Accumulating evidence increasingly supports a strong and multifaceted association between drug dependence and binge eating. Epidemiological investigations confirm high comorbidity between binge eating and substance use disorders;animal models reveal that addiction-like behaviors generalize across substances (including food);and neurobiological studies reveal common reward pathways for both food and illicit drugs. To better define the nature of this association, the current proposal examines daily behavioral associations between the most commonly abused drug among treatment populations, namely opiates, and binge eating behaviors. Specifically, I will investigate how abstinence from opiates among individuals recovering from addiction is associated with affect-driven binge eating, and how these dysregulated eating patterns are longitudinally associated with risk for opiate lapse and relapse.
My research aims are to: 1) establish an ideal assessment system for quantifying daily caloric and nutritional intake and binge eating behavior in individuals recovering from opiate addiction;2) test whether the relationship between negative affect and binge eating differs for individuals recovering from opiate addiction and demographically-matched controls;3) identify time- specific (e.g., stress) and person-specific (e.g., personality) factors that exacerbate affect-driven binge eating as moderated by addiction status;and 4) test the effects of various coping strategies, and particularly the practice of affet-driven binge eating, on the longitudinal risk for relapse among those in recovery from opiate addiction. To accomplish these aims, I will study a minimum of N = 106 participants from two treatment facilities for drug addiction and N = 35 demographically comparable healthy controls from a community sample in the geographic vicinity of the treatment centers. Participants will respond to electronic signals three times daily over fourteen consecutive days by answering questions about drug use and cravings, negative affect, and eating behaviors occurring during the day. Individuals recovering from addiction will also be assessed every two weeks over 24 months to determine ongoing risk for relapse, substance use and other health outcomes. By integrating my proposed research plan with a plan to receive formal training and mentorship from faculty with expertise in affective models of drug use, the treatment of drug addiction, binge eating, and the neurobiology of addiction, the proposed Career Development Award complements my background in quantitative methodology by providing training I need to develop an independent and productive line of research dedicated to understanding the co-occurrence of addictive and binge eating behaviors, particularly in relationship to affect dysregulation. The research and training that I propose will lead to the submission of an R01 proposal that will provide a transition to an independent research career and serve to inform clinicians and clients about the ways in which binge eating influences recovery efforts for individuals in treatment for opiate use disorder.
Many individuals recovering from drug addiction learn to regulate negative affect induced by drug cravings with replacement behaviors such as binge eating. Neurobiological evidence suggests that this practice may lead to 'spiraling dysregulation'and to faster and more probable relapse. The proposed research examines the potentially deleterious and mutually perpetuating association between opiate addiction and binge eating with the ultimate goal of informing treatment and interventions for those in recovery.
|Zerwas, Stephanie; Von Holle, Ann; Watson, Hunna et al. (2014) Childhood anxiety trajectories and adolescent disordered eating: findings from the NICHD Study of Early Child Care and Youth Development. Int J Eat Disord 47:784-92|