Volume 23, Number 1 (Spring 2017)                   IJPCP 2017, 23(1): 22-37 | Back to browse issues page




DOI: 10.18869/nirp.ijpcp.23.1.22

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Babaei S, Asgharnejad farid A, Lavasani F, Birashk B. Comparing Impulse Control and Emotional Regulation in Patients With and Without Food Addiction. IJPCP. 2017; 23 (1) :22-37
URL: http://ijpcp.iums.ac.ir/article-1-2435-en.html

PhD in Clinical Psychology Associate Professor, Department of Clinical Psychology, Shool of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences , asgharnejad.ali@gmail.com
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Extended Abstract
1. Introduction
Addiction is an acquired chronic recurrent disorder that starts with some unpleasant experiences and responses. It is associated with a series of engagement, moderation, tolerance, rejection, psychological experiments, and social consequences. In other words, addiction is a destructive tension between drugs (or an activity such as gambling) and patients [1]. As food addiction is a new diagnostic category with only a few research works focusing on it, this paper aims to examine the components of impulse control and emotion regulation in food addiction. Our assumption is that people with food addiction probably register poor performances with reference to the components of impulse control and emotion regulation compared with the control group.
2. Method
The research is a causal-comparative and cross-sectional study (ex post facto). Forty-three male patients with food addiction who were referred to the obesity clinic of Imam Khomeini Hospital and obesity clinics in Tehran were initially considered for the study. Of them, 30 men were selected via purposive sampling as the experimental group. Of the 72 employees of the Imam Khomeini Hospital, obesity-treating private clinics in Tehran and students of Tehran University of Medical Sciences, 30 males were selected as the control group according to the simulations carried out by the research group. The exclusion criteria included severe diagnostic psychiatric disorders. A semi-structured interview (SCID-I) was used to screen patients. The Yale Food Addiction questionnaire was used to identify the research groups. The Barratt Impulsiveness Scale and Gratz’s Difficulty in Emotional Regulation Scale Questionnaire were used in order to assess impulse control and emotional regulation, respectively. To evaluate each variable, multivariate analysis of variance (MANOVA) (value of statistical significance is 0/05) was used in conjunction with SPSS software version 16.
3. Results
We found that 13 patients in the food addiction group (43.3%) had acquired a diploma compared to 15 patients in the control group (50%). Equal number of patients, i.e., 8 (26.7%), had attained an above-diploma education level in both the groups 8 (26.7%). The number of patients who had obtained a Bachelor’s degree in the food addiction group was 9 (30%) while the count in the control group was 7 (23.3%).
The first hypothesis was that the impulse control in people with food addiction is different from that of the control group. To investigate this hypothesis, the multivariate analysis of variance was used. The results showed that there is a difference between the groups with regard to at least one variable. To examine the assumptions of multivariate analysis of variance and data normalization, the Kolmogorov-Smirnov test was used. The results of this test were higher than 0.05 (P>0.05) in all indices, resulting in data normality Bartlett sphericity test was used to investigate the correlation between the dependent measures. The results indicated that there was a significant correlation (P<0.001) between the dependent measures for carrying out multivariate analysis of variance. The results of the test of Levene’s homogeneity of error variance were not significant (P>0.05). This suggests that error variance is the same across all levels of group variables. 
The results of MANOVA are shown in Table 1. As Table 1 shows, there is a statistically significant difference between two groups in the context of all impulse control sub-tests and general indicator of the scale.
The second hypothesis is that emotional regulation in people with food addiction is different from that of the control group. To investigate this hypothesis, multivariate analysis of variance was used. The results showed that there is a difference between the two groups with regard to at least one variable. The results of the Kolmogorov-Smirnov test was higher than 0.05 (P>0.05) in all indices, resulting in data normality. The result of the Bartlett sphericity test was significant (P<0.001). This indicates that there is a sufficient correlation between the dependent measures for carrying out multivariate analysis of variance . The results of the test of Levene’s homogeneity of error variance were not significant (P>0.05). This suggests that error variance is the same between across levels of group variable.
The results of the MANOVA conducted for emotion regulation indices are provided in Table 2. Table 2 shows that there is a statistically significant difference between the two groups in the context of all impulse control sub-tests and general indicator of the scale.
4. Discussion and Conclusion
The results showed that there is a statistically significant difference between the food addiction group and the control group in all scale indices of impulse control. This means that 
food addiction patients have cognitive impulsivity, higher no-movement, wider no-planning and weaker performance on impulse control compared to the control group.
The findings of this study are consistent with many other findings regarding drug-dependent individuals, where impulsivity plays a role as the background and the risk factors in the such disorder (drug dependency and also all of the behavioral addiction) [49-57] Also, in studies regarding overeating and food addicts in which impulsivity, again, plays the role of facilitator and risk factor, similar results were obtained [58, 59]. Diret al. (2013) found evidence showing that drug and alcohol use as well as frequent overeating and its subsequent clearance are impulsive triggers [60]. The core (center) impulsivity is negative emotions in which the person does an impulsive act while experiencing the negative emotions simultaneously. So, impulsive actions are attempts to regulate negative emotions [61].
In fact, the results of different studies have shown that emotion regulation is not only one of the most important and influential causes but also the maintaining factor of drug dependence disorder [63]. Drug dependence and continued use, in fact, is the result of the low level of emotional regulation strategies and the inability to deal effectively with emotions and manage them, especially in cases of first-time drug use. On the other hand, it seems that the same process occurs in people with food addictions as well. The results obtained in this study are consistent with the research conducted by Levitan and Davis (2010), Desmetand Schifferstein (2008), Dryanz et al (2011), Macht and Simon (2000), Brown et al (2009), Macht (2008), Gearhardt et al (2012) and Baldovsky et al. (2015) in which emotion dysregulation led to eating disorders and pathological overeating [39-41, 64-67]. In fact, according to the results of this study and other studies, it seems that people with food addiction overeat and consume their food as a defense mechanism in the face of negative emotions and low self-esteem. This mechanism is similar to drug addiction, which highlights the role of depression, anxiety, negative mood and lack of emotional regulation as incentives in drug use or food intake [8]. Generally, the results of this study are consistent with the results of Khantzian’s self-treatment theory. From this perspective, addictive behaviors are rooted in intolerable and painful emotions such as depression, anxiety, shame, anger and sense of helplessness, and drug use is an attempt to compensate for the shortcomings of the ego in defense against these emotions. This view is in line with the frequency of clinical observations and studies emphasizing the important role of human psychological suffering in addictive disorders [63]. According to it, treatment for these patients consists of conscious methods of controlling impulses and desires as well as effective methods of creating emotion regulations [65].
Acknowledgments
This research was extracted from the MSc. thesis of the first author, in the Department of Clinical Psychology, Shool of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
Conflict of Interest
The authors declared no conflicts of interest.
Type of Study: Original Research | Subject: General
Received: 2016/09/29 | Accepted: 2017/01/8

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