that the influence from parents as it is
related to emotional eating may not persist once individuals live outside of the home.
Given that college students spend most of their time with their roommate(s) and friends,
emotional eating may be influenced by people that immediately surround them. The lack
of a relationship between the level of adaptation to college and emotional eating was also
unexpected too. It may be possible that level of adaptation to college and emotional
eating are related, but that this relationship cannot be captured cross-sectionally at one
time point. Additionally, all of the data was collected during the fall semester. By
measuring one’s emotional eating and level of adaptation to college longitudinally over
time, it is possible that this relationship can be captured.
Limitations and Future Directions
Data from this study was obtained from an online self-report study which may be
limited in some ways. In addition, the measure of perceived parental bonding did not
have a parent report to verify the individual’s perception. Furthermore, while the study
asked individuals to report their race, there was no method to distinguish whether
individuals were born in the United States, fully acculturated, or those who still had a
strong ethnic identity as the analysis into possible ethnic differences was not one of the
initial hypothesis. An additional measure such as the Multigroup Ethnic Identity
Measure would strengthen this study in the future. Because this study did not intend to
64
examine cultural differences in emotional eating in detail, no data were collected beyond
the standard races. However, the term Asian encompasses a vast number of ethnic
identities from India, Vietnam, China, Taiwan, and Japan to name a few. All of these
countries have markedly different cultures. Results from the exploratory analysis finding
that Asian college students significantly emotionally ate more than White college
students can be further researched in future studies by adding an ethnic identity measure
and more precisely ascertaining the country of origin. Moreover, while fliers to recruit
individuals to participate in the study were posted throughout the campus, the vast
majority of participants were recruited from the Psychology 101 pool. Thus, results from
the present study cannot be generalized to the general population. Lastly, because
findings consisted of correlations between measures from a cross-sectional data set, the
results should be interpreted with caution.
Research into emotional eating spans numerous fields including genetics,
psychology, biology, sociology, and anthropology. Spanning multiple fields of study,
there are many factors that are associated with emotional eating. While this study was
not able to capture the full picture of emotional eating due to its complexity, future
research should continue to clarify important questions. A further examination into the
cultural differences and level of acculturation among students would help clarify
racial/ethnic differences in emotional eating. In addition, an investigation into why
emotional eating is an index of negative eating behavior that leads to negative health for
some individuals and yet, it is not for others. Moreover, research in emotional eating
should examine not only negative emotions, but also positive emotions since studies have
shown that eating is associated with positive moments such as celebrations. While this
65
particular study attempted to explore emotional eating to positive emotions, a study that
specifically looks into positive emotions would be beneficial. Furthermore, although the
present study did not allow for the parents to also be a part of the study, future studies
may benefit from having the parents’ perspective too whether it is their perceived views
of their own parenting or their own levels of emotional eating. Lastly, future research
into parental bonding, coping style and emotional eating should be done in a longitudinal
fashion to better capture the influence of the child-parent dynamic on adult coping style
and emotional eating. Therapy should focus on improving coping strategies and the
reduction of maladaptive strategies.
66
Table 1.
Sample Descriptives
n=173
Sex
Male
Female
n
72
101
%
41.6
58.4
Academic Standing
Freshman
Sophomore
Junior
Senior
78
52
22
21
45.1
30.1
12.7
12.1
Current Living Situation
Dorm
Off-campus
Greek
150
18
5
86.7
10.4
2.9
Number of Roommates
0
1
2
3
4
5
8
33
86
7
16
7
23
1
19.1
48.7
4
9.2
4
13.3
0.6
Race
Hispanic or Latino
Asian
Black or African American
Native Hawaiian or Other Pacific
Islander
White
American Indian and White
Asian and White
Asian and Black
1
55
9
1
0.6
31.8
5.2
0.6
100
4
2
1
57.8
2.3
1.2
0.6
Yes
No
71
99
41
57.2
Taken meds past 30 days?
67
Table 2.
Medications Taken in Past 30 Days from Participants in Study
Male (n) Female (n)
Total (n) % of Total
Sample
Birth Control Medication
0
51
51
29.48
Asthma Medication
3
2
5
2.89
Antibiotics
2
2
4
2.31
Anti-inflammatory Medication
12
10
22
12.72
Allergy Medication
4
3
7
4.05
Table 3.
The COPE Subscales as used in the Current Study
Factors in Coping
Subscale
Self-sufficient
Active Coping
Planning
Suppression of Competing Activities
Restraint Coping
Religion
Positive Reinterpretation and Growth
Acceptance
Humor
Socially-supported
Seeking Social Support for Emotional Reasons
Seeking Social Support for Instrumental Reasons
Venting of emotions
Avoidant Coping
Denial
Behavior Disengagement
Mental Disengagement
Substance Use
68
Table 4
Normality
Variable
Mother Care*
Mother Control
Father Care
Father Control
EES Frustration
EES Anger
EES Depression
EES Total
SACQ Full
SACQ Academic
SACQ Social*
SACQ Personal
SACQ Attach
COPE Self
COPE Social
COPE Avoid*
Skewness Kurtosis
-3.40
-1.78
1.42
-0.22
2.59
-1.02
-1.06
-1.31
1.48
-1.81
1.36
-1.26
.52
-1.44
.52
-1.92
-1.36
1.36
-1.27
2.05
2.73
3.38
-0.36
2.39
-3.62
0.95
0.55
-0.21
0.99
0.96
3.81
0.51
*. Variable = non-normal distribution
Table 5.
Non-normal Distribution Log Transformation
Variable
Skewness
Kurtosis
SACQ Attach -2.06
.54
Maternal Care -3.24
-1.32
COPE Avoid 1.69
-1.02
SACQ_Social .74
1.14
69
Table 6.
Gender Independent T-test
IV
Sex
EES Frustration*
M
F
EES Anxiety
M
F
EES Depression** M
F
EES Total*
M
F
EES Positive
M
F
SACQ Full**
M
F
SACQ Academic* M
F
SACQ Social
M
F
SACQ Personal
M
F
SACQ Attach**
M
F
COPE Self
M
F
COPE Social**
M
F
COPE Avoid
M
F
Mother Care*
M
F
Mother Control*
M
F
Father Care**
M
F
Father Control
M
F
n
71
97
72
99
72
100
71
94
69
100
72
101
72
101
72
101
72
101
72
101
69
88
68
91
70
96
68
98
71
96
68
96
69
100
Mean
20.65
23.53
17.85
19.69
12.11
14.45
50.55
57.65
3.61
3.38
338.79
348.12
120.28
122.89
96.25
97.10
71.33
73.67
82.70
86.75
78.43
80.36
26.35
32.76
28.23
27.97
26.28
28.54
17.06
14.77
21.43
26.80
13.73
13.66
SD
8.02
7.89
7.05
6.21
4.53
4.22
17.95
16.33
3.19
2.77
15.79
15.21
8.68
8.26
8.91
8.82
7.55
8.35
10.65
9.73
13.74
14.26
7.43
7.89
7.28
5.57
6.44
6.76
7.63
7.36
7.95
8.12
6.53
7.87
t
-2.32
df
166
p-value
0.02
-1.81
169
0.07
-3.48
170
0.001
-2.65
163
0.01
.49
167
0.62
-3.91
171
0.00
-2.01
171
0.05
-.62
171
0.54
-1.89
171
0.06
-2.59
171
0.01
-.86
155
0.39
-5.19
157
0.00
.261
164
0.80
-2.16
164
0.03
1.95
165
0.05
-4.21
162
0.00
.07
167
0.95
Note. *. Significant at the 0.05 level (2-tailed)
**. Significant at the 0.01 level (2-tailed)
A. Scores range from 0 – 44 on EES Frustration, 0 – 36 on EES Anxiety, 0 – 20 on EES
Depression, and 0 – 100 on EES Total (EES Positive not included). Scores range from
0 – 12 on EES positive (exploratory). Higher scores indicate greater emotional eating.
B. Scores range from 24 - 216 on SACQ Academic, 20 – 180 on SACQ Social, 15 – 135 on
SACQ Personal, 15 – 135 on SACQ Attach, and 67 – 603 on SACQ Full. Higher scores indicate better
adjustment.
C. Scores range from 32 – 128 on COPE Self, 16 – 64 on COPE Avoid, and 12 – 48 on COPE
Social. Higher scores indicate greater use of the specific coping style.
D. Scores range from 0 – 36 on Mother Care and Father Care. Scores range from 0 – 39 on
Mother Control and Father Control. Higher scores on care suggest greater warmth and care. Higher scores
on control reflects greater control.
70
Table 7.
Coping Styles and Parental Bonding
Mother Mother
Care
Control
Mother Care
----Mother Control
-.54** ----Father Care
.57**
-.37**
Father Control
-.36** .42**
COPE Self
.08
.01
COPE Social
.08
-.11
COPE Avoid
-.24** .18*
Father
Care
Father
Control
COPE
Self
COPE
Social
COPE
Avoid
-----.40*
.16*
.15
-.30**
-----.01
-.03
.44**
----.32**
.12
----.04
-----
Note: *. Correlation is significant at the 0.05 level (2-tailed)
**. Correlation is significant at the 0.01 level (2-tailed)
Bold: Significant at p < 0.01, r > 0.3 and used in analysis
Table 8.
Coping Style and Adjustment to College
SACQ SACQ SACQ
Social Full
Person
SACQ Social ----SACQ Full
0.48** ----SACQ
-0.17* 0.41** ----Personal
SACQ
0.06
0.54**
Academic
SACQ
0.40** 0.61** -0.13
Attach
COPE Self
-0.02
0.06
-0.16*
COPE Social 0.03
0.20*
0.01
COPE Avoid -0.17* -0.08
0.25**
SACQ
SACQ
Academic Attach
COPE
Self
COPE COPE
Social Avoid
----0.09
-----
0.03
0.12
0.12
0.18*
0.18*
0.23**
Note: *. Correlation is significant at the 0.05 level (2-tailed)
**. Correlation is significant at the 0.01 level (2-tailed)
Bold: Significant at p < 0.01, r > 0.3 and used in analysis
----0.32** ---0.12
0.04
----
71
72
Table 10.
Coping and Emotional Eating Correlation M +F
COPE COPE COPE EES
EES
Self
Social Avoid Anxiety Frustration
COPE
----Self
COPE
.32** ----Social
COPE
.12
.04
----Avoid
EES
.10
.21** .29** ----Anxiety
EES
.08
.27** .36** .82**
----Frustration
EES
.10
.61**
.31** .21** .61**
Depression
EES
.10
.94**
.30** .34** .93**
Total
EES
.13
.06
.03
.52**
.55**
EES
EES
Depression Total
EES
Positive
----.79**
-----
.25**
.53**
-----
Positive
Note: *. Correlation is significant at the 0.05 level (2-tailed)
**. Correlation is significant at the 0.01 level (2-tailed)
Bold: Significant at p < 0.01, r > 0.3 and used in analysis
Table 11.
Coping and Emotional Eating Correlation M
COPE COPE COPE EES
Self
Social Avoid Anxiety
COPE
----Self
COPE
.39** ----Social
COPE
.01
.24*
----Avoid
EES
.02
.28*
.32** ----Anxiety
EES
.02
.36** .40** .87**
Frustration
EES
-.02
.30*
.30*
.61**
Depression
EES
.01
.34** .39** .95**
Total
EES
.24
.10
.06
.52**
Positive
Note: *. Correlation is significant at the 0.05 level (2-tailed)
**. Correlation is significant at the 0.01 level (2-tailed)
Bold: Significant at p < 0.01, r > 0.3 and used in analysis
EES
EES
EES
Frustration Depression Total
EES
Positive
----.62**
-----
.95**
.79**
-----
.49**
.24**
.48**
-----
73
Table 12.
Coping and Emotional Eating Correlation F
COPE COPE COPE EES
Self
Social Avoid Anxiety
COPE
----Self
COPE
.26*
----Social
COPE
.24*
-.13
----Avoid
EES
.15
.10
.27** ----Anxiety
EES
.11
.12
.35** .77**
Frustration
EES
.16
.18
.14
.54**
Depression
EES
.15
.15
.32** .90**
Total
EES
.04
.00
.02
.55**
Positive
Note: *. Correlation is significant at the 0.05 level (2-tailed)
**. Correlation is significant at the 0.01 level (2-tailed)
Bold: Significant at p < 0.01, r > 0.3 and used in analysis
EES
EES
EES
Frustration Depression Total
EES
Positive
----.58**
-----
.93**
.76**
-----
.65**
.31**
.61**
-----
74
Table 13.
Asian vs. White Independent T-Test
IV
Race
n
EES Frustration**
A
54
W
96
EES Anxiety**
A
54
W
99
EES Depression
A
54
W
100
EES Total**
A
54
W
95
EES Positive**
A
52
W
99
SACQ Full*
A
55
W
100
SACQ Academic
A
55
W
100
SACQ Social
A
55
W
100
SACQ Personal
A
55
W
100
SACQ Attachment** A
55
W
100
COPE Self
A
52
W
89
COPE Social
A
49
W
92
COPE Avoid
A
54
W
96
Mother Care**
A
52
W
96
Mother Control**
A
54
W
97
Father Care*
A
54
W
94
Father Control**
A
54
W
97
Mean
13.11
9.71
11.72
8.90
9.24
8.02
34.02
26.50
4.44
2.81
340.06
345.57
121.82
121.39
95.02
97.28
72.55
72.60
80.96
87.14
80.96
87.14
29.31
30.23
28.76
27.63
24.58
29.13
19.17
13.75
22.72
25.65
15.63
12.32
SD
7.77
7.65
6.28
6.59
4.27
4.73
16.43
17.15
3.16
2.77
14.76
16.79
6.65
9.09
8.59
9.01
7.23
8.34
9.96
10.28
12.84
14.12
7.02
8.91
6.72
6.14
6.86
6.14
6.73
7.57
7.83
8.49
6.90
7.40
t
2.60
df
148
p-value
0.01
2.57
151
0.01
1.58
152
0.12
2.58
145
0.01
3.28
149
0.001
-2.03
153
0.04
.31
153
0.76
-1.52
153
0.13
-.04
153
0.97
-3.62
153
0.00
1.63
139
0.11
-.63
139
0.53
1.05
143
0.30
-4.13
146
0.00
4.38
149
0.00
-2.08
146
0.04
2.70
149
0.01
Note. *. Significant at the 0.05 level (2-tailed)
**. Significant at the 0.01 level (2-tailed)
E. Scores range from 0 – 44 on EES Frustration, 0 – 36 on EES Anxiety, 0 – 20 on EES
Depression, and 0 – 100 on EES Total (EES Positive not included). Scores range from
0 – 12 on EES positive (exploratory). Higher scores indicate greater emotional eating.
F. Scores range from 24 - 216 on SACQ Academic, 20 – 180 on SACQ Social, 15 – 135 on
SACQ Personal, 15 – 135 on SACQ Attach, and 67 – 603 on SACQ Full. Higher scores indicate better
adjustment.
G. Scores range from 32 – 128 on COPE Self, 16 – 64 on COPE Avoid, and 12 – 48 on COPE
Social. Higher scores indicate greater use of the specific coping style.
H. Scores range from 0 – 36 on Mother Care and Father Care. Scores range from 0 – 39 on
Mother Control and Father Control. Higher scores on care suggest greater warmth and care. Higher scores
on control reflects greater control.
75
Table 14.
Regression Coefficients
Model 1
Model 2
b
Constant
14.75
Sex
8.123
Asians
9.55
Blacks
9.88
Whites
-2.2
Constant
-23.31
Sex
4.698
Asians
12.452
Blacks
16.605
Whites
2.065
Cope_Avoid .826
Cope_Social .547
SE b
7.518
2.743
6.313
8.189
6.068
9.598
2.698
5.792
7.623
5.583
.163
.191
β
.233
-0.349
.129
-.063
.135
.334
.216
.059
.271
.303
Table 15.
Multiple Linear Regression Model Summary
R2
Adj R2
R2 Change F Change
Model 1
.141 .117
.141
5.87
Model 2
.300 .270
.159
16.03
t
1.962
2.943
1.513
1.207
-.363
-2.428
1.741
2.150
2.178
.370
3.466
4.259
Sig
.0001
.0001
p
0.052
0.004
0.133
0.229
0.717
0.016
0.084
0.033
0.031
0.712
0.001
0.0001
76
77
Appendix A
Parental Bonding Inventory
78
Appendix B
Student Adaptation to College Questionnaire
79
80
Appendix C
EES – Revised
We all respond to different emotions in different ways. Some types of feelings lead people to
experience an urge to eat. Please indicate the extent to which the following feelings lead you
to feel an urge to eat by checking the appropriate box.
81
Appendix D
COPE Inventory
We are interested in how people respond when they confront difficult or stressful
events in their lives. There are lots of ways to try to deal with stress. This questionnaire
asks you to indicate what you generally do and feel, when you experience stressful
events. Obviously, different events bring out somewhat different responses, but think
about what you usually do when you are under a lot of stress.
Then respond to each of the following items by blackening one number on your
answer sheet for each, using the response choices listed just below. Please try to respond
to each item separately in your mind from each other item. Choose your answers
thoughtfully, and make your answers as true FOR YOU as you can. Please answer every
item. There are no "right" or "wrong" answers, so choose the most accurate answer for
YOU--not what you think "most people" would say or do. Indicate what YOU usually do
when YOU experience a stressful event.
1 = I usually don't do this at all
2 = I usually do this a little bit
3 = I usually do this a medium amount
4 = I usually do this a lot
1. I try to grow as a person as a result of the experience.
2. I turn to work or other substitute activities to take my mind off things.
3. I get upset and let my emotions out.
82
4. I try to get advice from someone about what to do.
5. I concentrate my efforts on doing something about it.
6. I say to myself "this isn't real."
7. I put my trust in God.
8. I laugh about the situation.
9. I admit to myself that I can't deal with it, and quit trying.
10. I restrain myself from doing anything too quickly.
11. I discuss my feelings with someone.
12. I use alcohol or drugs to make myself feel better.
13. I get used to the idea that it happened.
14. I talk to someone to find out more about the situation.
15. I keep myself from getting distracted by other thoughts or activities.
16. I daydream about things other than this.
17. I get upset, and am really aware of it.
18. I seek God's help.
19. I make a plan of action.
20. I make jokes about it.
21. I accept that this has happened and that it can't be changed.
22. I hold off doing anything about it until the situation permits.
23. I try to get emotional support from friends or relatives.
24. I just give up trying to reach my goal.
25. I take additional action to try to get rid of the problem.
83
26. I try to lose myself for a while by drinking alcohol or taking drugs.
27. I refuse to believe that it has happened.
28. I let my feelings out.
29. I try to see it in a different light, to make it seem more positive.
30. I talk to someone who could do something concrete about the problem.
31. I sleep more than usual.
32. I try to come up with a strategy about what to do.
33. I focus on dealing with this problem, and if necessary let other things slide a little.
34. I get sympathy and understanding from someone.
35. I drink alcohol or take drugs, in order to think about it less.
36. I kid around about it.
37. I give up the attempt to get what I want.
38. I look for something good in what is happening.
39. I think about how I might best handle the problem.
40. I pretend that it hasn't really happened.
41. I make sure not to make matters worse by acting too soon.
42. I try hard to prevent other things from interfering with my efforts at dealing with
this.
43. I go to movies or watch TV, to think about it less.
44. I accept the reality of the fact that it happened.
45. I ask people who have had similar experiences what they did.
46. I feel a lot of emotional distress and I find myself expressing those feelings a lot.
84
47. I take direct action to get around the problem.
48. I try to find comfort in my religion.
49. I force myself to wait for the right time to do something.
50. I make fun of the situation.
51. I reduce the amount of effort I'm putting into solving the problem.
52. I talk to someone about how I feel.
53. I use alcohol or drugs to help me get through it.
54. I learn to live with it.
55. I put aside other activities in order to concentrate on this.
56. I think hard about what steps to take.
57. I act as though it hasn't even happened.
58. I do what has to be done, one step at a time.
59. I learn something from the experience.
60. I pray more than usual.
85
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