Motivation and emotion/Book/2019/Junk food and psychological distress

Overview
The hassles of daily life can be stressful! Each day we are faced with several external stressors, this can include a lack of sleep, university assignments, the loss of a job, or working long hours. Australian Psychological Society (2015) has reported that people between the ages of 18 and 25 years consistently report their top stressors as family issues, financial issues and health issues (Australian Psychological Society, 2015). Evidence suggests that psychological and external cues or stressors are strongly correlated with overeating and junk food.



Several emotional theories eating theories suggest that individuals eat in order to cope or mask negative emotions (Kaplan & Kaplan, 1957 and Adam & Epel, 2007). Eating behaviour is not always initiated due to physiological symptoms of hunger. Emotional mechanisms have shown to drive our desire to eat high fat, high sugar or artificial foods also referred to as, junk food (Adam & Epel 2007). Research has shown that as a consequence, this may be a risk factor highly correlated with obesity (Desai et al., 2008). In 2017-2018, the Australian Institute of Health and Welfare reported that 1 in 4 children were reported as overweight or obese and, 1 in 3 adults in Australia were overweight or obese which is a 19% increase from 1995 reported data.

This chapter explores the biological causes of hunger while psychologically distressed and why people seek more highly palatable (e.g., high fat, high sugar) foods while experiencing negative emotions. Theories and research of how psychological distress motivates food choices and intake is investigated. Identifying the motivation for eating palatable foods which may contribute to the rising rates of obesity may yield better treatments. Understanding ways to cope with psychological distress may also contribute to the increase in mental health and well-being.




 * What is psychological distress?
 * What are the impacts of psychological distress on food consumption?
 * What are the biological effects of junk-food on psychological distress?

What is psychological distress?
Psychological distress can be defined by an internal emotional suffering in response to one or multiple external stressors (Cascarini, 2006). People experience varied amounts of distress and this is determined by the way the individual copes with the external stressors (Cascarini, 2006). Distress is uncomfortable and upsetting, and can include feelings of vulnerability, sadness and as such is closely linked to anxiety and depression (Kessler, Nelson, McGongale,and Blazer, 1996).

 Sally is a full-time university student. She lives out of home and rents near campus. She works 5 days a week to be able to afford rent and food for each week. She is currently experiencing the pressures of maintaining a high GPA so she can receive a scholarship for her postgraduate studies.

Sally recently fell so ill she is unable to work and is finding it hard to keep up with her university work. She is now feeling anxious about falling behind in her subjects and is having financial difficulties from being unable to work.

 {What stressors in the above case study could potentially be making Sally psychologically distressed? }


 * type=""}

+ Financial issues - Donald Trump + University - All of the above

Distress vs. Eustress
Is all stress a negative experience? There are two types of stress, eustress, and distress.

Distress is defined as feelings of negative emotions and is a consequence of negative response to stressors. Eustress refers to a positive response to stress. This type of stress has proven to be beneficial as it can enhance one's functioning. See the Table.1 and Table.2 below to see the differences between the types of stress:

Psychological theories
The impacts of psychological distress is shown commonly on television shows and movies when someone is experiencing a break up. Stereotypically there are scenes of bingeing on large amounts of ice cream, chocolate and, self-pity to soothe the pain. According to behavioural theories, this depiction of how people manage external stressors is not far off.

The relationship between emotion and eating behaviour has been widely studied as the basis of literature on obesity. Current research suggests that eating is utilised as a self-coping strategy used to mask negative emotions, but how is this related to the consumption of high-fat and high sugar foods, also known as “junk food”?

Psychosomatic Theory of Obesity - Kaplan & Kaplan (1957)
Kaplan & Kaplan (1957) proposed that in times of distress, you experience negative emotions that make you feel uncomfortable. Eating is then used as an emotional strategy to reduce this discomfort. This phenomenon is also known as “emotional eating”. It is hypothesised that the act of eating while experiencing intense emotions will temporarily diminish these emotions. They found that obese people could not tell the difference between physiological hunger and anxiety. This result could be explained due to the fact that this was a learnt behaviour. Similarly to eating to reduce hunger, they eat to reduce comfort. One issue with this theory is that it only includes obese individuals however, this behaviour is also found in normal-weight people to regulate their negative emotions (Macht, 1999).

A study involving 100 university students examined the preferences of food while experiencing various emotions (Lyman, 1982). The consumption of healthy foods was more likely to occur during positive moods, and negative emotions were more highly correlated with the consumption of junk food. This is also demonstrated by the eating behaviour found in eating disorders. The consumption of food in bulimia and avoidance of food has been found as a stabilising factor of dysmorphic emotions, and self-esteem (Bacher, Latzer, Kreitler, and Berry., 1999). Generally, people will experience a binge eating episode after negative emotional states (Bacher et al., 1999).

Boggiano and colleagues (2014) designed the Palatable Eating Motives Scales (PEMS) to reveal what motivated for eating junk food, fast food and desserts and, how are these associated to binge eating. It differs from other eating scales as it explains why people eat palatable foods, in comparison to assessing which emotions trigger food intake (Lyman, 1982, & Bacher et al. 1999). The subjects consisted of 150 students at the University of Alabama at Birmingham. Three scales were administered. The PEMS questionnaire consists of measure of food intake and sensitivity to reward or punishment. The Yale Food Addiction Scale (YFAS), which is based on the DSM-IV-TR criteria for substance dependence and measures. Lastly, the Binge Eating Scale (BES), which measured the binge eating severity of each participant. Results concluded that coping was found as a motive for eating palatable foods, and it was significantly associated with increased binge eating scores.

These studies provide evidence of the relationship between negative affect and food consumption however, the samples primarily consist of students. This is problematic, as the scales used do not account for individual characteristics such as income. Students are generally struggling with financial issues, so it could be questioned as to how accessible it is for them to purchase healthy foods.  Unhealthy foods are more likely to be consumed while in a positive mood.

True or False?
 * type=""}

-True + False

Operant Conditioning - Skinner (1938)


Operant conditioning is a method of learning that strengthens or decreases behaviour through rewards and punishment. It is hypothesised that individuals engage in eating behaviours to regulate their moods through their food choices and the amount eaten. The reward and gratification centres have shown to have associations with food consumption (Singh, 2014), which is governed by dopamine. Reward and pleasure centres are activated when a particular food is eaten, creating a positive feeling. This creates a repetitive behaviour. This learnt behaviour can explain why after a long intense day at work you reach for a packet of chips even though you're not feeling physically hungry but, it makes you feel relaxed. Specific foods (generally hyper-palatable) have been identified as an influence on the activity from the brain rewards centre and positive chemical release, for example chocolate.

 There are over 300 chemicals that compose chocolate, which have various effects on our body through the nervous system (McGeer & Mcgeer, 1980). Chocolate causes the release of certain neurotransmitters, and these neurotransmitters can have a great impact on our mood. An ingredient included in chocolate is tryptophan which is an essential amino acid needed to produce serotonin (McGeer & Mcgeer, 1980). Serotonin is known as an anti-depressant or the “happy-chemical”. Another pleasure-inducing chemical released is endorphins. Endorphins help reduce feelings of stress and lead to feelings of excitement (McGeer & Mcgeer, 1980).

Reward Based Stress Eating Theoretical Model - Adam & Epel (2007)
Recent research has revealed that there may be biological causes to emotional eating, specifically related to the release of cortisol and ghrelin. Cortisol is a steroid hormone which is also referred to as the stress hormone that is produced by the adrenal gland. It is produced by our bodies in response to stress. High levels of cortisol have shown to predict greater future weight gain (Chao, Jastreboff, White, Grilo, and Sinha, 2017). Ghrelin is a hormone that is related to appetite regulation, with increased levels of ghrelin inducing hunger. Ghrelin levels are reduced once a person begins to eat. Results from studies have suggested that high levels of ghrelin is associated in increased food cravings and reward-driven eating behaviours.

This is clearly illustrated through the Reward Based Stress Eating theoretical model proposed by Adam & Epel (2007). The model emphasises the role of cortisol and that in combination with the reward circuitry, people are motivated to eat calorie dense foods. However, unlike other theories it includes cognitive restraint. Cognitive restraint is the act of cognitively restricting food intake, and is presented in the model as highly correlated with stress producing stronger reward based eating. This suggests that people dieting by restricting their foods are more likely to indulge in something to eat when they have increased levels of cortisol.

 {Sally has been really upset about school lately. Sally’s mum takes her to her favourite ice cream shop to make her feel better. A couple of weeks later, Sally failed her maths test and felt really disappointed and upset. Sally goes to the kitchen to get something to eat to make her feel better.

According to Skinners Operant Conditioning theory what is Sally likely to eat?}


 * type=""}

- Carrot sticks + Ice cream - Apple - A salad

Does eating junk food reduce psychological distress?
"You are what you eat", could this be true when referring to eating junk food and experiencing feelings of psychological distress? The food that we ingest may be impacting the way we feel. "Bad" food such as chips, chocolate and lollies may be the cause for these "bad" feelings. You may feel positive feelings while consuming the food however the feelings that initiated the eating are still there. Often after overeating there are feelings of guilt and shame, which are commonly seen in people suffering from bulimia (Bacher et al., 1999).

There are some biological explanations of how the consumption of junk food impacts psychological distress symptoms. Foods that contain high-fat and high-sugar also promote inflammation of not only the gut, but the entire body (Hashioka, et al. 2018). The consumption of sugar can impact the lining of our gut and allows for harmful substances to pass into the body. Once small molecules escape from the gut into the bloodstream it causes inflammation. This inflammation has been linked as an important pathogenic factor in major depression (Hashioka, et al., 2018). It causes neuro-inflammation through several postulated pathways and as such, it affects brain functions such as neurotransmitter metabolism. These brain functions are relevant to major depression, and produce behavioural changes and depressive moods (Dantzer, 2017). An associated condition with major depression is also generalised anxiety disorder (Kessler, Nelson, McGongale,and Blazer, 1996). However, there seems to be a lack of studies analysing the direct biological impact of junk-food on mood, rather there is an abundance of studies focussing on healthy food patterns and emotions.

Various studies have found evidence correlating a healthy diet with positive mental health and well-being (Lai, et al. 2014). One study found adolescents with diets high in unhealthy food were more likely to experience psychological problems (Kulkarni, Swinburn & Utter, 2015). In 2014, a systematic review and meta-analysis was conducted looking at deitary-patterns and depression (Lai, et al. 2014). 13 observational studies were analysed which revealed that a healthy diet (intakes of fruit, vegetables, fish and whole grains) was significantly associated with reduced odds of depression. However, these studies cannot conclude that an unhealthy diet causes psychological problems. As the previous research discussed earlier in the chapter indicates that negative emotions may be the underlying cause of eating unhealthy foods. So, do eating habits improve as emotions are regulated? Or, are people with better mental health consuming healthier foods because of their positive mood?



What has inflammation been linked to as an important pathogenic factor?


 * type=""}

- Crying - Anxiety - Loneliness + Major depression

Real World Applications
So how can these studies and information from this chapter help with your emotional and eating behaviours?

The first step in changing behaviour is becoming aware of it (Corstorphine, Mountford, Tomlinson, Waller & Myer, 2007). These theories and studies have shown that the main way to cope with emotions is to use food to relieve or mask the tension. Discouraging emotional avoidance is vital for treatment. Corstorphine and colleagues (2007) showed that treatment which involved accepting and engaging in problem solving strategies assisted in one’s ability to cope with distress. A few managing items from the study included:


 * When I am really angry, I do something to calm myself mentally:
 * Count to 100
 * If I find I am getting too anxious I will do something to soothe myself
 * Listen to music
 * Read a book
 * Meditation
 * I cope with feeling lonely, I do something to remind myself that there are other people there for me
 * Look at photographs
 * Message friends

Previously discussed, studies suggests that a healthier diet is associated with better health and well-being (Kulkarni, Swinburn & Utter, 2014). Everyday Health has published an article which includes specific foods and drinks which contain anxiety reduction properties. A few of these foods include, bananas, dark chocolate and chamomile tea. These options are a healthier and likely to be more beneficial substitute to eat while experiencing negative emotions.

Conclusion
The relationship between junk food and psychological distress is bilateral. Research has shown that in order to cope with psychological distress, people are overeating to relieve the tension (Kaplan & Kaplan, 1957, Macht, 1999). However, this avoidance behaviour only masks the emotions and does not effectively treat it. According to Skinner’s Operant Conditioning Theory (1983), choosing to consume junk food while experiencing psychological distress can be explained through the reward and pleasure centres activated while eating the particular junk food, this in turn creates positive feelings and associations. While experiencing psychological distress people are more likely to reach for more palatable foods such as high-fat and high-sugar foods, these food choices may actually induce feelings of depression or anxiety (Hashioka, et al., 2018, and Dantzer, 2017). There are various studies that have found correlations between healthier diet patterns and better mental health and well-being (Lai, et al. 2014). Future studies should incorporate a naturalistic observation into their methodology as a majority of these studies are self-reported. The issue with self-reporting of emotional eating is that it may not truly reflect the eating behaviour. Hopefully, understanding the impacts of psychological distress will assist you in becoming aware of your eating behaviours and lead to positive and productive coping strategies which will enhance your mental and physical well-being.


 * Take home messages


 * Emotional eating is not caused by physiological hunger rather, it is used a coping mechanism for negative emotions.
 * Eating certain foods while feeling specific emotions (particularly hyper-palatable foods) is a learnt behaviour.
 * The properties of junk food are linked to biologically inducing depressive and anxious symptoms
 * The healthiest ways to cope with psychological distress is by becoming aware of it and engage in different problem solving strategies to reduce the negative feelings.
 * Overall, a healthier diet pattern is recommend for overall mental and physical well-being.