1. Leeds Institute of Health Sciences Co-occurrence of alcohol misuse and disordered eating in young adults in higher education Romy Sherlock, Bridgette Bewick, Robert West & Andrew Hill Academic Unit of Psychiatry & Behavioural Sciences School of Medicine University of Leeds

2. Context concern about mental health of student population –reports by AUCC, RCPsych –transition, increased vulnerability –academic, financial, peer pressures recognition of EDs, self-harm & alcohol misuse –functional similarities?

3. Co-occurrence ED & SH clinical samples: –ED treated – 32-70% self-harmed –self-harm – 61-100% ED symptoms Community/student samples: –probable ED – ~3x risk of recent SH Wright et al, 2009

4. Co-occurrence ED & SH clinical samples: –ED treated – 32-70% self-harmed –self-harm – 61-100% ED symptoms Community/student samples: –probable ED – ~3x risk of recent SH more variable ED & alcohol problems: –strongest in binge eating; absent in AN –strongest in community/student samples Gadalla & Piran, 2007 Wright et al, 2009

5. Research hypotheses 1.Disordered eating (DE) would be associated with increased risk of alcohol misuse (AM) (women) 2.Those with co-occurring DE and AM would have poorer well-being, more negative consequences, and be more impulsive

6. Student health behaviour survey Bristol Online Survey (BOS) –AUDIT  7-day alcohol diary grid –EDE-Q – key ED diagnostic features  7-day ED behaviour diary grid –negative consequences (YAACQ) –impulsivity (BIS/BAS) –emotional well-being (CORE-10) –formal help-seeking

7. SHBS sample N=1745 (1577 in analysed sample) –4 week window –printer credit incentives 22.1 yr, 69% female, 82% UGs, 77% UK

8. SHBS outcomes alcohol intake and problems: –24.5% hazardous, 9.2% harmful (units) –33.9% hazardous, 12.0% harmful (AUDIT) –30.1% binge drank on 1 or more days  more men at extreme levels

9. SHBS outcomes alcohol intake and problems: –24.5% hazardous, 9.2% harmful (units) –33.9% hazardous, 12.0% harmful (AUDIT) –30.1% binge drank on 1 or more days  more men at extreme levels DE features (from EDE-Q): – 34.2% over-evaluation of shape or weight – 4.8% binge eating episodes – 5.9% purging  more women

10. SHBS outcomes Co-occurrence risk women: –shape/wt overconcern: R=1.87 (1.30,2.69) harmful AUDIT –shape/wt overconcern: R=1.41 (1.16,1.71) binge drinking –binge eating: R=2.49 (1.49,4.17) harmful AUDIT men –binge eating: R=2.22 (1.07,4.63) harmful AUDIT

11. SHBS outcomes Compared with AM-only group, co-group: –poorer well-being –? more –ve consequences of alcohol –? higher behavioural inhibition/avoidance –same minimal help seeking Compared with DE-only group, co-group: –no difference well-being –no difference in –ve consequences of DE –? higher fun seeking (impulsivity) –? lower help seeking

12. Conclusions 1.evidence of DE and AM co-occurrence in female students 2.little evidence of greater impairment in those with DE and AM co-occurrence

13. Conclusions 1.evidence of DE and AM co-occurrence in female students 2.little evidence of greater impairment in those with DE and AM co-occurrence 3.student experience and progress –academic achievement? –pre-Uni problems & changes by year? –support and interventions?