Hi! My name is Alexis Dumain, and I am a junior at UNC-Chapel Hill, double-majoring in psychology and creative writing. While at UNC, I have worked in the Bardone-Cone Eating Disorders and Body Image Lab as a research assistant and through an independent project in which I investigated interoceptive deficits — basically, a diminished ability to appropriately detect and respond to internal bodily cues — as a contributing mechanism to anorexia nervosa. I am very passionate about expanding research on eating disorders to include autonomic mechanisms and consider trauma in the progression of these conditions, and in treatment.
So, my placement at the UNC Center of Excellence for Eating Disorders (CEED) through the Gil Internship was the perfect fit. Founded in 2003, and directed by Dr. Cynthia Bulik, CEED has two main ‘arms:’ research and and treatment services. In both of these arms, there are many opportunities for training — of postdoctoral fellows completing their clinical internships; graduate students in psychology, epidemiology, and nutrition; and of undergraduate researchers, like me. Though CEED also treats individuals with eating disorders in an inpatient unit, I am working on their research team under the mentorship of Dr. Melissa Munn-Chernoff, the Director of Research Training at CEED and a professor in the Department of Psychiatry at UNC. I have also been able to sit in on team meetings between CEED and their international collaborator, the Centre for Eating Disorders Innovation (CEDI) at the Karolinska Institutet in Stockholm, Sweden. This semester, my main project has been a research paper that investigates whether history of childhood trauma influences the association between eating expectancies and disordered eating characteristics.
I’ll break it down: eating expectancies are the collection of beliefs that a person holds about food and the function it serves in their life. For example, one of the main ones that I have studied is “Eating Alleviates Boredom,” meaning this person believes that when they are bored, eating can help pass the time. More personal expectancies might be “Eating Is a Way to Fuel My Body” or “Eating Connects Me to My Culture.” Whatever the specific ones, they are formed and reinforced through experience. What’s more, the existing literature has connected certain eating expectancies to the development of certain features of disordered eating; for instance, Eating Helps Manage Negative Affect connects negative urgency, or the tendency to act rashly when distressed, with binge eating and compensatory behaviors, such as purging or intense exercise. Since it is well-established that trauma exposure is associated with disordered eating, especially binge eating, I hypothesized that the experience of a traumatic event (or several) might also influence the development of certain eating expectancies, which are formed and reinforced through experience.
Though there is not a lot of literature available on this connection currently, it has been incredibly meaningful to delve into this question through my partnership with CEED. More research on this topic will eventually help clinicians and researchers develop more effective treatments for disordered eating. By viewing trauma as an important experience in the formation of eating expectancies, therapists would be better able to address the driving beliefs that contribute to the development of the eating disorder.
Briefly, our research found that a history of childhood trauma influenced the disordered eating characteristic of body dissatisfaction only, where individuals with a history of trauma showed significantly greater mean scores than individuals without a history of trauma. Also, the negative eating expectancies (i.e., Eating Helps Manage Negative Affect; Eating Leads to Feeling Out of Control; and Eating Alleviates Boredom) were significantly associated with body dissatisfaction, regardless of trauma status. Therefore, addressing both trauma status and endorsement of negative eating expectancies is important in effective treatments of disordered eating.
Through my work on this project and with the CEED researchers as a whole, I have gained a lot of familiarity with statistical analyses and software. I learned not only proper data management techniques, but also gained confidence in deciding which analyses are appropriate to answer a particular research question. Working with CEED was also helpful in expanding my experience with different sectors in the field of eating disorder research. The Bardone-Cone Lab, where I still work, focuses on the sociocultural factors that influence the development of eating disorders; CEED consists of a more diverse array of researchers, including epidemiologists and biostatisticians, and several of their projects emphasize the role of genetics and biology (e.g., the microbiome) in these disorders. I see my work in these two settings as complementary, making me a stronger and more capable researcher and eventually, clinician. It is my firm belief that there is no single modality with which to best understand these complex conditions, and I am incredibly thankful to have been able to gain experience in another corner of this field with UNC CEED!