The association between premenstrual symptom severity and eating disorder: Mediation by food addiction and emotional eating, moderation by irrational beliefs.

Severe premenstrual symptoms (PS) have been linked to emotional eating (EE) and binge eating. The purpose of this study was to examine whether EE, dietary restraint, and/or food addiction (FA) mediated the relationship between PS and the odds of screening positive for an eating disorder. The role of irrational beliefs (IB), which can lead to dysfunctional emotional and/or behavioral responses, was examined as a potential moderator. 600 women (mean age = 26.6 ± 0.2 years) who had menstruated at least twice in the previous year completed online questionnaires. Methods to screen out automated ("bot") responses were employed. Through purposive sampling, 25 % of the sample identified primarily as Asian, Black, Latina/Hispanic, White. No significant racial/ethnic identity differences were found for PS or any psychological measures. Results indicated that there was a positive relationship between PS and IB, depression, EE, external eating, dietary restraint, FA, and the odds of screening positive for an eating disorder. PS was weakly negatively associated with age but not with body mass index. EE and FA mediated the positive relationship between PS and the odds of having a positive screen for an eating disorder (controlling for depression). The association between PS and FA was stronger at higher levels of IB. IB also moderated the association between EE and the odds of having a positive screen for an eating disorder. Overall, the results indicate that those who have more severe PS engage in more uncontrolled eating in the form of EE and FA (particularly at higher IB levels for the latter) which are associated with higher odds of having a positive screen for an eating disorder.