(PS11-A3) Examining Eating Expectancies in the Relationship Between Symptoms of ADHD and Binge Eating

         ADHD is associated with greater Binge Eating (BE) in young adults (Hansom et al., 2019). Individuals with ADHD may have difficulties with planning, organization, impulse control and emotion regulation, increasing vulnerability to BE (Cortese et al., 2008; Barkley, 2014). One factor that may link symptoms of ADHD and BE is eating expectancies (EE). Expectancies are learned relationships between behaviors and outcomes that then affect future behaviors (Tolman, 1932). While the relationship between symptoms of ADHD and EE has not been examined, expectancies regarding substance use have shown to link ADHD and addictive behaviors (Elmore et al., 2018). Evidence for the overlap between BE and addictive behaviors (Kim & Hodgins, 2018), and the role of EE in BE (Schell et al., 2019), suggests that EE may explain the association between ADHD and BE. The purpose of this study was to examine whether the different forms of EE [i.e., eating alleviates negative affect (EE-NA), eating alleviates boredom (EE-BOR), eating is pleasurable (EE-REW), and eating leads to feeling out of control (EE-LOC)] mediate the relationship between symptoms of ADHD and BE, and to test which of these is the strongest independent mediator of this association.

            259 women (79.2% White; M age= 26.55 yrs., M BMI= 27.46 kg/m²) completed self-report measures of ADHD (Adult ADHD Self-Report Scale (ASRS; Kessler et al., 2005), BE (Binge Eating Scale (BES; Gormally; 1982), and EE (Eating Expectancies Inventory (EEI; Hohlestein et al., 1998). Four separate percentile corrected bootstrap mediation analyses (PROCESS, Hayes, 2018), one for each EE (EE-NA, EE-BOR, EE-REW, and EE-LOC), were used to examine whether ADHD is indirectly associated with BE through its effect on EE. Results of these four models indicated that ADHD symptoms were indirectly associated with BE symptoms through EE-NA (indirect effect (b=2.65, 95% CI [1.80, 3.55]), EE-LOC (indirect effect b = 3.04, 95% CI [2.10, 4.00]), and EE-REW (indirect effect b = -.64, 95% CI [-1.14, -.23]), but not EE-BOR (b= -.02, 95% CI [-.74, .64).

            A parallel mediation analysis was used to examine all four EEs simultaneously. Results showed that ADHD was indirectly associated with BE through EE-LOC (b= 2.42, 95% CI [1.56, 3.26]). The completely standardized indirect effect was b= .20, 95% CI [.13, .27], indicating that for a woman who is .81 points higher on the ASRS, she is 1.98 points higher on the BES due to the effect of ADHD on BE through EE-LOC. ADHD was also indirectly associated with BE through EE-NA (b = .69, 95% CI [.08, 1.38]). The completely standardized indirect effect was b= .06, 95% CI [.01, .11], indicating that for a woman who is .81 points higher on the ASRS, she is .60 points higher on the BES due to the effect of ASRS on BES through EE-NA. The indirect paths through EE-REW and EE-BOR were not significant (b= -.15, 95% CI [-.53, .19]; b= -.00, 95% CI [-.34, .33], respectively). Results suggest that expectations that eating will lead to a loss of control and alleviate negative emotions may help explain the link between ADHD and BE among women, suggesting a need to target these cognitions and improve behavioral and emotional regulation when working with women with ADHD and BE. Additional clinical implications, limitations and future directions will be discussed.