(PS14-12) Greater Distress Intolerance, but Not Eating Inflexibility, Strengthened the Association Between Perceived Stress and Loss of Control Eating

Introduction: Two proposed targets in third-wave cognitive behavior therapies for binge eating disorder (BED) include psychological flexibility (the ability to make values-driven choices during aversive experiences) and distress tolerance (the capacity to cope with unpleasant emotional states). The current study sought to examine whether these individual characteristics– levels of distress intolerance and a type of psychological inflexibility (eating inflexibility)-- might also moderate the relationship between perceived stress, a well-established risk factor for binge eating, and loss of control (LoC) eating.

Method: A cross-sectional online study using Prolific Academic sampled non-clinical adults (N = 389; Mage = 37.42 (SD = 12.84) from the United States. Participants completed self-report measures of perceived stress (Perceived Stress Scale), LoC eating (Loss of Control Over Eating Scale), distress intolerance (Distress Tolerance Scale), and eating inflexibility (Food Awareness and Acceptance Questionnaire). Participants with complete and valid data (e.g., passed attention checks, duration >25 min) were retained. The PROCESS Macro for SPSS (Model 2) tested main effects (predictors of LoC eating) and moderation effects (distress tolerance and eating flexibility moderating association between stress and LoC eating).

Results: Significant main effects of perceived stress, b = .03, BCa CI [.01, .05], p = .002, and distress intolerance, b= .45, BCa CI [.33, .56], p < .001, on LoC eating were found. No significant main effect of eating inflexibility on LoC eating was found, b = .002, BCa CI [-.01, .01], p = .763. There was a significant moderating effect of distress intolerance on the association between stress and LoC eating, b = .02, BCa CI [0.00, 0.037], p =.043, such that the association was stronger for participants who reported higher distress intolerance (b = .05, p < .001). Eating inflexibility did not emerge as a significant moderator of the association between perceived stress and LoC eating, b = .00, BCa CI [-0.00, 0.00], p =.077. 



Discussion: Consistent with previous work, stress was significantly associated with LoC eating, and this association was stronger for those with greater distress intolerance. Though mood intolerance is a proposed target of cognitive behavioral therapy for eating disorders (CBT-E), this finding highlights the potential role for interventions that more explicitly target distress tolerance, such as DBT for binge eating disorder (DBT-BED). Inconsistent with prior work, support for the role of eating inflexibility in LoC eating was not found.