Date of Award

2014

Document Type

Open Access Dissertation

Department

Psychology

Sub-Department

Clinical-Community Psychology

First Advisor

Mark Weist

Abstract

Binge-eating disorder (BED) refers to experiencing a loss of control while eating high quantities of food in a short period of time. A serious public health concern, BED is highly comorbid with other psychological disorders and increases risk for obesity and other health concerns, such as metabolic disorder and diabetes. Little is known about what mental health symptoms contribute to the development of BED for children and adolescents. Research with adults indicates that two strong predictors of binge-eating behavior include impulsivity and depression, and these symptom areas may contribute to BED for youth, as well. In the current study, I evaluated the extent to which ADHD symptoms, depression symptoms, and these symptoms together predict binge-eating symptoms. Further, the degree to which developmental patterns of symptom severity for both ADHD and depression symptoms remain consistent from childhood to adolescence is also unclear. Although current research indicates that ADHD is a chronic, lifelong behavioral disorder, some research indicates that some youth may display onset of ADHD as late as 12 years of age and other findings indicate that some children display remission of symptoms as they reach adolescence. Thus, the degree to which ADHD remains a consistent diagnosis across childhood and adolescence appears unclear. Likewise, the correspondence between childhood and adolescent symptoms of depression also is unclear. Risk for depression escalates during adolescence, particularly for girls, but the degree to which those who develop clinical levels of depression symptoms in adolescence demonstrated sub-threshold depression symptoms in childhood is unclear. To evaluate these questions, I evaluated the degree to which childhood symptom severity was consistent with adolescent symptom severity or transitioned to different levels of symptom severity. Data for these analyses came from the Johns Hopkins Field Trial, a longitudinal study on school-based prevention programs (N = 678; age at initial assessment: M = 6.2, SD = .34; 46.8% female; 86.8% African-American; 63.4% received free or reduced lunch). To assess this study’s hypotheses, teacher-reported ADHD symptoms and child self-reported depression symptoms assessed at four time points in each developmental period (childhood: fall and spring of first grade, second grade, and third grade; adolescence: sixth, seventh, eighth, and ninth grades) represented the initial level and change in ADHD and depression symptoms. Independent latent class analyses were used to identify the fewest groupings that best represent the individual differences in the intercepts and slopes of ADHD and depression symptoms during childhood and adolescence. These four latent class models were then combined within a transition model to identify the extent to which childhood symptoms classes predicted adolescent symptom classes. Symptom classes from each latent class model were then used to predict binge-eating symptoms in tenth grade. Latent class growth modeling with ADHD and depression symptoms in childhood and adolescence indicated that three classes best fit childhood ADHD symptoms and adolescent depression symptoms, whereas two classes best fit childhood depression symptoms and adolescent ADHD symptoms. The full transition model resulted in two classes for childhood and adolescent depression and adolescent ADHD symptoms, whereas three classes continued to fit childhood ADHD symptoms the best. Both ADHD and depression symptoms displayed strong correspondence from childhood and adolescence, although ADHD and depression symptom classes did not predict each other across development periods. Childhood and adolescent ADHD symptom classes but not depression symptom classes predicted 10th grade binge-eating behaviors. The “high” ADHD symptoms class from childhood had higher binge-eating symptoms than the “increasing moderate” or “low” childhood ADHD symptoms classes. During adolescence, the “high” ADHD symptoms class also displayed more binge-eating symptoms than the “low” adolescent ADHD symptoms class. Further, childhood and adolescent ADHD symptom classes interacted, where binge-eating behaviors were highest for those who were members of both the “high” childhood and “high” adolescent ADHD symptoms classes. These results indicate that elevated impulsivity and inattention symptoms create vulnerability for binge-eating behaviors. Further research is necessary to identify the mechanisms that contribute to increased binge-eating for children and adolescents with high ADHD symptoms.

Rights

© 2014, Kathryn Van Eck

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