Hraní digitální her českými adolescenty
Na dopady násilí ve hrách u respondentů mezi 18 a 21 lety se zaměřili Brady a Matthews (2006). Výsledky přinášejí závažná zjištění, a to, že agresivní hry mají ...
Gearhardt
Data v rámci celého výzkumného projektu jsou získávána dvěma způsoby. První sběr dat byl realizován prostřednictvím polostrukturovaného interview s hráči počítačových her, na základě kterého byly identifikovány všechny důležité aspekty týkající se hraní (vliv hraní na sociální život, motivace začít hrát, přínosy, negativní dopady atp.). Na základě odpovědí, zhodnocení dosavadních diagnostických nástrojů, překladu dostupných nástrojů užívaných k hodnocení závislosti na internetu, hraní her, videoher a rešerše literatury byl vytvořen dotazník. Reliabilita a validita nástroje byla ověřena v pilotním testování, které přispělo k posouzení formulace a vhodnosti daných položek a následnému upravení metody do finální podoby. Národní testování bude probíhat formou dotazníkového šetření, kde budou respondentům zároveň předloženy další psychodiagnostické nástroje zaměřené na ostatní psychologické fenomény. V rámci testování bude posuzováno rizikové chování, pro toto kritérium bude užit nástroj Výskyt rizikového chování u adolescentů (Dolejš & Skopal, 2015). Tato metoda obsahuje 18 položek a umožňuje zhodnotit získané výsledky ve třech faktorech – abúzus, delikvence a šikana z pohledu oběti. Impulzivitu bude měřit Škála impulzivity Dolejš a Skopal (SIDS, 2016), která zkoumá chování a reagování jedince v různých situacích, celkem je tvořena 24 otázkami. Agresivita bude posuzována pomocí Dotazníku agresivity Busse a Perryho (BPAQ, 1991). Další dotazník deseti otázkami cílí na informace týkající se alkoholu a jiných drog (dotazník ESPAD). Poslední zkoumanou oblastí je závislostní chování spojené s jídlem hodnocené dle dotazníku mYFAS 2.0 (Schulte, <anchor>Gearhardt</anchor>, 2017).
Preliminary validation of the Yale Food Addiction Scale for children - ScienceDirect
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## Article preview

- [Abstract](#preview-section-abstract)
- [Introduction](#preview-section-introduction)
- [Section snippets](#preview-section-snippets)
- [References (34)](#preview-section-references)
- [Cited by (159)](#preview-section-cited-by)

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## [Eating Behaviors](/journal/eating-behaviors "Go to Eating Behaviors on ScienceDirect")

[Volume 14, Issue 4](/journal/eating-behaviors/vol/14/issue/4 "Go to table of contents for this volume/issue"), December 2013, Pages 508-512

[![Eating Behaviors](https://ars.els-cdn.com/content/image/1-s2.0-S1471015313X00030-cov150h.gif)](/journal/eating-behaviors/vol/14/issue/4)

# Preliminary validation of the Yale Food Addiction Scale for children [☆](\#aep-article-footnote-id1), [☆☆](\#aep-article-footnote-id2)

Author links open overlay panelAshley N.Gearhardta, Christina A.Robertob, Marissa J.Seamansc, William R.Corbind, Kelly D.Brownelle

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## Highlights

- •
Interest in addiction's role in eating is growing.

- •
Seventy-five children completed the Yale Food Addiction Scale for children.

- •
The YFAS-C appears to have adequate internal consistency.

- •
The YFAS-C appears to have convergent and incremental validity.

- •
The YFAS-C may be helpful in identifying addictive eating in children.


## Abstract

### Introduction

Evidence is growing that an addictive process may play a role in problematic [eating behavior](/topics/neuroscience/eating-behavior "Learn more about eating behavior from ScienceDirect's AI-generated Topic Pages"). The majority of research on this topic has examined the concept of “food addiction” solely in adult samples. If certain foods have addictive potential, children may be impacted as much as (or more) than adults due to psychological and neurobiological vulnerabilities at younger developmental stages. In the current study, we developed a measure of [food addiction](/topics/psychology/food-addiction "Learn more about food addiction from ScienceDirect's AI-generated Topic Pages") in children that reflects the diagnostic indicators of addiction.

### Materials and methods

The content and reading level of the Yale Food Addiction Scale (YFAS) was altered to be appropriate for children (YFAS-C). The YFAS-C and other eating-related measures were administered to study participants to examine the validity and reliability of the YFAS-C.

### Participants

75 children were recruited from the community ranging from lean to obese.

### Results

The validation of the YFAC-C provides preliminary support for its [convergent validity](/topics/psychology/convergent-validity "Learn more about convergent validity from ScienceDirect's AI-generated Topic Pages") with like constructs and incremental validity in predicting [body mass index](/topics/psychology/body-mass-index "Learn more about body mass index from ScienceDirect's AI-generated Topic Pages"). Internal consistency was adequate given the small number of items on the scale.

### Discussion

The YFAS-C appears to be a helpful tool for identifying addictive-like eating in children.

## Introduction

A growing body of evidence suggests that highly processed foods, or ingredients in these foods, may be capable of triggering an addictive process (Avena et al., 2008, Gearhardt, Davis et al., 2011). Animal models of addictive eating find that rats given access to sugar or highly processed foods exhibit classic behavioral and biological signs of addiction (e.g., withdrawal, tolerance, dopaminergic downgrading) (Avena et al., 2008, Johnson and Kenny, 2010). In adult humans, patterns of neural activation commonly implicated in addiction are also indicated in obesity (Volkow, Wang, Fowler, & Telang, 2008) and behavioral indicators of addiction such as loss of control over consumption and continued use despite negative consequences are also present in eating disorders (Gearhardt et al., 2009a, Gold et al., 2003). Although evidence is growing to support the concept of addictive-like eating among adults, little is known about the role it may play in childhood obesity. In the substance dependence literature, an earlier age of exposure to addictive substances (e.g., alcohol, nicotine) is implicated in risk for the development of problematic substance use in the future (DeWit, Adlaf, Offord, & Ogborne, 2000). This risk is thought to result from adaptations in a vulnerable neural system (Tapert, Caldwell, & Burke, 2005), as well as an increased likelihood of relying on substances to cope psychologically (Clark, Thatcher, & Tapert, 2008). If highly processed foods also have addictive potential, children may be more susceptible to this effect than adults due to neural and psychological vulnerabilities.

There is some evidence to suggest that addictive processes may be at play in problematic eating behavior in children. Central components of addiction (i.e., emotionally triggered use and binge consumption) (Berking et al., 2011, Naimi et al., 2003) are also factors in problematic eating. Emotional eating and binge eating are documented phenomena in adults (Arnow et al., 2006, Grilo et al., 2001), but evidence is growing that children (especially obese children) are prone to these tendencies as well (Shapiro et al., 2007, van Strien and Oosterveld, 2008). In a qualitative study of overweight/obese 8-to-21 year olds, behaviors consistent with addiction (e.g., tolerance, cravings) were frequently described and 66% identified addiction as a contributor to their eating problems (Pretlow, 2011). Additionally, 15.2% of children receiving treatment at a pediatric lipid clinic reported that they often felt addicted to food (Merlo, Klingman, Malasanos, & Silverstein, 2009). Children who answered affirmatively to more addiction-related eating questions were also more likely to indicate other eating-related issues (Merlo et al., 2009).

This evidence is consistent with an addictive process contributing to childhood obesity, but further examination of this concept is needed. To facilitate future work on the topic, a valid measure is needed to operationalize food addiction in children based upon substance dependence diagnostic criteria. Although there is no validated measure of food addiction in children, the Yale Food Addiction Scale (Gearhardt, Corbin, & Brownell, 2009b) is a validated measure of addictive-like eating behavior in adults based on the Diagnostic and Statistical Manual of Mental Disorder IV-Text Revision (DSM-IV-TR) (American Psychiatric Association, 2000) diagnostic criteria for substance dependence (see Table 1). Higher scores on the YFAS are associated with a more severe presentation of binge eating disorder (BED) (Gearhardt, White, et al., 2011) and food addiction (as assessed by the YFAS) is associated with a pattern of neural response during exposure to food cues and food consumption that is consistent with the neural activation associated with other addictive behaviors (Gearhardt, Yokum, et al., 2011). The current study seeks to develop a new version of the YFAS to assess symptoms of food addiction in children. The YFAS for children (YFAS-C) is designed to measure the degree to which the substance dependence criteria outlined in the DSM-IV (American Psychiatric Association, 2000) are relevant to the consumption of calorie-dense foods in children. We conduct a preliminary validation of the YFAS-C by examining the internal consistency of the measure, the convergence with other measures of eating behavior, and the incremental utility of the measure in predicting body mass index (BMI) above and beyond other measures of eating.

## Section snippets

## Participants

This study was approved by the Yale Institutional Review Board. Parental guardians provided written informed consent and children provided verbal assent. A total of 117 children and their parents were recruited from the New Haven community for a larger study on family dining preferences and eating habits. The parents of the children participating in the study were 65.1% (n=47) Caucasian, 25.7% (n=18) African-American, 2.9% (n=2) Hispanic and 4.3% (n=3) of other race/ethnicity. A subset of 75

## Establishment of scoring thresholds

Thresholds for the continuous questions in the adult YFAS were used as starting points to establish cut-offs for the YFAS-C. To evaluate whether the cut-offs accurately identified increased risk for eating pathology, scatter plots were created to explore the relation between YFAS-C questions and BMI. Of the 25 questions on the YFAS-C, three were altered from the scoring thresholds used in the adult YFAS. Additionally one question with a dichotomous scoring option from the adult version was

## Discussion

The goal of the current study was to conduct a preliminary evaluation of a measure to operationalize addictive-like eating behavior in children and to examine the association of this scale with other measures of problematic eating. A CFA provided support for a single factor for the YFAS-C and demonstrated adequate internal consistency when the 22 items comprising the 7 diagnostic criteria were evaluated (Bentler, 1990, Browne and Cudek, 1993). The relatively lower internal consistency when the

## Conclusion

The current study provides preliminary evidence that the YFAS-C is a reliable and valid tool to operationalize food addiction in children. This measure provides a definition of addictive eating that is consistent with the diagnostic criteria for substance dependence, thus increasing the likelihood of identifying a similar process. Further, preliminary analyses suggest that the measure exhibits adequate internal consistency, as well as convergent and incremental validity. The YFAS-C provides an

## Role of funding sources

During this work, Christina Roberto was supported by the National Institute of Diabetes and Digestive and Kidney Diseases grant 1F31DK088523-01. The funding source had no involvement in the interpretation of the data, writing of the report, and in the decision to submit the manuscript.

## Contributors

Ashley N. Gearhardt: Dr. Gearhardt developed the YFAS-C, conducted analyses, drafted the initial manuscript and approved the final manuscript as submitted.

Christina A. Roberto: Dr. Roberto designed the study, supervised data collection, critically evaluated initial drafts, and approved the final manuscript as submitted.

Marissa J. Seamans: Ms. Seamans coordinated data collection, critically evaluated initial drafts and approved the final manuscript as submitted.

William R. Corbin: Dr. Corbin

## Conflict of interest

All authors declare that they have no conflicts of interest.

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## Cited by (159)

- ### [The burden of overweight/obesity and weight-related behaviors attributable to food addiction in emerging adults](/science/article/pii/S0195666324002022)



2024, Appetite



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While food addiction has been positively associated with excess weight and disordered eating behaviors, this has not been examined in representative samples of emerging adults, who are at elevated risk for these outcomes. This study investigated relationships of food addiction with weight outcomes, weight perception, and weight-control behaviors in emerging adults and estimated the population attributable fraction to food addiction. Data from an observational cohort study were collected in seven annual waves from 2010 to 2016. A nationally representative sample of 2785 10th grade students was recruited from schools within each U.S. census region (73% participation) (mean ± SD baseline age = 16.3 ± 0.5years). Wave 7 retention was 81% (n = 2323, 60% female, mean ± SD = 22.6 ± 0.5 years). Outcomes included current BMI, BMI change from baseline – wave 7, increased weight status in wave 7 (increased weight status from baseline-wave 7), perceived overweight, dieting, any weight-control behavior, and extreme weight-control behaviors. Food addiction was measured in wave 7 using the modified Yale Food Addiction Scale. Relative risk of the outcomes associated with food addiction, and population attributable fraction, were estimated using adjusted log-binomial or robust Poisson regression analyses accounting for the complex survey design. Food addiction prevalence was 4.7%. Participants with food addiction were primarily females (91%); food addiction was uncorrelated with other sociodemographics. Food addiction was associated with 48%–167% increased RR for all outcomes, but these were attenuated after adjustment for confounders (31%–64%). The population attributable fraction for food addiction ranged from 2% (high wave 7 BMI) – 5% (extreme weight-control behaviors). Although the population attributable fraction estimates indicate that the public health burden of these outcomes attributable to food addiction may be relatively minor, food addiction may signal the presence of several adverse mental health symptoms.

- ### [Dietary intake in children and adolescents with food addiction: A systematic review](/science/article/pii/S2352853224000087)



2024, Addictive Behaviors Reports



Show abstract







Food addiction (FA) is characterized by behavioral changes related to the consumption of palatable foods, marked by dependence, impulsivity, and compulsion. Children and adolescents are more vulnerable to FA owing to their significant consumption of ultra-processed foods. This review aims to investigate the differences in dietary intake in pediatric populations with and without FA. We conducted a systematic literature review. PubMed, ScienceDirect, and PsycINFO databases were searched up to July 2023. Potentially eligible studies were independently checked by two researchers. The methodological quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional studies. Of the 4868 articles identified, six studies were included. All the included studies had high methodological quality. High consumption of calories and fat was observed in children and adolescents with FA. A diet quality analysis showed that the consumption of ultra-processed foods, such as sugary drinks, sweets, and chips, was related to FA. Given these findings, we concluded that FA in childhood may be associated with higher energy consumption and, consequently, higher intake of macronutrients. Few studies have examined the relationship between FA and food intake in childhood, and more studies are required.

- ### [The qualitative evaluation of food addiction across the lifespan](/science/article/pii/S0195666323026326)



2024, Appetite



Show abstract







Although it remains controversial, food addiction (FA) research has expanded substantially and empirical evidence for FA is growing. While quantitative studies have explored the prevalence and correlates of FA during childhood and adolescence, little is known about the perceived lived experience of FA across the lifespan, nor how experiences and perceptions of FA may change over time. For this study, 16 participants who met symptom threshold criteria for FA on the Yale Food Addiction Scale 2.0 completed in-depth, semi-structured qualitative interviews focused on their perceptions of the development of FA overtime, and perceived risk and protective factors. Thematic analysis was used to develop themes about the lived experience of FA in childhood, adolescence, and adulthood. Overall, highly palatable foods were viewed as the most problematic, while minimally processed foods were less associated with impairment and distress. Themes in childhood included a strong desire for highly processed foods and the perception that parental control over food choices could be either protective or risky for the later development of FA depending on which foods were available at home. In adolescence and young adulthood, increasing autonomy over food choices and the high availability of highly processed foods in the college environment were viewed as risk factors. Additionally, weight gain was a prominent theme. Finally, adulthood was characterized by more severe manifestations of FA, and the stress of adult responsibilities (e.g., work, parenting) contributed to this perception. This research sets the stage for future quantitative studies to explore these novel findings at the population level.

- ### [Food Insecurity and Food Addiction in a Large, National Sample of Lower-Income Adults](/science/article/pii/S2475299123266202)



2023, Current Developments in Nutrition



Show abstract







Growing research has highlighted associations between food insecurity and eating-related problems. Food addiction is one important, clinically significant pattern of problematic eating, which is related to, but distinct from, eating disorders. To date, there is only one study examining the association between food insecurity and food addiction, to our knowledge. Additional research is needed to understand the complexities of this association.



We examined the association between food insecurity and food addiction in a large, national convenience sample of lower-income adults and potential heterogeneity in this association by age, gender, race, and ethnicity.



A cross-sectional, web-based study was conducted among 1780 US adults (≥18 y) with household incomes <250% of the federal poverty guideline. Household food security was assessed using the Household Food Security Survey Module. Food addiction was assessed using the modified Yale Food Addiction Scale (mYFAS), version 2.0. Multivariate logistic regression models examined the associations between food insecurity and food addiction, adjusting for sociodemographic covariates.



The prevalence of food addiction was 7.3%, and the prevalence of food insecurity was 51%. Compared with adults with food security, adults with food insecurity endorsed each mYFAS symptom with significantly greater frequency, including failure to fulfill major role obligations (20%), continued use despite social or interpersonal problems (18%), and craving or strong desire to use (16%). After adjustment, food insecurity was associated with 3.82-fold higher odds of food addiction (95% CI 2.36, 6.19), with no significant heterogeneity by age, gender, or race and ethnicity. The most problematic foods reported by adults with food insecurity were chips, nondiet soda, chocolate, pizza, and ice cream.



These findings provide additional support for the association between food insecurity and food addiction. Mechanistic studies are needed to explore the role of psychosocial factors, eating behaviors, and the food environment in contributing to these associations.

- ### [Changes in Adults’ Eating Behaviors During the Initial Months of the COVID-19 Pandemic: A Narrative Review](/science/article/pii/S2212267222009704)



2023, Journal of the Academy of Nutrition and Dietetics



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Factors such as regulations and health concerns shifted daily habits, including eating behaviors, during the early months of the coronavirus disease 2019 (COVID-19) pandemic. This comprehensive narrative review synthesizes research on eating behavior changes during the early months of the pandemic (February to June 2020), including changes in amount, rate, and timing of food consumption, types and healthfulness of foods consumed, the occurrence of other specified eating behaviors (eg, restrained eating or binging), and reasons for eating (eg, stress or cravings), among adults. A literature search using three EBSCOhost databases and Google Scholar was conducted to identify relevant articles made available in 2020. A total of 71 articles representing 250,715 individuals from more than 30 countries were reviewed. Findings show eating behaviors changed little during the early COVID-19 pandemic for most participants. Among those whose eating behaviors changed, increases in both intake and frequency of eating meals and snacks were more common than decreases. Findings on timing of eating and healthfulness of food consumed showed mixed results. However, when changes occurred in the type of food consumed, increases were more common for snacks, homemade pastries, white bread/pasta, legumes, and fruits/vegetables; decreases were more common for meats, seafood/fish, frozen foods, fast food, dark breads/grains, and dark leafy green vegetables. During the pandemic, binging, uncontrolled eating, and overeating increased, meal skipping decreased, and restrictive eating had mixed findings. Changes in factors such as emotions and mood (eg, depression), cravings, and environmental factors (eg, food insecurity) were related to changes in eating behaviors. Findings can inform clinical practitioners in efforts to mitigate disruptions to normal, healthy eating patterns among adults both in and outside of global health catastrophes.

- ### [Daytime sleepiness, addictive-like eating, and obesity sequelae in Black and African American youth with obesity](/science/article/pii/S2352721822001450)



2022, Sleep Health



Show abstract







The purpose of the current study was to examine the association between poor sleep health (ie, excessive daytime sleepiness), obesity sequelae (ie, percent overweight and serum leptin levels), and addictive-like eating behaviors, an obesity phenotype, in a sample of Black/African American (B/AA) adolescents.



The current study analyzed archival baseline data from a sample of B/AA adolescents with obesity enrolled in a sequential randomized clinical trial.



Data were collected in the participants’ homes by trained research assistants unaware of treatment condition.



A sample of 181 B/AA adolescents with obesity between the ages of 12 and 16 years ( _M =_ 14.26, _SD_ = 1.46) and having a body mass index (BMI) above the 95th percentile for age and gender were sampled.



Self-report measures included the Cleveland Adolescent Sleepiness Questionnaire and the Yale Food Addiction Scale-Children (YFAS-C). Anthropomorphic data and blood samples were used to determine BMI and serum leptin levels, respectively.



Excessive daytime sleepiness was positively correlated with YFAS-C symptom count, _r_ = 0.295, _P_ < .001\. Serum leptin levels and percent overweight were both positively correlated with each other, _r_ = 0.445, _P_ < .001 and with YFAS-C symptom count, _r_ = 0.215, _P_ = .006\. After controlling for age and gender, results supported an indirect effect from daytime sleepiness to both serum leptin levels ( _estimate_ = 2.210, _SE_ = 0.932, _P_ = .018) and percent overweight ( _estimate_ = 2.817, _SE_ = 1.415, _P_ = .046) through YFAS-C symptom count.



Culturally informed interventions on eating behaviors (ie, addictive-like eating) when excessive daytime sleepiness is reported are needed. Early intervention may help prevent the onset or worsening of obesity among adolescents.


[View all citing articles on Scopus](http://www.scopus.com/scopus/inward/citedby.url?partnerID=10&rel=3.0.0&eid=2-s2.0-84886771055&md5=f04b73c21d4b405fcb748141196fc239)

[☆](#baep-article-footnote-id1)

Funding: During this work, Christina Roberto was supported by the National Institute of Diabetes and Digestive and Kidney Diseases grant 1F31DK088523-01.

[☆☆](#baep-article-footnote-id2)

Financial disclosure: The authors have no financial disclosures to report.

[View full text](/science/article/pii/S147101531300072X)

Copyright © 2013 Elsevier Ltd. All rights reserved.

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