Food addiction, emotion regulation, and self- compassion: the mediating role of executive functions

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Abstract Background This research aimed to examine the mediating role of executive functions in the relationship between food addiction and emotion regulation as well as self-compassion. Methods In this study, in the form of a structural equation modeling, 251 subjects (219 women and 32 men) were chosen via convenience sampling and responded to the following questionnaires: difficulties in emotion regulation scale (DERS-16), Rice self-compassion, food addiction 2, and behavior rating inventory of executive function for adults (BRIEF-A). Results The findings indicated that there is a positive and significant relationship between deficits in emotion regulation and food addiction. Also, executive functions mediated the relationship between emotion regulation, self-compassion, and food addiction. Nevertheless, no relationship was found between self-compassion and food addiction. Conclusions Thus, it can be concluded that consolidating the emotion regulation skills and executive functions may contribute to prevention from or improvement of food addiction, thereby preventing the ensuing negative consequences such as obesity and cardiovascular disease.
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Methods In this study, in the form of a structural equation modeling, 251 subjects (219 women and 32 men) were chosen via convenience sampling and responded to the following questionnaires: difficulties in emotion regulation scale (DERS-16), Rice self-compassion, food addiction 2, and behavior rating inventory of executive function for adults (BRIEF-A). Results The findings indicated that there is a positive and significant relationship between deficits in emotion regulation and food addiction. Also, executive functions mediated the relationship between emotion regulation, self-compassion, and food addiction. Nevertheless, no relationship was found between self-compassion and food addiction. Conclusions Thus, it can be concluded that consolidating the emotion regulation skills and executive functions may contribute to prevention from or improvement of food addiction, thereby preventing the ensuing negative consequences such as obesity and cardiovascular disease. Biological sciences/Psychology Health sciences/Health care food addiction self-compassion emotion regulation executive functions Figures Figure 1 Figure 2 Plain English summery Obesity (characterized by increased body mass index (BMI)) is a major risk factor for non-communicable diseases such as cardiovascular disease and some cancers (1). One of the underlying factors behind obesity is food addiction (2), whose weighted mean prevalence in normal population is 20%, while being higher among those with eating disorders and clinical populations (3). In addition, studies suggest that different types of disorder including anxiety, mood, and eating as well as type II diabetes are positively associated with food addiction. Thus, possibly those with food addiction have less life satisfaction (4). Accordingly, the studies examining obesity as well as its contributing factors such as food addiction are of special clinical importance. Background Food addiction is a severe form of overeating; in most cases this polyphagia is associated with very tasty foods (such as those with high sugar and fat content, which remarkably activate the reward system in both humans and animals). It is linked to loss of control over eating, craving for food, and reduction of food consumption in spite of adverse consequences ( 5 , 6 ). In patients suffering from obesity, food addiction is associated with deficient cognitive functions, impulse control, existence of psychiatric symptoms, poorer diet, as well as frequent bouts of emotional eating ( 4 ). One of the variables associated with food addiction is emotion regulation. Emotion regulation refers to adaptive methods for responding to emotional distress instead of controlling emotions or weakening of emotional arousal ( 7 ). Emotion regulation is a multidimensional construct including a) awareness, perception and acceptance of emotions, b) ability of dealing with targeted behaviors as well as inhibiting impulsive behaviors when experiencing negative emptions), c) flexible use of suitable situational strategies for modifying the intensity and/or duration of emotional responses instead of complete elimination of emotions, and d) tendency to experiencing negative emotions as part of following significant activities in life ( 8 , 9 ). Deficits in emotion regulation occur when the person lacks the necessary skills for regulating negative emotions or emotional distress ( 10 ). Lack of emotion regulation is associated with different types of behaviors including overeating ( 11 ). Emotion dysregulation is positively linked to food addiction and predicts its criteria ( 12 ). In addition, different aspects of emotion dysregulation have been implicated in food addiction such as difficulty in engaging in goal-oriented behaviors, impulsivity, emotional awareness, and limited access to emotion regulation strategies as well as sense of loneliness ( 13 ). Another variable associated with food addiction is self-compassion. Self-compassion has been discussed as one of the important strategies for coping with negative emotions and depression. According to Neff, K. D ( 14 ), it has been defined based on three components (dichotomous). These three components are a) self-kindness (as opposed to self-judgment), referring to the ability of treatment with care and self-understanding against self-judgment and being self-critical; b) common humanity (as opposed to isolation), which notes recognition of this fact that defects and failure are normal and common aspects among all humans, unlike sense of loneliness at the time of failure and deficiency; and c) mindfulness (against over-identification), which involves awareness and acceptance of experiences against over-identification of thoughts and emotions. Self-compassion can be a useful emotion regulation strategy in disorders such as major depression ( 15 ). Diac, A.E et al.( 16 ) indicated chocolate addiction (one of the types of food addiction) has a negative correlation with self-compassion. Another research found that different symptoms of eating disorders are negatively associated with self-compassion, with this negative correlation being partially mediated by emotion regulation ( 17 ). It seems that self-compassion is an adaptive emotion regulation strategy in eating disorders and body image ( 18 ). Nevertheless, very sparse studies have been done on self-compassion and food addiction, and most have dealt with the relationship between self-compassion and different types of eating disorders. Although some studies have suggested a relationship between emotion regulation plus self-compassion and food addiction, the number of these studies is very limited. Further, the underlying mechanism of this relationship is still poorly understood. Thus, identification of the underlying mechanisms among these variables is today a challenge ahead of us. One of the variables that is associated with both food addiction and emotion regulation is executive functions. Executive functions (EFs) refer to a set of higher order cognitive abilities that are essential for pursuing and achieving a goal ( 19 ). Furthermore, EF also known as executive control or cognitive control refers to a group of up-button mental processes required at the time of focus and attention, and when automatic impulse or reliance on instinct or intuition is wrong, inadequate, or impossible. The major EFs include: 1) inhibitory control including self-control (behavior inhibition) and interference control (selected attention and cognitive inhibition), 2) working memory (WM), and 3) cognitive flexibility (also known as set shifting, mental flexibility, or mental set shifting, being closely associated with creativity). EFs are skills that are essential for mental and physical health, success in life and school, as well as cognitive, social, and psychological development ( 20 ). Studies have shown that the brain EFs are associated with the emotion regulation ( 21 ). Based on some studies, impulsivity is also positively linked to food addiction ( 22 ). Meanwhile, working memory which is one of the EF components is partially associated with self-compassion ( 23 ). Self-control has also shown a relationship with self-compassion ( 24 ). As mentioned above, EFs are linked to food addiction and emotion regulation. Also, impulsivity, indicating impaired inhibitory control, is connected with food addiction. Meanwhile, emotion regulation is linked to food addiction and self-compassion. Nevertheless, so far sparse studies have been done on relationship between food addiction and self-compassion. Further, since EFs are also linked to food addiction, emotion regulation, and self-compassion, they (EFs) may explain the relationship between these two groups of variables. Thus, our hypothetical structural modeling in this research has been presented in Fig. 1 . Further, since self-compassion is one of the emotion regulation strategies, EFs may explain the relationship between this variable and food addiction. Overall, this research aims to present structural modeling of mediating role of executive functions in the relationship between emotion regulation, self-compassion, and food addiction. Methods The research was conducted in accordance with relevant regulations and guidanelines, including the Declaration of Helsinki. This project was approved by the University of Tehran Research Ethics Board (File number: IR.UT.PSYEDU.REC.1402.031). Informed consent was obtained from all subjects and/or their legal guardian(s). Research design and participants The present research has been of fundamental research type regarding aim, and descriptive research regarding data collection and of correlation type. The statistical population consisted of all Iranian men and women above 18 years of age in 2023, who had access to mobile phone. From among the statistical population, according to Klein ( 25 ) criterion and considering an extra 10% for possible attrition of the subjects, eventually 251 subjects were chosen through convenience sampling. This sample consisted of 219 women and 32 men. The mean age of all subjects was 38.06 with SD 12.90. Out of these 251 subjects, 43.4% were single, 47% were married, 4% were divorced, and the rest were either widowed or engaged. Less than 13% of the subjects had below bachelor levels of education, 41% had bachelor’s degree, 39.8% had master's degree, and 6% had degrees above Masters. For measuring the research variables, the following instruments were used: Food addiction: YFAS 2.0 was developed by Gearhardt et al. in Yale University in 2016 ( 26 ). YFAS 2.0 consists of 35 items evaluating the following aspects of food addiction: 1) losing control over food consumption, 2) continuing the consumption in spite of negative consequences, 3) failed attempts for quitting or reducing the behavior, 4) tolerating or needing excessive amounts, 5) withdrawal symptoms at the time of abstaining, 6) reducing other activities due to food, 7) severe craving for food, 8) considerable clinical dysfunction or discomfort. This scale is scored using eight-point Likert scale ranging from 0 (never) to 7 (always). Accordingly, the higher the score gained by the subject, the more severe their food addiction is. The Cronbach alpha coefficient which is a criterion for internal consistency in a sample of 550 subjects was 0.96. The first person who normalized the YFAS 2.0 scale for Iranian students was Ghanbari ( 27 ). The Cronbach alpha coefficient has been variable from 0.86 to 0.93 in different studies. Emotion dysregulation: DERS-16 scale was presented by Bjureberg et al. ( 28 ). This scale has five subscales including refusing negative emotions, problems of goal-oriented involvement, impulse control problems, limited access to emotion regulation strategies, and absence of clear emotions. This questionnaire includes 16 items ranking based on five-point Likert scale from 1 (almost never) to 5 (almost always). The higher the score acquired by the subject, the greater their difficulty in emotion regulation. The Cronbach alpha coefficient which is a criterion for internal consistency was 0.89 for the total scale, while ranging from 0.78 to 0.91 for the subscales in a 550-subject study. The Persian version of DERS-16 scale was translated and verified by Fallahi et al. in 2021 ( 29 ). They tested the psychometric properties of the Persian version of DERS-16 in a sample consisting of 400 Iranian students. The Cronbach alpha coefficient obtained was 0.91 for the total scale and 0.77–0.86 for the subscales. Self-compassion: SCS-SF scale developed by Raes et al. ( 30 ) measures six components of self-compassion: self-kindness, self-judgment, common humanity, isolation, mindfulness, and overidentification. This scale includes 12 items ranking through a five-point Likert scale from 1 (almost never) to 5 (almost always). The higher the score gained by the subject, the greater their self-compassion. The Cronbach alpha coefficient which is a criterion for internal consistency was 0.89 for the total scale while ranging from 0.78 to 0.91 for the subscales. The SCS-SF Persian version was translated and verified by Khanjani et al. in 2016 ( 31 ). They tested the psychometric properties of the Persian version of SCS-SF in a sample consisting of 270 Iranian students. The Cronbach alpha coefficient was obtained 0.86 for the total scale and 0.72–0.83 for the subscales. Executive functions: ultimately, to measure executive functions, BRIEF-A self-measurement scale, with 75 items, is used. The subscales of this scale were first designed by Roth et al. in 2005 ( 32 ) for measuring executive functions of adults. This scale includes nine subscales of 1) inhibition (inhibitory control), 2-self-monitoring, 3-planning and organization, 4-shifting (cognitive flexibility), 5) activity initiation, 6) task supervision, 7) emotional control, 8) working memory, and 9) organization of resources and materials. Each item is scored from 0 (never) to 2 (often). The higher the score of the subject in a subscale, the greater the deficit and difficulty in that scale. Scoring and interpretation. Cronbach alpha for the self-report form of the clinical scales was average to high (0.73–0.90) and for the indices and total score was high (93.93–0.96). To report the informed person for clinical scales, the indices and total score showed high internal consistency (0.80–0.98). This scale was translated by Mani et al. in 2018 ( 33 ) into Persian. According to the paper of Mani et al., the Cronbach alpha coefficient for BRIEF-A subscales varied from 0.650 to 0.838, indicating good internal consistency of the items. In this study, we only included the three subscales of inhibition, shifting, and working memory into the analysis. Method of implementation To implement this research, ethical considerations have been considered. To observe these considerations, before conducting the research, ethics code was received from faculty of psychology and educational sciences of Tehran University, code IR.UT.PSYEDU.REC.1402.031. Further, at the beginning of the questionnaire link, an explanation was provided about the research and the principle of confidentiality of responses for the participants. After studying the points, the participants would announce their consent only if they had the possibility of participation. After announcing consent, the questionnaire items were provided to them. Also, the participants could withdraw from the study at any of its stages. The link of this questionnaire was shared in a number of social network channels in Telegram. First, all of the measurement instruments were prepared as online scales, in order to facilitate and accelerate their completion. Next, using convenience sampling method, the participants willing to take part in the research were asked to fill in the scales completely in the Porseline website. Also, to reward the participants for their time and completion of scales, cash reward was considered. In this research, descriptive statistics including frequency, percentage, mean, standard deviation, as well as inferential statistics including correlation coefficient and structural equation modeling have been used. All of the above stages were done using SPSS 26 as well as IMUS software ( 24 ) at significance level of < 0.05. Results Descriptive indices: Table 1 presents the descriptive indices. Table 1 Descriptive indices Variable No. Min. Max. Mean SD Food addiction 251 1.00 7.17 2.186 1.288 Emotion regulation 251 1.00 4.75 2.678 0.893 Self-compassion 251 1.42 4.83 3.272 0.729 Cognitive flexibility 251 1.00 2.75 1.585 0.396 Inhibitory control 251 1.00 3.00 1.703 0.453 Working memory 251 1.00 2.88 1.600 0.453 Examination of normality: to test the hypothetical model, first its presumptions were investigated. Since the sample size has been above 100, the absolute value of the skewness coefficients of variables has been lower than 3 and absolute value of the kurtosis coefficients of variables has been lower than 10. As such, the distribution can be conceived as normal. Since in the link of implementation of the research, all items were compulsory, thus there were no missing data. Investigation of the outliers also showed that there were no univariate or multivariate outliers. Multivariate normality examination based on Mann-Whitney test also showed that distribution of multivariate data is established (p > 0.5). Considering the normality of distribution of variables, to explore their correlation, Pearson parametric correlation coefficient has been used, with its results reported in the following table. Table 2 Pearson correlation analysis between research variables 1 4 5 6 1 Food addiction 1 2 Emotion regulation .502 ** 1 3 Self-compassion − .344 ** − .698 ** 1 4 Cognitive flexibility .427 ** .549 ** − .475 ** 1 5 Inhibitory control .429 ** .649 ** − .606 ** .644 ** 1 6 Working memory .402 ** .593 ** − .524 ** .705 ** .717 ** 1 * significance at 5% error level ** significance at 1% error level The results of Table 2 show that at 1% error level, there is a positive and significant linear relationship between every pair of variables. In this section, we intend to investigate the mediating role of executive functions in the relationship between food addiction and emotion dysregulation as well as self-compassion; for the conceptual model test, structural equation modeling has been used. Figure 2 presents the conceptual model of the relationship between the variables defined in the research in standard coefficients state. Table 3 reports the standard and nonstandard coefficients as well as the t-statistic value for examining the significance of relationships between variables. Table 3 Estimating the coefficients between variables in the conceptual model Exogenous variable Endogenous variable Standard coefficient Nonstandard coefficient Estimation error t P Emotion dysregulation <--- Food addiction 0.341 0.491 0.129 3.794 < 0.001 Self-compassion <--- Food addiction 0.102 0.18 0.14 1.285 0.199 Emotion dysregulation <--- Executive functions 0.525 0.183 0.025 7.3 < 0.001 Self-compassion <--- Executive functions -0.283 -0.121 0.029 -4.11 < 0.001 Executive functions <--- Food addiction 0.321 1.328 0.394 3.371 < 0.001 Executive functions <--- Cognitive flexibility 0.787 1 Executive functions <--- Inhibitory control 0.851 1.236 0.087 14.214 < 0.001 Executive functions <--- Working memory 0.85 1.235 0.087 14.196 < 0.001 Based on the results of Table 3 , it can be stated that emotion dysregulation has a positive and significant effect on food addiction. Self-compassion has had a negative and significant effect on food addiction. Emotion dysregulation showed a positive and significant effect on executive functions. Finally, self-compassion has shown a negative and significant effect on executive functions, and executive functions have revealed a positive and significant effect on food addiction. To explore the mediating role of executive functions between emotion regulation and food addiction as well as self-compassion and food addiction, Sobel Z test was employed, with its results presented Table 3 . Table 4 Indirect and significant effects of the mediating variable of executive functions based on one of the exogenous variables Exogenous variable Indirect effect (a*b) Standard error statistic \({\varvec{T}}_{\varvec{s}-\varvec{M}}\) Result Emotion dysregulation 0.243 0.080 3.038 Significant Self-compassion -0.161 0.062 -2.578 Significant Since the absolute value of T s -M statistic in the above table for both exogenous variables of self-compassion and emotion dysregulation has been larger than 1.96, thus it can be concluded that the mediating effect of executive functions by both exogenous variables of self-compassion and emotion dysregulation on food addiction has been significant at 5% error level. Comparison of coefficients (factor loads) between the latent variable of executive functions and its three components shows that the factors of working memory and inhibitory control have been more important in determining executive functions when compared with cognitive flexibility. The results of Table 5 reveal desirable fitness of the conceptual model, where the experimental data well match the model of interest. Table 5. Fitness indices of the conceptual model Index RMSEA GFI CFI NFI Value 2.287 0.072 0.981 0.990 0.983 Favorable range 1≤&≤3 0≤&≤0.1 0.9≤&≤1 0.9≤&≤1 0.9≤&≤1 Outcome Favorable Favorable Favorable Favorable Favorable Discussion The aim of this research was to present a structural modeling of the mediating role of executive functions in the relationship between emotion regulation, self-compassion, and food addiction. The findings showed that executive functions mediate the relationship between emotion regulation, self-compassion, and food addiction. Self-compassion is linked to food addiction through executive functions, but it is not directly or singly correlated, yet emotion regulation is associated both directly and indirectly. Emotion dysregulation, executive functions, and food addiction The findings revealed that there is a positive and significant relationship between emotion regulation and food addiction. Accordingly, it can be stated that the higher the score acquired by the person in emotion dysregulation, the higher their score would also be in food addiction. This is in line with the results of other studies evaluating the relationship between emotion regulation and food addiction ( 12 , 34 , 35 ). For example, emotion dysregulation has been observed in many psychological health issues including different types of eating disorders and drug abuse. Indeed, bulimia behavior is a way for regulating and modifying emotions especially the negative ones ( 12 , 34 , 35 ). In other words, when the person experiences emotions especially negative and unpleasant ones, to reduce them and bring them to a tolerable level, they employ overeating behavior. This is because they are not able to use adaptive and healthy skills of emotion regulation ( 12 ). These findings can also be explained by Gross emotion regulation theory. According to Gross, the emotion generation process has four components of situation, attention, arousal, and response. Meanwhile, emotion regulation strategies alter the emotion path. Here, food addiction also as a maladaptive strategy for emotion regulation can change the path of negative emotions ( 36 ). Gross states that emotion regulation can be done with the aims of reducing, reinforcing, or maintaining positive or negative emotional experiences ( 37 , 38 ). Furthermore, according to Gross theory, emotion regulation techniques that focus on the primary stages of emotional processing process (antecedent-focused) are more effective than the techniques that are response oriented ( 39 ). Accordingly, we can conclude that binge eating behavior in food addiction is indeed a response, and as stated earlier response-oriented techniques are less effective. Accordingly, inefficacy in emotion regulation skills may lead to food addiction. The findings showed that executive functions reinforce the relationship between emotion dysregulation and food addiction. Numerous studies have shown that there is a relationship between executive functions of the brain and different types of psychological health issues. These findings are in line with the results of other researchers ( 4 , 12 , 40 , 41 ). for example, Oliveira et al. ( 4 ) found that cognitive defunctions and inhibitory control are associated with food addiction. Research has also shown that patients suffering from eating disorders who have characteristics such as emotion dysregulation, executive problems, and impulsive personality are more susceptible to different types of drug abuse disorders ( 40 ). These results also concur with the findings obtained by Pivarunas, B & Connor ( 12 ). As explanation, it can be stated that when a person does not have the necessary skills for management of emotions, emotion dysregulation occurs. When the person experiences negative emotions, due to lacking skills of emotion regulation, they would act impulsively. This impulsive action itself is a sign of weakness in executive functions especially inhibitory control. In addition, working memory which is one of the executive functions also provides cognitive resources to the person, which can be harnessed when experiencing emotions for managing them ( 41 ). Thus, when the person has deficit in inhibition control and working memory, regulation and modification of emotions especially negative emotions would be difficult. Meanwhile, due to impulsivity, they may use maladaptive strategies such as polyphagia and overeating foods that are very sweet, fatty, or salty for modifying emotions. Therefore, training emotion regulation skills can be one of the courses of action for treating food addiction. In addition, by presenting exercises for improving inhibition control and working memory, we can facilitate the influence of emotion regulation skills. Self-compassion, executive functions, and food addiction Self-compassion and food addiction had a significant relationship with mediation of executive functions. This is also in line with the findings of other studies ( 16 , 18 , 42 – 47 ). Different studies have indicated that self-compassion is one of the adaptive skills of emotion regulation ( 46 ). As mentioned above, in case of absence of suitable emotion regulation skills and experiencing negative emotions, individuals may act impulsively. Alternatively, due to deficit of cognitive resources, they may not be able to manage their emotions adaptively when experiencing them ( 12 , 41 ). In other words, when the person has high self-compassion, they would have fewer problems in executive functions and vice versa. Otherwise, the person would act impulsively for emotion regulation towards overeating or consuming unhealthy foods. Here, if the person has self-compassion, they would treat this behavior gently, and would sympathize with themselves. This causes mitigation of negative emotions and their regulation. When experiencing negative emotions, such individuals can modify and endure them adaptively. These research studies can explain why executive dysfunctions especially inhibitory control reinforce and make the negative relationship between self-compassion as an emotion regulation skill and food addiction significant. One of the components of self-compassion is self-kindness and common humanity. A person who has learned these two components knows that they are not impeccable and are open to mistakes. However, if they have low self-kindness and common humanity, negative emotions prevail and the person would again act impulsively ( 48 ). Another component of self-compassion is mindfulness. Mindful individuals show less impulsive behavior. According to the research results, mindfulness can lead to improved working memory, cognitive flexibility, and inhibitory control ( 43 , 44 , 47 ). Thus, we can conclude that the individuals with higher levels of self-compassion would acquire lower scores of food addiction. As such, we can consider training self-compassion scale as one of the solutions for treating food addiction. Our findings show that in the hypothetical model, food addiction and self-compassion do not have a direct relationship. This seems to be in contradiction to previous findings ( 16 , 42 , 45 ). Previous studies have indicated that there is a negative relationship between self-compassion and chocolate addiction, which is one of the subsets of food addiction. This means the higher the score gained by the subject in chocolate addiction, the lower their self-compassion would be ( 16 ). Further, higher levels of self-compassion have been associated with lower levels of bulimia nervosa ( 45 ). In addition, a higher score in self-compassion has been associated with fewer symptoms of eating disorders ( 42 ). The most important interpretation for the difference of this finding with other studies is use of different statistical analyses. In this study, we employed path analysis method in order to measure the mediating role of executive functions in the relationship between self-compassion and food addiction. As such, a considerable portion of the variance is explained by executive functions, which itself confirms our model. However, it causes the direct relationship between self-compassion and food addiction not to become significant. Meanwhile, in other studies such as the one by Taylor et al. ( 42 ), this mediating variable has not been used. Other reasons can include the different statistical populations and sample, various measurement instruments, as well as the fact that most of the mentioned studies have measured constructs similar to food addiction such as overeating or different types of eating disorders. Limitations and suggestions This study has been novel as it has examined the mediating role of executive functions in the relationship between self-compassion and food addiction as well as emotion regulation and food addiction. Nevertheless, as with any studies, it has had some limitations. Firstly, in this research nonrandomized convenience sampling method has been used. Further, this study has been implemented completely using self-report questionnaires, while there are other instruments for measuring executive function variables. In addition, the method of this research has been structural equation modeling; thus, causal relations cannot be deduced from that. Therefore, generalization of the research findings should be done cautiously. For future studies, it is recommended to use computerized instruments for measuring executive functions such as IVA test. Further, for generalizing the findings, randomized sampling would be better. In addition, as mentioned earlier, the role of inhibitory control skills and working memory in explaining the executive functions has been greater than that of cognitive flexibility. It is suggested for future studies to examine the role of this variable itself as an exogenous variable in the relationship between food addiction and emotion regulation and self-compassion. Conclusions Based on this research findings, it can be concluded that part of the treatment and prevention from obesity and food addiction can be undertaken by training emotion regulation and self-compassion skills. Further, improvement of executive functions can be helpful in enhancing the effect of emotion regulation on food addiction. It can also be a ground for developing self-compassion, which itself leads to reduction of food addiction symptoms. Declarations Author information Faculty of psychology, university of Tehran, Tehran, Iran Narges Alsadat Salili ORCID NO: 0009-0009-9953-8743 Email address: [email protected] Faculty of psychology, university of Tehran, Tehran, Iran Azam Noferesti ORCID NO: 0000-0003-25636980 Email address: [email protected] Faculty of humanities, Tarbiat Modares university, Tehran, Iran Hojatollah Farahani ORCID NO: 0000-0002-9799-7008 Email address: [email protected] Authors and Affiliations Contributions This data in this paper was collected as part of NAS's masters thesis. AN is her primary graduate supervisor. NAS and AN contributed to the development of the project and the current data analytic plan. NAS wrote the initial draft and conducted the data analysis. AN edited drafts of the manuscript. HF contributed to the data analysis All three authors reviewed the final manuscript. Corresponding author Correspondence to Narges Alsadat Salili Ethics declarations Ethics approval and consent to participate This project was reviewed by the University of Tehran Research Ethics Board (File number: IR.UT.PSYEDU.REC.1402.031). Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Funding Not applicable. Author Contribution This data in this paper was collected as part of N.A.S's masters thesis. A.N. is her primary graduate supervisor. N.A.S. and A.N. contributed to the development of the project and the current data analytic plan. N.A.S. wrote the initial draft and conducted the data analysis. A.N. edited drafts of the manuscript. H.F. contributed to the data analysis All three authors reviewed the final manuscript. Acknowledgements Not applicable. Availability of data and materials Data and materials are available upon request References Organization WH. 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Investigating the relationship between reward sensitivity, impulsivity, and food addiction: A systematic review. European Eating Disorders Review. 2020;28(4):368-84. Carr MM, Schulte EM, Saules KK, Gearhardt AN. Measurement invariance of the modified Yale Food Addiction Scale 2.0 across gender and racial groups. Assessment. 2020;27(2):356-64. Fan L, Wang Y. Healthy eating behaviors and self-control in scarcity: The protective effects of self-compassion. Appetite. 2022;169:105860. Kline P. An easy guide to factor analysis: Routledge; 2014. Gearhardt AN, Corbin WR, Brownell KD. Development of the Yale Food Addiction Scale Version 2.0. Psychology of Addictive Behaviors. 2016;30(1):113. Ghanbari N, Nooripour R, Firoozabadi A, Var TSP, Wisniewski P, Hosseini SR. Psychometric assessment of Persian translation of Yale food addiction scale version 2.0 (YFAS 2.0) in Iranian college students. Journal of Eating Disorders. 2022;10(1):1-9. Bjureberg J, Ljótsson B, Tull MT, Hedman E, Sahlin H, Lundh L-G, et al. Development and validation of a brief version of the difficulties in emotion regulation scale: the DERS-16. Journal of psychopathology and behavioral assessment. 2016;38:284-96. Fallahi V, Narimani M, Atadokht A. Psychometric Properties of the Difficulties in Emotion Regulation Scale Brief Form (Ders-16): in Group of Iranian Adolescents. Journal of Shahid Sadoughi University of Medical Sciences. 2021. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the self‐compassion scale. Clinical psychology & psychotherapy. 2011;18(3):250-5. Khanjani S, Foroughi AA, Sadghi K, Bahrainian SA. Psychometric properties of Iranian version of self-compassion scale (short form). Pajoohandeh Journal. 2016;21(5):282-9. Roth RM, Gioia GA. Behavior rating inventory of executive function--adult version: Psychological Assessment Resources Lutz, FL; 2005. McCuen‐Wurst C, Ruggieri M, Allison KC. Disordered eating and obesity: associations between binge‐eating disorder, night‐eating syndrome, and weight‐related comorbidities. Annals of the New York Academy of Sciences. 2018;1411(1):96-105. Anestis MD, Selby EA, Fink EL, Joiner TE. The multifaceted role of distress tolerance in dysregulated eating behaviors. International Journal of Eating Disorders. 2007;40(8):718-26. Anestis MD, Smith AR, Fink EL, Joiner TE. Dysregulated eating and distress: Examining the specific role of negative urgency in a clinical sample. Cognitive therapy and research. 2009;33:390-7. Gross JJ. Emotion regulation. Handbook of emotions. 2008;3(3):497-513. Gross JJ. Emotion regulation: Current status and future prospects. Psychological inquiry. 2015;26(1):1-26. Gross JJ. Handbook of emotion regulation: Guilford publications; 2013. Kobylińska D, Kusev P. Flexible emotion regulation: How situational demands and individual differences influence the effectiveness of regulatory strategies. Frontiers in psychology. 2019;10:72. Lozano-Madrid M, Clark Bryan D, Granero R, Sánchez I, Riesco N, Mallorquí-Bagué N, et al. Impulsivity, emotional dysregulation and executive function deficits could be associated with alcohol and drug abuse in eating disorders. Journal of clinical medicine. 2020;9(6):1936. Barkus E. Effects of working memory training on emotion regulation: Transdiagnostic review. PsyCh journal. 2020;9(2):258-79. Taylor MB, Daiss S, Krietsch K. Associations among self-compassion, mindful eating, eating disorder symptomatology, and body mass index in college students. Translational Issues in Psychological Science. 2015;1(3):229. Bahrami A, Tabatabaee SM, Delavarpour M. .Effectiveness of mindfulness training (with music) on working memory and cognitive flexibility in children with learning disabilities. Journal of Learning Disabilities. 2022;11(4):6-20. Mrazek MD, Franklin MS, Phillips DT, Baird B, Schooler JW. Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering. Psychological science. 2013;24(5):776-81. Serpell L, Amey R, Kamboj SK. The role of self-compassion and self-criticism in binge eating behaviour. Appetite. 2020;144:104470. Turk F, Kellett S, Waller G. Comparing self‐compassion versus body exposure for adult women with moderate to severe body dissatisfaction: A feasibility and pilot trial. Clinical Psychology & Psychotherapy. 2022;29(4):1475-80. Pozuelos JP, Mead BR, Rueda MR, Malinowski P. Short-term mindful breath awareness training improves inhibitory control and response monitoring. Progress in brain research. 2019;244:137-63. Neff KD. Self‐compassion, self‐esteem, and well‐being. Social and personality psychology compass. 2011;5(1):1-12. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3987214","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":281628784,"identity":"d24c3417-0675-4a1b-a819-bddd967277b9","order_by":0,"name":"Narges Alsadat Salili","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8ElEQVRIiWNgGAWjYFADdsbGAwkVQAYzcwORWpgZGw4knIEwiNXCwHCAsQ3EIqDFnP3s4xcf/jDY8zczNxx4OK82mr8dqOVHxTacWix70s0sZ7YxJM44DHRY4rbjuSAGY8+Z2zi1GBxIYzPmbWBIYIBoOZbbAGQwM7bh0XL+GZvxH6DD5MFa5hzLnU9Qy4005scMbAyMG8BaGmpyNxDW8oyNsbdNInEjSEvCsQO5IMZBvH45n8b84ccfG3u54+0PH/6oqcudd/7wwQc/KnBrAQI2CQYGCRjnMJg8gE89EDB/QOLUEVA8CkbBKBgFIxEAADeHYQSA75pqAAAAAElFTkSuQmCC","orcid":"","institution":"university of Tehran","correspondingAuthor":true,"prefix":"","firstName":"Narges","middleName":"Alsadat","lastName":"Salili","suffix":""},{"id":281628785,"identity":"e99583b3-ec30-4774-bb65-bbc6a44c7182","order_by":1,"name":"Azam Noferesti","email":"","orcid":"","institution":"university of Tehran","correspondingAuthor":false,"prefix":"","firstName":"Azam","middleName":"","lastName":"Noferesti","suffix":""},{"id":281628786,"identity":"3cf5e381-9e29-4575-b59c-3492e11e91b7","order_by":2,"name":"Hojatollah Farahani","email":"","orcid":"","institution":"Tarbiat Modares university","correspondingAuthor":false,"prefix":"","firstName":"Hojatollah","middleName":"","lastName":"Farahani","suffix":""}],"badges":[],"createdAt":"2024-02-25 07:33:53","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3987214/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3987214/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":53247272,"identity":"4db75b71-3050-4207-9cd9-107e94096471","added_by":"auto","created_at":"2024-03-22 11:36:26","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":79918,"visible":true,"origin":"","legend":"\u003cp\u003eHypothetical model\u003c/p\u003e","description":"","filename":"Fig.1.Hypotheticalmodel.png","url":"https://assets-eu.researchsquare.com/files/rs-3987214/v1/eed2a36abcc98141889cb229.png"},{"id":53247271,"identity":"7f0f854b-9d07-43c7-8234-7ee94d7d93df","added_by":"auto","created_at":"2024-03-22 11:36:26","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":78025,"visible":true,"origin":"","legend":"\u003cp\u003eStandard coefficients resulting from executing the conceptual model\u003c/p\u003e","description":"","filename":"Fig.2.Standardcoefficientsresultingfromexecutingtheconceptualmodel.png","url":"https://assets-eu.researchsquare.com/files/rs-3987214/v1/a3699cf29261f271cf918b08.png"},{"id":56758278,"identity":"1da4a5d9-3940-428e-b84f-7a65e3f167c5","added_by":"auto","created_at":"2024-05-20 06:14:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":713747,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3987214/v1/3d788181-ec41-45ac-869c-43cea752e81f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Food addiction, emotion regulation, and self- compassion: the mediating role of executive functions","fulltext":[{"header":"Plain English summery","content":"\u003cp\u003eObesity (characterized by increased body mass index (BMI)) is a major risk factor for non-communicable diseases such as cardiovascular disease and some cancers (1). One of the underlying factors behind obesity is food addiction (2), whose weighted mean prevalence in normal population is 20%, while being higher among those with eating disorders and clinical populations (3). In addition, studies suggest that different types of disorder including anxiety, mood, and eating as well as type II diabetes are positively associated with food addiction. Thus, possibly those with food addiction have less life satisfaction (4). Accordingly, the studies examining obesity as well as its contributing factors such as food addiction are of special clinical importance.\u003c/p\u003e"},{"header":"Background","content":"\u003cp\u003eFood addiction is a severe form of overeating; in most cases this polyphagia is associated with very tasty foods (such as those with high sugar and fat content, which remarkably activate the reward system in both humans and animals). It is linked to loss of control over eating, craving for food, and reduction of food consumption in spite of adverse consequences (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). In patients suffering from obesity, food addiction is associated with deficient cognitive functions, impulse control, existence of psychiatric symptoms, poorer diet, as well as frequent bouts of emotional eating (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOne of the variables associated with food addiction is emotion regulation. Emotion regulation refers to adaptive methods for responding to emotional distress instead of controlling emotions or weakening of emotional arousal (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Emotion regulation is a multidimensional construct including a) awareness, perception and acceptance of emotions, b) ability of dealing with targeted behaviors as well as inhibiting impulsive behaviors when experiencing negative emptions), c) flexible use of suitable situational strategies for modifying the intensity and/or duration of emotional responses instead of complete elimination of emotions, and d) tendency to experiencing negative emotions as part of following significant activities in life (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Deficits in emotion regulation occur when the person lacks the necessary skills for regulating negative emotions or emotional distress (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Lack of emotion regulation is associated with different types of behaviors including overeating (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Emotion dysregulation is positively linked to food addiction and predicts its criteria (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). In addition, different aspects of emotion dysregulation have been implicated in food addiction such as difficulty in engaging in goal-oriented behaviors, impulsivity, emotional awareness, and limited access to emotion regulation strategies as well as sense of loneliness (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAnother variable associated with food addiction is self-compassion. Self-compassion has been discussed as one of the important strategies for coping with negative emotions and depression. According to Neff, K. D (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e), it has been defined based on three components (dichotomous). These three components are a) self-kindness (as opposed to self-judgment), referring to the ability of treatment with care and self-understanding against self-judgment and being self-critical; b) common humanity (as opposed to isolation), which notes recognition of this fact that defects and failure are normal and common aspects among all humans, unlike sense of loneliness at the time of failure and deficiency; and c) mindfulness (against over-identification), which involves awareness and acceptance of experiences against over-identification of thoughts and emotions. Self-compassion can be a useful emotion regulation strategy in disorders such as major depression (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Diac, A.E et al.(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) indicated chocolate addiction (one of the types of food addiction) has a negative correlation with self-compassion. Another research found that different symptoms of eating disorders are negatively associated with self-compassion, with this negative correlation being partially mediated by emotion regulation (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). It seems that self-compassion is an adaptive emotion regulation strategy in eating disorders and body image (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Nevertheless, very sparse studies have been done on self-compassion and food addiction, and most have dealt with the relationship between self-compassion and different types of eating disorders.\u003c/p\u003e \u003cp\u003eAlthough some studies have suggested a relationship between emotion regulation plus self-compassion and food addiction, the number of these studies is very limited. Further, the underlying mechanism of this relationship is still poorly understood. Thus, identification of the underlying mechanisms among these variables is today a challenge ahead of us.\u003c/p\u003e \u003cp\u003eOne of the variables that is associated with both food addiction and emotion regulation is executive functions. Executive functions (EFs) refer to a set of higher order cognitive abilities that are essential for pursuing and achieving a goal (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Furthermore, EF also known as executive control or cognitive control refers to a group of up-button mental processes required at the time of focus and attention, and when automatic impulse or reliance on instinct or intuition is wrong, inadequate, or impossible. The major EFs include: 1) inhibitory control including self-control (behavior inhibition) and interference control (selected attention and cognitive inhibition), 2) working memory (WM), and 3) cognitive flexibility (also known as set shifting, mental flexibility, or mental set shifting, being closely associated with creativity). EFs are skills that are essential for mental and physical health, success in life and school, as well as cognitive, social, and psychological development (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Studies have shown that the brain EFs are associated with the emotion regulation (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Based on some studies, impulsivity is also positively linked to food addiction (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Meanwhile, working memory which is one of the EF components is partially associated with self-compassion (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Self-control has also shown a relationship with self-compassion (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAs mentioned above, EFs are linked to food addiction and emotion regulation. Also, impulsivity, indicating impaired inhibitory control, is connected with food addiction. Meanwhile, emotion regulation is linked to food addiction and self-compassion. Nevertheless, so far sparse studies have been done on relationship between food addiction and self-compassion. Further, since EFs are also linked to food addiction, emotion regulation, and self-compassion, they (EFs) may explain the relationship between these two groups of variables. Thus, our hypothetical structural modeling in this research has been presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Further, since self-compassion is one of the emotion regulation strategies, EFs may explain the relationship between this variable and food addiction. Overall, this research aims to present structural modeling of mediating role of executive functions in the relationship between emotion regulation, self-compassion, and food addiction.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e The research was conducted in accordance with relevant regulations and guidanelines, including the Declaration of Helsinki. This project was approved by the University of Tehran Research Ethics Board (File number: IR.UT.PSYEDU.REC.1402.031). Informed consent was obtained from all subjects and/or their legal guardian(s).\u003c/p\u003e \u003cp\u003eResearch design and participants\u003c/p\u003e \u003cp\u003eThe present research has been of fundamental research type regarding aim, and descriptive research regarding data collection and of correlation type. The statistical population consisted of all Iranian men and women above 18 years of age in 2023, who had access to mobile phone. From among the statistical population, according to Klein (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) criterion and considering an extra 10% for possible attrition of the subjects, eventually 251 subjects were chosen through convenience sampling. This sample consisted of 219 women and 32 men. The mean age of all subjects was 38.06 with SD 12.90. Out of these 251 subjects, 43.4% were single, 47% were married, 4% were divorced, and the rest were either widowed or engaged. Less than 13% of the subjects had below bachelor levels of education, 41% had bachelor\u0026rsquo;s degree, 39.8% had master's degree, and 6% had degrees above Masters.\u003c/p\u003e \u003cp\u003eFor measuring the research variables, the following instruments were used:\u003c/p\u003e \u003cp\u003eFood addiction: YFAS 2.0 was developed by Gearhardt et al. in Yale University in 2016 (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). YFAS 2.0 consists of 35 items evaluating the following aspects of food addiction: 1) losing control over food consumption, 2) continuing the consumption in spite of negative consequences, 3) failed attempts for quitting or reducing the behavior, 4) tolerating or needing excessive amounts, 5) withdrawal symptoms at the time of abstaining, 6) reducing other activities due to food, 7) severe craving for food, 8) considerable clinical dysfunction or discomfort. This scale is scored using eight-point Likert scale ranging from 0 (never) to 7 (always). Accordingly, the higher the score gained by the subject, the more severe their food addiction is. The Cronbach alpha coefficient which is a criterion for internal consistency in a sample of 550 subjects was 0.96. The first person who normalized the YFAS 2.0 scale for Iranian students was Ghanbari (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). The Cronbach alpha coefficient has been variable from 0.86 to 0.93 in different studies.\u003c/p\u003e \u003cp\u003eEmotion dysregulation: DERS-16 scale was presented by Bjureberg et al. (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). This scale has five subscales including refusing negative emotions, problems of goal-oriented involvement, impulse control problems, limited access to emotion regulation strategies, and absence of clear emotions. This questionnaire includes 16 items ranking based on five-point Likert scale from 1 (almost never) to 5 (almost always). The higher the score acquired by the subject, the greater their difficulty in emotion regulation. The Cronbach alpha coefficient which is a criterion for internal consistency was 0.89 for the total scale, while ranging from 0.78 to 0.91 for the subscales in a 550-subject study. The Persian version of DERS-16 scale was translated and verified by Fallahi et al. in 2021 (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). They tested the psychometric properties of the Persian version of DERS-16 in a sample consisting of 400 Iranian students. The Cronbach alpha coefficient obtained was 0.91 for the total scale and 0.77\u0026ndash;0.86 for the subscales.\u003c/p\u003e \u003cp\u003eSelf-compassion: SCS-SF scale developed by Raes et al. (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) measures six components of self-compassion: self-kindness, self-judgment, common humanity, isolation, mindfulness, and overidentification. This scale includes 12 items ranking through a five-point Likert scale from 1 (almost never) to 5 (almost always). The higher the score gained by the subject, the greater their self-compassion. The Cronbach alpha coefficient which is a criterion for internal consistency was 0.89 for the total scale while ranging from 0.78 to 0.91 for the subscales. The SCS-SF Persian version was translated and verified by Khanjani et al. in 2016 (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). They tested the psychometric properties of the Persian version of SCS-SF in a sample consisting of 270 Iranian students. The Cronbach alpha coefficient was obtained 0.86 for the total scale and 0.72\u0026ndash;0.83 for the subscales.\u003c/p\u003e \u003cp\u003eExecutive functions: ultimately, to measure executive functions, BRIEF-A self-measurement scale, with 75 items, is used. The subscales of this scale were first designed by Roth et al. in 2005 (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e) for measuring executive functions of adults. This scale includes nine subscales of 1) inhibition (inhibitory control), 2-self-monitoring, 3-planning and organization, 4-shifting (cognitive flexibility), 5) activity initiation, 6) task supervision, 7) emotional control, 8) working memory, and 9) organization of resources and materials. Each item is scored from 0 (never) to 2 (often). The higher the score of the subject in a subscale, the greater the deficit and difficulty in that scale. Scoring and interpretation. Cronbach alpha for the self-report form of the clinical scales was average to high (0.73\u0026ndash;0.90) and for the indices and total score was high (93.93\u0026ndash;0.96). To report the informed person for clinical scales, the indices and total score showed high internal consistency (0.80\u0026ndash;0.98). This scale was translated by Mani et al. in 2018 (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) into Persian. According to the paper of Mani et al., the Cronbach alpha coefficient for BRIEF-A subscales varied from 0.650 to 0.838, indicating good internal consistency of the items. In this study, we only included the three subscales of inhibition, shifting, and working memory into the analysis.\u003c/p\u003e \u003cp\u003eMethod of implementation\u003c/p\u003e \u003cp\u003eTo implement this research, ethical considerations have been considered. To observe these considerations, before conducting the research, ethics code was received from faculty of psychology and educational sciences of Tehran University, code IR.UT.PSYEDU.REC.1402.031. Further, at the beginning of the questionnaire link, an explanation was provided about the research and the principle of confidentiality of responses for the participants. After studying the points, the participants would announce their consent only if they had the possibility of participation. After announcing consent, the questionnaire items were provided to them. Also, the participants could withdraw from the study at any of its stages. The link of this questionnaire was shared in a number of social network channels in Telegram.\u003c/p\u003e \u003cp\u003eFirst, all of the measurement instruments were prepared as online scales, in order to facilitate and accelerate their completion. Next, using convenience sampling method, the participants willing to take part in the research were asked to fill in the scales completely in the Porseline website. Also, to reward the participants for their time and completion of scales, cash reward was considered.\u003c/p\u003e \u003cp\u003eIn this research, descriptive statistics including frequency, percentage, mean, standard deviation, as well as inferential statistics including correlation coefficient and structural equation modeling have been used. All of the above stages were done using SPSS 26 as well as IMUS software (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) at significance level of \u0026lt;\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eDescriptive indices: Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the descriptive indices.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive indices\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMin.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMax.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFood addiction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.288\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotion regulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.678\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.893\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-compassion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.729\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCognitive flexibility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.585\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.396\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInhibitory control\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.703\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.453\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking memory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.600\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.453\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eExamination of normality: to test the hypothetical model, first its presumptions were investigated. Since the sample size has been above 100, the absolute value of the skewness coefficients of variables has been lower than 3 and absolute value of the kurtosis coefficients of variables has been lower than 10. As such, the distribution can be conceived as normal.\u003c/p\u003e \u003cp\u003eSince in the link of implementation of the research, all items were compulsory, thus there were no missing data. Investigation of the outliers also showed that there were no univariate or multivariate outliers. Multivariate normality examination based on Mann-Whitney test also showed that distribution of multivariate data is established (p\u0026thinsp;\u0026gt;\u0026thinsp;0.5).\u003c/p\u003e \u003cp\u003eConsidering the normality of distribution of variables, to explore their correlation, Pearson parametric correlation coefficient has been used, with its results reported in the following table.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePearson correlation analysis between research variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFood addiction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmotion regulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.502\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-compassion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.344\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.698\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCognitive flexibility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.427\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.549\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.475\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInhibitory control\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.429\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.649\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.606\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.644\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWorking memory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.402\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.593\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.524\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.705\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.717\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e* significance at 5% error level\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e** significance at 1% error level\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe results of Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e show that at 1% error level, there is a positive and significant linear relationship between every pair of variables.\u003c/p\u003e \u003cp\u003eIn this section, we intend to investigate the mediating role of executive functions in the relationship between food addiction and emotion dysregulation as well as self-compassion; for the conceptual model test, structural equation modeling has been used. Figure\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents the conceptual model of the relationship between the variables defined in the research in standard coefficients state.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e reports the standard and nonstandard coefficients as well as the t-statistic value for examining the significance of relationships between variables.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eEstimating the coefficients between variables in the conceptual model\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExogenous variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEndogenous variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStandard coefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNonstandard coefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eEstimation error\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotion dysregulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;---\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFood addiction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.341\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.491\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.794\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-compassion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;---\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFood addiction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.285\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.199\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotion dysregulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;---\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExecutive functions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.525\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e7.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-compassion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;---\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExecutive functions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e-4.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExecutive functions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;---\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFood addiction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.321\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.328\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.394\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.371\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExecutive functions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;---\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCognitive flexibility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.787\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExecutive functions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;---\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInhibitory control\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.851\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.236\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e14.214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExecutive functions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;---\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWorking memory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e14.196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBased on the results of Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, it can be stated that emotion dysregulation has a positive and significant effect on food addiction. Self-compassion has had a negative and significant effect on food addiction. Emotion dysregulation showed a positive and significant effect on executive functions. Finally, self-compassion has shown a negative and significant effect on executive functions, and executive functions have revealed a positive and significant effect on food addiction.\u003c/p\u003e \u003cp\u003eTo explore the mediating role of executive functions between emotion regulation and food addiction as well as self-compassion and food addiction, Sobel Z test was employed, with its results presented Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eIndirect and significant effects of the mediating variable of executive functions based on one of the exogenous variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExogenous variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndirect effect\u003c/p\u003e \u003cp\u003e(a*b)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStandard error\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003estatistic \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\({\\varvec{T}}_{\\varvec{s}-\\varvec{M}}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eResult\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotion dysregulation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.080\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSignificant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-compassion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-2.578\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSignificant\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSince the absolute value of T\u003csub\u003es\u003c/sub\u003e-M statistic in the above table for both exogenous variables of self-compassion and emotion dysregulation has been larger than 1.96, thus it can be concluded that the mediating effect of executive functions by both exogenous variables of self-compassion and emotion dysregulation on food addiction has been significant at 5% error level.\u003c/p\u003e \u003cp\u003eComparison of coefficients (factor loads) between the latent variable of executive functions and its three components shows that the factors of working memory and inhibitory control have been more important in determining executive functions when compared with cognitive flexibility.\u003c/p\u003e \u003cp\u003eThe results of Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e reveal desirable fitness of the conceptual model, where the experimental data well match the model of interest.\u003c/p\u003e\u003cp\u003eTable 5. Fitness indices of the conceptual model\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eIndex\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cbr\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eRMSEA\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eGFI\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eCFI\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eNFI\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eValue\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e2.287\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e0.072\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e0.981\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e0.990\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003e0.983\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eFavorable range\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1\u0026le;\u0026amp;\u0026le;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0\u0026le;\u0026amp;\u0026le;0.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.9\u0026le;\u0026amp;\u0026le;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.9\u0026le;\u0026amp;\u0026le;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.9\u0026le;\u0026amp;\u0026le;1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eOutcome\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003eFavorable\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003eFavorable\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003eFavorable\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003eFavorable\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cspan dir=\"LTR\"\u003eFavorable\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe aim of this research was to present a structural modeling of the mediating role of executive functions in the relationship between emotion regulation, self-compassion, and food addiction. The findings showed that executive functions mediate the relationship between emotion regulation, self-compassion, and food addiction. Self-compassion is linked to food addiction through executive functions, but it is not directly or singly correlated, yet emotion regulation is associated both directly and indirectly.\u003c/p\u003e \u003cp\u003eEmotion dysregulation, executive functions, and food addiction\u003c/p\u003e \u003cp\u003eThe findings revealed that there is a positive and significant relationship between emotion regulation and food addiction. Accordingly, it can be stated that the higher the score acquired by the person in emotion dysregulation, the higher their score would also be in food addiction. This is in line with the results of other studies evaluating the relationship between emotion regulation and food addiction (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). For example, emotion dysregulation has been observed in many psychological health issues including different types of eating disorders and drug abuse. Indeed, bulimia behavior is a way for regulating and modifying emotions especially the negative ones (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). In other words, when the person experiences emotions especially negative and unpleasant ones, to reduce them and bring them to a tolerable level, they employ overeating behavior. This is because they are not able to use adaptive and healthy skills of emotion regulation (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). These findings can also be explained by Gross emotion regulation theory. According to Gross, the emotion generation process has four components of situation, attention, arousal, and response. Meanwhile, emotion regulation strategies alter the emotion path. Here, food addiction also as a maladaptive strategy for emotion regulation can change the path of negative emotions (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Gross states that emotion regulation can be done with the aims of reducing, reinforcing, or maintaining positive or negative emotional experiences (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Furthermore, according to Gross theory, emotion regulation techniques that focus on the primary stages of emotional processing process (antecedent-focused) are more effective than the techniques that are response oriented (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). Accordingly, we can conclude that binge eating behavior in food addiction is indeed a response, and as stated earlier response-oriented techniques are less effective. Accordingly, inefficacy in emotion regulation skills may lead to food addiction.\u003c/p\u003e \u003cp\u003eThe findings showed that executive functions reinforce the relationship between emotion dysregulation and food addiction. Numerous studies have shown that there is a relationship between executive functions of the brain and different types of psychological health issues. These findings are in line with the results of other researchers (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). for example, Oliveira et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) found that cognitive defunctions and inhibitory control are associated with food addiction. Research has also shown that patients suffering from eating disorders who have characteristics such as emotion dysregulation, executive problems, and impulsive personality are more susceptible to different types of drug abuse disorders (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). These results also concur with the findings obtained by Pivarunas, B \u0026amp; Connor (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). As explanation, it can be stated that when a person does not have the necessary skills for management of emotions, emotion dysregulation occurs. When the person experiences negative emotions, due to lacking skills of emotion regulation, they would act impulsively. This impulsive action itself is a sign of weakness in executive functions especially inhibitory control. In addition, working memory which is one of the executive functions also provides cognitive resources to the person, which can be harnessed when experiencing emotions for managing them (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). Thus, when the person has deficit in inhibition control and working memory, regulation and modification of emotions especially negative emotions would be difficult. Meanwhile, due to impulsivity, they may use maladaptive strategies such as polyphagia and overeating foods that are very sweet, fatty, or salty for modifying emotions. Therefore, training emotion regulation skills can be one of the courses of action for treating food addiction. In addition, by presenting exercises for improving inhibition control and working memory, we can facilitate the influence of emotion regulation skills.\u003c/p\u003e \u003cp\u003eSelf-compassion, executive functions, and food addiction\u003c/p\u003e \u003cp\u003eSelf-compassion and food addiction had a significant relationship with mediation of executive functions. This is also in line with the findings of other studies (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan additionalcitationids=\"CR43 CR44 CR45 CR46\" citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e). Different studies have indicated that self-compassion is one of the adaptive skills of emotion regulation (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). As mentioned above, in case of absence of suitable emotion regulation skills and experiencing negative emotions, individuals may act impulsively. Alternatively, due to deficit of cognitive resources, they may not be able to manage their emotions adaptively when experiencing them (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). In other words, when the person has high self-compassion, they would have fewer problems in executive functions and vice versa. Otherwise, the person would act impulsively for emotion regulation towards overeating or consuming unhealthy foods. Here, if the person has self-compassion, they would treat this behavior gently, and would sympathize with themselves. This causes mitigation of negative emotions and their regulation. When experiencing negative emotions, such individuals can modify and endure them adaptively. These research studies can explain why executive dysfunctions especially inhibitory control reinforce and make the negative relationship between self-compassion as an emotion regulation skill and food addiction significant. One of the components of self-compassion is self-kindness and common humanity. A person who has learned these two components knows that they are not impeccable and are open to mistakes. However, if they have low self-kindness and common humanity, negative emotions prevail and the person would again act impulsively (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). Another component of self-compassion is mindfulness. Mindful individuals show less impulsive behavior. According to the research results, mindfulness can lead to improved working memory, cognitive flexibility, and inhibitory control (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e). Thus, we can conclude that the individuals with higher levels of self-compassion would acquire lower scores of food addiction. As such, we can consider training self-compassion scale as one of the solutions for treating food addiction.\u003c/p\u003e \u003cp\u003eOur findings show that in the hypothetical model, food addiction and self-compassion do not have a direct relationship. This seems to be in contradiction to previous findings (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). Previous studies have indicated that there is a negative relationship between self-compassion and chocolate addiction, which is one of the subsets of food addiction. This means the higher the score gained by the subject in chocolate addiction, the lower their self-compassion would be (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Further, higher levels of self-compassion have been associated with lower levels of bulimia nervosa (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). In addition, a higher score in self-compassion has been associated with fewer symptoms of eating disorders (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). The most important interpretation for the difference of this finding with other studies is use of different statistical analyses. In this study, we employed path analysis method in order to measure the mediating role of executive functions in the relationship between self-compassion and food addiction. As such, a considerable portion of the variance is explained by executive functions, which itself confirms our model. However, it causes the direct relationship between self-compassion and food addiction not to become significant. Meanwhile, in other studies such as the one by Taylor et al. (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e), this mediating variable has not been used. Other reasons can include the different statistical populations and sample, various measurement instruments, as well as the fact that most of the mentioned studies have measured constructs similar to food addiction such as overeating or different types of eating disorders.\u003c/p\u003e \u003cp\u003eLimitations and suggestions\u003c/p\u003e \u003cp\u003eThis study has been novel as it has examined the mediating role of executive functions in the relationship between self-compassion and food addiction as well as emotion regulation and food addiction. Nevertheless, as with any studies, it has had some limitations. Firstly, in this research nonrandomized convenience sampling method has been used. Further, this study has been implemented completely using self-report questionnaires, while there are other instruments for measuring executive function variables. In addition, the method of this research has been structural equation modeling; thus, causal relations cannot be deduced from that. Therefore, generalization of the research findings should be done cautiously. For future studies, it is recommended to use computerized instruments for measuring executive functions such as IVA test. Further, for generalizing the findings, randomized sampling would be better. In addition, as mentioned earlier, the role of inhibitory control skills and working memory in explaining the executive functions has been greater than that of cognitive flexibility. It is suggested for future studies to examine the role of this variable itself as an exogenous variable in the relationship between food addiction and emotion regulation and self-compassion.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eBased on this research findings, it can be concluded that part of the treatment and prevention from obesity and food addiction can be undertaken by training emotion regulation and self-compassion skills. Further, improvement of executive functions can be helpful in enhancing the effect of emotion regulation on food addiction. It can also be a ground for developing self-compassion, which itself leads to reduction of food addiction symptoms.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eAuthor information\u003c/h2\u003e \u003cp\u003eFaculty of psychology, university of Tehran, Tehran, Iran\u003c/p\u003e \u003cp\u003eNarges Alsadat Salili\u003c/p\u003e \u003cp\u003eORCID NO: 0009-0009-9953-8743\u003c/p\u003e \u003cp\u003eEmail address: [email protected]\u003c/p\u003e \u003cp\u003eFaculty of psychology, university of Tehran, Tehran, Iran\u003c/p\u003e \u003cp\u003eAzam Noferesti\u003c/p\u003e \u003cp\u003eORCID NO: 0000-0003-25636980\u003c/p\u003e \u003cp\u003eEmail address: [email protected]\u003c/p\u003e \u003cp\u003eFaculty of humanities, Tarbiat Modares university, Tehran, Iran\u003c/p\u003e \u003cp\u003eHojatollah Farahani\u003c/p\u003e \u003cp\u003eORCID NO: 0000-0002-9799-7008\u003c/p\u003e \u003cp\u003eEmail address: [email protected]\u003c/p\u003e \u003c/p\u003e\u003ch2\u003e \u003cb\u003eAuthors and Affiliations\u003c/b\u003e \u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eContributions\u003c/strong\u003e \u003cp\u003eThis data in this paper was collected as part of NAS's masters thesis. AN is her primary graduate supervisor. NAS and AN contributed to the development of the project and the current data analytic plan. NAS wrote the initial draft and conducted the data analysis. AN edited drafts of the manuscript. HF contributed to the data analysis All three authors reviewed the final manuscript.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCorresponding author\u003c/strong\u003e \u003cp\u003eCorrespondence to Narges Alsadat Salili\u003c/p\u003e \u003c/p\u003e\u003ch2\u003e \u003cb\u003eEthics declarations\u003c/b\u003e \u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003e This project was reviewed by the University of Tehran Research Ethics Board (File number: IR.UT.PSYEDU.REC.1402.031).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003eNot applicable.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCompeting interests\u003c/strong\u003e \u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eThis data in this paper was collected as part of N.A.S's masters thesis. A.N. is her primary graduate supervisor. N.A.S. and A.N. contributed to the development of the project and the current data analytic plan. N.A.S. wrote the initial draft and conducted the data analysis. A.N. edited drafts of the manuscript. H.F. contributed to the data analysis All three authors reviewed the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e\u003ch2\u003eAvailability of data and materials\u003c/h2\u003e \u003cp\u003eData and materials are available upon request\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOrganization WH. News-Room Fact-Sheets Detail Obesity and Overweight. Online, URL: https://www who int/newsroom/fact-sheets/detail/obesity-and-overweight. 2020.\u003c/li\u003e\n\u003cli\u003eSom M, Constant A, Zayani T, Pabic EL, Moirand R, Val-Laillet D, Thibault R. Food addiction among morbidly obese patients: prevalence and links with obesity complications. Journal of Addictive Diseases. 2022;40(1):103-10.\u003c/li\u003e\n\u003cli\u003ePraxedes DR, Silva‐J\u0026uacute;nior AE, Macena ML, Oliveira AD, Cardoso KS, Nunes LO, et al. Prevalence of food addiction determined by the Yale Food Addiction Scale and associated factors: A systematic review with meta‐analysis. European Eating Disorders Review. 2022;30(2):85-95.\u003c/li\u003e\n\u003cli\u003eOliveira J, Colombarolli MS, Cordas TA. Prevalence and correlates of food addiction: systematic review of studies with the YFAS 2.0. Obesity Research \u0026amp; Clinical Practice. 2021;15(3):191-204.\u003c/li\u003e\n\u003cli\u003eGearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale food addiction scale. Appetite. 2009;52(2):430-6.\u003c/li\u003e\n\u003cli\u003eHebebrand J, Albayrak \u0026Ouml;, Adan R, Antel J, Dieguez C, De Jong J, et al. \u0026ldquo;Eating addiction\u0026rdquo;, rather than \u0026ldquo;food addiction\u0026rdquo;, better captures addictive-like eating behavior. 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Behaviour research and therapy. 2014;58:43-51.\u003c/li\u003e\n\u003cli\u003eDiac AE, Constantinescu N, Sefter II, Raşia EL, T\u0026acirc;rgoveţu E. Self-compassion, well-being and chocolate addiction. Romanian Journal of Cognitive Behavioral Therapy and Hypnosis. 2017;4(1-2).\u003c/li\u003e\n\u003cli\u003eMeyer LP, Leppma M. The role of mindfulness, self‐compassion, and emotion regulation in eating disorder symptoms among college students. Journal of College Counseling. 2019;22(3):211-24.\u003c/li\u003e\n\u003cli\u003eTurk F, Waller G. Is self-compassion relevant to the pathology and treatment of eating and body image concerns? A systematic review and meta-analysis. Clinical Psychology Review. 2020;79:101856.\u003c/li\u003e\n\u003cli\u003eCristofori I, Cohen-Zimerman S, Grafman J. Executive functions. Handbook of clinical neurology. 2019;163:197-219.\u003c/li\u003e\n\u003cli\u003eDiamond A. Executive functions. Annual review of psychology. 2013;64:135-68.\u003c/li\u003e\n\u003cli\u003eSchmeichel BJ, Tang D. The relationship between individual differences in executive functioning and emotion regulation: A comprehensive review. Motivation and its regulation: The control within. 2014:133-51.\u003c/li\u003e\n\u003cli\u003eMaxwell AL, Gardiner E, Loxton NJ. Investigating the relationship between reward sensitivity, impulsivity, and food addiction: A systematic review. European Eating Disorders Review. 2020;28(4):368-84.\u003c/li\u003e\n\u003cli\u003eCarr MM, Schulte EM, Saules KK, Gearhardt AN. Measurement invariance of the modified Yale Food Addiction Scale 2.0 across gender and racial groups. Assessment. 2020;27(2):356-64.\u003c/li\u003e\n\u003cli\u003eFan L, Wang Y. Healthy eating behaviors and self-control in scarcity: The protective effects of self-compassion. Appetite. 2022;169:105860.\u003c/li\u003e\n\u003cli\u003eKline P. An easy guide to factor analysis: Routledge; 2014.\u003c/li\u003e\n\u003cli\u003eGearhardt AN, Corbin WR, Brownell KD. Development of the Yale Food Addiction Scale Version 2.0. Psychology of Addictive Behaviors. 2016;30(1):113.\u003c/li\u003e\n\u003cli\u003eGhanbari N, Nooripour R, Firoozabadi A, Var TSP, Wisniewski P, Hosseini SR. Psychometric assessment of Persian translation of Yale food addiction scale version 2.0 (YFAS 2.0) in Iranian college students. Journal of Eating Disorders. 2022;10(1):1-9.\u003c/li\u003e\n\u003cli\u003eBjureberg J, Lj\u0026oacute;tsson B, Tull MT, Hedman E, Sahlin H, Lundh L-G, et al. Development and validation of a brief version of the difficulties in emotion regulation scale: the DERS-16. Journal of psychopathology and behavioral assessment. 2016;38:284-96.\u003c/li\u003e\n\u003cli\u003eFallahi V, Narimani M, Atadokht A. Psychometric Properties of the Difficulties in Emotion Regulation Scale Brief Form (Ders-16): in Group of Iranian Adolescents. Journal of Shahid Sadoughi University of Medical Sciences. 2021.\u003c/li\u003e\n\u003cli\u003eRaes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the self‐compassion scale. Clinical psychology \u0026amp; psychotherapy. 2011;18(3):250-5.\u003c/li\u003e\n\u003cli\u003eKhanjani S, Foroughi AA, Sadghi K, Bahrainian SA. Psychometric properties of Iranian version of self-compassion scale (short form). Pajoohandeh Journal. 2016;21(5):282-9.\u003c/li\u003e\n\u003cli\u003eRoth RM, Gioia GA. Behavior rating inventory of executive function--adult version: Psychological Assessment Resources Lutz, FL; 2005.\u003c/li\u003e\n\u003cli\u003eMcCuen‐Wurst C, Ruggieri M, Allison KC. Disordered eating and obesity: associations between binge‐eating disorder, night‐eating syndrome, and weight‐related comorbidities. Annals of the New York Academy of Sciences. 2018;1411(1):96-105.\u003c/li\u003e\n\u003cli\u003eAnestis MD, Selby EA, Fink EL, Joiner TE. The multifaceted role of distress tolerance in dysregulated eating behaviors. International Journal of Eating Disorders. 2007;40(8):718-26.\u003c/li\u003e\n\u003cli\u003eAnestis MD, Smith AR, Fink EL, Joiner TE. Dysregulated eating and distress: Examining the specific role of negative urgency in a clinical sample. Cognitive therapy and research. 2009;33:390-7.\u003c/li\u003e\n\u003cli\u003eGross JJ. Emotion regulation. Handbook of emotions. 2008;3(3):497-513.\u003c/li\u003e\n\u003cli\u003eGross JJ. Emotion regulation: Current status and future prospects. Psychological inquiry. 2015;26(1):1-26.\u003c/li\u003e\n\u003cli\u003eGross JJ. Handbook of emotion regulation: Guilford publications; 2013.\u003c/li\u003e\n\u003cli\u003eKobylińska D, Kusev P. Flexible emotion regulation: How situational demands and individual differences influence the effectiveness of regulatory strategies. Frontiers in psychology. 2019;10:72.\u003c/li\u003e\n\u003cli\u003eLozano-Madrid M, Clark Bryan D, Granero R, S\u0026aacute;nchez I, Riesco N, Mallorqu\u0026iacute;-Bagu\u0026eacute; N, et al. Impulsivity, emotional dysregulation and executive function deficits could be associated with alcohol and drug abuse in eating disorders. Journal of clinical medicine. 2020;9(6):1936.\u003c/li\u003e\n\u003cli\u003eBarkus E. Effects of working memory training on emotion regulation: Transdiagnostic review. PsyCh journal. 2020;9(2):258-79.\u003c/li\u003e\n\u003cli\u003eTaylor MB, Daiss S, Krietsch K. Associations among self-compassion, mindful eating, eating disorder symptomatology, and body mass index in college students. Translational Issues in Psychological Science. 2015;1(3):229.\u003c/li\u003e\n\u003cli\u003eBahrami A, Tabatabaee SM, Delavarpour M. .Effectiveness of mindfulness training (with music) on working memory and cognitive flexibility in children with learning disabilities. Journal of Learning Disabilities. 2022;11(4):6-20.\u003c/li\u003e\n\u003cli\u003eMrazek MD, Franklin MS, Phillips DT, Baird B, Schooler JW. Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering. Psychological science. 2013;24(5):776-81.\u003c/li\u003e\n\u003cli\u003eSerpell L, Amey R, Kamboj SK. The role of self-compassion and self-criticism in binge eating behaviour. Appetite. 2020;144:104470.\u003c/li\u003e\n\u003cli\u003eTurk F, Kellett S, Waller G. Comparing self‐compassion versus body exposure for adult women with moderate to severe body dissatisfaction: A feasibility and pilot trial. Clinical Psychology \u0026amp; Psychotherapy. 2022;29(4):1475-80.\u003c/li\u003e\n\u003cli\u003ePozuelos JP, Mead BR, Rueda MR, Malinowski P. Short-term mindful breath awareness training improves inhibitory control and response monitoring. Progress in brain research. 2019;244:137-63.\u003c/li\u003e\n\u003cli\u003eNeff KD. Self‐compassion, self‐esteem, and well‐being. Social and personality psychology compass. 2011;5(1):1-12.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"food addiction, self-compassion, emotion regulation, executive functions","lastPublishedDoi":"10.21203/rs.3.rs-3987214/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3987214/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThis research aimed to examine the mediating role of executive functions in the relationship between food addiction and emotion regulation as well as self-compassion.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn this study, in the form of a structural equation modeling, 251 subjects (219 women and 32 men) were chosen via convenience sampling and responded to the following questionnaires: difficulties in emotion regulation scale (DERS-16), Rice self-compassion, food addiction 2, and behavior rating inventory of executive function for adults (BRIEF-A).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe findings indicated that there is a positive and significant relationship between deficits in emotion regulation and food addiction. Also, executive functions mediated the relationship between emotion regulation, self-compassion, and food addiction. Nevertheless, no relationship was found between self-compassion and food addiction.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThus, it can be concluded that consolidating the emotion regulation skills and executive functions may contribute to prevention from or improvement of food addiction, thereby preventing the ensuing negative consequences such as obesity and cardiovascular disease.\u003c/p\u003e","manuscriptTitle":"Food addiction, emotion regulation, and self- compassion: the mediating role of executive functions","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-22 11:36:19","doi":"10.21203/rs.3.rs-3987214/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"08b1dbfd-058b-49e4-bacb-f9ccc1c40a05","owner":[],"postedDate":"March 22nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":29653826,"name":"Biological sciences/Psychology"},{"id":29653827,"name":"Health sciences/Health care"}],"tags":[],"updatedAt":"2024-05-20T06:06:04+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-22 11:36:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3987214","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3987214","identity":"rs-3987214","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}

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