(PS7-50) Food Craving Cross-sectionally Mediates the Association Between Cognitive Rigidity and Binge Eating Frequency in Pregnancy

Introduction:

Cognitive inflexibility is associated with the experience and severity of disordered eating, and specifically with binge eating disorder. Food cravings are conceptualized as cognitive states in which automatic thoughts pertaining to highly palatable foods are actively elaborated upon, thereby increasing in salience and strength. This process is difficult to interrupt, especially when cognitive rigidity is present, which is consistent with evidence pointing to a link between cognitive rigidity/inflexibility and food cravings. Furthermore, food cravings have been found to be a powerful predictor of binge and loss of control eating. Food cravings tend to be especially prevalent in pregnant people and pregnancy is also a high-risk period for the development and/or exacerbation of binge and loss of control eating, which is associated with a range of adverse outcomes for parents and their offspring. This study assessed the mediating role of food cravings in the relationship between cognitive flexibility and binge eating in pregnant people.

Methods: 253 individuals in their first (27.7%), second (40.3%) and third (32.0%) trimesters of pregnancy reported demographics and information regarding their current and prior pregnancies. They then completed the Detail and Flexibility Questionnaire (DFlex), a measure of “cognitive rigidity” (Cronbach’s α in the present sample = .85) and “attention to detail” (α = .88) as well as the Prenatal Eating Behavior Screening tool, a measure of disordered eating behaviors and cognitions specifically in pregnancy (α = .88). The outcome of interest to this study was frequency of binge eating as indicated by scores on PEBS item 8. The hypothesized mediation model was tested by assessing the indirect effect by examining the product of the A path and the B path while controlling for the direct effect of the C path. Significance was determined via bootstrapping with 5000 resamples.

Results: FCQ-T-r scores were significantly and positively correlated with frequency of binge eating (r = .54, p < .001) and the two DFlex subscales (r = .50, p < .001 and r = .48, p < .001, respectively); DFlex subscale scores were also significantly and positively associated with frequency of binge eating (r = .28, p < .001 and r = .30, p < .001, respectively). There was a significant positive indirect effect of cognitive flexibility on binge eating frequency (b = .034, 95% C.I. .022, .049, p < .001). Furthermore, the direct effect of cognitive flexibility on binge eating frequency in the presence of the mediator was not significant (b = .004, 95% C.I. -.015, .023, p = .649), suggesting full cross-sectional mediation.

Conclusion: The results of this cross-sectional study indicate that food cravings fully mediate the relationship between cognitive rigidity and binge eating frequency in pregnancy. Food cravings are highly modifiable predictors of eating behaviors and are thus important targets for treatment in individuals engaging in binge eating. There is evidence supporting the efficacy of acceptance-based approaches in reducing the maladaptive impacts of cravings, and these approaches should be further researched and evaluated within the context of binge eating in pregnancy.