Application of the transtheoretical model of change to binge eating and smoking

Abstract

Applicability of the stage of change and decisional balance constructs for bingers and smokers was examined in a study of 191 participants; bingers (n = 47), smokers (n = 80), and controls (n = 64). The Stage of Change Inventory (SCI) was cross-validated with the University of Rhode Island Change Assessment (URIC A) scale and used to assign bingers and smokers to one of five stages of change; precontemplation, contemplation, action, maintenance, and recovery. Psychological distress, the characteristics of binge eating and smoking, and the pros and cons of behavioural change were evaluated as a function of the stages of change. Although an increase in the con scores from precontemplation to action did not support the weak principle of the decisional balance, an increase in the pros of behavioural change from precontemplation to action provided support for the strong principle for bingers and smokers. Results of the Brief Symptom Inventory (BSI) indicated that psychological distress was not related to stage of change for bingers or smokers. However, bingers were found to score significantly higher than controls on the Global Severity Index (GSI) of the BSI. Several measures were used to further explore the phenomenology of binge eating and smoking. Results of the Binge Eating Adjective Checklist (BEAC) and Smoking Adjective Checklist (SAC) suggested that both behaviours serve a function in reducing the amount of psychological distress experienced by participants. For bingers, degree of loss of control and negative affect were found to vary as a function of stage of change, with precontemplators experiencing the least negative consequences associated with their behaviour and action-takers the most. The overall findings support the applicability of the transtheoretical model for bingers and smokers and further suggest that stage of change is related to characteristics of binge eating such as negative affect and loss of control.