Appetite 40 (2003) 47–54 www.elsevier.

com/locate/appet

Research Report

Relationship of gender and eating disorder symptoms to reported cravings for food: construct validation of state and trait craving questionnaires in Spanish
Antonio Cepeda-Benitoa,*, Mari Carmen Fernandezb, Silvia Morenoc
a

Texas A&M University, Department of Psychology, College Station, Texas, TX 77843-4235, USA b Facultad de Psicologia, Universidad de Granada, 18071 Granada, Spain c ´ ´ ´ Centro de Psicologıa Clınica Viania, Sos del Rey Catolico #7, 18006 Granada, Spain Received 1 February 2002; accepted 24 October 2002

Abstract Using confirmatory factor analysis, we cross-validated the factor structures of the Spanish versions of the State and Trait Food Cravings Questionnaires (FCQ-S and FCQ-T; Cepeda-Benito et al., 2000a) in a sample of 304 Spanish college students. Controlling for eating disorder symptoms and food deprivation, scores on the FCQ-T were higher for women than for men, but no sex differences were observed on the FCQ-S. Eating disorder symptomatology was predictive of trait cravings, whereas food deprivation was predictive state cravings. Trait cravings, but not state cravings, were more strongly associated to symptoms of anorexia and bulimia nervosa than with other psychopathology. We suggest that cravings can be conceptualized as multidimensional motivational states and that our data support the hypothesis that food cravings are strongly associated with symptoms of bulimia nervosa. q 2002 Elsevier Science Ltd. All rights reserved.
Keywords: Craving; Eating disorder symptoms; Measurement

1. Introduction Cravings are subjective motivational states that, in theory, promote ingestive behaviors. Similarly to the hypothesized causal relationship between drug cravings and compulsive drug use (Tiffany, 1990), the construct of food cravings has been important for theories and treatments of eating disorders. Food cravings have been blamed for binge eating in bulimia, early dropout from weight-loss treatments, over-eating in obese individuals, and the prevalence of bulimia nervosa (see review by Cepeda-Benito et al. (2000b)). The effectiveness of pharmacotherapy in reducing compulsive or binge eating has been attributed to the possibility that serotonin-enhancing drugs either block or reduce food cravings (Fluoxetine Bulimia Nervosa Collaborative Study Group, 1992). Moreover, some cognitive-behavioral interventions for binge eating also target

* Corresponding author. Tel.: þ 1-409-845-8038; fax: þ1-409-845-4727. E-mail address: acb@tamu.edu (A. Cepeda-Benito).

cravings through cue-exposure and response-prevention methods (Bulik et al., 1990, 1998). To date, the predominant model highlighting the role of cravings in binge eating and bulimia has been the starvation/dietary restraint model (Fairburn and Cooper, 1989; Heatherton and Polivy, 1992; Vitousek, 1996; Cooper, 1997). This model explains the development of a self-fueling cycle of dietary restraint, food craving and bingeing in which calorific restriction and homeostatic imbalances cause cravings and drive individuals to bingeing (Fairburn and Cooper, 1982; Booth et al., 1990; Cepeda-Benito and Gleaves, 2001). However, in sharp contrast with the hypothesis that calorific deficits trigger food cravings and bingeing, several studies have downplayed the role of hunger in the experience of food cravings (Davis et al., 1985; Hill et al., 1991) and the impact of dietary restraint in bingeing and purging (Heatherton and Polivy, 1992; Cooper et al., 1993; Lowe et al., 1996, 1998). Moreover, some investigators have indicated that cravings are not necessarily pathological, as suggested by the high incidence of chocolate and other food cravings in normal individuals

0195-6663/03/$ - see front matter q 2002 Elsevier Science Ltd. All rights reserved. doi:10.1016/S0195-6663(02)00145-9

In particular. 2001. 2.. (2001) also reported that cravers were more concerned with body weight than noncravers.. Dye.48 A. 1991. Lafay et al. Thus. as a tool intended to measure a stable construct. 39 items). Gendall and Joyce. To our knowledge the FCQT and the FCQ-S are the only available (published) measures of food cravings that have been psychometrically validated. men were more likely to report positive mood in connection with food cravings. Christensen and Pettijohn (2001) classified as cravers 91% of their sample after asking participants whether they ‘generally experienced intense desires or urges (cravings) to eat specific foods’ (p.. we also studied the extent to which sex differences in food-craving report are a mere reflection of the higher prevalence of eating-disorder symptomatology in women than men. Participants were recruited through verbal announcements at the beginning of different class periods. the main aim of the study was to investigate the relationship between eating disorder symptoms and food cravings. 2001). but also the notion that food-cravings are not necessarily linked to eating disorder psychopathology. 2001. in the two studies described in the previous paragraph. Recent studies have found greater incidence of food cravings in women than men and have reported that patterns of associations between food craving and mood varies as a function of sex. Michener and Rozin. would not be affected by a categorical (sex) and a relatively stable (eating disorder psychopathology) measure. or. the present study was also conceived as a crossvalidation of the Spanish FCQ-T and FCQ-S. 1991. Rozin et al. or longing for specific types of food (Weingarten and Elston. Although neither of these studies examined whether sex differences in food craving report were due to differential mood or eating disorder psychopathology. (2) find that the FCQ-T. 1990. Controversies regarding the origin and manifestation of food cravings are due in part to a lack of scientific consensus regarding what should be the most adequate definition and measurement of food cravings (see Cepeda-Benito and Gleaves. Whereas some researchers have defined cravings as a mere desires for a specific food or drug. Given the lack of consensus regarding the nature of food cravings and their role in maintaining binge eating among bulimia nervosa patients. would not be affected by a temporal or incidental variable such as such as length of time without eating. 2000b). Ages ranged from 17 to 38 with a mean age of 19.. sex differences in craving report have attributed to hormonal changes related to menstruation. and the fact that many individuals experience cravings as a simple yearning. as a measure of temporal and circumstantial states. conversely. 2001). Method 2. and sex differences in dietary and mood-regulating neurotransmitter deficiencies. especially women cravers. and troublesome in women than men (Rozin et al. whether sex differences in food-craving report continue to emerge even after removing the influence of eating disorder psychopathology.. Lafay et al. and previously validated food craving instruments: the Food Craving QuestionnaireTrait (FCQ-T) and the Food Craving Questionnaire-State (FCQ-S. others claim that a craving could be any desire for anything (Kozlowski et al. 2001. and (3) show that the FCQ-S. (2001) classified about 20% of their sample as cravers and stated that ‘subjects were considered to be cravers if they experienced a strong urge to eat specific foods at least once a week during the past 6 months’ (p. Reid and Hammersley. Cepeda-Benito et al. we expected to (1) replicate the factor structures of both questionnaires. Lafay et al. their sex effects and conflicting results highlight the importance of studying food cravings in both men and women. 197). 1990). Given that the Spanish version of the FCQ-T did not include in its original validation two items later added to the final and revised English version of the FCQ-T (37 vs. For instance. 1989). We want to emphasize that the present study is the first to examine sex differences in craving report while controlling for eating disorder psychopathology.. / Appetite 40 (2003) 47–54 (Rozin et al. These instruments were created consistent with the theory that food cravings can arise from or be expressed as both physiologically and psychologically mediated processes (Weingarten and Elston. intense. Cepeda-Benito et al. cultural influences. 1994). desire. (2001) found that whereas women associated food cravings with negative mood states. Gofton and Murcott.1 (SD ¼ 2. They were asked to complete the questionnaires anonymously during their regular class periods. Noting that food cravings are more prevalent. Participants and procedures The participants were 304 volunteer undergraduate psychology students (75% women) from the Univesidad de Granada. The present research measured cravings as a continuous variable using two multi-factorial. 2000b). Christensen and Pettijohn (2001) reported that carbohydrate cravings were more strongly associated with negative mood in men than women. 2000a). Such pattern of results would not only support the hypothesis that food cravings are more prevalent among individuals with behavioral symptoms of bulimia. All administrations were group sessions and participants were not compensated for their . we predict that both eating disorder symptoms and sex will uniquely and substantially contribute to predict food-craving report. whereas the psychometric properties of the Spanish versions have been validated using a single sample of Spanish respondents (Cepeda-Benito et al. Conversely.1.8) years. To date. 1991). 138). 2001. The English version of the instruments have been validated and crossvalidated using three samples of American participants (Cepeda-Benito et al. and eating-disorder psychopathology (see reviewes by Benton. Granada is a city of over two hundred sixty thousand people in Southern Spain. 1991). In sharp contrast. 2000a..

(2) anticipation of positive reinforcement that may result from eating.94 and factor-scale alphas ranged from 0. with the generalized least squares (GLS) method (for recommendations for GLS. other scales tap more general dimensions of psychopathology often found among eating disorder clients. including inadequacy. The overall alpha for the FCQ-S was 0. the Ineffectiveness scale surveys general feelings of distress. 1998). see Browne (1982. Participants are asked to think of the food or foods they usually crave (for the FCQ-T) or the specific foods they are currently craving while completing the questionnaire (for the FCQ-S). worthlessness. For the FCQ-S. we performed CFA. the nine scales of the FCQ-T measured: (1) intentions and plans to consume food. That is. In the present sample.. and lack of control (see Garner. Garner indicated that the 0 –3 scoring system is recommended over a 1 – 6 scoring system because responses in the nonsymptomatic direction should not aggregate to contribute to a total scale score that measures symptomatology.2. Eating disorder symptoms were measured with the Eating Disorder Inventory-2 or EDI-2 (Garner. Always in reference to craved foods. at risk male (N ¼ 26) and female (N ¼ 251) individuals. Ineffectiveness.90 range. Subscale totals are obtained by adding the weights assigned to their respective items. preoccupation with weight. 1984) and Anderson and Gerbing (1988)). 1990). and a nonclinical control sample of male (N ¼ 2057) and female (N ¼ 1751) adolescents. 2000a). (2) anticipation of positive reinforcement that may result from eating. (8) environmental cues that may trigger food cravings.62 to 0.3. For example. and factor-derived scales provided alphas in the 0. . 1991). The Spanish version of the EDI-2 (Garner. Also in reference to craved foods. (5) thoughts or preoccupation with food. ‘usually’. Cepeda-Benito et al. (2000b) obtained results supporting the above structures and the notion that cravings have multidimensional features (Tiffany. Full-scale and factor-scale totals for both instruments can be calculated by simply adding the corresponding item scores. respectively (Cepeda-Benito et al. ‘sometimes’. Statistical methods With regards to the factor structure crossvalidation. The instructions of the FCQ-T ask participants how frequently each statement ‘would be true for you in general’ using a six point scale that ranges from 1 (‘Never’ or ‘Not Applicable’) to 6 (‘Always’). the five factors or scales of the FCQ-S measured: (1) an intense desire to eat. 2. / Appetite 40 (2003) 47–54 49 contribution. (3) anticipation of relief from negative states and feelings as a result of eating. 1998) was tested with a Spanish national sample of male (N ¼ 4) and female (N ¼ 302) eating disorder patients. ‘often’. participants were asked to indicate the extent to which they agreed with each statement ‘right now.89 and factor-scale alphas ranged from 0.83. the analyses yielded excellent fit indices for nine and five factor solutions for the FCQ-T and FCQ-S. urges or desires for one or more specific types of food. 1990. These authors also found support for the construct validity of the English versions of the instruments. Using confirmatory factor analyses (CFA). 2000b). participants were asked to report cravings for specific foods but the specific food cravings to which they referred varied across individuals. The eight clinical scales of the EDI-2 measure dimensions that are clinically relevant to eating disorders but while some scales measure symptoms highly characteristic of eating disorders.72 to 0. ‘rarely’. The eight clinical scales of the EDI-2 were named Drive for Thinness. and (9) guilt that may be experienced as a result of cravings and/or giving into them. (4) obsessive preoccupation with food or lack of control over eating. The remaining three responses are assigned a weight of 1. Measures The FCQ-T (39 items) and the FCQ-S (15 items) measure the intensity of 9-trait and 5-state dimensions of food cravings.A. or 3. Body Dissatisfaction. (3) anticipation of relief from negative states and feelings as a result of eating.68– 0. The normative profiles of Spanish. Weingarten and Elston. Interpersonal Distrust. and Interoceptive Awareness. the overall alpha for the FCQ-T was 0. while Drive for Thinness assesses dieting concerns. using LISREL 8. Bulimia. Maturity Fears. Perfectionism.92. The instructions and the items of the instruments ask respondents about cravings. 1991. 2. and effectively discriminates between eating disorder and control populations (Garner. and fear of weight gain. Cepeda-Benito et al.. Research with both the English and Spanish versions indicates that EDI-2 scores correlate positively and substantially with other measures of eating disorder symptoms. Thus. eating-disorder patients and control participants were highly similar to the normative profile of their US counterparts. and (5) craving as a physiological state. or ‘never’.93. 1991). (4) possible lack of control over eating if food is eaten. the overall alpha for the EDI-2 was 0. (7) emotions that may be experienced before or during food cravings or eating. with higher numbers indicating more intense pathology. 2. The three responses farthest from the symptomatic direction receive a weight of zero. Dividing the number of participants by the class sizes we estimated a participation rate of 90%. In our study. (6) craving as a physiological state. at this very moment’ using a five point Likert scale that ranged from 1 (‘Strongly Agree’) to 5 (‘Strongly Disagree’). respectively (Cepeda-Benito et al. Participants rated the extent to which each item applied to them ‘always’. and Bulimia measures tendencies to think about and engage in bingeing. The EDI-2 consists of 64 items that yield eight ‘clinical’ scales and 27 additional items (items 65– 91) that generate three ‘provisional’ scales.

That is.0.43 – 3.1. 9.42 (SD ¼ 0. 1990). and the Root Mean Square Error of Approximation (RMSEA.59 0.87 – 4 0. CFI ¼ 0. Browne and Cudeck (1993) suggest that values of the RMSEA of 0. and the total score from the EDI-2 and food deprivation as the set of covariate variables. the Tucker-Lewis index (TLI. RMSEA ¼ 0. To examine the discriminant validity of both multifactor models.99. Although none of these confidence intervals contained 1.05 or less indicate a close fit.42 0.14.05/2).60 in both instruments.44 0. We also analyzed the relative influence of eating disorder symptoms.35 – 3 0.48 – 5 0.60 0. 3. Cepeda-Benito et al. TLI ¼ 0. Inter-factor correlations for the FCQ-S ranged for 0. 1988). respectively).48 0.16. Lack of control over eating 5. which can be interpreted as support for the discriminant validity of the model.62 – 7 0. 7. the high correlations between some factors weakens the overall discriminant validity of the model. This analysis was carried out after assessing that the MANCOVA assumption of homogeneous regression planes was met. Bentler and Bonett. whereas values greater than 0. eating disorder symptoms uniquely and exclusively predicted trait cravings. see Table 2).36 0. we used the total scores from the FCQ-T and FCQ-S as the multivariate dependent variable with sex as the independent (group) variable. TLI. 1990).49 – 4 0. Model fit was evaluated using the Normed-Fit Index (NFI. Plans or intentions to eat Anticipation of positive reinforcement from eating Anticipation of negative reinforcement from eating Lack of control over eating Thoughts or preoccupation with food Craving as a physiological state or hunger Emotions experienced before or during food cravings Environmental cues that may trigger food cravings Guilt from cravings and/or for giving into them 1 – 2 0.. That is.21 0.53 0.66 0. Steiger.40 0.40 – and specified a nine and a five factor models for the trait and state version of the FCQ.17 0. providing further support for the multidimensional structure of the food craving questionnaires.0 and item-factor loadings were above 0. (Cepeda-Benito et al. Inter-factor correlations for the FCQ-T ranged for 0. 2000b): NFI ¼ 0. 1980).74 0. and RMSEA ¼ 0.36 – 9 0.039. with a mean inter-factor correlation of 0. Factor structure crossvalidation The responses to the FCQ-T in Spanish gave an excellent fit the nine-factor structure of this instrument in English .87– 0.44 – 8 0. see Marsh et al.17.025 following the Bonferroni method (0. 1989).27 – 3 0. we also examined confidence intervals around the factor correlations (þ or 2 2 standard errors) to see if any contained 1. respectively.50 0.37 0.56 0. 5. / Appetite 40 (2003) 47–54 Table 1 Interfactor correlations or PHI matrix for the FCQ-T Scales 1. Anticipation of positive reinforcement from eating 3.08 indicate adequate fit. Correlation analyses examined the degree of association of specific eating disorder symptoms (EDI-2 scales) with trait and state cravings (FCQ-T and FCQ-S scales. 8.40 0.44 0.98. 2. with a mean inter-factor correlation of 0. Overall. 1992). food deprivation and sex on trait and state food cravings we conducted multivariate analysis of covariance (MANCOVA).46 0. Eating disorder symptoms. Bentler.07. An intense desire to eat 2.99.27 0. Univariate analyses also explored the unique contribution of each covariate variable to predict FCQ-T and FCQ-S scores.55 0. The TLI and CFI have been found to be unaffected by sample size (Marsh et al.38 0.2.98.99. Univariate analyses on each dependent variable examined the source of the multivariate effects. food deprivation and gender effects on trait and state food cravings As expected. 0.90 or greater reflect an adequate fit (Byrne.66– 0. whereas length of Table 2 Interfactor correlations or PHI matrix for the FCQ-S Scales 1. 6. 1988). 3.10 indicate room for improvement in the model. and CFI values of approximately 0.54 0.05 and 0. Anticipation of negative reinforcement from eating 4. see Table 1).67 0. 1989. Mulaik et al.44 0.37 0.46 (SD ¼ 0.. CFI ¼ 0. itemmodification indices were below 5.36 0.38 0.0 (Anderson and Gerbing.43 0. The responses to the FCQ-S in Spanish also resulted in an excellent fit for the five-factor structure of the instrument: NFI ¼ 0. The alpha level for statistical significance of the univariate effects was adjusted at a .41 0. 1988).50 A. 4.23.51 0.38 0..37 0.52 0.99.23 – 5 0..51 – 6 0. For the NFI. values between 0. neither time by sex nor eating disorder symptoms by sex interacted to predict the set of dependent variables (see Stevens. Craving as a physiological state or hunger 1 – 2 0. TLI ¼ 0.42 0. Results 3. the Comparative Fit Index (CFI.

001.01 20. p .4.60b 0.38a 0. Cepeda-Benito et al. 4. 0.51b 0. Bulimia.02 0.02 20.03 20.12 0. Table 4 Correlations between the EDI-2 scales and the FCQ-S scales Scales An intense desire to eat Anticipation of positive reinforcement from eating Anticipation of negative reinforcement from eating Lack of control over eating Craving as a physiological state or hunger a D Thin 20.01 0. 0. p .16 0.11 0. Bulim.01 0. / Appetite 40 (2003) 47–54 Table 3 Correlations between the EDI-2 scales and the FCQ-T scales Scales Plans or intentions to eat Anticipation of positive reinforcement from eating Anticipation of negative reinforcement from eating Lack of control over eating Thoughts or preoccupation with food Craving as a physiological state or hunger Emotions experienced before or during food cravings Environmental cues that may trigger food cravings Guilt from cravings and/or for giving into them D Thin 0.12 0.16. 0.02.15 0.02 Note: EDI-2 scale abbreviations are defined in Table 3.05 0. Bulimia.001. 0.10 0. respectively.04 0. the correlations between FCQ-S scales and EDI-2 scales were overall small or close to zero.07 I Distr 20.01 Int Aw 0.21 0.295) ¼ 12. After controlling for EDI-2 scores and food deprivation. Wilk’s Lambda ¼ 0. These patterns of correlations are congruent with the notion that the FCQ-S and the FCQ-T measure state and trait cravings.22 0. b ¼ 0. Large sized correlations ¼ r .01 0. Additional analyses Additional analyses were carried out to examine association patterns between EDI-2 subscales and the factor-derived scales of the FCQ-T and the FCQ-S.01 0. B Diss. Bulimia. Drive for Thinness. Maturity Fears.12 0. 0. Medium sized correlations ¼ r .18 0. while food deprivation only predicted FCQ-S scores. 0. I Distr.02 20.02 20.28 0.39. and univariate FCQ-S scores.26 0. with the exception of a moderate correlation between the Lack of Control craving scale and the Bulimia scale of the EDI-2 (see Table 4).001. and Body Dissatisfaction.38a B Diss 0.59b 0.18 0. The results also supported the expectation that women would report greater cravings than men above and beyond sex differences in eating disorder symptomatology. p .04 20.792. Perfec. p .21 0. p .07 0.29.2. Cohen (1988) characterized r ¼ 0. Univariate analyses indicated that FCQ-T scores were significantly higher for women (M ¼ 110) than for men (M ¼ 98).13 20.18.30a 0.29.15 20.04 0. Moreover.14 Note: EDI-2 scales: D Thin.01 0.17 0. p . 1.04 0.52b 0. Body Dissatisfaction. Int Aw. F(4.11 0. and that such difference would be specific to trait rather than situational cravings. F(2.10 20.16 0.71b Bulim 0.001.01 0. Conversely.10 20. 0. F(1.08 0.05 0.A. F .08 Int Aw 0. p .04 0.24 0. a medium sized correlations ¼ r .05 Mat Fear 20. 0.005. t(295) ¼ 7.09 20. and 0.09 0.11 0. was the measure that was most consistently and substantially associated with the FCQ-T scales (see Table 3).11 Ineffec 20.06 0.35a 0.03 0. 0.20.10 0.10 B Diss 20.19 0.22 0.17 20. .08 0.11 0.37a 0.11 I Distr 0.5 as large effect sizes.38a 0. Examination of the bivariate correlations indicated that the pattern of associations with the FCQ-T were medium to high for the EDI-2 scales that measure eating-disorder symptoms. F(2. Perfectionism.01 0.1 as a small.58b Ineffec 0. Wilk’s Lambda ¼ 0.49. Interpersonal Distrust.295) ¼ 27.18 Bulim 0. examination of the separate contributions of EDI-2 and food deprivation scores revealed that the EDI-2 measure only predicted FCQ-T scores.34a 0. Mat Fear.11 0.14 0.29 0. 0.26 0.18 0.49.09 0.22 0.26 Perfect 0.16 0. 0.17 0. 0. b ¼ 0. but that there were no sex differences for FCQ-S report.15 0. ineffectiveness.09 20. there was a significant sex difference on the FCQ-T and FCQ-S multivariate variable. Internal Awareness.37 0.294) ¼ 6.03 0.07 0. However.01 20. but small to medium for the scales that measure more general psychopathology (see Table 3). EDI-2 scores and food deprivation together strongly predicted the FCQ-T and FCQ-S multivariate variable. t(295) ¼ 2.295).11 20. respectively.1.588) ¼ 18.12 0.9.23 0.16 0.39a 0. the only scale of the EDI-2 that specifically measures tendencies to think about and engage in bingeing.03 0.3 as medium. F(2. b Large sized correlations ¼ r .02 0.10 0.25 0.01 0.02 0.20 0.01 Perfect 20.17 0.03 0.960.30a 51 Mat Fear 0.19 0. food deprivation uniquely and exclusively predicted state cravings.001. Drive for Thinness.36a 0. EDI-2 subscales and food deprivation together also predicted univariate FCQ-T scores. Ineffec.

at the basic level researchers could manipulate mood and test the hypothesis that food cravings are elicited by affective states (Buffenstein et al. whereas scales that measure less specific symptoms of eating disorders (Ineffectiveness. eating disorder symptoms were predictive of higher trait cravings. 1997). the scales Drive for Thinness. none of confidence intervals around the factor correlations (þ or 2 2 standard errors) contained 1. Bulimia. Although the study was conducted with a highly relevant sample (most participants were young. Maturity Fears. effectively reduce craving reactivity (Bulik et al. whilst the FCQ-T was and the FCQ-S was not sensitive to ‘trait’ variables (eating disorder symptoms and sex). the hypothesis that dietary restraint leads to cravings.0 (Anderson and Gerbing. researchers could test whether interventions. Michener and Rozin. boredom. We suggested that cravings are not necessarily pathological. Regarding the FCQ-S. and to life-time prevalence of bulimia nervosa (Gendall et al. 1996). the FCQ-S was and the FCQ-T was not influenced by an incidental circumstance (food deprivation). Moreover.. For example. Multivariate analyses supported the notion that eating disorder habits found in bulimic patients contribute to the experience of food cravings (Green. The present investigation shows that there is a clear relationship between eating disorder symptoms and food cravings. after controlling for food deprivation and sex. longer version of the Spanish FCQ-T. 1991. female college students). and cravings lead to bingeing needs to be investigated directly with bulimia nervosa patients. 1991. emotional states.. having readily access to snacks). 1994). Discussion How best conceptualize cravings has been and will most likely continue to be a controversial subject within both the drug addiction and eating disorders literature (Cepeda-Benito and Gleaves. reduced bingeing in bulimic patients). Confirming our expectations. the nine and five factor solutions of the FCQ-T and FCQ-S.. That is. Most notably. The results represent a significant contribution to the literature in that this is the first study to crossvalidate the factor structures of the Spanish versions of the trait and state FCQ. Although we predicted an overall substantial association between trait cravings and the EDI-2. the results are consistent with previous research liking cravings to symptoms of bulimia (van der Ster Wallin et al. Cepeda-Benito et al. their respective associations with the Drive for Thinness and Body Dissatisfaction scales of the EDI-2 were substantially different. a scale that assesses bingeeating tendencies was the measure most consistently associated with the FCQ-T. At the applied level. anger. Scores obtained with the FCQ-T supported this prediction after controlling for eating disorder symptoms and degree of food deprivation. This finding is important in that.g. The present investigation provides further support for a multidimensional conceptualization of trait and state food cravings. Thus. CFA showed excellent fit indices for the apriori proposed factor structures and there were various sources of evidence for the discriminant validity of the models. 2001. 1991). Weingarten and Elston. and other relevant stimuli. 1994). 1990. and contributes to a better understanding of the link between eating disorder symptoms and food cravings. rather than a using a dichotomous classification of individuals into ‘cravers’ and ‘noncravers’ according to an arbitrary and ambiguous definition of food cravings. Bulimia. the present study is the first to establish and association between food cravings and symptoms of bulimia using a continuous measure of food cravings of known reliability and validity. this is the first study to show that gender/sex differences in craving report remain after removing the variance accounted for by eating disorder psychopathology. That is. the study is the first to examine the psychometric properties of the revised. Federoff et al. Finally. Rozin et al. but that consistent with prior empirical findings women would report higher levels of craving than men (Weingarten and Elston. were replicated. we also expected that this association would be particularly high with the scales of the EDI-2 that measure eating disorder symptoms in general and bulimia nervosa symptoms in particular. / Appetite 40 (2003) 47–54 5. The results also supported the convergent and discriminat validity of the FCQ-T and the FCQ-S in that the arrangement of associations between these measures and the other trait and state variables in the study followed congruent patterns.. That is.. That is.. to our knowledge. 1995. 1997). . On the one hand. euphoria) and environmental circumstances (e. Cepeda-Benito and Tiffany.g. 1988). 1990). 1998.g. Perfectionism. future studies should investigate the extent to which the factor structures of FCQ-T and FCQ-S replicate with eating disorder patients. 2001). although the correlation between the Positive Reinforcement and Negative Reinforcement factors of the FCQ-T were very high. Tiffany and Carter. respectively. but future research should also study the processes by which such relationship comes about. Moreover. and Interoceptive Awareness) were weakly associated with trait cravings. However. we can assert that variables other than eating disorder psychopathology play an important role in food craving differences between men and women. further investigations should examine whether the FCQ-S is sensitive to food craving changes in reaction to food cues.52 A. and whether such changes in craving reactivity translate into better treatment outcomes (e. and Body Dissatisfaction were moderately-to-strongly associated with trait cravings. it remains to be seen whether this state measure will be sensitive to other psychological states (e. In particular. Negative Reinforcement but not Positive Reinforcement cravings were significantly associated with Drive for Thinness and Body Dissatisfaction. Interpersonal Distrust. These results also lend support to the notion that food cravings are not necessarily pathological and can be independent of eating disorder symptoms (Rozin et al. Moreover. being alone. Moreover. such as cue-exposure/responseprevention strategies.

Stephens. 237– 263). Asymptotically distribution-free methods for the analysis of covariance structures. Behaviour Research and Therapy. 62–83. J. R. Hillsdale. F. 277 –314). & Kaye.). T. Hetherington (Ed. V. M. & Basdevant. Food cravings in women with a history of anorexia nervosa.. DC: Hemisphere. Gleaves. A. C. Appetite. E.. Weaver. A. (1995). (1993). UK: Leatherhead. Crowther. Carter. P. 411 –423. J. double-blind trial. Newbury Park. Testing Structural Equation Models (pp. Charles. P. (1990).. 17. Appetite.). Psychological Medicine. Leatherhead: Surrey. Cohen. K. R. Cepeda-Benito. 58. Williams. D. The special place of chocolate in the Anglo-American diet: towards a sociology of food cravings and addictions. Archives of General Psychiatry. Christensen. Structural equation modeling in practice: a review and recommended two-step approach. . Surrey. L. D.. & Joyce. (1988). Browne. In M. Washington. Food Cravings and Addiction (pp. 36. Physiology and Behavior. K. dietary restraint and mood. E. D. & Blair. H. future investigations should aim to delucidate whether we should distinguish between healthy and unhealthy food cravings. McIntosh. D. P. (1982). 28. & Murcott. Garner. 116 –119. Clark (Eds. The role of exposure with response prevention in the cognitivebehavioural therapy for bulimia nervosa. & Fairburn. 135 –155). M.. Statistical Power Analysis for the Behavioral Sciences (2nd ed. (1996). M. and food intake. 238–246. In K. M. & Reynoso. Surrey. Fluoxetine Bulimia Nervosa Collaborative Study Group (1992). Eschwege. Cognitive Behaviour Therapy for Psychiatric Problems: A Practical Guide (pp. L. 29. In K.. J. (1997). Bulik. International Journal of Eating Disorders.. The effect of preexposure to food cues on the eating behavior of restrained and unrestrained eaters.. Mood and carbohydrate cravings. Addictive Behaviors. Byrne. Gleaves. Hetherington (Ed. measurement. Oxford: Oxford Medical Publications. L. Benton. J. W. C. A.. An experimental study of the relationship between thought and eating behaviour in bulimia nervosa. Chronic dieting and eating disorders: a spiral model. J. B. Topics in Applied Multivariate Analysis (pp. England: Cambridge University Press. D.). W.. D.. M. 521–548). Salkovskis.. Davis. Mann. 187–197. (1997). Cognitive theory in anorexia nervosa and bulimia nervosa: a review. F. 136 –162). A. Gender differences in the relation between food cravings and mood in an adult community: results from the Fleurbaix Laventie Ville Sante’ study. P. (2000a). Characteristics of food cravers who binge. Freeman.. International Journal of Eating Disorders. & Prentice. 107. (1988). F. Hobfall. P.. Hawton. M. J. 1067–1077. Poppitt. & Herman. F. 14. L. In M. 265–293). A.. Buffenstein. In M. & Poulos. 1125– 1138. Appetite. In M.A. L. The development and validation of Spanish versions of the state and trait food cravings questionnaires... J. 25. 31. M. Hawkins (Ed. FL: Psychological Assessment Resources. A. Alternative ways of assessing model fit. Food Cravings and Addiction (pp. Fedoroff. 139– 147. M. 381 –388. M. T. R. / Appetite 40 (2003) 47–54 53 because the results are congruent with the notion that food cravings are associated with eating disorder symptoms but are not necessarily pathological. EDI-2: Inventario de trastornos de la conducta alimentaria. 28.. D. Surrey. P. 88. C. (1985). Behavioural and Cognitive Psychotherapy. Hetherington (Ed. 611–623. Cepeda-Benito. 37. (2001). & Cooper. A. McDevitt. C.. T. Lafay. P. & J. Gendall. & Pettijohn. UK: Leatherhead. UK: Leatherhead. M. Booth. A. Cravings across the menstrual cycle and in premenstrual syndrome. Polivy. & Bonett. 591–606. M. Green.. Mennen.). Vila. G. Journal of Psychiatric Research. S. (1998). Eating Disorders Inventory—2.. & Solyom.. Tennenbaum (Eds. P. Food Cravings and Addiction (pp. H. R.. Surrey. 155–163. Sullivan. C. (1998). (1990). H. M. L.). M. I. Hill. C. The Etiology of Bulimia: The Individual and Familial Context (pp.. T. A. (1989). F. & Gerbing. Cravings are ambiguous: ask about urges or desires. A. 137–145. In D.). (2001). W. A. Bentler. Cooper.. P. The use of a dual-task procedure for the assessment of cognitive effort associated with cigarette craving. F. 749–757. D. R. Browne. M.. Food craving. Fairburn.. (2001). Wilkinson. 14... (1991). (2001). (2001). M. S. L.... Psychological Bulletin. 2. We thank the faculty. J. 331– 335. Cambridge. (2001). (1989). (1990). Fluoxetine in the treatment of bulimia nervosa: a multicenter. R. Behavior Research and Therapy. Significance tests and goodness of fit in the analysis of covariance structures. S. Cooper. C. L. L. Acknowledgements This research was financed by the Spanish Ministerio de ´ Ciencia y Tecnologıa (Ministry of Science and Technology) through a project titled Food Cravings and Eating Disorders: Assessment Instruments and Physiological Mechanisms. Epstein. 365– 390). Treatment of laxative abuse in a female with bulimia nervosa using an operant extinction paradigm. Covariance structures. Cepeda-Benito. J. (2001). UK: Leatherhead. J. (2001). Joyce. 72–141).). (1993). Browne. S.. Dietary restraint and binge eating: pseudo-quantitative anthropology for a medicalised problem habit? Appetite. & D.). & Bulik. W. Kirk. C. Hetherington (Ed. T. Mood and food: an analysis of bulimic episodes. Thomas.. 151–173. 403–409. Gendall. UK: Leatherhead. Heatherton. Dye. P. & Cudeck. J. Gofton. A.. 127. CA: Sage. M. L. M. R. (1991). 22. D.. A. & Joyce. M. M. Hetherington (Ed. Psychological and pharmacological explanations of chocolate craving. & Polivy. (1984). G. A. undergraduate assistants and participants from the psychology departments of the universities of Granada and Texas A and M for their generous help in facilitating of this research.. 566– 584). Sullivan. C. Fernandez. Surrey. 194 –205. C.. & Tiffany. (2000b). Psychopharmacology. V. M. Bollen.. D. 113– 145. Cepeda-Benito. New York: Springer. M. (1980). with implications for appetite research. Food Cravings and Addiction (pp. C. Behavior Therapy.. Psychological Bulletin. Kozlowski. Odessa. Eating disorders. & Gleaves. NJ: Erlbaum. & Erath. A. (1992). Journal of Substance Abuse. E. References Anderson. 19. J. Food Cravings and Addiction (pp. Comparative indexes in structural models. J. Hetherington (Ed. P. L. A Primer of LISREL: Basic Applications and Programming for Confirmatory Factor Analytic Models.. Food Cravings and Addiction (pp. D. A. Food intake and the menstrual cycle: a retrospective analysis. E. Borys. 31. 49. (1989). British Journal of Mathematical and Statistical Psychology. In M. Garner. Long (Eds.. A. R. (1997). R.). & Blundell. A critique of food cravings research: theory. In J... The development and validation of the state and trait food cravings questionnaires. Cepeda-Benito et al. M. S. Bentler. placebo-controlled. W.. M. Psychological Bulletin. V. J.). UK. Clark.). Dietary restraint and craving. P. 38. 3–29). 443 –445. 103.. In M. 33–47.. Lewis. D. Bulik. X. Madrid: TEA Ediciones SA.. & D. G.

(2001). James.. dieting. (1990). & Carter. Feurgueson. (1988). Rozin. (1996). S.. (1994). Cepeda-Benito et al. (1998). Weingarten. Dependence-like features of carbohydrates.. The current status of cognitive behavioral models of anorexia nervosa and bulimia nervosa. Restraint. P. Appetite. C.. B. R. 23–30. 263– 271. 173 –180...54 A. W.. Physiology and Behavior. M. A. P. G. On the relation of dieting and bingeing in bulimia nervosa. & Rozin. 89. R. K. Marsh. T.. 15. Is craving the source of compulsive drug use? Journal of Psychopharmacology. M. D. H. (1990). 107.. In P. & Holmgren. (1990). 103. N. H. Salkovskis (Ed. & Elston. & Hammersley. Structural model evaluation and modification: an interval estimation approach... W. Frontiers of Cognitive Therapy (pp. Food Cravings and Addiction (pp. Mulaik. D.. S. Binge eating versus nonpurged eating in bulimics: is there a carbohydrate craving after all? Acta Psychiatrica Scandinavica. 199–212. 105. E. C. Norring. 17. Psychological Review. Stevens. Lowe. (1998). H. 376–381. 231– 246. & Stoes. S. H. C. Gleaves. R. S. 25. L. Lind. Appetite. Weingarten. (1996). / Appetite 40 (2003) 47–54 Steiger. Levine. P. C. P. 12. Journal of Abnormal Psychology. 56. 477 –493). 147–168. R. 10. C.. Michener. K.. H. T. R. Evaluation of goodness-of-fit indices for structural equation models.. DiSimone-Weiss. (1991).. NJ: Lawrence Erlbaum. et al. UK: Leatherhead. Tiffany. The phenomenology of food cravings. 508– 517. In M. 430– 445. D. Balla. Goodness-of-fit indices in confirmatory factor analysis: the effect of sample size. Vitousek. & McDonald. R. Appetite. & Stilwell. (1991). M.. Psychological Bulletin. Reid. Mahwah. M. V. . Tiffany. 391–410. R. M. (1994).. J..). (1992). 419– 422.. 97. D. and the continuum model of bulimia nervosa. P. L. & Murphy-Eberenz. Lowe. H. 17. S.. & Gayda. New York: The Guildford Press. Multivariate Behavioral Research. Applied Multivariate Statistics for the Social Sciences. Psychological Bulletin. Alstine. Food cravings in a college population. Journal of Abnormal Psychology. (1989). D. Hetherington (Ed. A.). J. Bennett. & Elston. 383 –418).. Chocolate craving and liking. 167– 175.. Pharmacological versus sensory factors in the satiation of chocololate craving. Surrey. Gleaves. J. A cognitive model of drug urges and drug-use behavior: role of automatic and nonautomatic processes. van der Ster Wallin.

Sign up to vote on this title
UsefulNot useful