Skip to main content
NCBI home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2016 Aug 1.
Published in final edited form as: Eat Behav. 2015 Apr 27;18:91–96. doi: 10.1016/j.eatbeh.2015.04.005

Delay discounting, but not disinhibition or inattention, partially mediates the effects of neuroticism on disordered eating in adolescents

Sneha Thamotharan 1, Meagan Hubbard 1, Sherecce Fields 1,*
PMCID: PMC4504812  NIHMSID: NIHMS694233  PMID: 26010818

Abstract

Adolescence represents an integral developmental period for the prevention and intervention of disordered eating. Individuals with high levels of neuroticism have been shown to respond with greater impulsivity and use of disordered eating as a coping mechanism. However, the exact mechanism through which neuroticism and impulsivity affect disordered eating remains unknown. To understand the effects of personality and impulsivity on disordered eating in adolescence, the present study aimed to investigate whether impulsivity mediated the relationship between neuroticism and disordered eating. Adolescents (N = 40) between the ages of 13 and 19 (Mage = 18.25 years; S.D. = 1.30) were queried on eating attitudes and personality, as well as completed behavioral tasks assessing impulsivity (delay discounting, disinhibition and inattention). Mediation analyses revealed that both neuroticism was significantly associated with patterns of disordered eating, but delay discounting, and not disinhibition and inattention, appeared to mediate the relationship between neuroticism and disordered eating. These results should guide prospective research exploring the relations between neurotic and impulsive behavior, particularly delay discounting on disordered eating, which will assist in future treatment efforts targeting the development of maladaptive eating behaviors.

Keywords: Neuroticism, Impulsivity, Delay Discounting, Disordered Eating, Adolescents

1. Introduction

Adolescence represents a critical time in the manifestation and maintenance of disordered eating. Disordered eating during adolescence is high and those adolescents who engaged in disordered eating are at increased risk for these behaviors ten years later (Neumark-Sztainer, Wall, Larson, Eisenberg, & Loth, 2011). Disordered eating can be conceptualized as dieting, unhealthy weight control practices and binge eating (Neumark-Sztainer, et al., 2011). This often includes the negative monitoring and maintenance of weight, shape, and eating. Unfortunately, disordered eating is associated with a number of problematic outcomes including obesity and eating disorders, especially in youth (Gearhardt, Boswell, & White, 2014; Neumark-Sztainer et al., 2006; Peebles et al., 2012). This can lead to risk for health complications involving the cardiovascular, skeletal, endocrine, reproductive, and gastrointestinal systems (Torstveit & Sundgot-Borgen, 2014). In addition to being physically harmful, disordered eating can also have a detrimental psychological impact (Butcher, Mineka & Hooley, 2013). Those engaging in disordered eating can experience elevated levels of suicidal ideation, depression, mood and anxiety disorders, substance abuse, and withdrawal from interpersonal relationships (Torstveit & Sundgot-Borgen, 2014; NIMH, 2011).

Thus, recent research efforts have focused on determining the risk factors associated with disordered eating broadly, to identify those at risk for eating disorders or obesity. Multiple etiologies focusing on biological, socio-cultural, and behavioral factors have been proposed with hopes of enhancing prevention, education, and treatment programs. As a result, it has been proposed that certain personality-behavioral traits play a significant role in the pathogenesis and development of disordered eating, which renders certain adolescents more vulnerable to disordered eating-conducive environments than others.

A large majority of research has focused on personality characteristics. Specifically, neuroticism, which is marked by high levels of anxiety, moodiness, worry, and perfectionism, is one of the most consistent associated risk factors in research studying disordered eating (Butcher, Mineka, & Hooley, 2013). Individuals with eating disorders (EDs) have been found to have higher levels of neuroticism than the general population, as well as those engaging in behaviors on the ED spectrum (Cassin & Von Ranson, 2005; Davis & Fischer, 2013; Izydorczyk, 2012; Maclaren & Best, 2009). Interestingly, emotional eating, a facet of disordered eating, was also found to be related to neuroticism (Izydorczyk, 2012). Further, individuals who scored lower on the neuroticism scale were predicted to have less disordered eating behaviors and attitudes than those with higher levels of neuroticism (Ferguson, Munoz & Winegard, 2012; Grella, 2013). Neuroticism has also been shown to increase the likelihood of developing disordered eating patterns (Juarascio, Perone & Timko, 2011). Meaning that higher levels of neuroticism forecasted higher levels of disordered eating, at a proportional rate (Brannon & Petrie, 2008).

However, previous results linking neuroticism to disordered eating are not consistent. Brown (2007) found that neuroticism did not appear to be significant personality characteristic in prediction of internalization of the thin-ideal or body dissatisfaction, and therefore eating disorder development. Further links between neuroticism and disordered eating are currently absent from the literature. Thus, understanding the underlying behavioral mechanisms influencing disordered eating choices have recently become of interest. At the forefront of this discussion has emerged the contribution of impulsivity to disordered eating. Impulsivity, behavior characterized by little forethought, unplanned reactions without considering future consequences, and disregard for choices in favor of long-term success (International Society for Research on Impulsivity, 2011), is considered a dimensional construct. These constructs in are thought to include: failure to maintain attention for a period of time (inattention), disinhibition of responses, and inability to see the long-term consequences and failure to make decisions in favor of long-term goals (delay discounting or decision making; Reynolds, Penfold & Patak, 2008).

Within the spectrum of eating disorders, impulsivity has been extensively studied (Claes, Vandereycken & Vertommen, 2005; Claes, Nederkoom, Vandereycken, Guerrieri & Vertommen, 2006; Fischer, Smith & Cyder, 2008). Generally, those women with greater body dissatisfaction were found to be more impulsive, such as those that fall on either extreme of the eating disorder spectrum (Scherr, Ferraro, & Weatherly, 2010). Further, particular ED subtypes were determined by rates of impulsivity, with bingeing/vomiting types showing the highest correlations of urgency and sensation seeking behaviors (Claes et. al., 2005). Moreover, Fields and colleagues (2011) found that impulsivity contributes to onset and maintaining of behaviors leading to obesity as well as being more prevalent in obese adolescents when compared to healthy-weight counterparts.

It has been suggested that disordered eating is used as a means to cope with neurotic and impulsive urges. Individuals with high levels of neuroticism, or negative affect state, were more likely to act irrationally, or make rash decisions, thereby making these individuals more vulnerable to disordered eating (Davis & Fischer, 2013). Bulimic women were found to have higher rates of distress as a result of their neurotic personality trait and in response, greater levels of impulsivity, than women who were not diagnosed with an eating disorder (Fischer, Smith, Annus & Hendricks, 2007). It was also determined that binge eating, a common type of disordered eating, was found to help bulimic women cope with both their neurotic tendencies and impulsive urges, suggesting that disordered eating may serve as a coping mechanism and a result of both neurotic and impulsive tendencies (Fischer et al., 2007). Therefore, because individuals with high levels of neuroticism, or negative affective states, have been shown to act irrationally or make rash decision, recent research has begun to explore the interplay between neuroticism and impulsivity on disordered eating and development of EDs (Davis & Fischer, 2013).

Previous research examining the association between neuroticism and disordered eating are mixed. Further research examining neuroticism, impulsivity and disordered eating is scarce and no study to date has examined impulsivity as a mediator between neuroticism and disordered eating. Moreover, previous research has almost exclusively focused on adult populations and not adolescents; even though this developmental period is most vulnerable to the onset of disordered eating. An examination of neuroticism and impulsivity in the manifestation and maintenance of disordered eating is needed. Neuroticism renders individuals susceptible to more stress, which may result in greater impulsivity and willingness to engage in unhealthy coping mechanisms, such as disordered eating. Understanding how impulsivity, as a behavioral construct, may mediate the relationship between neuroticism and disordered eating can provide a better understanding of the underlying mechanism through which these factors relate to one another.

The objective for the present study is to determine if delay discounting, a dimension of impulsivity, mediates the relationship between neuroticism and engagement in disordered eating. Based on previous research, we hypothesize that impulsivity -- delay discounting, disinhibition, and inattention -- will mediate the relationship between neuroticism and all subscales of disordered eating, but only partially. This information may increase our knowledge of the underlying mechanisms contributing to the onset of disordered eating and therefore eating disorders, in adolescents and emerging adults in hopes to assist future education-, prevention-, and treatment efforts.

2. Methods

2.1. Participants

Participants consisted of adolescents (n = 40) recruited from the community and undergraduate psychology courses. More than half of the participants were female (n = 25; 62.5%) and the average age of all participants was 18.25 years (S.D. = 1.30, range = 13–19). The vast majority of participants reported Euro-American ethnicity (n = 30; 75.0%), while others reported Asian (n = 1; 2.5%), Hispanic (n = 8; 20.0%), and Other (n = 1, 2.5%) ethnicity. All participants included in the present analyses received either (1) monetary compensation between $25–35, with specific amount earned dependent on task performance (n = 6) or (2) course credit for their participation (n = 34; see Table 1).

Table 1.

Demographics

Total Mean (S.D) Range
Age 18.25 (1.30) 13–19
Males 15
Females 25
Asian 1
Euro-American 30
Hispanic 8
Other 1
Body Mass Index (BMI) 24.15 (5.14) 17.00–41.26
Quick Intelligence Score (KBIT-2)a 106 (12) 75–129
Open in a new tab
b

M= 100, S.D. = 15

Potential participants were excluded if they were not between the ages of 13–19 or were taking ADHD medication. These exclusion criteria are necessary because the present papers is focused on adolescents and medications used in the treatment of ADHD have been shown to reduce impulsive behavior as measured by the behavioral assessments included in the study (Tannock et al., 1989). The present includes individuals up to age 19 years to remain within the age range stipulated by The Council on Child and Adolescent Health (1988) who issued a statement defining the age limits of pediatrics to include commitments prior to birth until the developmental process is completed, thereby delegating responsibility of pediatrics to continue to age 21.

2.2. Measures

2.2.1. Neuroticism

Eysenck Personality Questionnaire – Short Form (EPQR-S) The EPQR-S (Eysenck & Eysenck, 1992) is a widely used 48-item self-report questionnaire used to measure personality characteristics. For the purpose of the present study, only questions pertaining to neuroticism were scored. One point was given for every “yes” answer and higher scores reflect greater levels of neurotic behavior.

2.2.2. Disordered Eating

The Eating Disorder Examination Questionnaire (EDE-Q; Fairburn, Cooper, & O’Connor, 2008) contains four subscale scores on ED psychopathology, consisting of Eating Concern (preoccupation with food and eating, fear of losing control, eating in secret), Weight Concern (dissatisfaction with weight or desire to lose weight), Shape Concern (obsessing over having a flat stomach, fear of gaining weight and altering shape, dissatisfaction/discomfort with shape), and Dietary Restraint (restraint/avoidance of eating, dietary rules, continually having an empty stomach). The scoring system consists of a 0–6 scale for each question, with 0 indicating no days and 6 indicating everyday in the 28-day period. The greater the cumulative score of the questions, the higher the engagement in ED indicative behaviors.

2.2.3. Behavioral measures of impulsivity

2.2.3.1. Delay Discounting Questionnaire

The Delay Discounting Questionnaire (DDQ; Richards, Zhang, Mitchell, & de Wit, 1999) assesses decision making. This task presents participants with choices between $10 available after a specified delay and a smaller amount available immediately. This computerized task uses an adjusting amount procedure to derive indifference values. Smaller indifference values, calculated using discounting curves and analyzed with an area under the curve (AUC) method, signify greater discounting by delay and greater impulsivity.

2.2.3.2. Go/Stop-Task

The Go/Stop Task (Dougherty et al., 2003) was designed to measure behavioral inhibition. For this task, participants are presented a series of three-digit numbers on a computer screen and are instructed to click the mouse button when a matching three-digit number appears (go signal). On a randomly selected 25% of the trials, the numbers turn from black to red, and participants are instructed that when the numbers turn red, they are to inhibit their responses. Participants who are able to stop 50% of the time with shorter intervals are considered to have better inhibitory control.

2.2.3.3. Continuous-Performance-Task II (CPT-II)

The CPT II (Conners, 2004) is a computerized measure of sustained attention, or vigilance. Participants are presented a computer screen with white letters flashing on a black background and are instructed to click the mouse button when they are presented letters on the computer screen other than the letter “X”. The primary dependent measures involve response accuracy (errors of omission). Errors of omission occur when there is no response to a letter other than “X,” which is taken to reflect inattention.

2.3. Procedure

Participants were recruited using fliers distributed throughout the community and through the Psychology Subject Pool at the university. Interested persons voluntarily called the study hotline to be provided with a brief description of the study and screened for inclusion. Participants meeting inclusion criteria were invited to the laboratory where they were consented and participated in the testing session. Participants than completed the Eysenck Personality Questionnaire-Short form, EDE-Q, DDQ, Go/Stop Task, and the CPT-II. Participants completed other tasks not immediately relevant to the current analyses, and are therefore not described here. The present study is cross-sectional and all assessments were administered in one session. In addition, task order was randomized for individual participants, to limit interference of task order on results. Total time for completing the study was about two hours. All participants chose to complete the study after invitation.

2.4. Analytical Approach

Mediation analyses were conducted according to the format as outlined in Hamilton, Ansell, Reynolds, Potenza, and Sinha (2013). Although the present study is cross-section and not ideal for a mediation model that implies causality, a mediation model more suggestive of a structural relationship rather than a casual can still be informative (Iacobucci, 2008; MacKinnon, 2008). In addition, though decision making may be thought of as occurring prior to neuroticism, because a neurotic personality, especially under stress, has been shown to disrupt decision making it can be also be conceptualized as occurring between the antecedent (neuroticism) and the target behavior (disordered eating). Further, it has been suggested that researchers examine both a mediation and moderation model, both separate and together, to better understand the relational dynamics of the variables being examined. Currently analyses revealed that a mediation model, but not moderation model elucidated the relational dynamics of the variables. Rather than the relationship between neuroticism and disordered eating differing by level of decision making, decision making explained how and why neuroticism influenced disordered eating, thus only a mediation analysis is presented (Fairchild & MacKinnon, 2009).

Mediation analyses was conducted according to the format as outlined in Hamilton, Ansell, Reyanolds, Potenza, and Sinha (2013; see Figure 1). Regressions conducted within the mediation model included neuroticism, impulsivity and disordered eating. Gender was included as a covariates because it was positively associated with engagement in disordered eating. To test the proposed mediation model (Figure 1), ordered regressions were used to test a, b, c and c′ pathways. The “a’ pathway represented non-standardized beta values from the linear regressions of neuroticism on the proposed mediator or delay discounting (Hamilton et al., 2013). The “b” pathway represented the regression of the mediator, delay discounting, on the dependent variable, disordered eating. The “c” pathway represents the linear regression of the neuroticism score on disordered eating without delay discounting in the model. The “c′” pathway represents the linear regression of neuroticism on disordered eating with the effects of delay discounting controlled. The “c′” pathway is also called the direct effect of neuroticism on disordered eating as it represents the effects of neuroticism on disordered eating independent of delay discounting. Mediation was determined to occur if the effect of the c pathway decreased in the c′ pathway (Hamilton et al., 2013). If the effect was reduced but still significant, partial mediation was determined by conducting a Sobel’s test of mediation (MacKinnon, Lockwood, Hoffman, West & Sheets, 2002) to show if the reduction was statistically significant.

Figure 1.

Figure 1

Open in a new tab

Mediating role of impulsivity in the association between neuroticism and disordered eating

3. Results

3.1. Descriptive Data

The data were screened for a number of criteria to ensure data integrity. To determine internal consistency, cronbach’s α was determined for each of the following measures: neuroticism, disordered eating and delay discounting and were all within the acceptable range (cronbach’s α = 0.77–0.82). Cronbach’s α was not determined for disinhibition and inattention they included only one value per participant. In addition, means and standard deviations were equivalent to similar samples on adolescents (Fields, Sabet, & Reynolds, 2013; Mond et al., 2014; Kennedy & Hughes, 2004).

Further, the data was examined to determine whether regression analyses could be conducted. To determine a linear relationship the authors used a scatter plot and also utilized Mahalanobis distance, to determine any outliers. No outliers were detected except for CPT commissions, which was no included in subsequent mediation analyses. Skewness (−0.20 – 0.80) and kurtosis (−1.28 – 0.51) values were determined for all study variables to determine multivariate normality. All values were also in the acceptable range, except again for CPT commissions. Multicollinearity between independent variables was also found (r = −0.36, p = 0.019). Although the issue of multicollinearity reduced the power, it was expected given that impulsivity is thought to be close in time to neuroticism. Mean and standard deviations of all measures are provided, as well as correlations among the disordered eating subscales are presented in Table 2.

Table 2.

Means and Standard Deviations for Variables as well as Correlations among Dependent Variabels

Measure M(SD) 1 2 3 4
Neuroticism 5.13(3.07)
Delay Discounting 0.56(0.28)
Disinhibition 192.87(61.97)
Inattention 61.59(26.78)
1. Dietary Retraint 1.49(1.23) ---
2. Eating Concern 1.74(1.96) 0.66** ---
3. Weight Concern 1.91(1.75) 0.68** 0.50** ---
4. Shape Concern 2.28(1.78) 0.64** 0.52** 0.892** ---
Open in a new tab

Note:

**

denotes significance at p < 0.001

3.2. Mediation Analysis

Mediation analyses focused only on delayed discounting, because neuroticism was not associated with either disinhibition (B = −0.65, p=0.87) or inattention [omissions (B=−0.10 p=0.87)]. In addition, neuroticism was not significantly associated with dietary restraint (b=0.11; t(40)=1.75; p=0.09), and therefore mediation analyses were not conducted with regard to this domain. Gender was associated with engagement in disordered eating, and was included as a covariate in all direct effect analyses (see Table 3)

Table 3.

Summary of Mediation Models

Effect of IV on
M (a)		 Effect of M on
DV (b)		 Total effect (c) Direct effect
(c’)		 Model (R2)
Eating
Concern		 −2.945 0.213 0.119 0.449
−0.033
Shape Concern −2.445 0.334 0.292 0.541
Weight
Concern		 −2.372 0.286 0.227 0.472
Open in a new tab

Note: IV = independent variable (i.e., neuroticism); M = mediator (i.e., delay discounting); DV = dependent variable (i.e., disordered eating subscales and global scale). The total effect is the effect of the IV and DV without including the mediators in the model. The direct effect is the effect of the IV on the DV, controlling for the effect of mediators. Analyses controlled for gender. All values significant at the p < 0.05 level. Neuroticism was not associated with dietary restraint, therefore no subsequent mediation analyses were conducted.

3.2.1. Eating Concern

Neuroticism was negatively associated with the delay discounting AUC [b=−0.03, t(40)=−2.45, p=0.02], and delay discounting was significantly associated with eating concern [b=−2.91, t(40)=−2.73, p=0.01] . The total effect of neuroticism on eating concern was significant [b=0.21, t(40)=2.08, p=0.04], but the direct effect, which controls for delay discounting, was not significant [b=0.12, t(40)=1.10, p=0.28; Model R2=0.45, F(3, 40)=2.95, p=0.05]. The absolute value of the unstandardized coefficient and of the path was reduced and became non-significant. This suggests that delay discounting fully mediates the relationship between neuroticism and eating concern. Individuals who are highly neurotic tend to discount more and are more likely to have higher levels of eating concern.

3.2.2. Weight Concern

Neuroticism was negatively associated with the delay discounting AUC [b=−0.03, t(40)=−2.45, p=0.02], and delay discounting was significantly associated with weight concern [b=−2.37, t(40)=−3.18, p=0.003] . The total effect of neuroticism on weight concern was significant [b=0.29, t(40)=3.80, p=0.001], but the direct effect, which controls for delay discounting, was reduced in significance [b=0.23, t(40)=2.89, p=0.007; Model R2=0.47, F(3, 40)=10.44, p<0.001]. The absolute value of the unstandardized of the path was reduced, and although decreased in significance was still significant. This suggests that delay discounting partially mediates the relationship between neuroticism and weight concern. Individuals who are highly neurotic discount more, but only show slightly higher levels of weight concern.

3.2.3. Shape Concern

Neuroticism was negatively associated with delay discounting AUC [b=−0.03, t(40)=−2.45, p=0.02], and delay discounting was significantly associated with shape concern [b=−2.45, t(40)=−2.78, p=0.008] . The total effect of neuroticism on shape concern was significant [b=0.33, t(40)=4.87, p<0.001], and the direct effect, which controls for delay discounting, was also significant [b=0.29, t(40)=3.90, p<0.001; Model R2=0.54, F(3, 40)=13.76, p<0.001]. However, the absolute value of the unstandardized coefficient of the path was reduced. Sobel’s test was of mediation showed that this reduction was statistically significant, Z=−2.02, p=0.04. This suggests that delay discounting partially mediates the relationship between neuroticism and shape concern. Individuals who are highly neurotic discount more, but are only slightly more likely to have higher levels of shape concern.

4. Discussion

The present study investigated the role of neuroticism and impulsivity in predicting engagement in disordered eating in adolescents. The separate contributions of neuroticism on disordered eating have been previously examined. However, the mediation model of whether impulsivity mediates the relationship between neuroticism and engagement in disordered eating has not been examined. Thus this is the first study to date to determine whether impulsivity mediates the relationship between neuroticism and engagement in disordered eating.

Neuroticism was not significantly associated with disinhibition and inattention. It is believed that the strong emotional reactivity displayed by these individuals may interfere with their executive functioning processes (Hirsh, Morisano, & Peterson, 2008). Given that neurotic individuals have a tendency strive for perfectionism, on tasks for inhibitory control and attention they may be more effortful and engaged in behavioral tasks-- which one would assume would contribute to better performance compared to low and moderate neurotic individuals. However, the disruption in executive functioning may undermine their performance goals, thereby resulting in an overall performance that is similar or worse than those low on neuroticism.

Delay discounting was found to fully mediate the relationship between neuroticism and eating concern. Meaning that delay discounting entirely explained the relationship between neuroticism and eating concern. Neurotic adolescents are more likely to have a preoccupation with food, fear or losing control over eating, a tendency to eat in secret, not partake in social eating and guilt about eating but this relationship was wholly explained by their decision making. Meaning that neurotic adolescents discount delayed rewards, such as healthy weight loss or weight maintenance, for immediate gratification such as eating is secret or eating unhealthy foods.

Delay discounting partially mediated the relationship between neuroticism and weight concern, neuroticism and shape concern. Partial mediation refers to the case in which the path from the independent variable (i.e., neuroticism) and the dependent variable (i.e., shape concern and weight concern) is reduced in absolute size but is still different from zero when the mediator is introduced (Hamilton et al., 2013). Neurotic adolescent were more likely to fixate on the importance of weight, have a negative reaction to prescribed weighing, a preoccupation with their shape/weight, be dissatisfied with their weight, and have a desire to lose weight, as well as want a flat stomach, be preoccupied with the importance of their shape, fear weight gain, be dissatisfied with their shape, experience discomfort when seeing body, avoiding exposure of their shape, and feel fat. Although, this was partially explained by their tendency to discount delayed rewards. The full and partial mediation by delay discounting of the effect of neuroticism on engagement in disordered eating demonstrates the importance of delay discounting in understanding the manifestation of disordered eating among adolescents and emerging adults.

It is important to note that delay discounting did not account for all the variance for the effects of neuroticism on engagement in disordered eating. Significant direct effects of neuroticism on engagement in disordered eating indicates the importance of neuroticism itself as a construct impacting engagement in disordered eating, even without delay discounting. Direct and indirect pathways of a neurotic personality on the engagement in disordered eating reveal different pathways of the effects. Emotional reactivity related to a neurotic personality may have effects on neuro-behaivoral functioning. Neuroticism may alter and disrupt executive functioning processes, thereby increasing vulnerability to engagement in disordered eating, especially via a depressed mood or as a coping mechanism to decrease anxiousness.

Moreover, neuroticism was not associated with eating restraint or how an adolescent exhibited restraint over eating, avoided eating or food, had strict dietary rules, or often functioned on an empty stomach. Since highly neurotic individuals, are often characterized by their high anxiety, excessive worrying and perfectionism -- it is likely that they are concerned with how they appear to others. This is consistent with finding within each “concern” domain (i.e., eating concern, shape concern and weight concern). Thus, neurotic adolescents may seem more aware with how they appear rather than actually engaging in overt unhealthy eating habits which may negatively impact how they are perceived. For example, functioning on an empty stomach cannot be perceived but avoiding food is easily perceived but can be interpreted negatively by others.

5. Limitations

The present study had several limitations. First data collection was restricted to self-report data. As a result, respondents may under-report behaviors that are viewed as undesirable to society, such as neurotic characteristics and disordered eating patterns. Further, although a complex model of factors is involved in adolescents’ vulnerability to engagement in disordered eating the present study focused on demonstrating an association between only neuroticism and impulsivity with regard to disordered eating. The study was also cross-sectional and therefore cannot prove causality but does shed light on the structural relationships of the variables. Therefore, a more complex model of risk factors over multiple time points (i.e., as adolescence transition into emerging adulthood) is desired. Also due to a small sample size, there was not enough power to conduct separate analyses by gender. Since females appear to be engaging in disordered eating at higher rates, an examination of gender is needed. Finally, participants in the present study were not representative of all adolescents. The sample was limited in ethnic diversity and included adolescents and emerging adults that were in school. Since school is believed to be a protective factor from poor health outcomes, these findings are believed to be an underestimate of the health-risk consequences (Bernard & Marshall, 1997; Rutman, Park, Castor, Tauali, & Forquera, 2006).

6. Conclusion

The goal of the present study was to help better understand the relationship between neuroticism, impulsivity and engagement in disordered eating, in the hopes of advancing prevention and treatment programs for maladaptive eating patterns in youth. High levels of neuroticism were significantly associated with disordered eating, indicating that having a neurotic personality renders adolescents more susceptible to developing various patterns of skewed perceptions of eating, weight, and shape concerns. However, neuroticism was not related to eating restriction, indicating a preoccupation with appearance but not necessarily manifestation of certain forms of maladaptive eating behavior. The present analysis supported previous findings that highly neurotic individuals prefer short-term gains over long-term rewards. On several of the eating disorder domain subtypes, delay discounting fully or partially mediated the relationship between neuroticism and patterns of disordered eating. Results indicate that neuroticism and impulsivity, specifically delay discounting may play an important role in adolescent engagement in disordered eating. Our understanding of mechanisms that underlie disordered eating during this developmental period would benefit greatly from increased research on the role of personality traits and delay discounting.

Highlights.

  • Neuroticism was associated with delay discounting

  • However, neuroticism was not associated with disinhibition or inattention

  • Delay discounting mediated the relationship between neuroticism and eating concern

  • For all other domains, except dietary constraint, a partial mediation was found

  • Neuroticism was not associated with dietary restraint

Footnotes

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Authors’ Disclosure

Meagan Hubbard conceived the study, interpreted the data, and drafted the manuscript; Sneha Thamotharan participated in conceiving the study and performed the statistical analyses, Sherecce Fields helped conceive the study and helped drafting the manuscript. All authors read and approved the final manuscript.

References

  1. Bernard B, Marshall K. Protecting adolescents from harm: Finding from the National Longitudinal Study on Adolescent Health Findings. JAMA. 1997;278(10):823–832. doi: 10.1001/jama.278.10.823. [DOI] [PubMed] [Google Scholar]
  2. Brannan ME, Petrie TA. Moderators of the body dissatisfaction-eating disorder symptomatology relationship: Replication and extension. Journal of Counseling Psychology. 2008;55(2):263–275. [Google Scholar]
  3. Brown AL. The effect of personality and internalization of the thin-ideal on body dissatisfaction. (Order No. AAI3295263, Dissertation Abstracts International: Section B: The Sciences and Engineering, 8390. 2007 Retrieved from http://lib-ezproxy.tamu.edu:2048/login?url=http://search.proquest.com/docview/621729852?accountid=7082. (621729852; 2008-99120-464)
  4. Butcher JN, Mineka S, Hooley JM. Abnormal Psychology. 15th ed. Boston, MA: Pearson; 2013. [Google Scholar]
  5. Cassin S, Von Ranson K. Personality and eating disorders: A decade in review. Clinical Psychology Review. 2005;25(7):895–916. doi: 10.1016/j.cpr.2005.04.012. [DOI] [PubMed] [Google Scholar]
  6. Claes L, Vandereycken W, Vertommen H. Impulsivity-related traits in eating disorder patients. Personality and Individual Differences. 2005;39(4):739–749. [Google Scholar]
  7. Claes L, Nederkoom C, Vandereycken W, Guerrieri R, Vertommen H. Impulsiveness and lack of inhibitory control in eating disorders. Eating Behaviors. 2006;7(3):196–203. doi: 10.1016/j.eatbeh.2006.05.001. [DOI] [PubMed] [Google Scholar]
  8. Conners CK. Conners’ Continuous Performance Test II. Toronto: MHS; 2004. [Google Scholar]
  9. Davis KR, Fischer S. The influence of trait anger, trait anxiety and negative urgency on disordered eating. Personality and Individual Differences. 2013;54(2):307–310. [Google Scholar]
  10. Dougherty DM, Bjork JM, Moeller FG, Harper RA, Marsh DM, Mathias CW, Swann AC. Familial transmission of Continuous Performance Test behavior: attentional and impulsive response characteristics. The Journal of General Psychology. 2003;130:5–21. doi: 10.1080/00221300309601271. [DOI] [PubMed] [Google Scholar]
  11. Eysenck HJ, Eysenck SBG. Manual for the Eysenck Personality Questionnaire– Revised. San Diego, CA: Educational and Industrial Testing Service; 1992. [Google Scholar]
  12. Fairburn CG, Cooper Z, O’Connor M. Eating Disorder Examination. Edition 16.0D) 2008. In C.G. [Google Scholar]
  13. Fairchild AJ, MacKinnon DP. A General Model for Testing Mediation and Moderation Effects. Prevention Science. 2009;10(2):87–99. doi: 10.1007/s11121-008-0109-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Ferguson CJ, Muñoz ME, Winegard B, Winegard B. The influence of heritability, neuroticism, maternal warmth and media use on disordered eating behaviors: A prospective analysis of twins. Psychiatric Quarterly. 2012;83(3):353–360. doi: 10.1007/s11126-012-9205-7. [DOI] [PubMed] [Google Scholar]
  15. Fields SA, Sabet M, Peal A, Reynolds B. Relationship between weight status and delay discounting in a sample of adolescent cigarette smokers. Behavioral Pharmacology. 2011;22(3):266–268. doi: 10.1097/FBP.0b013e328345c855. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Fields SA, Sabet M, Reynolds B. Dimensions of impulsive behavior in obese, overweight, and health-weight adolescents. Appetite. 2013;70:60–66. doi: 10.1016/j.appet.2013.06.089. [DOI] [PubMed] [Google Scholar]
  17. Fischer S, Smith GT, Annus A, Hendricks M. The relationship of neuroticism and urgency to negative consequences of alcohol use in women with bulimic symptoms. Personality and Individual Differences. 2007;43(5):1199–1209. [Google Scholar]
  18. Fischer S, Smith GT, Cyders MA. Another look at impulsivity: a meta-analytic review comparing specific dispositions to rash action in their relationship to bulimic symptoms. Clinical Psychology Review. 2008;28(8):1413–1425. doi: 10.1016/j.cpr.2008.09.001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Gearhardt AN, Boswell RG, White MA. The association of “food addiction” with disordered eating and body mass index. Eating Behaviors. 2014;15(3)):427–433. doi: 10.1016/j.eatbeh.2014.05.001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Grella S. The relationships among interpersonal problems, disordered eating, and substance abuse in college-age females. (Order No. AAI3516541, Dissertation Abstracts International: Section B: The Sciences and Engineering. 2013 Retrieved from http://lib-ezproxy.tamu.edu:2048/login?url=http://search.proquest.com/docview/1399052966?accountid=7082. (1399052966; 2013-99100-389)
  21. Hamilton KR, Ansell EB, Reynolds B, Potenza MN, Sinha R. Self-reported impulsivity, but not behavioral choices or response impulsivity, partially mediates the effort of stress on drinking behavior. Stress. 2013;16(1):3–15. doi: 10.3109/10253890.2012.671397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Hirsh JB, Morisano D, Peterson JB. Delay discounting: Interactions between personality and cognitive ability. Journal of Research in Personality. 2008;42(6):1646–1650. [Google Scholar]
  23. Iacobucci D. Mediation Analysis. Thousand Oaks: Sage Publications; 2008. [Google Scholar]
  24. International Society for Research on Impulsivity. What is Impulsivity. Accessed April 2012 from: http://www.impulsivity.org/
  25. Izydorczyk B. Neuroticism and compulsive overeating (A comparative analysis of the level of neuroticism and anxiety in a group of females suffering from psychogenic binge eating, and in individuals exhibiting no mental or eating disorders) Archives of Psychiatry and Psychotherapy. 2012;14(3):5–13. [Google Scholar]
  26. Juarascio AS, Perone J, Timko CA. Moderators of the relationship between body image dissatisfaction and disordered eating. Eating Disorders: The Journal of Treatment & Prevention. 2011;19(4):346–354. doi: 10.1080/10640266.2011.584811. [DOI] [PubMed] [Google Scholar]
  27. Kennedy DK, Hughes BM. The Optimism-Neuroticism Question: An Evaluation Based on Cardiovascular Reactivity in Female College Students. The Psychological Record. 2004;54:373–386. [Google Scholar]
  28. MacKinnon DP, Lockwood CM, Hoffman JM, West SG, Sheets V. A comparison of methods to test mediation and other intervening variable effects. Psychological Methods. 2002;7(1)):83–104. doi: 10.1037/1082-989x.7.1.83. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. MacKinnon DP. Introduction to Statistical Mediation Analysis. New York: Taylor Francis Group, LLC; 2008. [Google Scholar]
  30. Maclaren VV, Best LA. Female students’ disordered eating and the big five personality facets. Eating Behaviors. 2009;10(3):192–195. doi: 10.1016/j.eatbeh.2009.04.001. [DOI] [PubMed] [Google Scholar]
  31. Mond J, Hall A, Bentley C, Harrison C, Gratwick-Sarll K, Lewis V. Eating-Disordered Behavior in Adolescent Boys: Eating Disorder Examination Questionnaire Norms. International Journal of Eating Disorders. 2014;47:335–341. doi: 10.1002/eat.22237. [DOI] [PubMed] [Google Scholar]
  32. National Institute of Mental Health. Eating disorders: What are eating disorders. 2011 Retrieved from http://www.nimh.nih.gov/health/publications/eating-disorders/complete-index.shtml.
  33. Neumark-Sztainer D. I’m like, SO fat! Vol. 1. The Guilford Press; 2005. p. 5. [Google Scholar]
  34. Neumark-Sztainer D, Wall M, Gauo J, Story M, Ilaines J, Eisenberg M. Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: How do dieters fare five years later? Journal of the American Dietetic Association. 2006;106:559–568. doi: 10.1016/j.jada.2006.01.003. [DOI] [PubMed] [Google Scholar]
  35. Neumark-Sztainer D, Wall M, Larson NI, Eisenberg ME, Loth K. Dieting and disordered eating behaviors from adolescence to young adulthood: Findings from a 10- year longitudinal study. Journal of the American Dietetic Association. 2011;111(7):1004–1011. doi: 10.1016/j.jada.2011.04.012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Peebles R, Wilson JL, Litt IF, Hardy KK, Lock JD, Mann JR, Borzekowski DLG. Disordered Eating in a Digital Age: Eating Behaviors, Health and Quality of Life in Users of Websites With Pro-Eating Disorder Content. Journal of Medical Internet Research. 2012;14(5):148. doi: 10.2196/jmir.2023. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Reyonlds B, Penfold RB, Patak M. Dimensions of impulsive behavior in adolescents: Laboratory behavioral assessment. Experimental and Clinical Psychopharmacology. 2008;16(2):124–131. doi: 10.1037/1064-1297.16.2.124. [DOI] [PubMed] [Google Scholar]
  38. Richards JB, Zhang L, Mitchell SH, de Wit H. Delay and probability discounting in a model of impulsive behavior: Effect of alcohol. Journal of the Experimental Analysis of Behavior. 1999;71:121–143. doi: 10.1901/jeab.1999.71-121. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Rutman S, Park A, Castor M, Taualii M, Forquera R. Urban American Indian and Alasak Native Youth: Youth Risk Behaivor Survey 197-2003. Maternal and Child Health Journal. 2006;12(4):76–81. doi: 10.1007/s10995-008-0351-3. [DOI] [PubMed] [Google Scholar]
  40. Scherr J, Ferraro FR, Weatherly JR. Associations Between Impulsivity and Body Dissatisfaction in Females at Risk for Developing Eating Disorders. Current Psychology. 2010;29(4):297–306. [Google Scholar]
  41. Shisslak CM, Cargo M, Estes LS. The spectrum of eating disturbances. International Journal of Eating Disorders. 1995;18(3):209–219. doi: 10.1002/1098-108x(199511)18:3<209::aid-eat2260180303>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  42. Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents: Results from the national comorbidity survey replication adolescent supplement. Archives of General Psychiatry. 2011;68(7):714–723. doi: 10.1001/archgenpsychiatry.2011.22. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Tannock R, Schachar RJ, Carr RP, Chajczyk D, Logan GD. Effects of methylphenidate on inhibitory control in hyperactive children. Journal of Abnormal Child Psychology. 1989;17(5):473–491. doi: 10.1007/BF00916508. [DOI] [PubMed] [Google Scholar]
  44. Torstveit MK, Sundgot-Borgen J. Handbook of Sports Medicine and Science: The Female Athlete. Hoboken, NJ: John Wiley & Sons, Inc; 2014. [Google Scholar]

RESOURCES