(PS14-15) The Impact of Primary and Putative Consequences of Attentional Deficits on Eating Behavior: A Structural Equation Modeling Approach

Background

Eating disorders (EDs) represent serious psychiatric illnesses that are characterized and maintained by a range of cognitive, affective, and behavioral symptoms. Prior research on EDs has highlighted that executive functioning deficits – i.e., inattention and impulsivity – may contribute to symptom dynamics. As such, one condition that has been studied in its relationship to dysregulated eating behaviors is attention-deficit/hyperactivity disorder (ADHD). Prevalence rates of EDs in ADHD samples have been reported up to 12%. Taken together, these findings suggest that there may be a relationship between ADHD symptoms and ED psychopathology; however, there remains a need to clarify the predictive nature of this relationship. A statistical approach that is methodologically sound to test linear relations between latent variables of interest is structural equation modeling (SEM). 

Aim

This study utilized SEM to estimate the effect of ADHD symptoms (i.e., attention problems; APs) on ED symptoms (i.e., eating problems; EPs) in a community sample of adults.

Methods

Data were collected from 1,047 adults who participated in the Nathan-Kline Institute Rockland Sample, which is a large-scale research initiative aimed at investigating the causes, treatment, and prevention of mental illnesses. Participants were predominantly White (76.3%) and female (64.6%). APs were measured using the Conners’ Adult ADHD Rating Scale (CAARS) and EPs were measured using the Eating Disorder Examination Questionnaire (EDE-Q).

Results

In our resulting model, two latent AP factors were identified, one which loaded on to symptoms of inattention, and one which loaded on to symptoms of poor self-concept, which is a putative consequence of attentional deficits. These latent factors were then entered into the model to predict the following three latent EP factors: overvaluation of weight/shape; distractibility related to eating; and being dissatisfied with one’s body. Our model demonstrated a statistically significant relationship between behavioral inattention (AP) and distractibility related to eating (p < .05). Additionally, poor self-concept (AP) had a significant, direct effect on all EP factors, with the strongest relationships being to overvaluation of weight/shape and being dissatisfied with one’s body (p < .001). The overall fit indices of the model are as following: CFI = 0.95, NFI = 0.94, RMSEA = .06, SRMR = .07. With the exception of RMSEA, which fell slightly above the suggested threshold of 0.05, all of our indices demonstrated satisfactory model fit.

Conclusion

Findings from this study support prior research that suggests a meaningful relationship between ADHD symptoms and ED symptoms. Our results extend previous findings by demonstrating that both primary (i.e., behavioral difficulties) and secondary (i.e., poor self-concept) consequences of ADHD can influence ED symptoms, namely, distractibility related to eating, and overvaluation of weight/shape, respectively. The finding that attentional factors associated with ADHD predicted ED symptoms related to distractability suggests that for individuals experiencing cooccurring ADHD+ED, targeting these attentional difficulties in treatment may be beneficial.