Psychosocial Influences On and Behavioral Characteristics of Young Adult Food Addiction

Abstract

Introduction. Research on food addiction has increased in recent years, but there are few studies focusing on college-attending young adults, who may be at risk of developing food addiction due to the stress of the college environment. Additionally, causes and characteristics of food addiction are under-explored. Aim. This dissertation aims to 1) determine the impact of adverse childhood experiences (ACEs) and other early life influences on the development of food addiction in college-attending young adults and 2) determine the psychosocial and behavioral characteristics of young adults with food addiction. Methods. A sequential explanatory mixed-methods design was used for aims 1 and 2, in which quantitative data is collected first, analyzed, and then qualitative data is then collected. An online, cross-sectional survey was distributed to students attending a university in Appalachia in fall 2021. Food addiction was measured using the Yale Food Addiction Scale 2.0 (YFAS 2.0). Childhood trauma, depression, anxiety, stress, social support, post-traumatic stress disorder (PTSD), emotion regulation, coping styles, eating disorder symptoms, eating styles, diet quality, and anticipated effects of food were measured using validated tools. Demographic data and self-reported height and weight were also collected. For Aim 1, logistic regression was used to determine the impact of ACEs on the development of food addiction while controlling for other potential influences. For Aim 2, Kruskal-Wallis H was used to determine differences in mean scores of psychosocial and behavioral variables between those with and without food addiction. All quantitative analysis was analyzed using JMP Pro Version 16.0. For Aims 1 and 2, participants who met the criteria for food addiction were invited to participate in interviews that elicited more information on their causes and symptoms. Interviews were transcribed verbatim and thematic analysis was conducted using NVIVO software. Results. Respondents (n=1645) had a 21.9% prevalence of food addiction (5.7% mild, 4.7% moderate, 11.5% severe). For Aim 1, only depression remained a significant predictor of food addiction (OR = 3.33, 95% CI 2.19, 5.05). Thematic analysis found that many participants grew up in restrictive eating environments characterized by diet culture, while others had positive memories associated with mealtime. Participants often stated symptoms emerged when transitioning to college or when mental health worsened. For Aim 2, participants with food addiction had significantly higher ACEs, depression, anxiety, stress, emotion dysregulation, use of negative coping mechanisms, eating disorder symptoms, emotional eating, disinhibition when eating, negative expectations after eating healthy or junk food, and intake