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. Author manuscript; available in PMC: 2025 Jul 1.
Published in final edited form as: Int J Eat Disord. 2024 Apr 11;57(7):1609–1615. doi: 10.1002/eat.24217

Emotional Dysregulation Moderates the Relation Between Perceived Stress and Emotional Eating in Adolescent Military Dependents

Holly Spinner 1,2, Katherine A Thompson 1,2,*, Viviana Bauman 1,2, Jason M Lavender 1,2,3, Isabel Thorstad 1,2, Ruby Schrag 1,2, Tracy Sbrocco 5, Natasha A Schvey 4,5, Brian Ford 6, Caitlin Ford 7, Denise E Wilfley 8, Sarah Jorgensen 9, David A Klein 6,10, Jeffrey Quinlan 9, Jack A Yanovski 4, Mark Haigney 1,3, Marian Tanofsky-Kraff 1,4,5
PMCID: PMC11262967  NIHMSID: NIHMS1983766  PMID: 38600832

Abstract

Objective:

Adolescent children of U.S. service members (i.e., military-dependent youth) face unique stressors that increase risk for various forms of disinhibited eating, including emotional eating. Difficulties with adaptively responding to stress and aversive emotions may play an important role in emotional eating. This study examined emotion dysregulation as a potential moderator of the association between perceived stress and emotional eating in adolescent military dependents.

Method:

Participants were military-dependent youth (N=163, 57.7% female, Mage=14.5±1.6, MBMI-z=1.9±0.4) at risk for adult binge-eating disorder and high weight enrolled in a randomized controlled prevention trial. Prior to intervention, participants completed questionnaires assessing perceived stress and emotional eating. Parents completed a questionnaire assessing their adolescent’s emotion dysregulation. Moderation analyses were conducted using the PROCESS macro in SPSS and adjusted for theoretically relevant sociodemographic covariates.

Results:

The interaction between adolescent perceived stress and emotion dysregulation (parent-reported about the adolescent) in relation to adolescent emotional eating was found to be significant, such that higher emotion dysregulation magnified the association between perceived stress and emotional eating (p=.010). Specifically, examination of simple slopes indicated that associations between perceived stress and emotional eating were strongest for youth with above-average emotion dysregulation, and non-significant for youth with average or below-average emotion dysregulation.

Discussion:

Findings suggest that greater emotion dysregulation may increase risk for emotional eating in response to stress among military-dependent youth at risk for binge-eating disorder or high weight. Improving emotion regulation skills may be a useful target for eating disorder prevention among youth who are at risk for emotional eating.

Public Significance:

Prior research has shown that adolescent military dependents are at increased risk for eating disorders and high weight. The current study found that emotion dysregulation moderated the relationship between perceived stress and emotional eating among military dependent youths. There may be clinical utility in intervening on emotion regulation for adolescent dependents at particular risk for emotional eating and subsequent eating disorders.

Keywords: military dependents, adolescents, emotional eating, emotion dysregulation, perceived stress

Adolescent military dependents (i.e., children of military service members) face unique stressors that impact the entire family unit (Wadsworth et al., 2022), including parental deployments and frequent relocations, and are at increased risk for emotional distress (Cramm et al., 2019; Gorman et al., 2009). Additionally, military-dependent youth are at elevated risk for disinhibited eating, which encompasses a variety of eating behaviors characterized by a lack of restraint over eating (Read & McComiskey, 2021; Schvey et al., 2015; Shomaker et al., 2011; Swanson et al., 2011; Waasdorp et al., 2007). One form of disinhibited eating that may be especially salient for adolescents is emotional eating (i.e., eating in response to affective states), which is linked to a variety of health concerns (e.g., depression, anxiety, insulin resistance; Arexis et al., 2023; Evgin & Kılıç, 2022; Goossens et al., 2008; Zhang et al., 2023), disordered eating cognitions and behaviors, and onset of binge eating (Allen et al., 2008; Stice et al., 2002). Thus, there is a need to better understand factors that may contribute to emotional eating in military-dependent youth.

Affect-oriented theories posit that aversive internal experiences, (e.g., stress, negative emotions) can prompt disinhibited eating behaviors such as emotional eating, which may function as maladaptive coping or affect regulation strategies (Heatherton & Baumeister, 1991; Leehr et al., 2015; Polivy & Herman, 1993). Consistent with such theories, stress has been shown to prospectively predict emotional eating in children (Michels et al., 2015). Moreover, higher levels of cortisol reactivity, a physiological marker of stress, are associated with greater emotional eating in adolescents (Sato et al., 2023). Additionally, adolescents with higher weight may be particularly vulnerable to engaging in emotional eating in response to stress (Kubiak et al., 2008). Therefore, adolescent military dependents with higher weight may be at especially increased risk for emotional eating.

Emotion dysregulation (i.e., difficulties responding to/modulating emotional responses; Gross & Jazaieri, 2014) is linked to emotional eating in adolescents and adults (e.g., Gouveia et al, 2019; Michopoulos et al., 2015). Among adolescents, use of maladaptive emotion regulation strategies is positively associated with emotional eating (Vandewalle et al., 2016), and adaptive emotion regulation prospectively predicts less emotional eating (Shriver et al., 2019). Consistent with affect theories, individuals with greater emotion dysregulation may be more likely to engage in maladaptive behaviors such as emotional eating in response to stress.

Despite evidence that military-dependent youth have increased vulnerability to stress (Cramm et al., 2009; Gorman et al., 2009), difficulty regulating emotions (Chandra et al., 2010; Esposito-Smythers et al., 2011), and risk for emotional eating (Pine at al., 2020), data on associations among these constructs in this population are lacking. Therefore, we examined emotion dysregulation (parent-reported about the adolescent) as a potential moderator of the relationship between adolescent perceived stress and emotional eating in military-dependent adolescents at risk for binge-eating disorder and higher weight in adulthood. We hypothesized the relationship would be most robust among adolescents with greater emotion dysregulation.

Methods

Participants

Adolescent military dependents, aged 12–17 years, at risk for adult binge-eating disorder and high weight were recruited for a multisite randomized controlled prevention trial at the Uniformed Services University (Bethesda, MD) and Ft. Belvoir Community Hospital (Fort Belvoir, VA; ClinicalTrails.gov identifier: NCT02671292). Baseline data from the study sample have been previously published (e.g., Higgins Neyland et al., 2020; Higgins Neyland et al., 2021; Pearlman et al., 2020), but have not addressed perceived stress and emotion dysregulation in relation to emotional eating.

Participants were classified as at-risk based upon body mass index (BMI) ≥ 85th percentile for age and sex. Additionally, given the intervention (interpersonal psychotherapy) targets loss-of-control-eating (i.e., the experience of feeling unable to stop eating regardless of the amount of food consumed; LOC) and appeared most effective for youth with elevated anxiety in prior studies (Tanofsky-Kraff et al., 2010; Tanofsky-Kraff et al., 2014; Tanofsky-Kraff et al., 2017), the current study recruited youth with either ≥ one LOC-eating episode during the previous three months OR elevated anxiety symptoms (≥ 32 on the Trait subscale of the State-Trait Anxiety Inventory for Children; Spielberger, 1973).

Recruitment efforts included direct mailings, provider referrals, flyers posted at clinics and local military facilities, and online advertisements.

Exclusion criteria included any major medical problem, severe psychiatric disorders (e.g., psychosis, substance use disorders, active suicidal ideation) that may have impeded participation (for which 17 adolescents were excluded), weight loss > 3% of initial body weight within the past three months, current involvement in psychotherapy or a structured weight loss program, use of medications affecting mood, appetite, or body weight (unless they were on a stable dose for at least three months), or current or recent pregnancy (within one-year postpartum). In total, 32 adolescents were excluded for the following reasons: no LOC eating or anxiety (n=10), psychiatric disorders or referral to outside treatment (n=17), disqualifying medical conditions (n=2), inability to complete study procedures due to logistical concerns (n=1), and incomplete baseline data where eligibility could not be determined (n=2). Binge-eating disorder was not exclusionary, though no participant in the current sample met full-threshold criteria as assessed by the Eating Disorder Examination v14.0 OD/C.2 (Fairburn & Cooper, 1993).

The current study is cross-sectional and used data completed prior to enrollment in the interventions. Parents and adolescents provided written informed consent and assent, respectively. Demographic data were determined by parental report. The study was approved by the Uniformed Services University Institutional Review Board and the Ft. Belvoir Community Hospital research office.

Measures

Emotional Eating

The Emotional Eating Scale for children and adolescents (EES-C; Tanofsky-Kraff et al., 2007) is a 25-item questionnaire assessing tendency to experience urges to eat in response to specific emotions (with no time frame specified). Items are rated on a 5-point Likert-type scale and averaged to produce a total and three subscale scores. Given the total and subscales scores were highly correlated (rs≥.90, ps<.001), the total score (α=.95 in this sample) was examined.

Perceived Stress

The Perceived Stress Scale-14 (PSS-14; Cohen et al., 1983) is a 14-item questionnaire assessing perceptions of life situations as stressful during the past month. Items are rated on a 5-point Likert-type scale and summed to provide a total score (α=.78 in this sample).

Emotion Dysregulation

The Child Behavior Checklist (CBCL; Achenbach & Rescorla, 2001) is a parent-report questionnaire assessing emotional and behavioral problems in youth using a 3-point Likert-type scale. The Dysregulation Profile (CBCL-DP; Holtmann et al., 2011) measures adolescent emotion dysregulation, and was calculated as the sum of the T-scores of three syndrome scales: anxious/depressed, attention problems, and aggressive behaviors.

Covariates

Given LOC-eating frequency (sum of objective and subjective binge-eating episodes assessed using the Eating Disorder Examination; Fairburn & Cooper, 1993) and anxiety were inclusion criteria, they were evaluated as covariates. Given emotional eating may differ by sex (Tanofsky-Kraff et al., 2007), age (Ashcroft et al., 2008; Webb et al., 2021), and race/ethnicity (Kazmierski et al., 2021), these variables were also evaluated as covariates.

Analyses

Participants whose parents completed the CBCL were included in current analyses. Data were evaluated for normality using tests of skewness and kurtosis and visual inspection of histogram plots. Little’s Missing Completely at Random test (Little, 1988) revealed 1–8% of the data was missing, yet missing completely at random. Regression analyses were conducted using the PROCESS macro (Hayes, 2022) in SPSS to evaluate conditional effects of the independent variable (perceived stress) on the dependent variable (emotional eating) at three levels of the potential moderator (16th percentile, mean, 84th percentile); these common statistical cut points were selected given there are no clinical cutoffs or relevant norms for the CBCL-DP (Faraone et al., 2005). The EES-C total score was entered as the dependent variable, and PSS-14 and CBCL-DP scores (mean-centered to account for multicollinearity) were entered as main effects. Finally, a two-way interaction term (PSS-14 x CBCL-DP) was entered. Sex assigned at birth (0=female, 1=male), trait anxiety, and LOC-eating frequency (log transformed) were included as covariates. Given sample size demographic considerations, race was dichotomized (0=non-white; 1=white). Preliminary analyses revealed that BMI-z, race, ethnicity, and age were not correlated with the EES-C total score on a univariate level (ps>.05) and were thus excluded from the final model for parsimony. A series of t-tests and chi-square analyses were conducted to determine if there were significant differences between adolescents included versus excluded from the current analyses (due to availability of parent-completed CBCL data; see Appendix A).

Results

Participants were 163 adolescent military dependents with an average age of 14.5 (SD=1.6) years and a mean BMI-z of 1.9 (SD=0.4). From parent-reported demographics, 57.7% of participants were female, 46.0% were Non-Hispanic White, 22.1% were Non-Hispanic Black, 19.6% were Hispanic or Latine, 3.7% were Asian/Pacific Islander, and 14.7% reported mixed race, other, or were unknown. Mean scores were 163.64 (SD=15.94) for the CBCL-DP, 26.36 (SD=7.44) for the PSS-14, and 1.15 (SD=0.77) for the EES-C total score. The two-way interaction between perceived stress and emotion dysregulation for emotional eating was significant (Table 1). Simple slopes analyses revealed the association between perceived stress and emotional eating was significant for adolescents with above-average emotion dysregulation (b=.03, p=.007; see Figure 1), but not average (p=.458) or below-average (p=.747) dysregulation. Results of supplementary analyses examining the EES-C subscales are presented in Appendix A.

Table 1.

Hierarchical Regression Analyses Examining the Interaction between Perceived Stress and Emotion Dysregulation in Relation to Emotional Eating

Emotional Eating
B SE B β t (dfs) ΔR2
Step 1 .26
Sex −0.25 0.12 −0.16 t(140) = −2.13, p = .035
Trait Anxiety 0.04 0.01 0.31 t(140) = 4.10, p < .001
LOC-Eating 0.57 0.12 0.34 t(140) = 4.66, p < .001
Step 2 .02
Perceived Stress 0.01 0.01 0.12 t(138) = 1.48, p = .141
Emotion Dysregulation 0.01 0.004 0.11 t(138) = 1.56, p = .122
Step 3 .03
Perceived Stress × Emotion Dysregulation 0.001 <0.001 2.06 t(137) = 2.60, p = .010
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Note. Sex was parent-reported and coded as: 0=female, 1=male. Trait anxiety=Trait subscale of the State-Trait Anxiety Inventory for Children. LOC-Eating=loss-of-control-eating frequency in the past three months. LOC-eating was log transformed for analyses. Perceived stress=Perceived Stress Scale-14. Emotion dysregulation=Child Behavior Checklist-Dysregulation Profile. Total emotional eating was derived from the Emotional Eating Scale for children and adolescents.

Figure 1:

Figure 1:

Open in a new tab

Two-way interaction between perceived stress and emotion dysregulation for emotional eating among military-dependent youth.

Discussion

Consistent with the hypothesis, the association between adolescent perceived stress and emotional eating was strongest for adolescent military dependents with above-average parent-reported emotion dysregulation. Although preliminary, these findings suggest that adaptive emotion regulation may buffer against negative impacts of stress on the risk for emotional eating among high-risk military-dependent youth. These results are consistent with previous findings indicating maladaptive emotion regulation is associated with emotional eating in adolescents (Czaja et al., 2009). Moreover, evidence suggests that interventions specifically targeting emotion regulation skills, such as dialectical behavioral therapy, may decrease emotional eating among adults with higher weight (Glisenti & Strodl, 2012). However, future research should examine this in adolescent military dependents.

A strength of the current study was the focus on a vulnerable, yet understudied population (i.e., military-dependent youth), for whom the incidence of eating disorders has increased in recent years (Thompson et al., 2023). Military dependents represent an important pool of military recruits as they are more likely to volunteer for service (Lewis et al., 2022), and eating disorders and/or high body weight (which are linked to emotional eating; Stice et al., 2002; Stojek et al., 2017) may preclude future military accession. Moreover, the sample was relatively large in size and racially/ethnically diverse.

Study limitations include the cross-sectional design, precluding causal and temporal conclusions regarding the observed associations. Moreover, while the approach to evaluating moderation in this study did not require temporal precedence (Hayes, 2022), other approaches have more conservative requirements (Kraemer et al., 2008). As such, the current cross-sectional findings should be considered preliminary and represent a first-step to guide future research examining associations among these constructs longitudinally and using different conceptual frameworks (e.g., mediation). Additionally, the selective sample limits generalizability to civilian adolescents and those with serious psychiatric disorders, some of which may co-occur with disordered eating (Brausch & Gutierrez et al., 2009; Solmi et al., 2018; Zaider et al., 2000). The size and sociodemographic distribution of the sample also precluded a more comprehensive consideration of potential racial/ethnic difference. Furthermore, the measure used in this study does not assess positive affective states; a limitation given that difficulties regulating positive emotions may contribute to binge eating in youth (Howells et al., 2024). Finally, emotion dysregulation was assessed via parent-report, and findings may differ using adolescent-report (Bunford et al., 2020). However, the CBCL-DP is predictive of a range of psychiatric problems (Althoff et al., 2010; Holtmann et al., 2011).

In conclusion, above-average emotion dysregulation (according to parent report) may increase risk for emotional eating in response to stress among adolescent military dependents at risk for excess weight gain or binge-eating disorder. Examining these associations prospectively will be an important step for future research. Replication of these findings with prospective data would support interventions seeking to enhance emotion regulation to reduce or prevent emotional eating in high-risk youth.

Supplementary Material

Supinfo

Funding Statement:

This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases [grant number 1R01DK104115-01 to MTK] and the Defense Health Agency [number HU00012120008 awarded to the Military Cardiovascular Outcomes Research Program, Uniformed Services University]. JAY is supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH [ZIAHD00641]. The funding sources had no involvement in study design, in the collection, analysis and interpretation of data, in the writing of the report, or in the decision to submit the article for publication. The opinions and assertions expressed herein are those of the author(s) and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences, NICHD, the United States Air Force, the United States Navy, or the Department of Defense.

Footnotes

COI Disclosure: We have no conflicts of interest to disclose. JAY is Principal Investigator for pharmacotherapy projects unrelated to this research that receive funding or research materials from Soleno Therapeutics, Rhythm Pharmaceuticals, Hikma Pharmaceuticals, and Versanis Bio.

Disclaimer: The opinions and assertions expressed herein are those of the author(s) and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences or the Department of Defense.

Data Availability Statement:

Data can be made available upon reasonable request.

References

  1. Achenbach TM, & Rescorla LA (2001). Manual for ASEBA school-age forms and profiles. University of Vermont Research Center for Children, Youth, & Families. [Google Scholar]
  2. Allen KL, Byrne SM, La Puma M, McLean N, & Davis EA (2008). The onset and course of binge eating in 8- to 13-year-old healthy weight, overweight and obese children. Eating Behaviors, 9(4), 438–446. 10.1016/j.eatbeh.2008.07.008 [DOI] [PubMed] [Google Scholar]
  3. Althoff RR, Verhulst FC, Rettew DC, Hudziak JJ, & van der Ende J (2010). Adult outcomes of childhood dysregulation: A 14-year follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry, 49(11), 1105–1116. 10.1016/j.jaac.2010.08.006 [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Arexis M, Feron G, Brindisi M-C, Billot P-É, & Chambaron S (2023). A scoping review of emotion regulation and inhibition in emotional eating and binge-eating disorder: What about a continuum? Journal of Eating Disorders, 11(197). 10.1186/s40337-023-00916-7 [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ashcroft J, Semmler C, Carnell S, van Jaarsveld CHM, & Wardle J (2008). Continuity and stability of eating behaviour traits in children. European Journal of Clinical Nutrition, 62(8), 985–990. 10.1038/sj.ejcn.1602855 [DOI] [PubMed] [Google Scholar]
  6. Brausch AM, & Gutierrez PM (2009). The role of body image and disordered eating as risk factors for depression and suicidal ideation in adolescents. Suicide and Life Threatening Behavior, 39(1), 58–71. 10.1521/suli.2009.39.1.58 [DOI] [PubMed] [Google Scholar]
  7. Bunford N, Dawson AE, Evans SW, Ray AR, Langberg JM, Owens JS, DuPaul GJ, & Allan DM (2020). The Difficulties in Emotion Regulation Scale–Parent Report: A psychometric investigation examining adolescents with and without ADHD. Assessment, 27(5), 921–940. 10.1177/1073191118792307 [DOI] [PubMed] [Google Scholar]
  8. Chandra A, Martin LT, Hawkins SA, & Richardson A (2010). The impact of parental deployment on child social and emotional functioning: Perspectives of school staff. Journal of Adolescent Health, 46(3), 218–223. 10.1016/j.jadohealth.2009.10.009 [DOI] [PubMed] [Google Scholar]
  9. Cohen S, Kamarck T, & Mermelstein R (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. 10.2307/2136404 [DOI] [PubMed] [Google Scholar]
  10. Cramm H, McColl MA, Aiken AB, & Williams A (2019). The mental health of military-connected children: A scoping review. Journal of Child and Family Studies, 28(7), 1725–1735. 10.1007/s10826-019-01402-y [DOI] [Google Scholar]
  11. Czaja J, Rief W, & Hilbert A (2009). Emotion regulation and binge eating in children. International Journal of Eating Disorders, 42(4), 356–362. 10.1002/eat.20630 [DOI] [PubMed] [Google Scholar]
  12. Esposito-Smythers C, Wolff J, Lemmon KM, Bodzy M, Swenson RR, & Spirito A (2011). Military youth and the deployment cycle: Emotional health consequences and recommendations for intervention. Journal of Family Psychology, 25(4), 497–507. 10.1037/a0024534 [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Evgin D, & Kılıç KM (2022). Relationship between healthy life awareness, emotional eating, obesity awareness, and coping stress in adolescents. Psychology in the Schools, 60(6), 1898–1917. 10.1002/pits.22834 [DOI] [Google Scholar]
  14. Fairburn CG, & Cooper Z (1993). The Eating Disorder Examination. In Fairburn CG & Wilson GT (Eds.), Binge eating, nature, assessment and treatment (Vol. 12, pp. 317–360). Guilford Press. [Google Scholar]
  15. Faraone SV, Althoff RR, Hudziak JJ, Monuteaux M, & Biederman J (2005). The CBCL predicts DSM bipolar disorder in children: A receiver operating characteristic curve analysis. Bipolar Disorders, 7(6), 518–524. 10.1111/j.1399-5618.2005.00271.x [DOI] [PubMed] [Google Scholar]
  16. Glisenti K, & Strodl E (2012). Cognitive behavior therapy and dialectical behavior therapy for treating obese emotional eaters. Clinical Case Studies, 11(2), 71–88. 10.1177/1534650112441701 [DOI] [Google Scholar]
  17. Goossens L, Braet C, Vlierberghe LV, & Mels S (2008). Loss of control over eating in overweight youngsters: The role of anxiety, depression and emotional eating. European Eating Disorders Review, 17(1), 68–78. 10.1002/erv.892 [DOI] [PubMed] [Google Scholar]
  18. Gorman GH, Eide M, & Hisle-Gorman E (2009). Wartime military deployment and increased pediatric mental and behavioral health complaints. Pediatrics, 126(6), 1058–1066. 10.1542/peds.2009-2856 [DOI] [PubMed] [Google Scholar]
  19. Gouveia MJ, Canavarro MC, & Moreira H (2019). Associations between mindfulness, self-compassion, difficulties in emotion regulation, and emotional eating among adolescents with overweight/obesity. Journal of Child and Family Studies, 28(1), 273–285. 10.1007/s10826-018-1239-5 [DOI] [Google Scholar]
  20. Gross JJ, & Jazaieri H (2014). Emotion, emotion regulation, and psychopathology: An affective science perspective. Clinical Psychological Science, 2(4), 387–401. 10.1177/2167702614536164 [DOI] [Google Scholar]
  21. Hayes AF (2022). Introduction to mediation, moderation, and conditional process analysis: A regression based approach. Guilford Press. [Google Scholar]
  22. Heatherton TF, & Baumeister RF (1991). Binge eating as escape from self-awareness. Psychological Bulletin, 110(1), 86–108. 10.1037/0033-2909.110.1.86. [DOI] [PubMed] [Google Scholar]
  23. Higgins Neyland MK, Shank LM, Burke NL, Schvey NA, Pine AE, Quattelbaum M, Leu W, Gilmore D, Morettini A, Wilfley DE, Stephens M, Sbrocco T, Yanovski JA, Jorgensen S, Klein DA, Olsen CH, Quinlan J, & Tanofsky-Kraff M (2020). Parental deployment and distress, and adolescent disordered eating in prevention-seeking military dependents. International Journal of Eating Disorders, 53(2), 201–209. 10.1002/eat.23180 [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Higgins Neyland MK, Shank LM, Lavender JM, Rice A, Schindler R, Hennigan K, Solomon S, Kroke P, Schvey NA, Sbrocco T, Wilfley DE, Jorgensen S, Yanovski JA, Olsen CH, Haigney M, Klein DA, Quinlan J, & Tanofsky-Kraff M (2021). Permanent change of station moves and disordered-eating attitudes and behaviors in prevention-seeking adolescent military-dependents. Eating Behaviors, 40. 10.1016/j.eatbeh.2020.101470 [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Holtmann M, Buchmann AF, Esser G, Schmidt MH, Banaschewski T, & Laucht M (2011). The Child Behavior Checklist-Dysregulation Profile predicts substance use, suicidality, and functional impairment: A longitudinal analysis. Journal of Child Psychology and Psychiatry, 52(2), 139–147. 10.1111/j.1469-7610.2010.02309.x [DOI] [PubMed] [Google Scholar]
  26. Howells RL, Dunn LC, & Carter JC (2024). The relationship between difficulties in the regulation of positive and negative emotions and binge-eating symptoms in young adults. Eating Behaviors, 52. 10.1016/j.eatbeh.2023.101839 [DOI] [PubMed] [Google Scholar]
  27. Kazmierski KFM, Gillespie ML, Kuo S, Zurita T, Felix D, & Rao U (2021). Stress-induced eating among racial/ethnic groups in the United States: A systematic review. Journal of Racial and Ethnic Health Disparities, 8(4), 912–926. 10.1007/s40615-020-00849-w. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Kraemer HC, Kiernan M, Essex M, & Kupfer DJ (2008). How and why criteria defining moderators and mediators differ between the Baron & Kenny and MacArthur approaches. Health Psychology, 27(2S), S101–S108. 10.1037/0278-6133.27.2(Suppl.).S101 [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Kubiak T, Vögele C, Siering M, Schiel R, & Weber H (2008). Daily hassles and emotional eating in obese adolescents under restricted dietary conditions—The role of ruminative thinking. Appetite, 51(1), 206–209. 10.1016/j.appet.2008.01.008 [DOI] [PubMed] [Google Scholar]
  30. Leehr EJ, Krohmer K, Schag K, Dresler T, Zipfel S, & Giel KE (2015). Emotion regulation model in binge eating disorder and obesity—A systematic review. Neuroscience and Biobehavioral Reviews, 49, 125–134. 10.1016/j.neubiorev.2014.12.008 [DOI] [PubMed] [Google Scholar]
  31. Lewis C, Bergmann A, & Farnsworth M (2022). The military teen experience 2022. [Google Scholar]
  32. Little RJA (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83(404), 1198–1202. 10.1080/01621459.1988.10478722 [DOI] [Google Scholar]
  33. Michels N, Sioen I, Boone L, Braet C, Vanaelst B, Huybrechts I, & Hanauw SD (2015). Longitudinal association between child stress and lifestyle. Health Psychology, 34(1), 40–50. 10.1037/hea0000108 [DOI] [PubMed] [Google Scholar]
  34. Michopoulos V, Powers A, Moore C, Villarreal S, Ressler KJ, & Bradley B (2015). The mediating role of emotion dysregulation and depression on the relationship between childhood trauma exposure and emotional eating. Appetite, 91, 129–136. 10.1016/j.appet.2015.03.036 [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Pearlman AT, Schvey NA, Higgins Neyland MK, Solomon S, Hennigan K, Schindler R, Leu W, Gillmore D, Shank LM, Lavender JM, Stephens M, Jorgensen S, Klein D, Quinlan J, & Tanofsky-Kraff M (2020). Associations between family weight-based teasing, eating pathology, and psychosocial functioning among adolescent military dependents. International Journal of Environmental Research and Public Health, 17(1). 10.3390/ijerph17010024 [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Pine AE, Shank LM, Burke NL, Neyland MKH, Schvey NA, Quattelbaum M, Leu W, Wilfley DE, Stephens M, Jorgensen S, Olsen CH, Sbrocco T, Yanovski JA, Klein DA, Quinlan J, & Tanofsky-Kraff M (2020). Examination of the interpersonal model with adolescent military dependents at high risk for adult obesity. The American Journal of Psychotherapy, 73(2), 43–49. 10.1176/appi.psychotherapy.20190034 [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Polivy J, & Herman CP (1993). Etiology of binge eating: Psychological mechanisms. In Fairburn CG & Wilson GT (Eds.), Binge eating: Nature, assessment, and treatment. (pp. 173–205). Guilford Press. [Google Scholar]
  38. Read AK, & McComiskey CA (2021). The implementation and evaluation of the SCOFF (sick, control, one stone, fat, food) eating disorder screening tool for children and adolescents. Pediatric Nursing, 47(3), 124–132. [Google Scholar]
  39. Sato AF, Darling KE, Ruzicka EB, Fahrenkamp AJ, Shields CV, West CE, & Schuler SM (2023). A biobehavioral examination of emotional eating in adolescents: Evaluating the role of acute cortisol stress reactivity in the context of a multi-method assessment of eating in response to stress. Appetite, 184, 1–10. 10.1016/j.appet.2023.106486 [DOI] [PubMed] [Google Scholar]
  40. Schvey NA, Sbrocco T, Stephens M, Bryant EJ, Ress R, Spieker EA, Conforte A, Bakalar JL, Pickworth CK, Barmine M, Klein D, Brady SM, Yanovski JA, & Tanofsky-Kraff M (2015). Comparison of overweight and obese military-dependent and civilian adolescent girls with loss-of-control eating. International Journal of Eating Disorders, 48(6), 790–794. 10.1002/eat.22424 [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Shomaker LB, Tanofsky-Kraff M, & Yanovski JA (2011). Disinhibited eating and body weight in youth. In Preedy V, Watson R, & Martin C (Eds.), Handbook of behavior, food and nutrition. Springer. 10.1007/978-0-387-92271-3_139 [DOI] [Google Scholar]
  42. Shriver LH, Dollar JM, Lawless M, Calkins SD, Keane SP, Shanahan L, & Wideman L (2019). Longitudinal associations between emotion regulation and adiposity in late adolescence: Indirect effects through eating behaviors. Nutrients, 11(3). 10.3390/nu11030517 [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Solmi F, Melamed D, Lewis G, & Kirkbride JB (2018). Longitudinal associations between psychotic experiences and disordered eating behaviours in adolescence: A UK population-based study. The Lancet Child & Adolescent Health, 2(8), 591–599. 10.1016/S2352-4642(18)30180-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Spielberger CD (1973). Manual for the State-Trait Anxiety Inventory for Children. Consulting Psychologists Press. [Google Scholar]
  45. Stice E, Presnell K, & Spangler D (2002). Risk factors for binge eating onset in adolescent girls: A 2-year prospective investigation. Health Psychology, 21(2), 131–138. 10.1037//0278-6133.21.2.131 [DOI] [PubMed] [Google Scholar]
  46. Stojek MMK, Tanofsky-Kraff M, Shomaker LB, Kelly NR, Thompson KA, Mehari RD, Marwitz SE, Demidowich AP, Galescu OA, Brady SM, Yanovski SZ, & Yanovski JA (2017). Associations of adolescent emotional and loss of control eating with 1-year changes in disordered eating, weight, and adiposity. International Journal of Eating Disorders, 50(5), 551–560. 10.1002/eat.22636. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Swanson SA, Crow SJ, Grange DL, Swendsen J, & Merikangas KR (2011). Prevalence and correlates of eating disorders in adolescents: Results from the national comorbidity survey replication adolescent supplement. Archives of General Psychiatry, 68(7), 714–723. 10.1001/archgenpsychiatry.2011.22 [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Tanofsky-Kraff M, Shomaker LB, Wilfley DE, Young JF, Sbrocco T, Stephens M, Brady SM, Galescu O, Olsen CH, Kozlosky M, Reynolds JC, & Yanovski JA (2017). Excess weight gain prevention in adolescents: Three-year outcome following a randomized controlled trial. Journal of Consulting and Clinical Psychology, 85(3), 218–227. 10.1037/ccp0000153 [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Tanofsky-Kraff M, Shomaker LB, Wilfley DE, Young JF, Sbrocco T, Stephens M, Ranzenhofer LM, Elliot C, Brady S, Radin RM, Vannucci A, Bryant EJ, Osborn R, Berger SS, Olsen C, Kozlosky M, Reynolds JC, & Yanovski JA (2014). Targeted prevention of excess weight gain and eating disorders in high-risk adolescent girls: A randomized controlled trial. The American Journal of Clinical Nutrition, 100(4), 1010–1018. 10.3945/ajcn.114.092536 [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Tanofsky-Kraff M, Theim KR, Yanovski SZ, Bassett AM, Burns NP, Ranzenhofer LM, Glasofer DR, & Yanovski JA (2007). Validation of the Emotional Eating Scale adapted for use in children and adolescents (EES-C). International Journal of Eating Disorders, 40(3), 232–240. 10.1002/eat.20362 [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Tanofsky-Kraff M, Wilfley DE, Young JF, Mufson L, Yanovski SZ, Glasofer DR, Salaita CG, & Schvey NA (2010). A pilot study of interpersonal psychotherapy for preventing excess weight gain in adolescent girls at-risk for obesity. International Journal of Eating Disorders, 43(8), 701–706. 10.1002/eat.20773 [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. Thompson KA, Bauman V, Sunderland KW, Thornton JA, Schvey NA, Moyer R, Sekyere NA, Funk W, Pav V, Brydum R, Klein DA, Lavender JM, & Tanofsky-Kraff M (2023). Incidence and prevalence of eating disorders among active duty US military-dependent youth from 2016 to 2021. International Journal of Eating Disorders, 56(10), 1973–1982. 10.1002/eat.24025 [DOI] [PubMed] [Google Scholar]
  53. Vandewalle J, Moens E, Beyers W, & Braet C (2016). Can we link emotional eating with the emotion regulation skills of adolescents? Psychology & Health, 31(7), 857–872. 10.1080/08870446.2016.1149586 [DOI] [PubMed] [Google Scholar]
  54. Waasdorp CE, Caboot JB, Robinson CA, Abraham AA, & Adelman WP (2007). Screening military dependent adolescent females for disordered eating. Military Medicine, 172(9), 962–967. 10.7205/MILMED.172.9.962 [DOI] [PubMed] [Google Scholar]
  55. Wadsworth SM, Whiteman S, Lester P, Stander V, & Christ S (2022). Parental deployment and military children: A century of research. In Glick JE, King V, & McHale SM (Eds.), Parent-Child Separation (Vol. 1). Springer, Cham. 10.1007/978-3-030-87759-0_7 [DOI] [Google Scholar]
  56. Webb HJ, Kerin JL, & Zimmer-Gembeck MJ (2021). Increases in emotional eating during early adolescence and associations with appearance teasing by parents and peers, rejection, victimization, depression, and social anxiety. The Journal of Early Adolescence, 41(5), 754–777. 10.1177/0272431620950469 [DOI] [Google Scholar]
  57. Zaider TI, Johnson JG, & Cockell SJ (2000). Psychiatric comorbidity associated with eating disorder symptomatology among adolescents in the community. International Journal of Eating Disorders, 28(1), 58–67. [DOI] [PubMed] [Google Scholar]
  58. Zhang Z, Li N, Buckley JP, Cecil KM, Chen A, Eaton CB, Kalkwarf HJ, Lanphear BP, Yolton K, & Braun JM (2023). Associations between eating behaviours and cardiometabolic risk among adolescents in the Health Outcomes and Measures of the Environment study. Pediatric Obesity, 18(2). 10.1111/ijpo.12979 [DOI] [PMC free article] [PubMed] [Google Scholar]

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Supplementary Materials

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NIHMS1983766-supplement-Supinfo.docx (29.1KB, docx)

Data Availability Statement

Data can be made available upon reasonable request.

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