RISK FACTORS OF EMOTIONAL EATING IN UNDERGRADUATES

by ALAN Y HO

Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy

Dissertation Adviser: Dr. Anastasia Dimitropoulos

Department of Psychological Sciences CASE WESTERN RESERVE UNIVERSITY

August, 2014

CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES

We hereby approve the thesis/dissertation of

Alan Y Ho

Candidate for the Doctor of Philosophy degree *.

Committee Chair Anastasia Dimitropolous

Committee Member Heath Demaree

Committee Member Elizabeth Short

Committee Member Eileen Anderson-Fye

Date of Defense May 12, 2014

*We also certify that written approval has been obtained for any proprietary material contained therein.

1

Table of Contents

List of Tables ……………………………………………………………………… 2

List of Figures …………………………………………………………………….. 3

Abstract …………………………………………………………………………… 4

Introduction ……………………………………………………………………….. 6

Methods …………………………………………………………………………… 38

Results …………………………………………………………………………….. 43

Discussion ………………………………………………………………………… 49

Tables ……………………………………………………………………………... 66

Appendices …………………………………………………………………………. 77

References ………………………………………………………………………… 85

2

List of Tables

Table 1 – Sample Descriptives ...………………………………………………..... 66 Table 2 - Medications Taken in Past 30 Days from Participants in Study ………. 67

Table 3 – The COPE Subscales as used in the Current Study …………………….. 67 Table 4 – Normality ………………………………………………………………. 68 Table 5 – Non-Normal Variables Log Transformation …………………………. 68 Table 6 – Gender Independent T-tests …………………………………………….. 69 Table 7 – Coping Styles and Parental Bonding …………………………………… 70 Table 8 – Coping Styles and Adjustment to College ……………………………… 70 Table 9 – Parental Bonding and Emotional Eating Correlation …………………… 71 Table 10 – Coping and Emotional Eating Correlation M + F ……………………… 72 Table 11 – Coping and Emotional Eating Correlation, Male ……………………… 72 Table 12 – Coping and Emotional Eating Correlation, Female …………………… 73 Table 13 – Asian vs. White Independent T-Test …………………………………… 74 Table 14 – Regression Coefficients ………………………………………………… 75 Table 15 – Multiple Linear Regression Model Summary …………………………. 75

3

List of Figures Figure 1 – Hypothesized Model ……………………………………………………. 36

Figure 2 – Male (M), Female (F), and Male + Female (T) correlation results of hypothesized model …………………………………………………………………. 76

4

Risk Factors of Emotional Eating among Undergraduates

Abstract

By

ALAN Y HO

While food quenches one’s hunger, it also assuages feelings. When food is eaten to satisfy one’s feelings instead of satisfying hunger, it results in emotional eating which is associated with negative consequences such as increased risk for heart disease, symptoms of anxiety and depression, and increased risk of obesity. This study examined the risk factors of emotional eating in hopes of giving clinicians a better understanding on how to prevent or lesson emotional eating. There are a myriad of risk factors to emotional eating. Studying emotional eating is complex because it is influenced by many factors such as food preferences, genetics, culture, psychology, and the social and physical environment. Thus, there are many more risk factors than what is being studied here. However, this study attempts to add to the existing psychology literature in emotional eating. Using survey assessments, this study examined whether parental bonding was associated with emotional eating in non-clinical college students who lived among their peers instead of their family. Furthermore, this study investigated whether one’s level of adjustment to college was associated with emotional eating. In addition, an attempt to replicate previous associations between coping style, one’s transition to college, and parental bonding was performed using measures that allowed for more detailed analysis and in order to use these variables as predictors in a multiple regression.

Results indicated that perceived parental bonding and level of adjustment to college had 5 no meaningful association with emotional eating. However, gender and race differences in emotional eating were identified. Additionally, gender, race, avoidance coping and socially-supported coping predicted 27% of the variance seen in emotional eating suggesting that in order to curb emotional eating, therapy should concentrate on learning effective coping styles. In addition, this study may also help clinicians and dieticians alike better understand the risks that lead to emotional eating.

6

Introduction

Emotional states and situations can have a monumental effect on eating behavior that goes beyond our physiological need for food. Geliebter and Aversa (2003) define emotional eating as food intake that is triggered by strong emotions, both negative and positive, rather than to our internal hunger cues. The hot fudge sundae that you choose to eat after a depressing day or for a celebration is not necessarily due to hunger or your need to fulfill your daily recommended nutrient intake, but because it soothes you or makes you feel happier. Across cultures, food is used for celebrations such as weddings, birthdays, or after a sporting win and thus, it is likely that positive affect and food intake are related through associative learning (Patel & Schlundt, 2001). Likewise, the stress of final exams may lead someone to indulge in a pint of Ben & Jerry’s ice cream. Eating a small amount of sweet foods has been shown to improve negative mood states immediately, albeit temporarily (Macht & Mueller, 2007). Eating in response to an emotional state is convenient because food surrounds us and is an intricate part of our celebrations from holidays to personal milestones, our social life, business meetings, and even our mourning. This is something not observed in other animals and why researchers believe eating is more than just replenishing our energy (McGrew & Feistner, 1992).

However, eating in response to emotions and not internal hunger cues, is associated with negative consequences. Emotional eating has been associated with psychopathology including symptoms of anxiety and depression (Goossens, Braet, Van

Vlierberghe, & Mels, 2009; Heaven, Mulligan, Merrilees, Woods, & Fairooz, 2001), negative self-concept and feelings of physical incompetence (Braet & Van Strien, 1997), 7

difficulties in interpersonal relationships and sexuality (Van Strien, Schippers, & Cox,

1995), overeating (Wardle et al., 1992), and bulimic behaviors (Waller & Osman, 1998).

In addition, emotional eating has been linked with elevated consumption of high-calorie

and high fat foods (Oliver, Wardle, & Gibson, 2000; Wallis & Hetherington, 2004), increased risk of obesity (Sung, Lee, Song, Lee, & Lee, 2010), and poor weight loss outcomes (Elfhag & Rossner, 2005). Overconsumption of high-calorie and high fat foods and being overweight or obese is associated with pathological changes in the body which increases the risk for many chronic diseases such as heart disease, type 2 diabetes, and stroke (Lean, Hans, & Seidell, 1998).

Even if emotional eating is not associated with obesity, poor dietary behaviors such as eating food that are high in saturated fat have been linked to poor cardiovascular

health (Hermansen, 2000). The body runs on fuel in the form of nutrients from food and

if the fuel put into the body is not healthy, the body cannot function at peak performance

(Nantz, Rowe, Nieves, & Percival, 2006). For the body to function to the best of its

ability, essential nutrients such as vitamins, proteins, and minerals are necessary (Lane,

Magno, Lane, Chan, Hoyt, & Greenfield, 2008). Healthy food contains vitamins the

body requires to function optimally such as Vitamins A, B, C, and D (Lane et al., 2008).

Foods such as spinach and carrots contain a healthy amount of vitamin A, which

contributes to healthy skin and hair and healthy vision (Chapman, 2012). Fruits such as

oranges and grapefruit contain vitamin C, which increases one’s immune system and aids

in iron absorption (Nantz et al., 2006). Foods such as chicken, beef, pork, and fish

contain protein and vitamin B which are important for optimal brain performance and

lean muscle mass (Feng, 2012). Calcium, a mineral, aids in bone strength and is found in 8

foods such as milk and cheese (Lutz et al., 2012). These essential nutrients are found sparingly, if at all, in unhealthy foods even though sweet desserts or salty chips may satisfy one’s hunger.

Food intake characterized by high levels of saturated fat and processed sugar is negatively associated with high density lipoprotein (HDL) cholesterol and positively associated with levels of total cholesterol, blood sugar levels, and increased systolic blood pressure (van Dam, Grievinik, Ocke, & Feskens, 2003). HDL reduces plaque in the arteries and is considered “good” lipoproteins (van Dam et al., 2003). While there are certain risk factors for sub-optimal health that cannot be altered such as heredity and increasing age, eating behavior and obesity is a risk factor that can be changed (Brown &

Roberts, 2012). Thus, a look into the risk factors of emotional eating, which is linked to an increase in the likelihood of poor dietary behaviors, is important as it is a behavior that can be modified.

Self-Regulation

Researchers have suggested that emotional eating is a learned response (Bruch,

1973; Galloway, Farrow, & Martz., 2010); this response is believed to have emerged in adolescence in association with depressive feelings and inadequate parenting (Ouwen,

Van Strien, & van Leeuwe, 2009; Snoek, Engels, & Janssens, 2007; Van Strien, Snoek, van der Zwaluw, & Engels, 2010). In a recent study, Galloway and researchers (2010) investigated how feeding practices used in childhood relate to eating behaviors and weight status in early adulthood. College students’ and their parents’ retrospective reports on child feeding practices when the students were in middle school were examined. Parents have significant control over the intake and selection of foods their 9

child consumes as Galloway and researchers (2010) found a significant positive

correlation between the recollected use of controlling child feeding practices and current

emotional eating among college students. Moreover, in both males and females, parents’

recollections of using controlling feeding practices were positively correlated with BMI.

Unfortunately, parents’ use of controlling feeding practices is linked to poorer self- regulation of food intake in their children (Constanza & Woody, 1985). For example, due to social rule, meals are usually eaten at certain times and the selection of foods for the meal is either bought or made by the parents. With picky eaters who are underweight, a parent may encourage or demand the child to eat more food and to eat more calorie dense foods. With a child that is overweight, the parent may restrict the child from eating certain types of foods. Experimental findings show that restrictive feeding practices increase the likelihood of eating in the absence of hunger (Birch, Fisher, & Davison,

2003). Likewise, a parent may pressure the child to eat healthier foods. However, when a child is pressured to eat a type of food (usually healthy food), the child is more likely to report a greater dislike for that particular food later on in life (Galloway, Fiorito, Francis,

& Birch, 2006; Johnson & Birch, 1994). While done with good intention, pressuring a child to eat interferes with the child’s natural ability to self-regulate (Johnson and Birch,

1994).

The process of self-regulation develops over one’s lifespan. Poor self-regulation begins early in the lifespan at a time when food is the only accessible method to aid the individual's ability to self-regulate (Baker & Hoerger, 2012). At first, a child relies on the primary caregiver to manage and soothe their emotions. A child who is given treats after an accomplishment may grow up using treats as a reward. Likewise, a child who is 10

given ice cream as a way to stop crying may learn to link ice cream with feelings of

comfort. However, over the years, most individuals learn additional ways to manage

their emotions in other ways such as distracting themselves, talking to others, or framing

their situations in a more positive way (Ventura & Birch, 2008). This maturation is not

only learned but is also biological. Neurological changes, while constant, are much more

rapid when puberty occurs. Magnetic Resonance Imaging (MRI) studies of the brain

have shown that maturation tends to occur from the back of the brain to the front of the

brain (Sowell et al., 2003). As a result, the prefrontal cortex, a region of the brain thought

to be essential for managing attention and inhibiting thoughts and behaviors, is the last to

develop (Shaw et al., 2008; Sowell et al., 2003). Teens have less white matter in the

frontal lobes of their brains when compared to adults (Giedd et al., 1999 Sowell et al.,

2003). With more myelin, comes the growth of important brain connections, allowing for

better flow of information between brain regions. Children will tend to have poorer self-

regulation because of immaturity of the brain (McRae et al., 2012) and may therefore be

more likely to throw food tantrums, emotionally eat, and overeat. However, the ability to

successfully self-regulate requires not only the proper maturation of the brain but also

proper parenting. Effective parenting includes developing and clarifying clear

expectations on how to behave, staying calm in the midst of turmoil when the child

becomes upset, consistently following through with positive and negative consequences,

and being a positive role model (Lopez, 2004). Without the proper parenting, adults may

not properly learn to use more sophisticated ways to manage their emotions such as

problem solving or meditation. For some individuals, their ability to self-regulate remain less than optimal. Unfortunately, poor self-regulation likely contributes to a number of 11 unhealthy behaviors as individuals seek and consume tasty and unhealthy food in order to feel an immediate sense of gratification (Galloway et al., 2006; Johnson & Birch, 1994).

Effects of Stress on Eating Behavior

Emotional eating has also been found to occur in people with poor coping skills

(Ouwens, Van Strien, & Van Leeuwe, 2009). According to Lazarus and Folkman (1984), coping is the cognitive and behavioral efforts to manage internal and external demands created by a stressful situation. In Lazarus and Fokman’s (1984) transactional model of stress, the primary appraisal refers to the initial perception about a stressor and whether it is judged to be positive (eustress) or negative (distress). In general, when individuals view an event as threatening, they experience distress; however, when individuals view an event as challenging, they experience eustress. The secondary appraisal refers to the coping responses the individual draws on. Access to physical resources (e.g. health and energy), social (e.g. family and friends), psychological (e.g. self-esteem), and material resources (e.g. money) affects ones’ coping responses. The more resources an individual has, the better they will be able to cope.

Lazarus and Folkman (1987) also identified two ways of reducing distress: either problem-focused coping or emotion-focused coping. In problem-focused coping, individuals engage in a problem-solving behavior designed to eliminate or reduce the origin of the stress. For example, if an individual is experiencing stress at home with the family, this individual can devise a strategy such as scheduling family counseling to reduce or eliminate the stressful situation. The number of daily stressors, while possibly small in magnitude, has been associated with lowered mood in college students (Wolf,

Elston, & Kissling, 1989). Moreover, the accumulation of daily stressors can develop 12 into major stresses and increase anxiety and depression (Holahan, Moos, Holahan,

Brennan, & Schutte, 2005). Thus, problem-focused coping appears to be effective because its goal is to remove the stressor.

On the other hand, in emotion-focused coping, an individual experiencing stress at home will try to control the symptoms of stress such as talking to a friend who might provide sympathy. Emotion-focused coping incorporates a diverse number of coping styles and has shown to be both adaptive and maladaptive (Billings & Moos, 1984;

Bouteyre, Maurel, & Bernaud., 2007; Penland, Masten, Zelhart, Fournet, & Callahan,

2000; Wigndaele et al., 2007). Coping strategies that focus on negative emotions and thoughts increase psychological distress (e.g. venting of emotions and rumination) whereas coping strategies that regulate emotion (e.g. seeking social support) seem to reduce distress. In Billings and Moos’s (1984) study, the researchers analyzed the relationship between coping styles and depressive symptoms in 424 men and women undergoing treatment for depression. The results indicated that patients who focused on negative emotions had greater dysfunction while depressed patients who engaged in affect-regulation experienced less severe depressive symptoms. Mixed findings have been found in university samples regarding the adaptiveness of venting one’s emotions.

Bouteyre et al. (2007) showed a positive association between venting of emotions and depressive symptoms in first year psychology students whereas Penland et al. (2000) found that venting of emotions was an adaptive coping strategy and this coping style decreased depressive symptoms.

On the other hand, an emotion-focused coping strategy, seeking social support, has consistently shown to be adaptive and to be associated with decreased psychological 13 distress (Crocket et al. 2007; Wijndaele et al., 2007). Wijndaele et al. (2007) studied the relationship between emotion-focused coping and psychological distress and found that in the general population, individuals who regularly received social support had lower levels of anxiety and depressive symptoms. Likewise, Crocket et al. (2007) found that seeking social support was an effective coping strategy for university students experiencing high levels of stress. This negative association between seeking social support and psychological distress has also been supported by other researchers

(Bouteyre et al., 2007; Penland et al., 2000).

The effectiveness of emotion-focused coping varies because it incorporates more than one coping style. Coping styles that regulate emotion are adaptive because they prevent people from dwelling on their negative emotions and ensure that the individual takes steps to resolve the negativity (Carver, Scjeier, & Weintraub, 1989). For instance, seeking social support is effective because it encourages the individual to seek advice from others to engage and solve problems (Bouteyre et al., 2007). Conversely, emotion- focused strategies that focus on negative emotions are maladaptive because it requires the individual to focus on negative emotions rather than methods of removing them (Billings

& Moos, 1984).

A third type of coping is avoidance-oriented coping such as engaging in a substitute task or seeking a diversionary activity (Endler & Parker, 1994) such as drug use to avoid stress. Studies have shown that while avoidance-oriented coping strategies may be effective in the short term (Miller, Brody, & Summerton, 1988), they may contribute to negative long term consequences such as poor health because this strategy only delays dealing with the stressor (Cronkite & Moos, 1994). Clinically depressed 14 patients experience less improvement and greater dysfunction over time when engaging in avoidant coping (Billings & Moos, 1984). Similarly, in a ten year longitudinal study,

Holahan et al. (2005) found that avoidant coping is positively correlated with depressive symptoms. In this longitudinal study, the researchers examined how coping styles were correlated with life stressors and depressive symptoms four years later and ten years later.

Holahan and researchers found that individuals who engaged in avoidant coping styles at baseline were more likely to experience stressors four years later and to have depressive symptoms ten years later. This is most likely because avoidant coping styles fail to remove the stressor (Holahan et al., 2005).

In summary, the type of coping style used is associated with psychological distress. Problem-focused coping is negatively associated with stress, anxiety, and depression while avoidant-focused coping is positively associated with increased health problems. The association between emotion focused coping and psychological distress is mixed (Billings & Moos, 1984; Carver et al., 1989). In addition to the findings that the effectiveness of emotion-focused coping varies because it incorporates more than one coping style, recent studies (Litman, 2006; Tennen, Affleck, & Armeli, 2000) found that because problem-solving coping and emotion-focused coping often occur together depending on the unique experience, evaluating coping styles using problem-focused and emotion-focused coping is not ideal (Litman, 2006). While there is a high degree of overlap among problem and emotion focused scales, previous research has consistently identified factors that characterize coping with or without the assistance of social support

(Baqutayan, 2011; Litman, 2006; Tennen, Affleck, & Armeli, 2000). Two studies evaluating the dimensionality of the COPE inventory (Carver, et al., 1989) found that 15 these 3 factors best differentiates the unique coping styles: self-sufficient, socially- supported, and avoidant-coping (Litman, 2006). In addition, self-sufficient coping and socially-supported coping both are positively correlated with approach oriented behavior

(dealing with either the problem or related emotions) while avoidant coping is correlated with avoidance oriented behavior (ignoring or withdrawing from the stressor; Litman,

2006).

During stressful periods, eating behavior may change and some people cope with stress by indulging in emotional eating (Epel et al., 2004; Ozier et al., 2008; Timmerman

& Acton, 2001). Emotional eating, according to psychosomatic theory, is an atypical response to distress; the typical response is loss of appetite due to inhibition of gastric muscles (Gold & Chrousos., 2002). Timmerman and Acton (2001) examined the relationship between basic need satisfaction based on Maslow’s hierarchy (1943) (i.e., physiological, safety/security, love/belonging, esteem/self-esteem, and self-actualization) and emotional eating through questionnaires received from adults at a professional conference. Timmerman and Acton (2001) hypothesized that because a lack of basic needs according to Maslow’s hierarchy functions as a stressor, the more an individual lacks in basic needs, the more likely these individuals will engage in emotional eating to substitute for their need. Using the Basic Need Satisfaction Inventory (BNSI) to access basic need satisfaction, Timmerman and Acton (2001) found a strong negative correlation

(r = -.49; p < .001) to the Emotional Eating Scale (EES); the lower the level of basic need satisfaction (lower on Maslow’s hierarchy pyramid), the more likely one would engage in emotional eating (Timmerman & Acton, 2001). 16

Stress can also change an individuals’ preference for foods as people under stress prefer sweet and fatty foods, sugary drinks, and alcoholic beverages independent of gender and or whether one is on a diet or not (Dallman, 2010; Pagoto et al., 2009;

Rutters, Nieuwenhuizen, Lemmens, Born, & Westerterp-Plantega, 2009). Unfortunately, unhealthy foods and beverages such as these are most often eaten at times between meals because of their savory or sweet taste and their convenience. In addition, stress also changes the type of food consumed during a meal. Oliver and Wardle (1999) administered a self-report questionnaire to college students and found that meal-type foods, fruits and vegetables, were consistently reported to be consumed less under stressful conditions. Likewise, Epel et al. (2001) also found through their experiment that women who had high cortisol levels in response to stress ate more sweet high fatty foods than did women who did not have a high cortisol response to stress. However, it is unclear in this study whether women who tended to eat sweet fatty foods had a biological predisposition to higher cortisol levels.

However, not everyone responds to stress in the same manner. Previous research has found that stress produces differential effects on eating depending on the type of eating behavior (restrained eating, unrestrained eating, and emotional eating) the individual displays (Herman & Polivy, 1983; Zellner at al., 2006). One type of consumer is the restrained eater. Even though these individuals often feel hungry, think about food, and are readily tempted by the sight or smell of food, they consciously attempt to control their impulse to eat in order to maintain or lose body weight (Herman & Polivy, 1983).

In contrast, nondieters tend to be unrestrained eaters. Unrestrained eaters do not constantly try to control their food intake and do not feel guilty when they overeat 17

(Herman & Polivy, 1983). Zellner et al. (2006) performed two experiments to investigate whether food selection changes under stress. In the first experiment undergraduate female students were split into two groups: a stressed group and a no-stress group. The stressed group received a list of 10 unsolvable anagrams while the no-stress group received a list of 10 solvable anagrams. While performing the anagrams, four bowls of snacks containing M&Ms, grapes, potato chips, and peanuts were left on the table for the subjects to eat as a “thank you” for their participation in the experiment. The researchers concluded that stress caused changes in food choice away from healthy low fat food

(grapes) to less healthy high fat food (M&Ms). In the second part of the experiment,

Zellner et al (2006) found that not only did more females than males reported greater food consumption when stressed, but that of the women who increased their food intake due to stress, 71% were restrained eaters as opposed to women who undereat or who don’t change the amount they eat when stressed. The foods that these women report overeating (high caloric and high fat foods) when stressed are typically foods they normally avoid for weight-loss or health reasons; women who are stressed and eat these foods though report that it made them feel better.

Similarly, both restrained eaters and emotional eaters have been found to consume more energy and fat under stressful conditions, particularly those involving ego-threat or negative self-referent information, negative information about the self (Heatherton,

Herman, & Polivy, 1991; Polivy & Herman, 1999; Oliver et al., 2000). According to

Heatherton and Baumeister (1991), this behavior may be an attempt to escape or shift attention away from the aversive and threatening stimuli. Thus, instead of focusing on the negative, the attention is now shifted toward the immediate comforting stimulus of 18 food. Conversely, the intake of unrestrained and non-emotional eaters tends to stay the same, or even decrease under stress, which may be associated with the autonomic correlates of stress (Wallis & Hetherington, 2009). When under stress, the fight-or-flight response takes over and activates the body: heart rate accelerates, blood pressure rises, and blood rushes to the muscles instead of the stomach (Friedman, 1992). It is also clear that there is a greater prevalence of restrained eating and emotional and situational susceptibility to eat in females than in males and that restrained males are more successful at maintaining or losing weight than restrained females (Drapeau.et al., 2003).

For example, in women, a high restraint behavior tended to promote weight gain whereas in men, it had the opposite effect (Drapeau et al., 2003). Although someone with high restraint eating behavior will intend to limit food intake and to choose lower calorie foods to promote weight loss or prevent weight gain, once one “gives in to” these desires, all restraint may be abandoned. These results suggest that while eating behaviors are associated with body weight changes, how these changes are expressed differs between men and women.

Real time stressful circumstances, such as examinations (e.g. exams in college) or periods of high workload from a job, can provide a predictable context in which to study food intake as it is related to stress. Such studies have found that times of high workloads are associated with greater energy and fat intake (McCann, Warnick, & Knopp, 1990), or higher fat, sugar and total energy intake. In McCann, Warnick, and Knopp’s (1990) study, the subjects were employees who processed grants submitted by investigators at the University of Washington to funding agencies. Thus, due to the nature of this work, workloads tend to be cyclical. During high workload, not only was there greater energy 19 and fat intake, but these period were also associated with elevated cholesterol levels measured through blood samples. However, in other research, increased energy intake during high workload was found only in people who were restrained eaters (Wardle,

Steptoe, Oliver, & Lipsey, 2000). Among students, exams or high workload have also been associated with higher energy intake too (Pollard, Steptoe, Canaan, Davies, &

Wardle, 1995) or less healthy diets (Weidner, Kohlmann, Dotzauer, & Burns, 1996).

Macht, Haupt, and Ellgring (2005) explored whether eating functioned to alleviate stress, distract people from stressful emotions, or to relax individuals experiencing stress- induced emotions. The researcher, using a sample of college students, obtained self- reported emotions and eating behaviors from the students. The students were then split into two groups: one group was given an exam and the other group (control) was not given an exam. Two points in time were used: 1) well in advance of the exam date - 3 to

4 weeks before the date of the exam (baseline) and 2) just before the exam date - 3 to 4 days prior to the exam date. According to the self reports, students taking exams 3 days before the test reported increased feelings of tension, fear, and stress compared to the control group and they reported that they ate to distract themselves from these feelings rather than eating to feel better or to relax. However, in a separate study, Oliver, Wardle, and Gibson (2000) found that stress (threat of public speaking) did not alter overall intake of a buffet meal. Despite this, stressed emotional eaters ate more sweet high-fat foods

(chocolate and cake), and a more energy-dense meal, than either unstressed emotional eaters or non-emotional eaters. In addition, Epel, Lapidus, McEwen, and Brownell

(2001), found that emotional eaters may be more susceptible to effects of stress: women who ate more from a selection of snack foods after a stressful task also showed the 20 greatest release of the stress-sensitive hormone, cortisol and more stress-induced negative affect. Cortisol has been termed “the stress hormone” because it is secreted in higher levels during the body’s response to a stressor (Epel et al., 2001). In addition, these high reactors also showed a preference for sweet foods. It seems that emotional eaters may be more likely to experience mood disturbance when challenged and to seek comfort from food during stress-induced negative affect.

Neuroscience of Eating Behavior

There is increasing evidence that certain individuals are prone to develop maladaptive patterns of behavior such as an addiction to food that is similar to abuse of drugs such as heroin, methamphetamine, cocaine, ecstasy and alcohol (Gold, Graham,

Cocores, & Nixon, 2009). Drug addiction results from the hijacking of neurobiological pathways that have evolved in humans as a way to regulate reward, motivation, decision- making, and learning and memory (Wang, Vokow, Thanos, & Fowler, 2009). One of these pathways is known as the dopaminergic pathway which includes areas of the brain such as the ventral tegmental area (VTA), the nucleus accumbens, and the frontal cortex

(Lingford-Hughes & Nutt, 2003). Considerable evidence indicates that activation of these pathways tends to reinforce behavior such that organisms quickly learn behaviors that activate this system (Lingoford-Hughes & Nutt, 2003). For example, methamphetamine is one of the fastest growing illicit drug in the world especially among youth as the drug produces an intense euphoria which often leads to numerous sex- and drug-related risk behaviors and negative health outcomes (Fast, Kerr, Wood, & Small,

2014). Methamphetamine acts on the dopaminergic pathway and mimics the neurotransmitter dopamine, tricking the brain and its dopamine transporters to take in 21 methamphetamine into the cell. The excess dopamine in the cell forces the dopamine transporters to act in reverse by pushing the dopamine out of the cell and into the synaptic cleft (Wang et al., 2009). As a result, the excess dopamine in the synaptic cleft binds again and again to the postsynaptic receptors giving the user a feeling of intense pleasure and exhilaration. Drug-seeking behavior is motivated and reinforced by the high associated with the sudden increase in dopamine within the dopaminergic reward pathway of the brain (Gold et al., 2009).

The effects of dopamine, however, are not confined to just drugs, but also to gambling, sex, and eating addiction. Patients with Parkinson’s disease, a disease characterized by deficiencies in dopaminergic neurotransmission, are usually given L-

DOPA, a drug that is the precursor to dopamine and readily passes the blood brain barrier. A side effect of taking L-DOPA is the increase in developing behavioral addictions such as addictions to gambling, sex, and eating (Dagher & Robbins, 2009).

Mounting evidence suggest that an addiction to food also significantly increases levels of dopamine, in addition to serotonin in the brain creating a temporary elevation of mood

(Gold et al., 2009). When one eats a food high in carbohydrates, insulin gets released which breaks the carbohydrates down and increases blood concentration of glucose which is either used by the body or stored by the body cells (Gold et al., 2009). Insulin also indirectly increases the concentration of tryptophan, the precursor for serotonin, in the brain. This can lead to increased amounts of serotonin in the brain which temporarily elevates mood (Gold et al., 2009). According to Kenneth Blum’s Reward Deficiency

Syndrome (Blum et al., 2006), one seeks out substances that balances ones’ biochemical levels. For example, if one has a low serotonin level, one may seek out substances, such 22 as food, that raise serotonin levels. High carbohydrate and high sugar foods are examples of foods that temporarily raise serotonin levels (Gold et al., 2009).

Blum also concluded in a study that glucose cravings are caused by a lack of dopamine receptors in the brain (Blum et al., 2006). In animal models of obesity, dopamine activity is reduced in the tuberoinfundibular pathway that projects to the hypothalamus (Pijl, 2003). However, when treated with dopamine agonists, it reverses the obesity presumably by activating dopamine D1 and D2 receptors (Pijl, 2003). In humans, brain imaging studies show reductions in dopamine D2 receptors in the striatum of obese individuals (Wang et al., 2001). This finding is similar to the reductions reported in drug addicted individuals (Wang et al., 2001). In addition, for obese individuals, high-calorie food cues show a sustained response in brain regions implicated in reward and addiction even after eating (Dimitropoulos, Tkach, Ho, & Kennedy, 2012).

Likewise, imaging studies have also found abnormalities in the prefrontal cortex in obese individuals (Dimitropoulos et al., 2012; Wang, et al., 2009). When food-related stimuli are presented to individuals, the orbital frontal cortex (OFC) is activated along with reports of increased cravings (Wang et al., 2009). Similarly, increased OFC activation and increased cravings are reported when drug-related stimuli are presented to addicts

(Volkow & Fowler, 2000).

Emotional Eating and Weight

According to the US Centers for Disease Control and Prevention (CDC), the current American society has been described as obesogenic where people live in environments that promote overeating, eating unhealthy food, and physical inactivity

(Center for Disease Control & Prevention, [CDC], 2014). An estimated 65% of US 23 adults are currently either overweight or obese (Flegal, Carroll, Ogeden, & Johnson,

2002) defined as body mass index (BMI; calculated as kg/m2) greater than or equal to 25.

The abundant availability and aggressive marketing of food, the increased use of sedentary technological gadgets for enjoyment, and the commonplace use of motorized transportation results in extra consumption of food and a decline in physical activity

(Lake & Townshend, 2006; Swinburn, Egger, & Raza, 1999). In addition, evolution has favored genetic adaptations that allow humans to survive in periods of food shortages so that humans tend to overeat in times of food surplus and can rapidly lay down fat

(Bryant, King, & Blundell, 2008; Van Strien, Herman, & Verheijden, 2009). There may be selective pressure supporting opportunistic eating as over the course of millions of years this opportunistic eating behavior led to the individual’s survival. However, in the current obesogenic environment seen in the western world today, opportunistic eating is a counterproductive behavior that provides a positive energy balance, cardiovascular disease and shorter life span, weight gain, and increased likelihood of obesity.

Emotional eating and eating due to the obesogenic environment may be counteracted by imposing cognitive restraint on food intake. A review on the long-term effectiveness of diets by Mann et al (2007) concluded that diets are not the long-term answer. A problem with dietary restraint is that the body has trouble distinguishing between food shortage and a self-imposed food restriction (Goldsmith, et al., 2010;

Polivy & Herman, 1985). As a result, the body may act as if it is in starvation mode which increases feelings of hunger and slows down the metabolism. This may explain the difficulties in losing weight. However, the addition of physical activity has been found to be beneficial to maintaining a healthy body weight (Van Baak, 1999). Physical 24 activity increases caloric expenditure and metabolic rate and has also been associated with lower depressive symptomatology, decreased feelings of tension, and a greater emotional well-being (Amenesi & Whitaker, 2008; Dunn, Trevedi, Kampert, Clark &

Chambliss, 2005). In a recent web-based questionnaire study, emotional eating was positively correlated with weight gain (Koenders & van Strien, 2011). In addition, there was a negative correlation between physical activity and emotional eating. More importantly, a high level of sporting (three sports activities or more per week in the summer and winter) was related to weight loss and non-emotional eating.

However, despite the dangers of an obesogenic environment, not everyone becomes overweight or obese. Susceptibility to increased body weight can be attributed to many factors ranging from genetics, physiological, behavioral and psychological

(Blundell et al., 2005). A number of studies have focused on the psychological tendency of emotional eating and its association to obesity (de Lauzon-Guillain et al., 2006;

Geliebter & Aversa, 2003; Keskitalo et al., 2008; Van Strien, Frijters, Roosen, Knuiman-

Hijl, & Dafers, 1985). The association between obesity and emotional eating has yielded uneven results as some studies have found a positive association between higher weight status and emotional eating (Blair, Lewis, & Booth, 1990; Konttinen, Haukkala, Sarlio-

Lahteenkorva, Silventoinen & Jousilahti, 2009; Koenders & Van Strien, 2011; Van Strien et al., 1985) while other studies have found no association (Abramson & Wunderlich,

1972; Allison & Heshka, 1993; Fitzgibbon, Stolley, & Kirschenbaum, 1993).

Because emotional eating negatively affects health whether it leads to obesity or not, Macht (1999) specifically looked at emotional eating in healthy weight adults.

Macht (1999), using a self-report study of non-clinical sample of males and females, 25 investigated the influences of emotions (anger, fear, sadness, and joy) in healthy weight adults. Individuals completed a questionnaire of 33 items for each emotion and Macht

(1999) found that different emotions led to different eating behaviors. A factor analysis of the 33 item answers yielded four factors of eating which were labeled 1) eating due to hunger feelings, 2) impulsive eating (eating fast and carelessly) 3) sensory eating (eating intense and flavorful foods) and 4) hedonic eating (eating due to its pleasantness). Macht

(1999) found that impulsive and sensory eating occurred more often during anger than during other emotions. On the other hand, hedonic eating occurred more often during joy than during other emotions. In addition, women reported higher tendencies of impulsive and sensory eating than men during anger and sadness. This study shows that emotional eating is present not only in overweight and obese individuals, but also in healthy weight individuals. Moreover, there are different eating behavior patterns in relation to different emotional states.

We live in an obesogenic environment where the presence of food is ubiquitous.

It does not help, as far as our weight and health is concerned, that our genetic adaptations favor us to overeat in times of food surplus. Unlike hundreds of years ago, food is more easily obtained when we feel a need to eat. Studies have examined whether there is an association between emotional eating and BMI and the results are inconclusive.

Emotional eating can have negative health consequences and occurs in both healthy weight and overweight individuals.

Psychopathology

When negative emotions are felt, a loss of appetite and reduction of food intake are the natural physiological responses (Herman & Polivy, 1984; Schacter, Goldman, & 26

Gordon, 1968). However, when an increase in food intake is seen in response to a negative emotion, it is considered an unnatural response (Heatherton, Herman, & Polivy,

1991). Emotional eating has been identified as a possible factor triggering binge eating in bulimia nervosa (BN) (Engelberg, Steiger, Gauvin, & Wonderlich, 2007; Van Strien,

Schippers, & Cox, 1995), binge eating disorder (BED) (Dingemans, Martign, Jansen, & van Furth, 2009; Eldregde & Agras, 1996; Pinaquy, Chabrol, Simon, Louvet, & Barbe,

2003; Masheb & Grilo, 2006; Stein, Kennardy, Wiseman, Dounchism, Arnow, &

Wilfley, 2007), and anorexia nervosa (AN) (Ricca et al., 2012). In fact, binge eating and/or purge behavior appears to be precipitated by negative affect (Masheb & Grilo,

2006). These behaviors are seen as attempts to cope with negative affect by providing short term comfort (Smythet al., 2007; Wild et al., 2007). BN is characterized by episodic patterns of binge eating accompanied by a sense of loss of control and a strong desire to be thin. With BN, there may be compensatory behaviors such as vomiting and accompanied by little weight loss or even weight gain (Goldbloom & Garfinkel, 1993).

BED identifies overweight or obese patients who present with recurrent eating of an unusually large amount of food during a short period of time and who do not engage in the typical compensatory behaviors of bulimia nervosa (Devling, Walsh, Spitzer & Hasin,

1992). AN is characterized by self-imposed starvation due to a relentless pursuit of thinness and fear of being fat (Goldbloom & Garfinkel, 1993). Besides the physical health consequences associated with an eating disorder, psychological concerns such as phobias (Carter & Bewell-Weiss, 2011), obsessive compulsive disorder (Starcevic &

Brakoulias, 2014), dysphoria (Johnson & Larson, 1982), and isolation from other people

(Halmi et al., 1991) are of concern. 27

A recent study examined whether there are differences in emotion regulation deficits among people with eating disorders compared to control participants (Svaldi,

Griepenstroh, Tuschen-caffier, & Ehring, 2012). All three eating disorder groups (BD,

BED, and AN) reported significantly higher levels of emotion intensity, lower acceptance of emotions, less emotional awareness and clarity, and more emotional regulation difficulties than the healthy control group. Patients with eating disorders are unable to differentiate and regulate their emotional states (Bydlowski et al., 2002). Whether disturbances in regulating their emotions is the cause of eating disorders or is a personality trait is not yet fully understood (Bydlowski et al., 2002). Similarly, because these eating disorders are due in part to emotional states and a loss of control, Ricca and researchers (2012) investigated whether there was significantly more emotional eating among the disordered groups (BD, BED, and AN) compared to a healthy control group using the Emotional Eating Scale (EES) self assessment. Findings indicated there were no significant differences among the three disordered groups (BD, BED, and AN), yet, all of the patients showed significantly higher EES scores compared to health controls.

Research into the psychological well-being of normal weight female adults finds that female adults often show similar psychological symptoms to patients with an eating disorder. In a self-report study of 127 normal weight female adults, high levels of emotional eating were associated with low psychological well-being, low self-esteem, body image vulnerability, and feelings of inadequacy (Lindeman & Stark, 2001); these symptoms are the same ones seen in underlying eating disorders. In turn, an inability to regulate high negative affect is related to the development of depressive disorders and psychopathology (Kovacs, Joormann, & Gotlib, 2008). Emotional eating is also related 28 to emotional processing disturbances such as higher levels of alexithymia – inability to identify and express emotions (Van Strien, 2006), higher levels of anhedonia (Keranen,

Rasinaho, Hakko, Savolainen, & Lindeman, 2010), decreased emotional clarity (Larsen,

Van Strien, Eisinga, & Engles, 2006), lower attention to emotion (Moon & Berenbaum,

2009), and poor interoceptive awareness (Ouwens et al., 2009) in the non-clinical population. Interoceptive awareness is defined as sensitivity to stimuli originating from within the body (Sim & Zeman., 2004).

Likewise, in the clinical population, Sim and Zeman (2004) found poor interoceptive awareness in patients who suffered from bulimia nervosa. Van Strien,

Engels, Leeuwe, and Snoek (2005) found that emotional eating and interoceptive awareness account for a significant proportion of the relationship between negative affect and overeating in a study of clinical and nonclinical female adolescents. Rommel et al.

(2012) found that obese women exhibited deficits in emotional awareness and used emotional eating as an emotion regulation strategy significantly more than controls. The authors also showed that paternal and maternal overprotection negatively correlated with obese individuals’ level of emotional awareness and that emotional awareness was also negatively correlated with their level of emotional eating.

Whether it is an individual with an eating disorder or whether it is an individual who engages in high levels of emotional eating, both show similar characteristics such as low psychological well-being and feelings of inadequacy. Poor interoceptive awareness, poor emotional regulation, and low psychological well-being are all common associations with abnormal eating.

29

Parenting and Emotional Eating

Research on parenting practices reveal that there is a link between parents who minimize their child’s emotional expression or punish them for expressing negative emotions and a child that tends to be more emotionally reactive and less able to regulate their emotions; these children are more likely to use escape tactics such as avoiding the situation all together to deal with emotional distress (Fabes, Leonard, Kupanoff, &

Martin, 2001). Likewise, studies have found a link between parenting styles and emotional eating in children and adolescents (Schuetzmann, Richter-Appelt, Schulte-

Markwort, & Schimmelmann., 2008; Snoek, Engels, Jansens, & Van Strien., 2007;

Topham et al., 2011). Topham and researchers (2011) found that among 6 to 8 year olds, emotional eating was negatively correlated with authoritative parenting style (high warmth and high control). Besides lower levels of emotional eating, there was also a link between authoritative parents and children with greater self-discipline and more emotional maturity (Baumrind, 1991). Likewise, Snoek et al. (2007) found that adolescents who reported less maternal support, more maternal psychological control

(psychological manipulative strategies to control ones’ behavior), and less maternal behavioral control (control on whereabouts and activities) were associated with higher levels of emotional eating.

Similarly, a few studies have found an association between parenting and emotional processing disturbances (De Panfilis, Rabbaglio, Rossi, Zita, & Maggini.,

2003; Fukunishi, 1998). De Panfilis and researchers (2003) found that among eating disordered outpatients, alexithymia, was predicted by lower levels of maternal care.

Specifically, the TAS-20 (Toronto Alexithymia Scale) total score, a 20-item instrument 30

that is one of the most commonly used measures of alexithymia, and the ‘difficulty in describing feelings’ subscale of the TAS-20 were significantly correlated to low maternal care. Examples of high maternal caregiving behavior are responding promptly, accurately, and consistently to an infant’s signals and consistently having face-to-face interaction with the child. Similarly, Fukunishi (1998) found that in college students, difficulty identifying feelings and difficulty describing feelings not only were associated with abnormal eating attitudes, but were also associated with a lack of maternal care. In a recent study, Rommel and researchers (2012) investigated the impact of emotional awareness and parental bonding on emotional eating in obese women who sought treatment for obesity. Parental bonding is the emotional connection that the parent feels for the child. The authors found that paternal and maternal overprotection was negatively associated with obese patients’ levels of emotional awareness. In turn, emotional awareness was negatively associated with emotional eating.

Thus, research has found an association between emotional eating and emotions in children at an early age and parental care. Low maternal care is associated with individuals having difficulties identifying and describing their feelings and leads to increased abnormal eating behavior (De Panfilis et al, 2003; Fukunishi, 1998). In addition, research has found that an authoritative parenting style is negatively correlated with emotional eating in children. However, what is unknown is whether or not parental bonding is associated with emotional eating in a non-clinical university sample of healthy young adults.

31

Parental Bonding and Coping

Transitional periods require considerable adaptation to psychosocial and environmental changes. The transition to early adulthood is especially pronounced among young adults entering a university where the separation from family, loss of familiar social support, and academic demands are obstacles that young adults need to overcome. The ability to overcome these challenges requires factors such as an individuals’ ability to cope with these challenges; the ability to cope with these obstacles determines their well-being and success in college. The ability to cope seems to be derived from the bonding with the individuals’ parents (Adlaf, Gliksman, Demers, &

Newton-Taylor, 2001). The development of a secure relationship between child and parent impacts the child’s interaction with the environment such as exploring and discovering his surroundings, development of skills, and self-confidence (Ainsworth,

1985). The more secure a child feels, the more likely the child is to explore the surroundings and thus, develop the skills and independence to take on challenges.

Matheson and researchers (2005) found that maternal bonding was associated with an increased likelihood to use problem solving, active distraction, and social-support seeking and less likely to use less adaptive emotion-focused strategies (e.g. rumination, blame) or a passive resignation of failure (Matheson et al., 2005). Ultimately, the strength of this relationship may determine how well a young adult overcomes challenges during transitional periods.

Coping and Transition to College

Because college is often a time of adjustment and newfound independence, college students must draw upon coping strategies to deal with their experience of stress. 32

Individuals who have acquired good skills in coping with new situations tend to have less

difficulty making the transition into college because coping is a mechanism that reduces

stress (Tinto, 1993). In addition, coping is also an attempt to alter events or

circumstances that are threatening or challenging by making them less so (Smith & Renk,

2007). For example, coping with a challenging course in college may require a student to attend office hours and change the way studying is managed. Aspinwall and Taylor

(1992) found that coping strategies used by students significantly predicted their adjustment in college. Active coping, behavioral or psychological responses that change the nature of the stressor itself or how one thinks about it, was found to have positive and direct effect on college adjustment as compared to avoidant coping which showed a negative effect on college adjustment. Active coping predicted better adjustment to college. Similarly, Leong, Bonz, and Zachar (1997) also found that active coping predicted academic adjustment as well as personal-emotional adjustment, how a student is feeling psychologically and physically. The impact of coping on college adjustment is also supported by research that investigated the effects of coping styles on incoming medical students (Park & Adler, 2003). This study reported students’ coping styles was related to students’ psychological well-being and that escape-avoidance coping was

related to lower levels of psychological well-being. In addition, positive reappraisal and

planful problem solving were related to higher levels of psychological well-being. These

findings are consistent with Dyson and Renk’s (2006) result that found frequent use of

escape-avoidance coping among freshman was related to higher levels of depression.

Studies have also shown that students’ coping significantly predicted their

academic achievement in terms of grade point average (GPA; Baker & Siryk, 1984; 33

Sennett, Finchilescu, Gibson, & Strauss, 2003). Moreover, Hackett, Betz, Casas, and

Rocha-Singh (1992) reported significant positive relationships between coping and students’ college GPA. Likewise, studies have also shown that among psychological dispositions of coping strategies, perceived academic control, and self-esteem, coping strategies had the most effect on students’ GPAs (Clifton, Perry, Stubbs, & Roberts,

2004). Similarly, DeBerard, Spielman, and Julka (2004) found that escape-avoidance coping was negatively correlated with academic achievement. Coping styles not only affect an individuals’ academic performance, but also a young adults’ well-being.

Transition to College as a Unique Stressor

Leaving the comforts of home and going away to college is a significant

development in a persons’ life, one that entails varying levels of adjustment difficulties.

For example, students are typically away from parental guidance and free to eat whatever

they want. There are many temptations such as piling on portions of food at the dining

hall and eating sugary and salty snacks whenever students want. Students also tend to

exercise less after high school because students are busy with the adjustment to college,

with class, homework, and socializing (Racette, Deusinger, Strube, Highstein, &

Deusinger, 2005). Alcohol use and drug use may also begin or increase without parental

guidance (Racette, et al. 2005). All of the changes in one’s life may result in greater

stress. The cumulative result is sometimes termed the “Freshman 15” by the popular

press; a term used to describe the average weight gain, 15 pounds, freshmen put on their

first year of college (Holm-Denoma, Joiner, Vohs, & Heatherton, 2008). However, a

recent study found that the “Freshman 15” may be a myth as the average college student

gains only 2.5 to 3.5 pounds in their first year (Zagorsky & Smith, 2011). Furthermore, 34

the study indicated that college students only gained an additional half-pound than non-

college students of the same age and the only factor that increased weight gain was heavy

drinking.

However, research has shown that the better adjusted students (both psychological

and physical well-being) are less likely to report experiencing stress (Montgomery &

Haemmerlie, 2001) and to seek help from counseling or the campus psychological

service centers (Beyers & Goossens, 2002). In addition, students that score higher on the

personal-emotional adjustment score within the Student Adaptation to College

Questionnaire (SACQ) report fewer health visits to the doctor and fewer absences from

class due to illness (Beyers & Goossens, 2002). Striegel-Moore, Silberstein, Frensch, and Rodin (1989) reported that upon completion of their freshman year of college, a significant number of females reported an increase in eating disorder symptomatology including binge eating (14.6% increase) and a negative feeling regarding weight (22.9% increase). While it is known that poor adjustment to the stresses of college has negative consequences ranging from depression to eating disorders, it is not known whether the level of college adjustment contributes to the negative effects of emotional eating.

Emotional eating may be inappropriately used as a coping strategy among poorly adjusted students. In the absence of appropriate coping strategies in college, emotional eating may persist into adulthood and be a precursor to obesity, eating disorders, or psychopathology. Thus, examining the association between college adjustment and

emotional eating is warranted.

Aims and Hypothesis 35

The study of emotional eating is complex as it is influenced by many factors from food preferences, genetics, and the social and physical environment (Desmet &

Schifferstein, 2008; Levitan & Davis, 2010). With many variables to consider, the study of emotional eating still requires much research and careful study. This study examined the contribution of coping style, parental bonding, and college adjustment to emotional eating. To date, studies have not examined the association of these variables together with respect to emotional eating. One goal was made to replicate previous associations between coping style, stress, and parental bonding. In reference to coping style, this study attempted to study coping style using 3 factors that recent research has suggested to best differentiate the unique coping styles: self-sufficient, socially-supported, and avoidant-coping (Litman, 2006) Moreover,the current research investigated an unexplored area of psychology and examined the relationship between parental bonding and emotional eating in a non-clinical young adult population who live among their peers instead of their family. Individuals form many different relationships over the course of the life span, but the relationship between parent and child is among the most important

(Steinberg, 2001). Studies have shown that parenting affects the emotional response of young children, including emotional eating. Moreover, research has shown that low maternal care is associated with greater risk of alexithymia and poor interoceptive awareness in clinical samples. However, while research suggests a link between parenting and emotional eating in children, it is unknown whether parental bonding has a lasting influence on emotional eating in college students living away from their parents.

College is a unique time period in ones’ life span with possible stress due to demands from classes, the responsibility of being on one’s own, relationships, decisions about 36 whether to take part in alcohol or substance use, possible financial responsibilities, and trying to figure out how to balance everything. Thus, this study examined whether an individuals’ ability to adjust to college is associated with emotional eating where students have more access to when, what, and how much food they eat. Lastly, measures typically used to assess emotional eating such as the Dutch Eating Behaviour Questionnaire

(DEBQ) and Emotional Eating Scale (EES) do not assess positive emotions as a trigger

(Evers, Adriaanse, de Ridder, & de Witt Huberts., 2013). Thus, this study incorporated an exploratory positive emotion subscale, EES Positive, as emotional eating studies have emphasized negative emotions rather than positive emotions (Evers et al., 2013). It is important to examine positive emotions, in addition to negative emotions, because it is known that across cultures, food is used for celebrations and as a way of socialization

(Patel & Schlundt, 2001; Wansink, 2004). Thus, the possible link between overeating and eating in response to positive emotions should be examined.

The hypothesized model (Figure 1) is diagramed below:

37

The primary aims of this study was to investigate the relationships among emotional eating, student adaptation to college, coping style, and parental bonding in college students.

1. To confirm whether parental bonding in childhood was associated with type of

coping style used in college. Specifically, whether the level of care and the level

of independence a parent gives a child would be correlated with a type of coping

style. It was hypothesized that: (a) Avoidant coping styles would be negatively

associated with care score (high score = warmth, low score = coldness) and

positively associated protection score (high score = control, low score =

independence); (b) Self-sufficient and Socially-supported coping would be

positively associated with care score and negatively associated with protection

score.

2. To confirm whether the type of coping style (Self-sufficient, Socially-supported,

and Avoidant coping) used in college students would be associated with their

level of adjustment to college. It was hypothesized that: (a) students who use

avoidant coping styles would have a poorer adjustment to college. On the other

hand, students who use self-sufficient and socially-supported coping would have

higher levels of college adjustment.

3. To examine whether parental bonding would be associated with emotional eating.

In particular, it was hypothesized that: (a) students with cold (low care) parents

that were overprotective (high overprotection score) would be more likely to

emotionally eat (b) students with warm (high care) parents that allowed for their 38

independence (low overprotection score) would be negatively associated with

emotional eating.

4. To examine whether the level of adjustment to college would be associated with

emotional eating. It was hypothesized that students with a higher level of

adjustment to college would have lower levels of emotional eating.

5. To examine whether coping style, student adaptation to college, and parental

bonding would have an additive effect in explaining emotional eating. It was

predicted increases in avoidant coping, poorer parental bonding, and poorer

adaptation to college would result in greater emotional eating than the degree of

emotional eating associated with each predictor alone would indicate.

Method

Participants Participants were undergraduate students recruited from Case Western Reserve

University’s psychology research pool and from fliers displayed across the university campus. Students who participated in the research as a Psychology 101 student received course credit. Participants who were not part of the subject pool were entered into a drawing for a $100 Visa gift card and the winner was contacted and mailed the reward.

An informed consent waiver was obtained prior to study participation. Participants must have been able to read and understand English. In addition, students who lived at home with their parents and those who were on psychological medications that would significantly affect their eating behavior were excluded from the study. 39

245 students responded to the advertisements. Participants who met one or more

of the following were not included in the study: did not consent to the study, failed to

confirm that there wasn’t a chance they were pregnant, indicated that they were on

medication(s) that would significantly affect their eating behavior, did not complete at

least 90% of the survey, were under 18 years of age, lived at home, failed to complete

90% of the survey, or were extreme outliers and were determined that the individuals did

not fill out the survey in good faith were deleted from the final database used for analysis.

72 participants out of 245 (29.4%) were not included in the study due to one or more of

the above exclusion criteria. Of the 72 subjects not used in the study, 31 individuals

listed having taken an anti-depressant and/or anti-anxiety medication within the past 30 days. Because these medications have been known to affect eating behavior by reducing appetite (Haenisch & Bonisch, 2011; Kintscher, 2012), it is important to not include these

participants in this study. The resulting full dataset used for analysis had one hundred

seventy three participants (n = 173; Table 1). Demographic characteristics including

medication reported are displayed in Tables 1 and 2.

Measures The Emotional Eating Scale (EES: Arnow, Kenardy, & Agras, 1995) is a 25 item scale

with three factors: anger/frustration, anxiety, and depression. Participants indicate on a

5-point Likert scale ranging from a 0 “no desire to eat” to a 4 “an overwhelming urge to

eat”, to what extent each emotional descriptor (e.g., lonely, nervous, frustrated, etc…)

leads them to experience an urge to eat. The 3 subscales were derived from research in

which anger/frustration, anxiety, and depression accounted for 95% of the emotional

states preceding binge eating episodes in obese binge eaters (Arnow et al., 1995). The 40

EES demonstrated good reliability and validity (Arnow et al., 1995) and coefficient alphas for this study were 0.89 and 0.85 for the anger and anxiety subscales. Three additional positive items were added to the EES solely for exploratory purposes since positive emotions have been largely neglected: Attentive, in love, and content. No cutoffs exist for classifying emotional eating. Scores range from 0 to 44 on EES

Frustration, 0 to 36 on EES Anxiety, 0 to 20 on EES Depression, 0 to 100 on EES Total, and 0 to 12 for the exploratory subscale of EES Positive. The EES Total does not include the exploratory subscale of EES Positive.

The Student Adaptation to College questionnaire (SACQ: Baker & Siryk, 1989) is a 67 item measure designed to assess how well students adapt to the demands of their college experience. The level of adjustment items are ranked on a 9-point scale that ranges 1

“applies very closely to me” to 9 “doesn’t apply to me at all.” The 4 subscales include academic adjustment (e.g. ‘Has well-defined academic goals’, ‘has trouble concentrating when studying’), social adjustment (e.g. ‘fits in well with college environment’, ‘has several close social ties’, ‘gets along well with roommates’), personal-emotional adjustment (e.g. ‘being independent has not been easy’, ‘is not sleeping well’, ‘worries a lot about college expenses’), and institutional attachment (e.g. ‘is pleased about attending this college’). Scores range from 24 to 216 on academic adjustment, 20 to 180 for social adjustment, 15 to 135 on personal-emotional adjustment, 15 to 135 for attachment and 67 to 603 on the full scale score. The SACQ has good internal consistency, reliability, and criterion-related validity. Cronbach’s alpha values range from 0.77 for the personal- emotional adjustment subscale to 0.95 for the full scale score (Baker & Siryk, 1989). 41

The COPE Inventory (Carver et al., 1989) is a measurement of coping style which contains 15 subscales measured with a four-point Likert scale. The 15 subscales are active coping, planning, positive reframing, acceptance, humor, religion, using emotional support, using instrumental support, self-distraction, denial, venting, substance use, behavioral disengagement, mental disengagement, and self-blame. Each item in a subscale was measured using a frequency scale of (1) never, (2) seldom (3) often and (4) always. Thus, each item has a minimum score of 1 and a maximum score of 4. The

COPE has good reliability (alpha = .45 - .60) and test re-test scores (r=.45 - .86) over an eight week period in a university sample (Carver et al., 1989).

The COPE was chosen as the coping measure for this study because it assesses a broader variety of coping-styles. Carver et al. (1989) factored the individual COPE scale scores and identified four dimensions: problem-focused coping, emotion-focused coping, social-support, and avoidant-coping. However, recent studies have found that emotion and problem focused scales have a high degree of overlap as individuals may use both kinds of strategies depending on the situation (Tennen, Affleck, & Armeli, 2000). In addition, studies have found some items to weakly correlate with the original scales and a hierarchical factor structure with a number of primary factors loading on to a few second- order factors suggesting that the factor structure warrants further examination (Litman,

2006; Lyne & Roger, 2000). Within the COPE, Litman (2006) found three factors that provided the most stable factor structure: Self-sufficient coping, socially-supported coping, and avoidant-coping. Scores range from 8 to 32 on the self-sufficient factor, 4 to

16 on the avoidant-coping factor, and 3 to 12 on the socially-supported factor. These three factors will be used in this study (Table 3). 42

The Parental Bonding Inventory (PBI; Parker, Tupling & Brown, 1979) is a widely used and well validated self-report questionnaire that consists of two (father and mother) 25- item self-report questionnaires that assess parental bonding along two dimensions: care factor and over-protection factor. There are 12 care factor items and 13 over-protection factor items with each item scored from 0 to 3. Scores range from 0 to 36 for the care dimension and 0 to 39 for the over-protection dimension. The PBI asks the responder to evaluate the relationship between their parents and themselves from the first 16 years of their childhood. High scores on care suggest a parent who was warm and understand and low scores reflect a parent who was cold and rejecting. A high score on control reflects over-protection and a low score reflects a parent allowing independence. The PBI is reliable over time regardless of current mood state (Wilhelm, Niven, Parker, & Hadzi-

Pavlovic, 2005).

Procedure

Individuals were notified through the Psychology 101 online research tracking system, http://case.sona-systems.com/ and via posters throughout the university.

Participating in research provides students an opportunity to be acquainted with psychological research. Once an individual had voluntarily signed up to participate in the research through the online experiment tracking system, the SONA system automatically sent the individuals a link to the study. The first screen before any questions were to be answered was the approved consent notice where participants either accepted or rejected consent. After completion of the survey, which should have taken no more than 30 minutes to complete, research credit for the student was recorded. Once this was done, data was divided into 2 databases: one with the answers to the questions and one with 43

identifying information such as name and e-mail. Separating the information into two

databases ensured confidentiality.

Results

Missing Data

For participants with less than 10% of data missing (N=173), subscales on all

measures with missing value(s) were not used except the Student Adaptation to College

Questionnaire (SACQ). The SACQ had specific directions as to replacing missing

values. Prorated values were used by substituting the mean of the responses for the

subscale on which the missing item appeared. If an item appeared on only one subscale,

this prorated value from the subscale was used for the Full Scale as well. If items were

missing for items that appeared on more than one subscale, three different means had to

be calculated – two based on the subscales and one based on the Full Scale.

Outliers

In order to identify outliers in interval level variables and ordinal level variables,

all of the scores for a variable were converted to standard scores. A case was defined as

an outlier if its standard score was ±3.0 or beyond the mean (Jarrell, 1994). Analysis performed with and without the outliers were the same in terms of the number and specific variables that were significant and meaningful. In the analysis of outliers, it was found that two subjects consistently had outlier scores on the majority of the measures.

Thus, these two subjects were deleted from the final dataset.

44

Normality

To test whether or not the data was normally distributed, z-scores for skewness and kurtosis were calculated (Table 4). For small samples (n < 50), if absolute z-scores for either skewness or kurtosis were larger than 1.96, then the distribution of the sample was considered non-normal (West, Finch, and Curran, 1995). However, since this study had a medium sized sample (50 < n <300), an absolute z-value over 3.29 was considered

a non-normal distribution (West et al., 1995). Variables with skewness z-values and

kurtosis z-values of between -3.29 and +3.29 were considered normally distributed.

The following variables were considered non-normally distributed: Maternal

Care, SACQ Social, SACQ Attach, COPE Avoid. Thus, log transformations were

performed on these variables. Since Maternal Care and SACQ Attach variables had a

negative skew, a reflection of the data was done in addition to the subsequent log

transformation. The subsequent skewness and kurtosis values after the transformations

are depicted in Table 5 and subsequently used in the data analysis.

Data Analysis

Data analysis was carried out using the IBM SPSS statistical software program

(version 21.0) (SPSS 2012). The data was examined for accuracy of input and outliers.

Accuracy of input was examined through a 20% data reliability check; no errors were

found. A description of the study sample is given in Table 1.

Before correlations were performed, independent samples t-tests were conducted

to test for sex differences of emotional eating and other variables of interest.

Significance level was set at p < 0.05. This significance level was set at the standard 45 level because the purpose of performing the independent samples t-test was to explore the possibility of sex differences. If possible sex differences were found, then correlational analysis would be performed within each gender group and also for full group with both genders included. Independent sample t-tests were performed to check for gender differences (Table 6). Males rated their mothers as significantly more controlling in comparison to females. The following gender differences were also found with higher scores in females compared to males: EES Frustration, EES Depression, EES Total,

SACQ Full Scale, SACQ Academic, SACQ Attach, COPE Social, Mother Care, and

Father Care (Table 6).

Significance levels for Pearson correlations were set at a more stringent level of p

< 0.01 with r > 0.3 considered significant. With results from independent samples t-tests possibly signaling sex differences (Table 6), Pearson correlations were run within gender groups and for the full group.

The significance level for the multiple regression was set at p < 0.05. Mean and standard deviations were calculated for continuous data and frequencies were computed for categorical variables. Preliminary correlational analysis between emotional eating and demographic characteristics (e.g. gender) were conducted to determine whether these variables needed to be include as covariates in the regression analysis. Tolerance values for each predictor was used as a check for multicollinearity. The tolerance value is an indication of the percent of variance in the predictor that cannot be accounted for by the other predictors. Thus, a small value, values less than 0.10, indicates that a predictor is redundant. Tolerance values were high, above 0.845, for variables entered into the multiple regression indicating no multicollinearity issues. 46

Hypothesis 1: (a) Higher levels of avoidant coping styles will be negatively associated

with lower degrees of perceived warmth and positively associated with perceived

parental control. (b) Higher levels of self-sufficient and socially supported coping will be positively associated with a greater degree of perceived parental warmth and negatively associated with perceived parental control.

As hypothesis 1a predicted, there was a negative association between avoidant coping and perceived parental warmth and a positive association between avoidant coping and parental control (Table 7). However, this link was only found in perceived paternal care. Perceived paternal warmth was negatively associated with the use of avoidant coping (r = -0.30, p = 0.0001) and perceived paternal control was positively associated with the use of avoidant coping (r = 0.44, p = 0.0001).

For hypothesis 1b, correlation analysis did not indicate a significant relationship between any of the Parental Bonding Inventory subscales with perceived parental care

(Table 7).

Hypothesis 2: (a) A higher use of avoidant coping styles will result in poorer adjustment to college (lower SACQ scores). (b) On the other hand, a higher use of self-sufficient and socially-supported coping styles will be positively associated with higher levels of college adjustment.

2a. Hypothesis 2a was not supported as correlational analysis did not indicate a significant relationship between avoidant coping and any of the subscales for the Student

Adaptation College Questionnaire (Table 8). 47

2b. Likewise, hypothesis 2b was also not supported as results did not indicate a

significant relationship between self-sufficient and socially-supported coping with any of

the subscales for the Student Adaptation College Questionnaire (Table 8).

Hypothesis 3: (a) Students that perceive their parents to be cold (low care score) and

overprotective (high overprotection score) would be more likely to emotionally eat (b)

Students that perceive their parents to be warm (high care) parents that allowed for their

independence (low overprotection score) will have lower levels of emotional eating.

Hypothesis 3 was not supported as correlational analysis did not indicate a

significant relationship between any of the subscale scores of perceived parental bonding

and emotional eating.

Hypothesis 4: A higher level of adjustment to college will be negatively associated with

emotional eating.

Correlation analysis did not indicate a significant association between any of the subscales scores or total score of adjustment to college and scores of emotional eating

(Table 9).

Exploratory Analysis

Before hypothesis 5 was analyzed, an exploratory analysis was performed to see which additional independent variables may be factors in emotional eating. Analysis of the relationship between coping styles and emotional eating were found to be significant

(Table 10, 11, and 12). COPE Avoid was correlated with EES Total (M+F: r=0.34, p <

0.0001; F: r=0.32, p < 0.003; M: r=0.39, p < 0.001). Likewise, there was also an association between COPE Avoid and EES Frustration (M+F: r=0.36, p < 0.0001; F: 48

r=0.35, p < 0.001; M: r=0.4, p < 0.001). In males only, high levels of avoidance coping

was positively associated with EES Anxiety (Table 11: M: r=0.32, p < 0.007).

A link between socially supported coping and emotional eating was also found.

There was a link between COPE Social and EES Depression (Table 9; M+F: r=0.3, p <

0.0001). In males only (Table 11), COPE Social was positively associated with EES

Total and EES Anxiety, r=0.33, p < 0.005 and r = 0.34, p < 0.004 respectively.

Hypothesis 5: Increases in avoidant coping, poorer perceived parental bonding, and poorer adaptation to college will result in greater emotional eating than the degree of emotional eating associated with each predictor alone would indicate.

A hierarchical linear regression was run to predict emotional eating from COPE

Social and COPE Avoid while controlling for sex and race. Independent t-test was used to test for gender differences in emotional eating (Table 6). There was a significant difference in EES Frustration [t(166)= -2.319, p = 0.022], EES Depression [t(170)= -

3.477, p = 0.001], and EES Total [t(163)= -2.649, p = 0.009] with females emotionally eating more than males across the groups. Results of a one-way ANOVA and a subsequent independent t-test was used to test for possible group differences in emotional eating across race (Table 14). Race was found to be significantly different with Asian students emotionally eating significantly more than white students to anxiety [t(151)=

2.574, p = 0.011], frustration [t(148)= 2.599, p = 0.01], and total emotional eating

[t(145)= 2.581, p = 0.011]. Exploratory analysis also showed that Asian students engaged in greater emotional eating than white students to positive emotions [t(149)=3.28 , p =

0.001] 49

This regression model significantly predicted total emotional eating, F(6, 141) =

10.083, p < 0.0001, R2 = 0.30 (Table 14, 15). The results of the multiple linear regression suggests that a significant proportion of the total variation in emotional eating was predicted by socially supported coping and avoidance coping, p < 0.05. According to the R-squared, coefficient of determination, the independent variables explain 30% of the variability of emotional eating. The adjusted R-square is an adjustment of the R- squared that takes into account, penalizes, the addition of extraneous predictors to the model. The adjusted R-squared indicates that 27% of the variance in the dependent variable can be explained by gender, race, socially supported coping and avoidance coping. Socially supported coping and avoidance coping added 15.9% of the variance beyond sex and race.

Discussion

There are many risk factors of emotional eating because it is influenced by many factors such as food preferences, genetics, culture, psychology, and the social and physical environment. As a result of its complexity, it is almost impossible to study all of the possible factors in one study. While complex, this study examined unique and important factors that possibly were associated with emotional eating. Recent research has suggested that instead of studying coping using emotion-focused, problem-focused, and avoidance-oriented coping, the 3 factors that best differentiates the unique coping styles are self-sufficient, socially-supported, and avoidant coping (Litman, 2006). In addition, while research suggests a link between parenting and emotional eating in children, it is unknown whether this link has a lasting influence in college students who are living away from their parents and attempting to become independent. Lastly, while 50

studies have examined emotional eating in response to negative emotions, it was also

important to examine how positive emotions affect eating behavior because it is known

that food is also used for celebrations and as a way of socialization (Patel & Schlundt,

2001; Wansink, 2004). While there are many risk factors of emotional eating to consider, this study attempted to examine a few possible factors that have yet to be examined.

The major findings reported here indicate socially supported coping and

avoidance coping are important contributors to emotional eating and this is mediated in

part through gender and race (Figure 2). One of the major correlational findings was that

there was a significant positive relationship between avoidance coping and emotional

eating, regardless of gender. More specifically, individuals who tend to use more

avoidance coping tended to rate themselves as emotionally eating in response to

frustration more often in both genders. This finding is in contrast to a recent online study

of female college undergraduates from Canada, in which avoidant coping was not found

to be associated with emotional eating (Raspopow, Matheson, Abizaid, & Anisman,

2013). Instead, emotion focused coping was found to be positively associated with

emotional eating. According to Raspopow et al. (2013), emotion focused coping may be

a way of diminishing the adverse effects that come with emotional coping such as

rumination and self-blame by self-medicating through eating and increasing positive

feelings. Ingestion of highly palatable foods promote the release of serotonin which

temporarily increases mood states (Christensen & Pettijohn, 2001). However, the results

from the present study suggest that there is a positive relationship between the use of

avoidance coping and emotional eating in both females and males. Unlike self-sufficient

coping and socially-supported coping, avoidance coping is a short term solution to 51 alleviate stress (Holahan et al., 2005) and emotional eating, likewise, may soothe emotions temporarily but fail to permanently remove the stressor. Self-sufficient coping and socially-supported coping both are positively correlated with approach oriented behavior (dealing with either the problem or related emotions) while avoidant coping is correlated with avoidance oriented behavior (ignoring or withdrawing from the stressor;

Litman, 2006). The present findings suggests that in both males and females, there is an association between avoiding the stressor instead of actively fixing the problem and temporarily alleviating stress by turning to emotional eating instead of actively trying to fix the problem. Avoidance coping and emotional eating are similar in that both temporarily increase mood. Interestingly, the present study also found that emotionally eating to frustration was also positively associated with avoidance coping.

Frustration is an emotional state that varies from a mild annoyance to possibly an intense rage. Frustration can be caused by both external and internal events such as being annoyed at a specific coworker or feeling anger about personal problems. It may be possible that there is a link between individuals that have a low tolerance to the emotion of frustration and avoiding the problem at the core of the frustration by emotional eating in response to the specific emotion as a temporary and immediate gratification. In rational emotive therapy (RET; Ellis & Bernard, 1986), there is a concept, low-frustration tolerance (LTF), which stems from an irrational immediate gratification belief that “life should be easy and go the way I want. If not, it’s awful and I can’t stand it” (Wessler &

Wessler, 1983). Thus, there may be a link between individuals who tend to avoid the problem as a method of not dealing with the negative feelings and seeking immediate 52 gratification – one being emotional eating. This may be a plausible explanation of the positive relationship between emotionally eating to frustration and avoidance coping.

The idea of low-frustration tolerance is also known as discomfort anxiety and is created by the distorted views of the individuals’ ability to put up with the discomfort. In the present study, males who were more likely to use avoidance coping were also more likely to emotionally eat in response to anxiety. Previous research suggests that there are sex differences in brain connectivity and gender differences in which individuals outwardly show their emotions. Ingalhalikar and researchers (2014), using diffusion tensor imaging in a sample of 949 youths aged 8 – 22 years old found that male brains have more connections within each hemisphere while female brains are more interconnected between hemispheres. However, how this structural difference affects behavior and emotion is still unknown as it leaves out culture, which shapes how one thinks and how one uses the brain. For example, in a study of college students, females were more likely than males to express happiness during a frustrating task as opposed to a negative emotion (Chaplin, 2006). According to Keenan and Shaw (1997), girls are socialized by parents and teachers to consider the impact of the expression of negative emotions on others. Similarly, girls are more likely than boys to anticipate negative reactions from others in response to their expression of negative emotions (Underwood,

1997). Society expects different attitudes and behaviors from males and females and as a result, there is a tendency for boys and girls to be raised differently (Underwood, 1997).

In gender socialization, boys are raised to conform to the male gender role, and girls are raised to conform to the female gender role. A gender role is a set of behaviors, attitudes, and personality characteristics expected and encouraged of a person based on his or her 53 sex. Thus, there seems to be a unique positive relationship between avoidance coping and emotional eating in response to anxiety in males only that is not seen in females that is possibly due to gender socialization.

Another important finding was the positive correlation between socially- supported coping and emotional eating in response to feeling depressed. This finding is similar with the recent online study of female college undergraduates from Canada

(Raspopow et al., 2013) in which emotion focused coping was found to be positively associated with emotional eating. Emotion focused coping involves reducing the negative emotional responses such as depression and embarrassment. While the present study did not explicitly examine the emotional coping factor because of the high degree of overlap among problem and emotion focused scales (Litman, 2006), the subscale of socially-supported coping, used in the current study includes a number of emotion based coping strategies such as emotional social support and venting one’s emotions. The present finding suggests that individuals who are more focused on dealing with stress through social support and through reducing negative emotional responses are more likely to use emotional eating as a method of temporarily reducing negative feelings.

Both socially-supported coping and emotional eating are centrally based on emotions because emotions are at the center of social interactions among people. When an individual is feeling the blues or lonely, self-medicating through eating increases serotonin levels and mood. Likewise, seeking social support to reduce negative feelings also increases an individual’s mood (Christensen & Pettijohn, 2001).

Specific to males, those who endorsed a greater use of socially-supported coping also responded that they were more likely to emotionally eat, especially in response to 54 frustration. According to Littman (2006), socially-supported coping was significantly and positively correlated with BAS Reward Responsiveness, a 5-item subscale of the BIS

(Behavioral Inhibition)/BAS (Behavioral Approach) scales (Carver & White, 1994) that measures approach behavior. On the other hand, BIS measures inhibition or withdrawal behavior (Fowles, 1993). Carver (2004) found in his study that self-reported Fun

Seeking (BAS subscale) predicted reports of greater frustration after frustrative nonreward and self-reported Reward Responsiveness (BAS subscale) predicted reports of greater anger. Approach behavior yields negative affect when progress is inadequate, positive affect when progress exceeds criterion, and no affect when progress is acceptable but no more or less (Affleck et al., 1998; Carver, 2004; Carver & Scheier, 1999;

Lawrence, Carver, & Scheier, 2002). Likewise, withdrawal behavior yields negative affect when progress is inadequate, positive affect when progress exceeds criterion, and no affect when progress is acceptable but no more or less (Carver, 2004). Thus, the approach motivation can be responsible for negative affect such as frustration. Littman’s

(2006) research suggests a positive relation between socially-supported coping and BAS and Carver’s (2004) study suggests a positive association between BAS and levels of frustration. In turn, the present finding links socially-supported coping to emotional eating in response to frustration in males suggesting that in response to frustration possibly due to inadequate progress towards a goal, males may uniquely turn to social support and emotional eating.

In addition to gender differences, race differences were also found. Asians reported significantly higher levels of eating in response to frustration, anxiety, and overall emotional eating compared to White college students. In exploratory analysis, 55

Asians also significantly ate more than Whites in response to positive emotions.

However, as displayed in Table 13, these findings should be treated with caution as the mean scores for EES frustration (13.11 for Asians and 9.71 for Whites; range of 0 – 44),

EES anxiety (11.72 for Asians and 8.90 for Whites; range of 0 – 36), EES total (34.02 for

Asians and 26.50 for Whites; range of 0 – 100), and EES Positive (4.44 for Asians and

2.81 for Whites; range of 0-12) were below the median for their respective subscale score.

While the prevalence of eating disorders in preindustrialized, non-Western populations has generally been found to be lower than postindustrialized and Western societies (Anderson-Fye & Becker, 2003), this prevalence seems to be increasing

(Chisuwa & O’Dea, 2010; Cummins & Lehman, 2007). The increase of eating disorders in most non-Western societies might be due to the introduction of Western ideas such as fashion and media (Cummins & Lehman, 2007). For example, in the past, the slimness seen as a Western ideal for women would have been seen as possibly a sign of poverty in a traditional Chinese society (Lee, 1991). This supports the belief that culture plays an important role in the development of eating disorders, since their prevalence in Western societies is high. However, there are questions as to whether eating disorders develop differently in different cultures and whether health professionals identify eating disorders properly in non-Western groups that may lead to an underestimation of the prevelance of eating disorders in non-Western populations (Chisuwa & O’Dea, 2010; Cummins &

Lehman, 2007; Gordan, Perez, & Joiner, 2002; Makino, M., Tsuboi, K., & Dennerstein,

2004; Soh, Touyz, & Surgenor, 2006). 56

Eating disorder data on Asian countries show unique patterns that cannot be generalized broadly to all Asian countries (Kuboki, Nomura, Ide, Suematsu, & Araki,

1996; Tsai, 2000). Prevelance rates of anorexia and bulimia nervosa in Japan and China have been found to be lower than in Western nations (Lee, Hsu, & Wing, 1992; Tsai,

2000). On the other hand, South Korea has similar prevelance rates of eating pathology as the United States (Lippincott & Hwang, 1999) although Korean Americans have been found to have comparatively lower rates (Anderson-Fye & Becker, 2003; Ko and Cohen,

1998). Ko and Cohen (1998) explained that a possible reason for their finding is that

Korea has undergone rapid industrialization. Westernization of the native Koreans may create more disordered eating attitudes compared to Korean Americans because of the novelty and unfamiliarity of Western ideals. On the other hand, Korean Americans may feel less pressure to diet (Ko & Cohen, 1998) with one possible explanation being that

Asians, in general, may feel less risk of obesity compared to their Caucasian peers (Sing,

1993). According to Tsai and researchers (1998), Asian female students in the U.S. reported less body dissatisfaction than American students possibly due to their generally smaller body size. Similarly, another study found that Chinese people living in Hong

Kong showed higher levels of body dissatisfaction and dieting than Chinese people living in the US (Davis & Katzman, 1998). According to Chan, Ku, and Owens (2010), a possible reason for this may be that with the spread of Western values, the Chinese individuals living in Hong Kong experience Western standards determined in large part to media ideals while Chinese individuals living in the US have direct experience of the difference between media ideals and typical body size and shape of actual Westerners. 57

It is important to note that while this study collected data on race, there were no further questions as to the country of origin or as to whether students were international students or 1st generation Americans. At Case Western Reserve University, 8% of undergraduates in 2012 were international students and 18% of the student body population are Asian. For the fall semester of 2013, 4,661 students were enrolled from

96 different countries including 273 students from China, 3 students from Hong Kong, 18 students from India, 1 student from Japan, 48 students from the Republic of Korea, 1 student from Malaysia, 4 students from Taiwan, 2 students from Thailand, and 2 students from Viet Nam. In the present study, 31.8% of the respondents were Asian and based on demographic data from Case Western Reserve University, the majority of the sample were most likely Chinese. While studies of eating disorders among Asian Americans are sparse, it seems that higher levels of emotional eating in Asians compared to Whites is in contrast to the limited studies that found greater disordered eating attitudes in Whites than Asian Americans (Lucero, Hicks, Bramlette, Brassington, & Welter, 1992; Tsai et al., 1998).

However, emotional eating in Asian college students may reflect a difference in culturally appropriate behavior. The concept of the self is important in emotions.

Cultural constructions of the self can be categorized into the independent self and the interdependent self (Markus & Kitayama, 1991). The independent self is formed in a culture where individuality and independence are highly valued. On the other hand, the interdependent self develops out of cultures that emphasize the interrelationships and connections between members of the society. Individuals in this society are concerned more with how thoughts and feelings affect social interactions with others. There is a 58 greater emphasis on the relationship instead of the individual’s internal thoughts and feelings (Markus & Kitayama, 1991). In addition, previous studies have suggested that there are cultural differences in emotional expression (Kitayama, 2002; Markus &

Kitayama, 1991; Miller, 2002). Western European values such as independence and self- assertion encourage open emotion expression unless in the face of social threats such as embarrassment (Oyserman, Coon, & Kemmelmeier, 2002). On the other hand, Asian values such as interdependence and harmony encourage suppression equally for self- protective purposes and prosocial goals. For example, an individual may hide the joy from beating an opponent at a competitive game rather than openly expressing their glee.

Gross and John (2003) found that minorities in the United States, including Asian

Americans, reported higher levels of emotional suppression than Caucasians.

Furthermore, the use of suppression was associated with negative emotions for Western

Europeans while suppression was more normative for Asians since it was often used prosocially. As a result, rather than viewing emotional eating as a purely maladaptive response to emotions, emotional eating may be a normative and accepted response to emotions in the Asian culture. While it may be true that Asian Americans report higher levels of emotional suppression than Caucasians, it may be possible that Asian

Americans express their emotions not through dancing, yelling, or screaming, but expressing emotions through the love of food. A reflection of this may be seen at restaurants where many Chinese dishes are meant to be shared while many items on an

American menu are meant to be ordered individually. Socializing and eating are tightly connected and studies have shown that more food are eaten at meals with familiar and friendly people because these people help make the meal more enjoyable (Wansink, 59

2004). Instead of giving hugs or kisses, buying, eating, and sharing food may serve as the normal expression of emotion in Asian Americans.

Additionally, data for this study was collected mainly from Case Western Reserve

University which is located within 10 to 15 minutes from numerous Asian supermarkets,

Asian restaurants including dim sum, and Asian cafes that serve traditional Asian pastries, bubble tea, and desserts. The convenience of Asian supermarkets allows Asian populations the possibility of keeping the Asian tradition, especially as it pertains to food, in their daily life. These Asian supermarkets provide traditional foods and special seasonings such as whole roast duck, kimchi, mochi ice cream, and star anise that are typically not found in other grocery stores. While acculturation is a multidimensional process that is dynamic and complex (Satia, 2003; Satia et al., 2001), eating habits are often one of the last traditions to change (Lee, Sobal, & Frongillo, 1999). While Korean

Americans and Chinese Americans tend to eat American breakfasts and lunches more frequently than traditional meals, both groups tended to retain their traditional Korean and Chinese meals, respectively, for dinner (Lee, Sobal, & Frongillo, 2000; Pan, Dixon,

Himburg, & Huffman, 1999). Moreover, for Korean Americans, eating Korean meals had higher emotional attachment (Lee et al., 1999). With the convenience and abundance of Asian restaurants, cafes, and groceries that provided traditional Asian meals and snacks, Asian students at this particular university were potentially able to obtain traditional foods that have a high emotional attachment that was in stark contrast to

American food. It may be possible that the Asian group in this study rated themselves as emotionally eating more than their Caucasian counterparts because the dinner meal may be a meal with high emotional attachment that is typically not seen in Caucasians on a 60 regular meal to meal basis. In addition, Asians may significantly eat more to positive emotions than Whites because each trip to the Asian market and each traditional meal that the Asians eat and/or make may have much greater emotional attachment due to the greater difficulty, possibly, of attaining traditional Asian food from one’s foreign country or when one is living at home with their family.

Another important finding in this study is that females were found to significantly eat more to emotions than males. Females not only had higher general levels of emotional eating compared to males, but also higher levels of eating in response to frustration and depressed mood. The majority of emotional eating studies consist of a female only sample (Nguyen-Rodriquez, Unger, & Spruijt-Metz., 2009). However, for studies that include both genders, findings on sex differences have been mixed. Some studies found females reporting higher levels of emotional eating than males (Braet et al.,

2008; Tanofsky-Kraff et al., 2007) while a number of studies failed to find any sex differences in levels of emotional eating (Braet & van Strien, 1997; Caccialanza et al.,

2004; Nguyen-Rodriquez et al., 2009). Emotional eating has been identified as a factor triggering binge eating in bulimia nervosa (BN) (Engelberg et al., 2007), binge eating disorder (BED) (Dingemans et al., 2009; Pinaquy et al., 2003; Masheb & Grilo, 2006;

Stein et al., 2007), and anorexia nervosa (AN) (Ricca et al., 2012). All of these eating disorders have a much greater prevalence in women than in men (Dingemans et al., 2009;

Ricca et al., 2012). Likewise, research into the psychological well-being of normal weight female adults finds that females often show similar psychological symptoms to patients with an eating disorder. In a self-report study of 127 normal weight female adults, high levels of emotional eating were associated with low psychological well- 61 being, low self-esteem, body image vulnerability, and feelings of inadequacy (Lindeman

& Stark, 2001); these symptoms are the same ones seen in underlying eating disorders.

Based on the results of the present study, females may be more vulnerable to emotional eating.

Lastly, findings from this study indicate that the greater the perceived warmth of the individuals’ father growing up, the lesser the use of avoidant coping. Likewise, individuals that perceived their father to be more controlling were more likely to use greater amounts of avoidance coping. Parental bonding with the individuals’ parents early in life is associated with the ability to cope supports the previous literature (Adlaf et al., 2001). The development of a secure relationship between child and parent impacts the child’s interaction with the environment such as exploring and discovering his surroundings, development of skills, and self-confidence (Ainsworth, 1985).

Interestingly, in the present study, this relationship was only found in the perceived parental bonding in fathers, not mothers. In a recent study (Kochanska & Kim, 2013), researchers examined the effect of the parent child relationship and how this relationship may be associated with aggressive, troubled, or negative emotional behavior in middle childhood. A secure attachment with at least one parent was shown to be a protective factor against negative behavior and that secure attachment with two parents did not add a protective effect beyond the security of one (Kochanska & Kim, 2013). Furthermore, it didn’t matter whether the secure attachment was with the mother or the father. This was unique and according to the authors, this was likely due to the fact that fathers have just recently become increasingly more involved in caregiving (Kochanska & Kim, 2013).

Thus, while prior studies (Main & Weston, 1981; Suess, Grossmann, & Sroufe, 1992) 62

found the primacy of the mother as the attachment figure, it is possible that the increased

involvement of fathers in caregiving has decreased this primacy effect.

In addition, the effects of parental bonding with the mother and the father may

have unique effects depending on age of the child. Maternal parental bonding may be

more influential during grade school years while paternal parental bonding may be more

influential during later years of independence. Some studies have indicated that

compared to mothers, fathers tend to fill the role of a playmate rather than a caregiver

role for their children (Cabrera, Tamis-LeMonda, Bradley, Hofferth, & Lamb, 2000). In

addition, studies have found that fathers are more likely than mothers to encourage risk-

taking and exploration in their children (Paquette, 2004). Thus, while the results of this

study found a link between individuals that perceived their father to be warm and less

controlling and the use of avoidance coping as a method of dealing with stress while at

college, there was not a significant and meaningful relationship between perceived

maternal bonding and coping style.

All in all, gender, race, socially supported coping, and avoidance coping accounted for 30% of the explained variance in emotional eating. The R-square change

indicates that 15.9% of the variance in the dependent variable can be explained by

socially supported coping and avoidance coping. Avoidance coping and emotional eating

are similar in that both temporarily increase mood and both do not actively solve the root

of the stressor. In addition, socially supported coping encompasses many aspects of

emotional coping and thus, like emotionally eating, is based on reducing negative

emotion or increasing positive emotion. Perceived parental bonding and level of

adjustment to college were not predictors of emotional eating. However, the lack of a 63

significant finding may be due to the retrospective nature of the parental bonding report

or that emotional eating in college is influenced by other factors. While research

suggests a link between emotional eating and parenting style while the child and

adolescent are living at home (Schuetzmann et al., 2008; Snoek, et al., 2007; Topham et

al., 2011), results from the present study suggests that the influence from parents as it is

related to emotional eating may not persist once individuals live outside of the home.

Given that college students spend most of their time with their roommate(s) and friends,

emotional eating may be influenced by people that immediately surround them. The lack

of a relationship between the level of adaptation to college and emotional eating was also

unexpected too. It may be possible that level of adaptation to college and emotional eating are related, but that this relationship cannot be captured cross-sectionally at one

time point. Additionally, all of the data was collected during the fall semester. By

measuring one’s emotional eating and level of adaptation to college longitudinally over

time, it is possible that this relationship can be captured.

Limitations and Future Directions

Data from this study was obtained from an online self-report study which may be

limited in some ways. In addition, the measure of perceived parental bonding did not

have a parent report to verify the individual’s perception. Furthermore, while the study

asked individuals to report their race, there was no method to distinguish whether individuals were born in the United States, fully acculturated, or those who still had a strong ethnic identity as the analysis into possible ethnic differences was not one of the initial hypothesis. An additional measure such as the Multigroup Ethnic Identity

Measure would strengthen this study in the future. Because this study did not intend to 64

examine cultural differences in emotional eating in detail, no data were collected beyond

the standard races. However, the term Asian encompasses a vast number of ethnic

identities from India, Vietnam, China, Taiwan, and Japan to name a few. All of these

countries have markedly different cultures. Results from the exploratory analysis finding

that Asian college students significantly emotionally ate more than White college

students can be further researched in future studies by adding an ethnic identity measure

and more precisely ascertaining the country of origin. Moreover, while fliers to recruit

individuals to participate in the study were posted throughout the campus, the vast

majority of participants were recruited from the Psychology 101 pool. Thus, results from

the present study cannot be generalized to the general population. Lastly, because

findings consisted of correlations between measures from a cross-sectional data set, the

results should be interpreted with caution.

Research into emotional eating spans numerous fields including genetics,

psychology, biology, sociology, and anthropology. Spanning multiple fields of study,

there are many factors that are associated with emotional eating. While this study was

not able to capture the full picture of emotional eating due to its complexity, future

research should continue to clarify important questions. A further examination into the cultural differences and level of acculturation among students would help clarify

racial/ethnic differences in emotional eating. In addition, an investigation into why emotional eating is an index of negative eating behavior that leads to negative health for some individuals and yet, it is not for others. Moreover, research in emotional eating should examine not only negative emotions, but also positive emotions since studies have shown that eating is associated with positive moments such as celebrations. While this 65 particular study attempted to explore emotional eating to positive emotions, a study that specifically looks into positive emotions would be beneficial. Furthermore, although the present study did not allow for the parents to also be a part of the study, future studies may benefit from having the parents’ perspective too whether it is their perceived views of their own parenting or their own levels of emotional eating. Lastly, future research into parental bonding, coping style and emotional eating should be done in a longitudinal fashion to better capture the influence of the child-parent dynamic on adult coping style and emotional eating. Therapy should focus on improving coping strategies and the reduction of maladaptive strategies.

66

Table 1. Sample Descriptives n=173 n % Sex Male 72 41.6 Female 101 58.4

Academic Standing Freshman 78 45.1 Sophomore 52 30.1 Junior 22 12.7 Senior 21 12.1

Current Living Situation Dorm 150 86.7 Off-campus 18 10.4 Greek 5 2.9

Number of Roommates 0 33 19.1 1 86 48.7 2 7 4 3 16 9.2 4 7 4 5 23 13.3 8 1 0.6

Race Hispanic or Latino 1 0.6 Asian 55 31.8 Black or African American 9 5.2 Native Hawaiian or Other Pacific 1 0.6 Islander White 100 57.8 American Indian and White 4 2.3 Asian and White 2 1.2 Asian and Black 1 0.6

Taken meds past 30 days? Yes 71 41 No 99 57.2

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Table 2. Medications Taken in Past 30 Days from Participants in Study Male (n) Female (n) Total (n) % of Total Sample Birth Control Medication 0 51 51 29.48 Asthma Medication 3 2 5 2.89 Antibiotics 2 2 4 2.31 Anti-inflammatory Medication 12 10 22 12.72 Allergy Medication 4 3 7 4.05

Table 3. The COPE Subscales as used in the Current Study Factors in Coping Subscale Self-sufficient Active Coping Planning Suppression of Competing Activities Restraint Coping Religion Positive Reinterpretation and Growth Acceptance Humor

Socially-supported Seeking Social Support for Emotional Reasons Seeking Social Support for Instrumental Reasons Venting of emotions

Avoidant Coping Denial Behavior Disengagement Mental Disengagement Substance Use

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Table 4 Normality Variable Skewness Kurtosis Mother Care* -3.40 -1.78 Mother Control 1.42 -0.22 Father Care 2.59 -1.02 Father Control -1.06 -1.31 EES Frustration 1.48 -1.81 EES Anger 1.36 -1.26 EES Depression .52 -1.44 EES Total .52 -1.92 SACQ Full -1.36 1.36 SACQ Academic -1.27 2.05 SACQ Social* 2.73 3.38 SACQ Personal -0.36 2.39 SACQ Attach -3.62 0.95 COPE Self 0.55 -0.21 COPE Social 0.99 0.96 COPE Avoid* 3.81 0.51 *. Variable = non-normal distribution

Table 5. Non-normal Distribution Log Transformation Variable Skewness Kurtosis SACQ Attach -2.06 .54 Maternal Care -3.24 -1.32 COPE Avoid 1.69 -1.02 SACQ_Social .74 1.14

69

Table 6. Gender Independent T-test IV Sex n Mean SD t df p-value EES Frustration* M 71 20.65 8.02 -2.32 166 0.02 F 97 23.53 7.89 EES Anxiety M 72 17.85 7.05 -1.81 169 0.07 F 99 19.69 6.21 EES Depression** M 72 12.11 4.53 -3.48 170 0.001 F 100 14.45 4.22 EES Total* M 71 50.55 17.95 -2.65 163 0.01 F 94 57.65 16.33 EES Positive M 69 3.61 3.19 .49 167 0.62 F 100 3.38 2.77 SACQ Full** M 72 338.79 15.79 -3.91 171 0.00 F 101 348.12 15.21 SACQ Academic* M 72 120.28 8.68 -2.01 171 0.05 F 101 122.89 8.26 SACQ Social M 72 96.25 8.91 -.62 171 0.54 F 101 97.10 8.82 SACQ Personal M 72 71.33 7.55 -1.89 171 0.06 F 101 73.67 8.35 SACQ Attach** M 72 82.70 10.65 -2.59 171 0.01 F 101 86.75 9.73 COPE Self M 69 78.43 13.74 -.86 155 0.39 F 88 80.36 14.26 COPE Social** M 68 26.35 7.43 -5.19 157 0.00 F 91 32.76 7.89 COPE Avoid M 70 28.23 7.28 .261 164 0.80 F 96 27.97 5.57 Mother Care* M 68 26.28 6.44 -2.16 164 0.03 F 98 28.54 6.76 Mother Control* M 71 17.06 7.63 1.95 165 0.05 F 96 14.77 7.36 Father Care** M 68 21.43 7.95 -4.21 162 0.00 F 96 26.80 8.12 Father Control M 69 13.73 6.53 .07 167 0.95 F 100 13.66 7.87 Note. *. Significant at the 0.05 level (2-tailed) **. Significant at the 0.01 level (2-tailed) A. Scores range from 0 – 44 on EES Frustration, 0 – 36 on EES Anxiety, 0 – 20 on EES Depression, and 0 – 100 on EES Total (EES Positive not included). Scores range from 0 – 12 on EES positive (exploratory). Higher scores indicate greater emotional eating. B. Scores range from 24 - 216 on SACQ Academic, 20 – 180 on SACQ Social, 15 – 135 on SACQ Personal, 15 – 135 on SACQ Attach, and 67 – 603 on SACQ Full. Higher scores indicate better adjustment. C. Scores range from 32 – 128 on COPE Self, 16 – 64 on COPE Avoid, and 12 – 48 on COPE Social. Higher scores indicate greater use of the specific coping style. D. Scores range from 0 – 36 on Mother Care and Father Care. Scores range from 0 – 39 on Mother Control and Father Control. Higher scores on care suggest greater warmth and care. Higher scores on control reflects greater control. 70

Table 7. Coping Styles and Parental Bonding Mother Mother Father Father COPE COPE COPE Care Control Care Control Self Social Avoid Mother Care ----- Mother Control -.54** ----- Father Care .57** -.37** ----- Father Control -.36** .42** -.40* ----- COPE Self .08 .01 .16* -.01 ----- COPE Social .08 -.11 .15 -.03 .32** ----- COPE Avoid -.24** .18* -.30** .44** .12 .04 ----- Note: *. Correlation is significant at the 0.05 level (2-tailed) **. Correlation is significant at the 0.01 level (2-tailed) Bold: Significant at p < 0.01, r > 0.3 and used in analysis

Table 8. Coping Style and Adjustment to College SACQ SACQ SACQ SACQ SACQ COPE COPE COPE Social Full Person Academic Attach Self Social Avoid SACQ Social ----- SACQ Full 0.48** ----- SACQ -0.17* 0.41** ----- Personal SACQ 0.06 0.54** ----- Academic SACQ 0.40** 0.61** -0.13 0.09 ----- Attach COPE Self -0.02 0.06 -0.16* 0.03 0.18* ----- COPE Social 0.03 0.20* 0.01 0.12 0.18* 0.32** ---- COPE Avoid -0.17* - -0.08 0.12 - 0.12 0.04 ---- 0.25** 0.23** Note: *. Correlation is significant at the 0.05 level (2-tailed) **. Correlation is significant at the 0.01 level (2-tailed) Bold: Significant at p < 0.01, r > 0.3 and used in analysis

71

72

Table 10. Coping and Emotional Eating Correlation M +F COPE COPE COPE EES EES EES EES EES Self Social Avoid Anxiety Frustration Depression Total Positive COPE ----- Self COPE .32** ----- Social COPE .12 .04 ----- Avoid EES .10 .21** .29** ----- Anxiety EES .08 .27** .36** .82** ----- Frustration EES .10 .31** .21** .61** .61** ----- Depression EES .10 .30** .34** .93** .94** .79** ----- Total EES .13 .06 .03 .52** .55** .25** .53** ----- Positive Note: *. Correlation is significant at the 0.05 level (2-tailed) **. Correlation is significant at the 0.01 level (2-tailed) Bold: Significant at p < 0.01, r > 0.3 and used in analysis

Table 11. Coping and Emotional Eating Correlation M COPE COPE COPE EES EES EES EES EES Self Social Avoid Anxiety Frustration Depression Total Positive COPE ----- Self COPE .39** ----- Social COPE .01 .24* ----- Avoid EES .02 .28* .32** ----- Anxiety EES .02 .36** .40** .87** ----- Frustration EES -.02 .30* .30* .61** .62** ----- Depression EES .01 .34** .39** .95** .95** .79** ----- Total EES .24 .10 .06 .52** .49** .24** .48** ----- Positive Note: *. Correlation is significant at the 0.05 level (2-tailed) **. Correlation is significant at the 0.01 level (2-tailed) Bold: Significant at p < 0.01, r > 0.3 and used in analysis 73

Table 12. Coping and Emotional Eating Correlation F COPE COPE COPE EES EES EES EES EES Self Social Avoid Anxiety Frustration Depression Total Positive COPE ----- Self COPE .26* ----- Social COPE .24* -.13 ----- Avoid EES .15 .10 .27** ----- Anxiety EES .11 .12 .35** .77** ----- Frustration EES .16 .18 .14 .54** .58** ----- Depression EES .15 .15 .32** .90** .93** .76** ----- Total EES .04 .00 .02 .55** .65** .31** .61** ----- Positive Note: *. Correlation is significant at the 0.05 level (2-tailed) **. Correlation is significant at the 0.01 level (2-tailed) Bold: Significant at p < 0.01, r > 0.3 and used in analysis

74

Table 13. Asian vs. White Independent T-Test IV Race n Mean SD t df p-value EES Frustration** A 54 13.11 7.77 2.60 148 0.01 W 96 9.71 7.65 EES Anxiety** A 54 11.72 6.28 2.57 151 0.01 W 99 8.90 6.59 EES Depression A 54 9.24 4.27 1.58 152 0.12 W 100 8.02 4.73 EES Total** A 54 34.02 16.43 2.58 145 0.01 W 95 26.50 17.15 EES Positive** A 52 4.44 3.16 3.28 149 0.001 W 99 2.81 2.77 SACQ Full* A 55 340.06 14.76 -2.03 153 0.04 W 100 345.57 16.79 SACQ Academic A 55 121.82 6.65 .31 153 0.76 W 100 121.39 9.09 SACQ Social A 55 95.02 8.59 -1.52 153 0.13 W 100 97.28 9.01 SACQ Personal A 55 72.55 7.23 -.04 153 0.97 W 100 72.60 8.34 SACQ Attachment** A 55 80.96 9.96 -3.62 153 0.00 W 100 87.14 10.28 COPE Self A 52 80.96 12.84 1.63 139 0.11 W 89 87.14 14.12 COPE Social A 49 29.31 7.02 -.63 139 0.53 W 92 30.23 8.91 COPE Avoid A 54 28.76 6.72 1.05 143 0.30 W 96 27.63 6.14 Mother Care** A 52 24.58 6.86 -4.13 146 0.00 W 96 29.13 6.14 Mother Control** A 54 19.17 6.73 4.38 149 0.00 W 97 13.75 7.57 Father Care* A 54 22.72 7.83 -2.08 146 0.04 W 94 25.65 8.49 Father Control** A 54 15.63 6.90 2.70 149 0.01 W 97 12.32 7.40 Note. *. Significant at the 0.05 level (2-tailed) **. Significant at the 0.01 level (2-tailed) E. Scores range from 0 – 44 on EES Frustration, 0 – 36 on EES Anxiety, 0 – 20 on EES Depression, and 0 – 100 on EES Total (EES Positive not included). Scores range from 0 – 12 on EES positive (exploratory). Higher scores indicate greater emotional eating. F. Scores range from 24 - 216 on SACQ Academic, 20 – 180 on SACQ Social, 15 – 135 on SACQ Personal, 15 – 135 on SACQ Attach, and 67 – 603 on SACQ Full. Higher scores indicate better adjustment. G. Scores range from 32 – 128 on COPE Self, 16 – 64 on COPE Avoid, and 12 – 48 on COPE Social. Higher scores indicate greater use of the specific coping style. H. Scores range from 0 – 36 on Mother Care and Father Care. Scores range from 0 – 39 on Mother Control and Father Control. Higher scores on care suggest greater warmth and care. Higher scores on control reflects greater control. 75

Table 14. Regression Coefficients b SE b β t p Model 1 Constant 14.75 7.518 1.962 0.052 Sex 8.123 2.743 .233 2.943 0.004 Asians 9.55 6.313 -0.349 1.513 0.133 Blacks 9.88 8.189 .129 1.207 0.229 Whites -2.2 6.068 -.063 -.363 0.717 Model 2 Constant -23.31 9.598 -2.428 0.016 Sex 4.698 2.698 .135 1.741 0.084 Asians 12.452 5.792 .334 2.150 0.033 Blacks 16.605 7.623 .216 2.178 0.031 Whites 2.065 5.583 .059 .370 0.712 Cope_Avoid .826 .163 .271 3.466 0.001 Cope_Social .547 .191 .303 4.259 0.0001

Table 15. Multiple Linear Regression Model Summary R2 Adj R2 R2 Change F Change Sig Model 1 .141 .117 .141 5.87 .0001 Model 2 .300 .270 .159 16.03 .0001

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77

Appendix A

Parental Bonding Inventory

78

Appendix B Student Adaptation to College Questionnaire

79

80

Appendix C EES – Revised We all respond to different emotions in different ways. Some types of feelings lead people to experience an urge to eat. Please indicate the extent to which the following feelings lead you to feel an urge to eat by checking the appropriate box.

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Appendix D

COPE Inventory

We are interested in how people respond when they confront difficult or stressful events in their lives. There are lots of ways to try to deal with stress. This questionnaire asks you to indicate what you generally do and feel, when you experience stressful events. Obviously, different events bring out somewhat different responses, but think about what you usually do when you are under a lot of stress.

Then respond to each of the following items by blackening one number on your answer sheet for each, using the response choices listed just below. Please try to respond to each item separately in your mind from each other item. Choose your answers thoughtfully, and make your answers as true FOR YOU as you can. Please answer every item. There are no "right" or "wrong" answers, so choose the most accurate answer for

YOU--not what you think "most people" would say or do. Indicate what YOU usually do when YOU experience a stressful event.

1 = I usually don't do this at all

2 = I usually do this a little bit

3 = I usually do this a medium amount

4 = I usually do this a lot

1. I try to grow as a person as a result of the experience.

2. I turn to work or other substitute activities to take my mind off things.

3. I get upset and let my emotions out. 82

4. I try to get advice from someone about what to do.

5. I concentrate my efforts on doing something about it.

6. I say to myself "this isn't real."

7. I put my trust in God.

8. I laugh about the situation.

9. I admit to myself that I can't deal with it, and quit trying.

10. I restrain myself from doing anything too quickly.

11. I discuss my feelings with someone.

12. I use alcohol or drugs to make myself feel better.

13. I get used to the idea that it happened.

14. I talk to someone to find out more about the situation.

15. I keep myself from getting distracted by other thoughts or activities.

16. I daydream about things other than this.

17. I get upset, and am really aware of it.

18. I seek God's help.

19. I make a plan of action.

20. I make jokes about it.

21. I accept that this has happened and that it can't be changed.

22. I hold off doing anything about it until the situation permits.

23. I try to get emotional support from friends or relatives.

24. I just give up trying to reach my goal.

25. I take additional action to try to get rid of the problem. 83

26. I try to lose myself for a while by drinking alcohol or taking drugs.

27. I refuse to believe that it has happened.

28. I let my feelings out.

29. I try to see it in a different light, to make it seem more positive.

30. I talk to someone who could do something concrete about the problem.

31. I sleep more than usual.

32. I try to come up with a strategy about what to do.

33. I focus on dealing with this problem, and if necessary let other things slide a little.

34. I get sympathy and understanding from someone.

35. I drink alcohol or take drugs, in order to think about it less.

36. I kid around about it.

37. I give up the attempt to get what I want.

38. I look for something good in what is happening.

39. I think about how I might best handle the problem.

40. I pretend that it hasn't really happened.

41. I make sure not to make matters worse by acting too soon.

42. I try hard to prevent other things from interfering with my efforts at dealing with this.

43. I go to movies or watch TV, to think about it less.

44. I accept the reality of the fact that it happened.

45. I ask people who have had similar experiences what they did.

46. I feel a lot of emotional distress and I find myself expressing those feelings a lot. 84

47. I take direct action to get around the problem.

48. I try to find comfort in my religion.

49. I force myself to wait for the right time to do something.

50. I make fun of the situation.

51. I reduce the amount of effort I'm putting into solving the problem.

52. I talk to someone about how I feel.

53. I use alcohol or drugs to help me get through it.

54. I learn to live with it.

55. I put aside other activities in order to concentrate on this.

56. I think hard about what steps to take.

57. I act as though it hasn't even happened.

58. I do what has to be done, one step at a time.

59. I learn something from the experience.

60. I pray more than usual.

85

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