| الوصف: |
Food addiction (FA) theory posits that certain foods can trigger responses akin to traditional substances of abuse. FA has gained significant attention over time, and empirical evidence supporting the construct is growing. However, questions about the construct remain surrounding the measurement of FA, its developmental trajectory, and effective treatments. Most FA research is quantitative in nature, and little is known about the subjective experience of FA. This dissertation used qualitative interviewing and thematic analysis to explore three aims in a sample of individuals with FA. Aim 1 examined the measurement of FA. The Yale Food Addiction Scale (YFAS) is the most popular scale used to measure FA and has been quantitatively validated across numerous samples. However, little is known about the subjective interpretation of the scale. It is possible that items are interpreted inconsistently with the clinical conceptualization of substance use disorders, impacting the validity of the measure. We examined the subjective experience of completing the YFAS to determine if items were interpreted as expected, if any were irrelevant to the lived experience of FA, and if there are phenomena central to the lived experience of FA not captured by the scale. Participants interpreted most items on the scale in-line with the clinical conceptualization of FA. Tolerance and withdrawal-related items were most commonly misinterpreted. Problem-focused items were least relevant to participants' lived experience. Novel constructs including emotional eating also emerged. Aim 2 explored the developmental trajectory of FA. While numerous quantitative studies have explored the prevalence and correlates of FA in childhood and adolescence, little is known about the lived experience of FA early in the lifespan, nor how experiences of FA may change over time. Further, little is known about how dieting interacts with FA. We asked participants to describe their eating behaviors beginning in childhood and across their lifespan to identify novel, developmental aspects of FA and allowed participants to describe how dieting interacted with their FA. Parental control of food, food scarcity, and a drive for highly palatable foods in childhood were relevant to the development of FA. Autonomy over food, weight gain, and the college environment emerged as important to the lived experience of FA during adolescence and young adulthood. Adulthood was viewed as the most severe period of FA and participants felt increasing role responsibilities contributed to its severity. Participants also described dieting as a response to FA, rather than dieting contributing to addictive eating. Aim 3 examined treatment for FA. Currently, there are no empirically supported treatments for FA and little is known about preferences or motivations for treatment. We asked participants to describe attempts to control FA including what has helped and what has not, barriers to recovery, and preferences for treatments. Most participants felt diets were not effective and describing multiple failed diets. Accountability, replacement foods, and controlling the home food environment were considered helpful. Internal (e.g., eating to cope) and external (e.g., affordability) factors were considered barriers to change. Cognitive behavioral therapy and abstinence were preferred methods of treatment. This dissertation provided evidence for the face validity of the YFAS and potential methods for improvement. Novel constructs about the lived experience of FA across the lifespan and implications for treatment were uncovered, setting the stage for quantitative research to explore their prevalence and statistical significance. Research and clinical implications were discussed. |