Psychopathologie der Binge-Eating-Störung im Kindesalter - Psychosoziale Risikofaktoren und aufrechterhaltende Bedingungen

This dissertation contributes to the clarification of binge eating symptomatology in school aged children. Moreover, correlates of loss of control (LOC) over eating were examined, which may serve as putative risk and maintenance factors. Research on adults suggest a number of general and disorder specific psychosocial risk factors for binge eating disorder. Youth report dieting experiences prior to first binge eating. Further studies indicate that emotion regulation has an impact on the development and maintenance of binge eating and that problematic family functioning is associated with disordered eating in childhood. It remains unclear how these factors are associated with LOC eating in children. The sample consisted of 60 children with at least one LOC during the past three months and 60 children without LOC (individually matched for sex, age, percentile of BMI, school, socioeco-nomic status of mother) aged 8-13 years recruited from the community. First, we investigated if children with and without LOC differ in regard to emotion regulation skills. In a self-report questionnaire children with LOC eating reported more maladaptive emotion regulation strategies than children without, especially for the regulation of anxiety and anger. Yet, no group differences were found for the regulation of sadness and in the amount of adaptive strategies. Next, psychosocial risk factors of LOC eating were assessed in a case-control study using an established risk factor interview adapted for children. Children with LOC eating reported a higher number of dieting related risk factors and parental problems before the onset of first LOC eating episodes. Furthermore, they were exposed to more critical life events in the year prior to first LOC episodes than children without LOC eating. The following retrospective corre-lates predicted LOC eating: parental underinvolvement, critical comments on shape, weight or eating by the family and the critical life event of change of school. Finally, we examined if families with a child with LOC eating engaged in more maladaptive behaviours during family mealtimes than controls. Results showed more maladaptive commu-nication, affective involvement and a negative overall family functioning in families of LOC eating children. No goup differences were observed for critical comments on shape, weight or eating, encouragements to eating or restriction. Although no LOC eating child reported a loss of control during the mealtime, they eat faster than controls. Overall, this cross-sectional studies detected important correlates of LOC eating in children. Dieting-related risk factors, parental problems, and critical life events seem to be prevalent before the onset of first LOC eating episodes, which needs further validation in future prospec-tive studies. LOC eating goes along with deficts in emotion regulation as well as maladaptive family interaction during mealtimes. Therefore, prevention and intervention for LOC eating children should comprise trainings on emotion regulation and information on dieting risks in which parents should be integrated for a communication training and improvement of parental involvement.