Academic journal article Journal of Mental Health Counseling

Impact of Depressive Symptoms and Alcohol Use on Disordered Eating and Suicidality: A Moderated Mediation Study

Academic journal article Journal of Mental Health Counseling

Impact of Depressive Symptoms and Alcohol Use on Disordered Eating and Suicidality: A Moderated Mediation Study

Article excerpt

Eating disorders are some of the most serious mental disorders described in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013), with significant life-threatening medical and psychiatric morbidity and mortality (Boughtwood & Halse, 2010; Hudson, Hiripi, Pope, & Kessler, 2007). The short- and long-term pernicious effects of eating disorders and the related signs and symptoms have been comprehensively described in the literature. The National Eating Disorders Association (2005) reported that in the United States, as many as 10 million women and one million men are fighting a life-and-death battle with an eating disorder, and millions more are struggling with a binge eating disorder. Researchers have found that individuals with eating disorders are at an increased risk of suicide attempts (Corcos et al., 2002; Miotto, De Coppi, Frezza, & Preti, 2003).

Importantly, eating disorders are among the most prevalent disorders among emerging adults, with prevalence estimates ranging from 8% to 17% (Eisenberg, Nicklett, Roeder, & Kirz, 2011; Reinking & Alexander, 2005). Boughtwood and Halse (2010) reported that anorexia nervosa is the third most common illness among adolescent girls and has the highest mortality rate of all mental disorders. Most often, disordered eating attitudes include body, shape, or weight concerns, whereas disordered eating behaviors include extreme weight- or shape-control practices such as caloric restriction, extreme exercising, binge eating, purging, the use of laxatives, and other compensatory behaviors (Striegel-Moore & Bulik, 2007).

Notably, within the past decade, body image dissatisfaction has been increasingly considered as a potential risk factor for the development of depression among young adults (Crow, Eisenberg, Story, & Neumark-Szlainer, 2008; Lamis, Malone, Langhinrichsen-Rohling, & Ellis, 2010). For instance, Stice, Marti, & Rhode (2013), in a longitudinal study composed of 1,124 high school students aged 13.0 to 16.9 years, found that body dissatisfaction and disordered eating at baseline predicted onset of subsequent depression among initially nondepressed emerging adults. The researchers also found evidence of a positive relation between disordered eating and suicide risk (Stice et al., 2013). The importance of empirical studies examining disordered eating and related mental health corollaries and outcomes in college and university samples cannot be overstated.


Depressive symptoms among college students are also prevalent (Arria et al., 2009; Eiser, 2011). According to the American College Health Association-National College Health Assessment, a nationwide survey administered to college students, approximately 30% of college students reported experiencing feelings of depression in the past year (American College Health Association, 2012). Stress among young adults, especially college students, arises from a variety of factors, including changes related to the transition from high school and, in many cases, living independently for the first time (Reynolds, MacPherson, Tull, Baruch, & Lejuez, 2011) and uncertainty regarding acceptance by peers and even in family relationships. When individuals experience stressful situations, they rely on various resources and strategies to alter these situations and lessen their impact. Some individuals may turn to resources such as interpersonal networks, including family and/or friends. However, others may adopt negative coping strategies (e.g., alcohol or drug use) or other maladaptive behaviors (e.g., disordered eating) as means of coping with various emotional and social problems. Negative emotions such as those typically associated with depressive symptoms have also been found to increase the tendency for disordered eating (Gluck, Geliebter, Hung, & Yahav, 2004).


The use of alcohol is present in all age groups. …

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