Appetite 116 (2017) 423e430

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Appetite
journal homepage: www.elsevier.com/locate/appet

Positive and negative emotional eating have different associations

with overeating and binge eating: Construction and validation of the
Positive-Negative Emotional Eating Scale
Hedvig Sultson, Katrin Kukk, Kirsti Akkermann*
€ituse 2, 50409, Tartu, Estonia
Institute of Psychology, University of Tartu, Na

a r t i c l e i n f o a b s t r a c t

Article history: Research on emotional eating mostly focuses on negative emotions. Much less is known about how
Received 28 February 2017 positive emotions relate to overeating and binge eating (BE). The aim of the current study was to
Received in revised form construct a scale for positive and negative emotional eating and to assess its predictive validity. In study
16 May 2017
1, the Positive-Negative Emotional Eating Scale (PNEES) was constructed and tested on 531 women, who
Accepted 19 May 2017
also completed Eating Disorders Assessment Scale (EDAS). Results showed that a two-factor model
Available online 23 May 2017
constituting Positive emotional eating (PNEES-P) and Negative emotional eating (PNEES-N) fit the data
well. PNEES-N also showed good convergent validity in assessing binge eating, correlating highly with
Keywords:
Experience sampling method
EDAS subscale Binge eating. Further, a path analysis showed that after controlling for the mediating effect
Binge eating of PNEES-N, PNEES-P continued to significantly predict binge eating. In study 2 (N ¼ 60), experience
Negative emotional eating sampling method was used to assess overeating and BE in the natural environment. Palmtop computers
Overeating were given to participants for a three-day study period that prompted them with questions regarding
Positive emotional eating emotional experience, overeating, and BE. Results indicated that PNEES-P significantly predicted over-
eating, whereas PNEES-N predicted overeating and BE episodes only in a subsample of women who had
experienced at least one overeating or BE episode. Thus, positive and negative emotional eating might
have different relations with overeating and BE, with the latter being more characteristic of the severity/
frequency of overeating and BE. New assessment tools that in addition to negative emotional eating also
address positive emotional eating could be of potential help in planning intervention. Further, the ten-
dency to overeat in response to positive emotions could be integrated into current models of eating
disorders, especially when addressing relapse prevention.
© 2017 Elsevier Ltd. All rights reserved.

1. Introduction defined as emotional eating (Arnow, Kenardy, & Agras, 1995). It is

In most people, emotional stress elicits changes in appetite
(Macht, 2008). Acute severe stress is associated with the activation
of the hypothalamic-pituitary-adrenal (HPA) axis (Gold & Chrousos,
2002) that results in the suppression of appetite (Adam & Epel,
2007; Majzoub, 2006), whereas mild to moderate stress could
lead to increased food intake in some individuals (Oliver, Wardle, &
Gibson, 2000; Rutters, Nieuwenhuizen, Lemmens, Born, &
Westerterp-Plantenga, 2009), referred to as an atypical response
by Van Strien, Donker, and Ouwens (2016). This tendency to in-
crease one's food intake in response to negative emotions has been
* Corresponding author.
E-mail address: kirsti.akkermann@ut.ee (K. Akkermann).
believed that emotional eating has its roots in operant condition-
ing, according to which excessive eating, preceded by negative
affect, is maintained by negative reinforcement (Meyer, Waller, &
Waters, 1998). Thus, emotional eating might provide a mecha-
nism to downregulate one's negative affect.
A desire to eat in response to negative affect to alleviate one's
negative affect has also been associated with binge eating, which,
according to DSM-5 is defined as consuming significantly larger
amount of food than usual during a limited period of time
(American Psychiatric Association [APA], 2013). In addition, loss of
control over eating is also considered to be an important diagnostic
feature of binge eating (Pollert et al., 2013). Several studies have
demonstrated that emotional eating and binge eating are linked, as
significant associations between these two constructs have been
found in clinical and in non-clinical samples (Stice, Presnell, &

http://dx.doi.org/10.1016/j.appet.2017.05.035
0195-6663/© 2017 Elsevier Ltd. All rights reserved.
424 H. Sultson et al. / Appetite 116 (2017) 423e430
Spangler, 2002; Van Strien, Engels, van Leeuwe, & Snoek, 2005).
Further, Vainik, Neseliler, Konstabel, Fellows, and Dagher (2015)
demonstrated that negative emotional eating and binge eating
could be placed on a continuum of uncontrolled eating, as they
share a similar underlying factor. Thus, emotional eating might
characterize intermediate and binge eating severe levels of un-
controlled eating. Therefore, emotional eating might be a useful
marker in identifying early disordered eating behaviour (Haedt-
Matt et al., 2014).
Even though the vast majority of scientific literature pertaining
to emotional eating focuses on negative emotional eating, several
authors have found that positive emotions can also increase eating
(Bongers, Jansen, Havermans, Roefs, & Nederkoorn, 2013; Bongers,
Jansen, Houben, & Roefs, 2013; Bongers, de Graaff, & Jansen, 2016;
Evers, de Ridder, & Adriaanse, 2009). Bongers, Jansen, Houben, et al.
(2013) found that emotional eaters who were identified via the
implicit association test ate more after the positive compared to the
negative mood induction. An increase in food consumption after
positive mood induction compared to negative or neutral has been
established by few other studies (Evers, Adriaanse, de Ridder, & de
Witt Huberts, 2013; Patel & Schlundt, 2001). In addition, a recent
meta-analysis (Cardi, Leppanen, & Treasure, 2015) showed that
healthy participants consumed significantly more food following
positive or negative mood induction in comparison to neutral mood
(average effect sizes were similar). In contrast, some studies con-
ducted in laboratory settings have demonstrated that emotional
eaters tend to overeat following negative mood induction, whereas
no differences between neutral and positive mood induction have
been found (Macht & Simons, 2000; Van Strien et al., 2013). Thus,
the relationship between positive emotional eating and real-life
eating behaviour is mixed.
In comparison to negative emotional eating, the mechanisms
behind positive emotional eating are less clear. Several researchers
believe that positive and negative emotional eating are two
different constructs (Macht & Simons, 2000; Van Strien et al., 2013).
For example, Van Strien et al. (2016) showed that body-mass index
(BMI) and items measuring negative emotional eating loaded onto
the same factor, whereas items measuring positive emotional
eating and external eating loaded onto the other factor. Similarly,
Bourdier et al. (2017) found that BMI had a modest negative cor-
relation with positive emotional eating, and modest positive asso-
ciation with negative emotional eating. Thus, it is plausible that
even though positive emotions may elicit eating, they do not
necessarily mirror disordered eating. Eating in response to positive
emotions might rather be related to hedonic (Macht, 1999) or
external eating (Van Strien et al., 2016). This assumption is likely,
given that in a meta-analysis by Cardi et al. (2015), there was a
trend for more food to be consumed during the positive mood in-
duction when participants were offered both sweet and savoury
food compared to sweet or savoury food alone. Additionally, posi-
tive emotions have been linked to enhanced pleasantness of food
and an increased motivation to enjoy food (Macht, 1999; Macht,
Roth, & Ellgring, 2002).
Although several self-report measures of emotional eating, e.g.
the Dutch Eating Behaviour Questionnaire (DEBQ; Van Strien,
Frijters, Bergers, & Defares, 1986) have been developed, it is less
clear how accurately the self-report measure of emotional eating
mirrors real-life eating behaviour. Domoff, Meers, Koball, and
Musher-Eizenman (2013) included 12 studies in their meta-
analysis that compared self-reported emotional eating with food
intake in laboratory settings. According to authors, self-report
measures predicted actual food intake in emotional eaters only in
five studies, e.g. after watching a sad film clip (Van Strien, Herman,
Anschutz, Engels, & de Weerth, 2012), and after stress-induction
(Oliver et al., 2000). This relationship, however, was not observed
in some other studies (e.g., Adriaanse, de Ridder, & Evers, 2011). The
validity of self-reported emotional eating questionnaires is also
questioned in a recent paper by Bongers and Jansen (2016) who
reviewed several experimental and naturalistic studies, and re-
ported that the effect of self-reported emotional eating on subse-
quent food intake is observed in some studies, whereas in others, it
is ambiguous or not observed. However, Van Strien et al. (2012)
have argued that in order to detect such an effect, there must be
enough participants with extreme scores on the moderating vari-
able. By including emotional eaters who scored above the 80th
percentile and non-emotional eaters who scored below the 20th
percentile on the emotional eating subscale of the DEBQ, they
found that emotional eaters ate more after the sad mood and stress
induction, whereas non-emotional eaters ate less. The fact that the
evidence for the effect of self-reported emotional eating on actual
eating behaviour is mixed across laboratory and naturalistic studies
implies that emotional eating might be a more complex phenom-
enon than it has been believed (Bongers & Jansen, 2016). Therefore,
the predictive and discriminative validity of self-reported
emotional eating is in serious need of further validation.
Thus, upon constructing and validating an emotional eating
scale, it would be crucial to show how the scale reflects real-life
eating behaviour. One method of collecting data that more closely
mirrors real-life behaviour in comparison to laboratory experi-
ments and self-report measures is to use ecological momentary
assessment (EMA; Stone, Hufford, & Shiffman, 2008), also known as
the experience sampling method (ESM; Hektner, Schmidt, &
Csikszentmihalyi, 2007). EMA/ESM involves repeated measure-
ments of thoughts, behaviours, and/or physiological markers in
participants' natural environments. Furthermore, as retrospective
emotional ratings and eating behaviour are prone to retrospective
memory biases, EMA/ESM provides a way to produce results that
are more ecologically valid. Several researchers have investigated
binge eating using ESM (Crosby et al., 2009; Smyth et al., 2007;
Wegner et al., 2002).
Since the role of positive emotions regarding eating behaviour
has somewhat been neglected, the aim of the present study was to
construct the Positive-Negative Emotional Eating Scale (PNEES),
which captures eating in response to both positive and negative
emotions, and to assess its predictive validity via ESM. Even though
there already are emotional eating scales (i.e., Emotional Appetite
Questionnaire (EMAQ); Nolan, Halperin, & Geliebter, 2010)
measuring eating in response to positive emotions, we wanted to
include more variety in terms of positive emotional experience as
well as the phrasing of items. For these purposes, we conducted
two separate studies. The aim of the first study was to construct the
Positive-Negative Emotional Eating Scale (PNEES). The aim of the
second study was to assess the scale's predictive validity by testing
whether the scores on a self-report emotional eating scale predict
overeating (eating episodes without loss of control) and binge
eating (eating episodes with loss of control) episodes measured via
experience sampling method. The following hypotheses were
postulated for this study:
1) In comparison to positive emotional eating, negative emotional
eating is more strongly associated with binge eating.
2) Negative emotional eating predicts overeating (without LoC)
and binge eating (with LoC) episodes measured via experience
sampling method.
3) Positive emotional eating predicts overeating (without LoC)
episodes measured via experience sampling method.
 H. Sultson et al. / Appetite 116 (2017) 423e430
2. Study 1
2.1. Methods and materials
2.1.1. Sample characteristics
A web-based survey was conducted as the first step of a study of
affect regulation. The study design was approved by the Research
Ethics Committee of the University of Tartu. Participants were
recruited via university mailing lists in exchange for course credit
and online in exchange for personality-related feedback. The data
were collected during September 2013eMarch 2014. The initial
sample consisted of 724 adults. Men (N ¼ 71) were excluded from
the study due to low participation rate. Subsequently, women who
failed to fill in all questionnaires used in this study were also
excluded. The final sample consisted of 531 women aged 15e61
(M ¼ 29.57, SD ¼ 9.5). The results of the same study focusing on
several other eating behaviour measures and on the concept of
uncontrolled eating have been published in another paper (Vainik
et al., 2015).
2.1.2. Methods
2.1.2.1. Eating Disorders Assessment Scale (EDAS). Eating Disorders
Assessment Scale (a ¼ 0.92) (EDAS; Akkermann, 2010) is a 29-item
self-report questionnaire that measures eating disorder symptoms
characteristic of anorexia nervosa (AN), bulimia nervosa (BN), and
binge eating disorder (BED). The participant has to indicate on a six-
point Likert-type scale ranging from 0 (never) to 5 (always) the
extent to which the item describes her eating behaviour during the
last three months. The scale consists of 4 subscales: Restrained
eating (a ¼ 0.85), Binge eating (a ¼ 0.86), Purging (a ¼ 0.84), and
Preoccupation with body image and body weight (a ¼ 0.93). The
internal consistency statistics refer to values obtained within the
current sample. Total scale and subscales Binge eating and Purging
have demonstrated good discriminant validity in discriminating
AN, BN and BED patients from each other. Subscale Restrained
eating and Preoccupation with body image and body weight assess
the latent dimensions common to eating disorders. Construct val-
idity of the scale has been confirmed by strong correlations be-
tween EDAS and EDI-2 subscales that measure eating disorder
symptoms.
2.1.2.2. Positive-Negative Emotional Eating Scale (PNEES). A pre-
liminary version of the Positive-Negative Emotional Eating Scale
(PNEES) was constructed for this study. Emotions of the pre-
liminary version were chosen based on the emotions incorporated
in the Positive and Negative Affect Schedule (PANAS; Watson, Clark,
& Tellegen, 1988), the emotions pertaining to binge eating in
experimental studies, and the items related to emotional eating in
various emotional eating scales. The preliminary scale consisted of
30 items assessing the tendency to eat in response to various
positive (N ¼ 12) and negative (N ¼ 18) emotions. The participant
was instructed to indicate on a five-point Likert-type scale ranging
from 0 (never) to 4 (very often) the extent to which the item de-
scribes her eating behaviour. The preliminary version of the scale
has been added as a Supplement.
2.1.3. Data analyses
Statistical Package for the Social Sciences (SPSS) version 20 and
the statistical computing R environment 3.2.3 were used for the
data analyses. A factor analysis using principal axis factoring with
non-orthogonal Promax rotation was used to investigate the factor
structure of PNEES, and Pearson's correlation analyses were used to
assess correlations with EDAS total and subscale scores in SPSS.
Path analysis in R with “lavaan” package was conducted to inves-
tigate whether the association between positive emotional eating
425
and binge eating is mediated by negative emotional eating.
2.1.4. Results
Exploratory factor analysis with principal axis factoring was
chosen to investigate the factor structure of the scale. Since the
correlation between factors exceeded 0.32, a non-orthogonal Pro-
max rotation was chosen (Tabachnick & Fidell, 2007). According to
Kaiser's criterion, two factors which eigenvalue >1 were extracted.
A two-factor model showed good fit to the data, explaining 63% of
total variance. Gradually extracting items of which communalities
remained below 0.45, a total of 19 items out of 30 remained. 12
items loaded onto the first factor, accounting for 40.1% of total
variance. Since the items reflected eating in response to various
negative emotions, the factor was named Negative emotional
eating (PNEES-N). 7 items loaded onto the second factor, account-
ing for 22.9% of total variance. Second factor was named Positive
emotional eating (PNEES-P) because the items reflected eating in
response to various positive emotions. Rotated factor loadings and
communalities of PNEES are presented in Table 1. The final version
of the scale has been added as a Supplement.
In order to assess internal reliability, Cronbach's a coefficients
were calculated for the total scale and both subscales. Reliability
analysis yielded good internal consistency coefficients for PNEES
(a ¼ 0.93), and for subscales PNEES-N (a ¼ 0.95), and PNEES-P
(a ¼ 0.91), respectively. Next, Pearson's correlation analysis was
used to investigate how positive and negative emotional eating
relate to disordered eating, measured by EDAS. PNEES-N correlated
significantly with EDAS total score, and with subscales Restrained
eating, Purging, Preoccupation with body image and body weight,
and Binge eating. PNEES-P had significant correlations with EDAS
total score and with all the subscales, except Purging. The corre-
lation coefficients for PNEES and EDAS total and subscale scores are
presented in Table 2.
Since the two factors were moderately correlated (r ¼ 0.32), a
path analysis was conducted to see whether the effect of positive
emotional eating on binge eating is mediated by negative
emotional eating. Binge eating was entered into the model as the
dependent variable, PNEES-P as the independent variable, and
PNEES-N as the mediator variable. The indirect effect was signifi-
cant (b ¼ 0.25, SE ¼ 0.03, p < 0.001). The direct effect was also
significant (b ¼ 0.13, SE ¼ 0.03, p < 0.001). Positive emotional eating
significantly predicted binge eating, even though the effect was
partly mediated by negative emotional eating. Therefore, PNEES-P
predicted Binge eating independent of PNEES-N. This mediation
analysis explained a significant proportion of variance in Binge
eating scores (R2 ¼ 0.66, F ¼ 346.69, p < 0.001). The model with
significant path coefficients is presented in Fig. 1.
3. Study 2
3.1. Methods and materials
3.1.1. Sample characteristics
For Study 2, we used a subsample of the study by Kukk and
Akkermann (2017). 60 female participants out of 97 with the
mean age of 21.6 (SD ¼ 2.85) who also filled in PNEES were included
in the current study. Participants were recruited via university
mailing lists, social media, and advertisements in local campuses
and libraries. The data was collected from fall 2014 until early
spring 2015. The results of the original study focusing on the
relationship between fluctuations in negative emotions and binge
eating have been published in another paper (Kukk & Akkermann,
2017).
426 H. Sultson et al. / Appetite 116 (2017) 423e430

Table 1
Rotated factor loadings and communalities of the final version of PNEES (N ¼ 531).

Item Negative emotional eating Positive emotional eating Communalities

1. grumpy 0.86 0.12 0.76

2. upset 0.85 0.06 0.73
3. disappointed 0.84 0.15 0.74
4. irritated 0.83 0.06 0.70
5. tense or anxious 0.79 0.05 0.62
6. sad 0.79 0.13 0.64
7. helpless 0.78 0.18 0.65
8. restless 0.77 0.09 0.61
9. offended 0.76 0.17 0.60
10. angry 0.76 0.13 0.59
11. lonely 0.70 0.20 0.54
12. feeling guilty 0.69 0.18 0.51
13. active 0.12 0.83 0.70
14. excited about something 0.22 0.80 0.69
15. joyful 0.08 0.78 0.62
16. full of energy 0.08 0.78 0.60
17. fascinated about something 0.28 0.77 0.68
18. confident 0.05 0.72 0.51
19. content with myself 0.08 0.71 0.51

Note: Item loadings on the corresponding factor are presented in bold.

Table 2 3.1.2.2. Experience sampling method (ESM). To assess eating

Pearson's correlation coefficients between PNEES and EDAS total and subscale behaviour and emotional experience in natural environment,
scores. experience sampling method (ESM) was used. The experience
Scales Negative Positive sampling experiment was programmed into palmtop computers
emotional eating emotional eating (Handspring Visar Neo) using the free software iESP developed by
EDAS total 0.66* 0.29* Dr. Lisa Feldman Barrett and Daniel Barrett (http://www.
Restrained eating (EDAS) 0.23* 0.13* experience-sampling.org/esp/). The palmtop computers signaled
Purging (EDAS) 0.33* 0.08 randomly seven times per day (from 8:30 a.m. to 23:05 p.m.) for
Preoccupation with body image 0.52* 0.26*
three consecutive days. In order to minimize day of week effects
and body weight (EDAS)
Binge eating (EDAS) 0.81* 0.38* (Smyth et al., 2009), the study period was limited to Tuesday-
Thursday. Upon every signal, participants were asked to fill out a
Note: * - correlations are significant at p < 0.01.

Fig. 1. Standardized regression coefficients and their standard errors for the relationship between positive emotional eating and binge eating mediated by negative emotional
eating. Path a corresponds to the regression coefficient for the association between PNEES-P and PNEES-N. Path b corresponds to the regression coefficient for the association
between PNEES-N and Binge eating. The direct effect c’ is calculated by controlling for the mediator. * - regression coefficients are significant at p < 0.001.

3.1.2. Methods short questionnaire as quickly and as accurately as possible by

3.1.2.1. Positive-Negative Emotional Eating Scale (PNEES). The final
version of the Positive-Negative Emotional Eating Scale (PNEES,
a ¼ 0.89) was used in this study. The scale consists of 19 items that
measure eating in response to various positive and negative emo-
tions. Participants were instructed to indicate on a five-point Lik-
ert-type scale ranging from 0 (never) to 4 (very often) the extent to
which the item describes their eating behaviour. The scale has two
subscales: Positive emotional eating (PNEES-P, a ¼ 0.80) and
Negative emotional eating (PNEES-N, a ¼ 0.94), which comprise 7
and 12 items, respectively.
selecting appropriate answers on the screen of the palmtop com-
puters. The questionnaire consisted of the assessment of various
emotions and eating episodes. The emotions vere selected based on
previous literature on eating and emotions. The questionnaire was
in the same order at each trial.
First, participants were instructed to indicate on a four-point
Likert-type scale ranging from 1 (not at all) to 4 (to a large
extent) the extent to which the 16 emotion-related adjectives
described their current emotional state (i.e., “I am feeling sad …”).
Next, participants were asked whether they had experienced an
 H. Sultson et al. / Appetite 116 (2017) 423e430
overeating episode, and if so, whether they had experienced loss of
control during the eating episode. The overeating episode was
defined as an eating episode where the participant consumed a
relatively large amount of food within a brief period of time.
Overeating episodes involving loss of control were characterized as
binge eating (BE) episodes. Therefore, the number of overeating
episodes comprised eating episodes without loss of control, the
number of BE episodes comprised eating episodes with loss of
control. Participants were also explicitly instructed to ignore the
signal when it was inconvenient or dangerous to answer (e.g. while
driving, showering).
3.1.3. Procedure
Participants were first instructed to complete a series of self-
report questionnaires, including PNEES, via Internet on the online
survey center of the Institute of Psychology. Next, participants
signed up and attended a meeting where they were given further
information regarding the study. Participants completed the
informed consent form and were given palmtop computers for the
three-day study period. At the meeting, participants received
further instructions on how to use palmtop computers. They were
also reminded of the goals of the study and how to deal with any
questions that might arise from the signaling of the palmtop
computer.
3.1.4. Data analyses
Statistical Package for the Social Sciences (SPSS) version 20 and
the statistical computing R environment 3.2.3 were used for the
data analyses. Pearson's correlation analyses were conducted in
SPSS to assess the associations between positive/negative
emotional eating, the mean level of positive/negative affect, and the
number of binge and overeating episodes. For the mean level of
positive affect (PA) and negative affect (NA), mean scores of PA/NA
were calculated by taking the mean score of the responses given to
the items measuring PA/NA in ESM experiment. Further, only
emotions that matched the emotions incorporated in PNEES were
selected for further analyses. Thus, 12 emotions out of 16 were used
to calculate the mean score of positive and negative affect. The
division into PA and NA was verified via factor analysis. The mean
score of PA comprised the following emotions: excitement, joy,
satisfaction, confidence and motivation. The mean score of NA
comprised guilt, irritation, sadness, anxiety, anger, loneliness, and
disappointment. Linear regression analyses with “QuantPsyc”
package in R were conducted to assess whether positive/negative
emotional eating and the mean level of negative affect predict the
number of overeating and BE episodes experienced during the
three-day study period.
3.1.5. Results
The response rate for all measurement trials was 78.6%. In total,
31 women out of 60 (56.7%) experienced overeating (without LoC)
and/or BE episodes (with LoC) (range: 1e8). More specifically, 21
women (35%) experienced only overeating episodes (range: 1e5), 3
women experienced only BE episodes (5%) (range: 1e2), and 7
women (11.7%) experienced both overeating and BE episodes
(range: 2e8). Subsequently, Pearson's correlation analyses were
conducted to investigate how positive/negative emotional eating,
and positive/negative affect correlate with the total number of
overeating and BE episodes, and BE and overeating episodes
separately. The results of the Pearson's correlation analyses are
presented in Table 3.
The total number of overeating and BE episodes and the number
of overeating episodes alone were highly correlated (r ¼ 0.94). As
there were only 10 participants who experienced BE episodes, the
majority of the total number of overeating and BE episodes
427
consisted of overeating episodes. Therefore, we only tested a model
where the number of overeating episodes was the dependent
variable.
Based on the observed significant correlation coefficients,
PNEES-P and NA were entered into the linear regression model as
predictor variables, and the number of overeating episodes as the
dependent variable. According to the AIC criteria, the model with
PNEES-P and NA as predictor variables showed best fit to the data
(AIC ¼ 32.73) and explained a significant proportion of variance in
the number of overeating episodes (R2 ¼ 0.16, F(2,55) ¼ 5.31,
p ¼ 0.008). PNEES-P (b ¼ 0.32, SE ¼ 0.05, t ¼ 2.60, p ¼ 0.012)
significantly predicted the number of overeating episodes, whereas
the mean level of NA did not (p ¼ 0.116). As the association between
PNEES-N and overeating was not significant, PNEES-N as a pre-
dictor variable was not tested.
In subsequent analyses, we included a subsample of women
who experienced only overeating episodes (N ¼ 21) or both over-
eating and BE episodes (N ¼ 31). Pearson's correlation analyses
were conducted to investigate how positive/negative emotional
eating, and the mean level of positive/negative affect correlate with
overeating episodes and the total number of overeating and BE
episodes in those two subsamples. We did not conduct any analyses
on women who experienced only BE episodes due to a very small
sample size. The results of the Pearson's correlation analyses are
presented in Table 4.
As only PNEES-N had a significant correlation with the total
number of BE and overeating episodes in a subsample of 31 women,
a single linear regression model was tested. PNEES-N significantly
predicted the total number of BE and overeating episodes (b ¼ 0.46,
SE ¼ 0.04, t ¼ 2.78, p ¼ 0.009), and explained a significant pro-
portion of variance in the total number of BE and overeating epi-
sodes (R2 ¼ 0.21, F(1,29) ¼ 7.80, p ¼ 0.009).
4. Discussion
The aim of this paper was to construct an emotional eating scale
measuring eating in response to both positive and negative emo-
tions and to assess its predictive validity. In study 1, the preliminary
version of the Positive-Negative Emotional Eating Scale (PNEES)
was constructed. In study 2, experience sampling method was used
to test whether self-reported emotional eating predicts real-life
eating behaviour. For this purpose, data regarding emotional
experience, overeating and binge eating were collected.
The first hypothesis that negative emotional eating is more
strongly associated with binge eating than positive emotional
eating was confirmed. PNEES-N correlated strongly with EDAS
subscale Binge eating. The strong correlation between the two
constructs is plausible, as emotional eating and binge eating have
been found to be significantly correlated among clinical and non-
clinical samples (Poínhos, Oliveira, & Correia, 2013; Racine,
Culbert, Larson, & Klump, 2009; Van Strien et al., 2005). Further,
negative emotional eating has been found to be a good predictor of
binge eating onset among adolescent girls (Stice et al., 2002).
PNEES-N also had a strong correlation with EDAS total score, and
weak to moderate correlations with EDAS subscales Restrained
eating, Preoccupation with body image and body weight, and
Purging. This further confirms the link between negative emotional
eating and general psychopathology underlying eating disorders
(Lindeman & Stark, 2001).
Subscale Positive emotional eating also had a moderate corre-
lation with EDAS subscale Binge eating. This is in accordance with
the hypothesis, as the correlation between PNEES-P and Binge
eating is lower than with PNEES-N. Subscale Positive emotional
eating also correlated with EDAS total score and with its subscales
Restrained eating and Preoccupation with body image and body
428 H. Sultson et al. / Appetite 116 (2017) 423e430

Table 3
Pearson's correlation coefficients between positive/negative emotional eating, the mean level of positive/negative affect, and the total number of overeating and BE episodes,
BE episodes, and overeating episodes in the whole sample of women (N ¼ 60).

Measure PNEES-P PNEES-N PA NA Overeating and BE Overeating

PNEES-P e
PNEES-N 0.09 e
PA 0.13 -0.05 e
NA 0.13 0.26* -0.54** e
Overeating and BE 0.29* 0.21 -0.16 0.29* e
Overeating 0.35** 0.16 -0.09 0.26* 0.94** e
Binge eating 0.02 0.23 -0.24 0.25 0.69** 0.40**

Note: BE ¼ binge eating; PNEES-P ¼ Positive Emotional eating; PNEES-N ¼ Negative Emotional Eating; PA ¼ positive affect; NA ¼ negative affect. ** - correlations are significant
at p < 0.01, * - correlations are significant at p < 0.05.

Table 4
Pearson's correlation coefficients between positive/negative emotional eating, the
mean level of positive/negative affect, and the number of overeating episodes in a
subsample of women (N ¼ 21), and the total number of BE and overeating episodes
in a subsample of women (N ¼ 31).
Measure Overeating and BE
(N ¼ 31)
PNEES-P 0.35
PNEES-N 0.46**
PA 0.00
NA 0.17
Note: PNEES-P ¼ Positive Emotional eating; PNEES-N ¼ Negative Emotional Eating;
PA ¼ positive affect; NA ¼ negative affect. ** - correlations are significant at p < 0.01.
weight. Furthermore, PNEES-P still predicted binge eating after
controlling for the effect of PNEES-N. This is in line with previous
studies that have demonstrated that positive affect can also elicit
eating (Bongers, Jansen, Havermans, et al., 2013; Bongers, Jansen,
Houben, et al., 2013; Evers et al., 2013; Patel & Schlundt, 2001).
Although few authors have claimed that positive and negative
emotional eating are different constructs (Nolan et al., 2010; Van
Strien et al., 2013; Van Strien et al., 2016), we found a moderate
positive correlation between the two factors. Thus, some in-
dividuals tend to binge eat when they experience both positive and
negative emotions. There is some evidence that emotional eating
might not in fact reflect eating in response to various emotions.
Emotional eating might capture overeating in response to a variety
of food-related cues instead (Bongers et al., 2016; Evers et al., 2009).
Bongers et al. (2016) investigated whether emotional eaters in-
crease their food intake in response to negative emotional cues, or,
alternatively, to food-related cues in general. They found that
increased food intake in emotional eaters following negative mood
induction was also associated with increased intake in response to
positive mood and exposure to food. Further, emotional eaters also
tended to eat more following the control condition. Thus,
emotional eating might not reflect purely overeating in response to
negative emotions, but rather overeating in response to a variety of
food-related cues.
Eating in response to positive emotions may also be related to
positive urgency. It has been found that individuals who report
stronger levels of positive and negative urgency (proneness to act
hastily in response to positive and negative emotions) experience
more symptoms of addictive eating (Murphy, Stojek, & MacKillop,
2014). Further, positive and negative urgency have been found to
be positively correlated (Cyders & Smith, 2007), indicating that
some individuals tend to act impulsively in response to both pos-
itive and negative emotions, possibly including the tendency to eat.
The second hypothesis postulated that negative emotional
eating predicts overeating (without LoC) and binge eating (with
LoC) episodes measured via experience sampling method (ESM).
This hypothesis was partially confirmed. Negative emotional eating
did not predict overeating and BE episodes within the whole
sample. Nevertheless, within the subsample of women who expe-
rienced at least one overeating or BE episode, PNEES-N predicted
the number of overeating and BE episodes. As overeating has been
shown to be associated with emotional eating (Stojek et al., 2016;
Overeating Van Strien et al., 2005), our results further confirm the link be-
(N ¼ 21)
tween negative emotional eating and overeating. Similarly, the
0.29 association between emotional eating and BE in our study is in line
0.25
with the evidence that links emotional overeating with BE fre-
0.18
-0.08 quency (Masheb & Grilo, 2006) and severity (Ricca et al., 2009). The
fact that PNEES-N did not predict overeating or BE within the whole
sample could point towards the fact that negative emotional eating
might be more characteristic of individuals with eating disorders or
severe eating pathology, as emotional eating itself has been asso-
ciated with eating disorder features and depression (Masheb &
Grilo, 2006).
In addition, our results indicate that loss of control might also be
an important feature of negative emotional eating. PNEES-N pre-
dicted the total number of overeating and BE episodes within a
subsample of women. When individuals with BE episodes were
excluded from the subsample, leaving only individuals with over-
eating episodes, PNEES-N was no longer associated with eating
episodes. In comparison to overeating, binge eating has been
associated with larger amount of food, more distress and increased
guilt (Stein et al., 2007). Considering that binge eating is a signifi-
cant predictor of eating disorders (Latner, Hildebrandt, Rosewall,
Chisholm, & Hayashi, 2007) and that negative emotional eating
was associated with BE within the subsample of women with
overeating/BE, it is plausible that PNEES-N might be related to a
more severe eating pathology.
Even though PNEES-N had a strong correlation with EDAS sub-
scale Binge eating in Study 1, the number of binge eating episodes
alone obtained via ESM in Study 2 were not correlated with
negative emotional eating. This is contrary to our hypothesis. It is
plausible that due to the fact that in Study 2 there were only 10
women in our sample who had experienced at least one BE episode,
we failed to find associations with negative emotional eating. In
addition, due to the small sample of women with BE episodes, we
did not further investigate the relationship between emotional
eating and BE among binge eaters. However it would be useful to
investigate the role of negative emotional eating among individuals
with binge eating in the future.
The third hypothesis postulated that positive emotional eating
predicts overeating episodes measured via ESM. This hypothesis
was confirmed, as PNEES-P significantly predicted overeating.
PNEES-P was also associated with the total number of overeating
and BE episodes. Thus, it is clear that positive emotions could also
evoke overeating. However, among overeaters and binge eaters,
PNEES-N is a better predictor of the disturbed eating behaviour as
we have previously discussed. Eating in response to various posi-
tive emotions could be less related to eating pathology, and more to
 H. Sultson et al. / Appetite 116 (2017) 423e430
hedonic eating (Macht, 1999), as positive emotions have been
shown to enhance pleasantness of food and increase the motivation
to enjoy food (Macht, 1999; Macht et al., 2002). The associations
between hedonic eating and positive emotional eating could serve
as an important direction for future research.
There are few limitations to the study and several implications
for the future. To begin with, the sample size in Study 2 was rela-
tively small and the results from the regression analyses should be
replicated in a larger sample. It is plausible that a larger population-
representative sample could have produced slightly different re-
sults. PNEES factor structure and relations with overeating and
binge eating among men should also be investigated in future
studies. Further, we did not differentiate between BE episodes
preceeding or following positive and negative affect as it is meth-
odologically challenging.
Few studies also suggest that difficulties in emotion regulation
might even be a more important predictor of BE (Gianini, White, &
Masheb, 2013) and emotional eating (Spoor, Bekker, van Strien, &
van Heck, 2007) than negative affect alone. For example, we have
demonstrated that fluctuations in negative emotions along with
emotion regulation difficulties predicted BE among women (Kukk
& Akkermann, 2017). Failing to successfully regulate one's emo-
tions and therefore resorting to more maladaptive emotion regu-
lation strategies, e.g. binge eating, has been proposed to be a
mechanism underlying BE (Whiteside et al., 2007). Hence, it would
be useful to study how the subscales of PNEES relate to emotion
regulation difficulties as well as to negative and positive urgency.
Also, individual differences in appetitive responsiveness to
rewarding properties of food (Lowe & Butryn, 2007) should be
examined regarding its association with positive emotional eating.
As obesity has been associated with altered reward sensitivity
regarding food stimuli (Castellanos et al., 2009; Volkow, Wang, &
Baler, 2011), it would be useful to study the relation between
PNEES-P and hedonic eating within obese population. Specifically,
positive emotional eating could serve as a potential risk factor for
gaining weight.
In conclusion, we constructed the Positive-Negative Emotional
Eating Scale that showed good fit to the data and demonstrated
good psychometric properties. We further examined the predictive
validity of the scale by investigating how positive emotional eating
and negative emotional eating predict overeating and BE episodes
in the natural environment. We found that both subscales showed
good predictive validity as the self-reported positive and emotional
eating both predicted real-life eating behaviour measured via ESM.
Specifically, we found that positive emotional eating predicted
overeating episodes within the whole sample, whereas negative
emotional eating predicted overeating and BE within a subsample
of women who had experienced at least one overeating or BE
episode. Our results suggest that positive and negative emotional
eating might have different associations with overeating and binge
eating, as the latter might be related to a more severe eating
pathology.
Conflict of interest
There is no conflict of interest for any of the authors.
Role of the funding source
This research did not receive any specific grant from funding
agencies in the public, commercial, or non-profit sectors.
Acknowledgements
We would like to thank Uku Vainik for his assistance on the data
429
analyses and interpretation of the results of Study 1, Andero Uus-
berg and Helen Uusberg for their help with data collection, and
Karin T€
aht for her consultation on the data analyses.
Appendix A. Supplementary data
Supplementary data related to this article can be found at http://
dx.doi.org/10.1016/j.appet.2017.05.035.
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