Date of Award

2017

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

College of Nursing

First Advisor

Gayenell S. Magwood

Second Advisor

Martina Mueller

Third Advisor

Amy Adkins

Fourth Advisor

Dace Svikis

Abstract

Purpose: The purpose of this dissertation was to explore psychological and genetic associations of binge drinking and eating in college-age individuals, and to assess if overlap exists across phenotypes. Key contributing factors of binge drinking and binge eating informed the development of a hypothesized biobehavioral conceptual framework for binge behavior. Next, an integrative review of existing instruments that measure binge eating was conducted to observe concepts related to binge eating as applied clinically. Finally, a secondary analysis was carried out to investigate the phenotypes of interest in a study aim that focused on key concepts in the framework from survey data as well as an aim that investigated physiological concepts by way of genetic data. Problem: Binge drinking and eating are prevalent behaviors in our society and within the college-age population. Binge eating rates are increasing, and binge eating disorder (BED) was included as a primary diagnosis in the current edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5. Little is known about the etiology of binge eating; however, binge eating is regularly equated to substance use disorders in the literature. The specific aims of the dissertation study were to determine: Aim 1: If binge behaviors are associated with stress, impulsivity, and health outcome risks of obesity, anxiety, and depressive symptoms. Aim 2: If shared single nucleotide polymorphisms (SNPs) present for binge drinking and binge eating from a Genome-Wide Association Study (GWAS) and a candidate gene approach. Design: A secondary analysis of cross-sectional self-report data was conducted to achieve aim one within the framework of a mediation analysis, while a Genome-Wide Association Study (GWAS) was conducted to achieve aim two. Findings: Binge as a mediator applied to binge eating but not to binge drinking. Females demonstrated higher rates of binge eating, anxiety, and depressive symptoms than males. Overweight and obese participants were more likely to binge eat than binge drink. Racial differences showed that more Whites binge drink compared to Asians, Blacks, and Hispanics. No racial differences were noted among binge eating outcomes. No genetic overlap was noted among phenotypes nor was statistically significant output noted for the binge drink GWAS. Gene-based significance for binge eat included the following: PURG, LYPD5, SKAP2, TRAPPC1, and NCOA2. Conclusions: While binge drinking and binge eating are prevalent behaviors in college-age youth, binge eating shows heightened associations to pathologies without taking frequency into account. For the GWAS, preliminary analyses suggest that the binge drinking phenotype was oversaturated. It is probable that risky drinking behaviors were inseparable from problem drinking at this age by forming the phenotype from a binary approach assessing binge drinking within a month.

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