Multi-method evidence for a dual-pathway perspective on loss of control over eating among adolescents

Introduction: Loss of control over eating (LOC) is common among adolescents and is associated with negative developmental outcomes. Dual-pathway models propose that LOC is the result of an imbalance between immature regulatory processes (e.g., inhibitory control) and strong reactive processes (e.g., attentional bias, reward responsivity); but most studies have been conducted in adult samples. The aim of the current study was to investigate the dual-pathway perspective in the context of LOC in adolescents. Methods: A community sample of 295 adolescents (10-17 years; 64.1% girls; Mean Age = 14 years; SD = 1.99) was subdivided into a LOC-Group (n = 93) and a No-LOC-Group (n = 202) based on a self-report questionnaire. Both regulatory and reactive processes were measured with behavioral tasks and self-report questionnaires. Results: Significant interaction effects were found. More specifically, the combination of impaired inhibitory control and strong reward sensitivity and the combination of impaired inhibitory control and strong attentional bias increased the risk of experiencing LOC, both with the use of behavioral tasks as well as with self-report questionnaires. Conclusions: Our results provide multi-method evidence for the dual-pathway perspective in which impaired regulatory processes and strong reactive processes interact in explaining LOC in adolescents. Theoretical and practical implications are discussed.