BINGE EATING DISORDER AND ASSOCIATED PSYCHIATRIC COMORBIDITY CONFER INCREASED RISK OF
PHYSICAL AND MENTAL HEALTH CARE UTILIZATION ON COLLEGE CAMPUSES:
RESULTS FROM A NATIONAL SAMPLE.
Summar Reslan, B.A. 1, Karen K. Saules, Ph.D. 1, Daniel Eisenberg, Ph.D. 2
Eastern Michigan University, Department of Psychology 1
University of Michigan, School of Public Health 2
Introduction
Results
Binge eating disorder (BED) is defined as experiencing recurrent
episodes of binge eating in a discrete period of time accompanied
by a loss of control over eating and two of five associated
symptoms. BED is prevalent on college campuses with
approximately 5% meeting full BED criteria (Ivezaj et al., 2010) and
roughly 38% engaging in problematic binge eating behavior (Mintz
et al., 1998). Many studies have investigated the utilization of mental
health services on college campuses (Eisenberg et al., 2007), but
few have focused on the impact that BED may have on service
utilization. Among treatment seeking individuals who have BED,
74% report having at least one lifetime, and 43% report having at
least one current, psychiatric disorder (Grilo et al., 2009). We thus
hypothesized that those utilizing services will be more likely to have
comorbid psychological problems.
Approximately 5.4% (N = 465) of participants met BED criteria in this
sample. Compensatory behaviors were common among those with BED
(55%), but less than 1% of the sample met full bulimia nervosa criteria.
Logistic regression analyses indicated that relative to their non-BED
counterparts, those with BED had an increased likelihood for
psychological service utilization, OR = 1.966; CI.95 [1.707, 2.266], p <
.001, and medical health care utilization, OR = 1.298; CI.95 [1.044, 1.614],
p < .05. Amongst those with BED, engaging in compensatory behaviors
also increased psychological service utilization, OR = 1.744, CI.95 [1.318,
2.319], p < .001. BED in combination with anxiety or depression
increased likelihood of psychological service utilization. BED in
combination with depression and binge drinking increased likelihood of
medical health care utilization within the past 12 months.
Green = % utilizing psychological services within the past 12 months
Discussion
PARTICIPANTS/PROCEDURES: Data were drawn from the 2009
Healthy Minds Study (HMS), a national sample of college students.
HMS evaluates a range of mental health topics such as the
prevalence and disease burden of mental health conditions. This
database is composed of 8,597 undergraduate and graduate
students from 15 colleges and universities who completed an
online survey. This sample was predominately female (58.9%).
The rate of BED in this sample is comparable to other studies (e.g.,
Grucza et al., 2007; Ivezaj et al., 2010), suggesting that these findings may
generalize to other samples.
Research indicates those who binge eat have higher emotional
dysregulation than those who do not binge eat (Claes et al., 2005).
Utilizing rates of psychological service utilization as an index of
emotional dysregulation, results indicate that emotional dysregulation
is heightened among those with BED who also engage in
compensatory behaviors or who have other psychological
comorbidities in comparison to those with BED alone and those without
BED.
MEASURES:
Demographics
Depression and anxiety screening questions were drawn from
the Patient Health Questionnaire (PHQ; Spitzer, Kroenke, &
Williams, 1999)
(CAS; Wechler, Davenport, Dowdall, Moeykens, & Castillo, 1994)
Yellow = % using medical services within the last 12 months
***BED plus comorbidities significantly differ from all other groups for both psychological and medical
service utilization, p < .001.
Method
BED items were drawn from the SCID-I/NP (First, Spitzer, Gibbon,
& Williams, 2002). BED was screened positive if a liberal criterion
of binge episodes 1-2 times per week was met, as well as
endorsing two associated symptoms of BED.
Binge drinking items were drawn from the College Alcohol Study
Contact: shabhab1@emich.edu
Yellow = % utilizing medical services within the last 12 months
Green = % utilizing psychological services within the last 12 months
***Psychological Services: BED plus compensatory behaviors significantly differ from no BED, p < .001, and BED
alone, p < .01. BED no compensatory behaviors significantly differ from No BED, p < .001.
Health care utilization items were drawn from the Healthcare for
***Medical Services: BED alone significantly differ from No BED, p < .001.
Communities Study (Wells, Sturm, & Burnam, 2004). Items
assessed psychological and medical health care utilization
Presented at the 2010 Annual Meeting of the Society of Behavioral Medicine
within the past 12 months
Consistent with our hypothesis, those utilizing both psychological and
medical services were more likely to have comorbid psychological
problems. These results indicate that individuals with BED may not
perceive this pathological eating pattern as severe enough to warrant
the utilization of services until it becomes comorbid with other
psychological problems.
Those with BED who do not engage in compensatory behaviors utilize
medical services more so than those without BED and those with BED
plus compensatory behaviors. It is unclear how this relationship is
impacted by weight. To help clarify this relationship, the HMS 2010
survey will collect information on height and weight of respondents.
BINGE EATING DISORDER AND ASSOCIATED PSYCHIATRIC COMORBIDITY CONFER INCREASED RISK OF
PHYSICAL AND MENTAL HEALTH CARE UTILIZATION ON COLLEGE CAMPUSES:
RESULTS FROM A NATIONAL SAMPLE.
Summar Reslan, B.A. 1, Karen K. Saules, Ph.D. 1, Daniel Eisenberg, Ph.D. 2
Eastern Michigan University, Department of Psychology 1
University of Michigan, School of Public Health 2
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