Eating disorders (EDs) and alcohol use disorders, as well as less severe eating disorder symptoms and alcohol use, are behaviors that can result in severe physical, social, psychological, occupational, and academic consequences; the risk of premature death may also be increased. These behaviors are often seen comorbidly. When comorbid, negative consequences may be amplified or increased and the outcome, prognosis, and recovery of the disorders may be hindered. A population particularly at risk of developing eating disorder symptoms as well as alcohol use and misuse, and therefore, potentially experiencing severe negative consequences, is college students. Understanding the reasons why eating disorder symptoms and alcohol use and misuse occur among college students is vital, as this allows effective intervention and prevention efforts to occur. The present study strived to provide insight into these reasons. A particular theory describing the reasons behind this relationship that has received support among college students is the Acquired Preparedness Theory (Fischer & Smith, 2008). This theory involves the constructs of negative urgency, eating and thinness/dieting expectancies, and alcohol expectancies. The present study examined these variables among 189 college women and 79 college men gathered through an online and subject pool sample. The predictor variables of gender and negative urgency were measured by the Demographic Information Survey and UPPS Impulsive Behavior Scale, Urgency subscale (Whiteside & Lynam, 2001), respectively. The moderator variables of eating and thinness/dieting expectancies and alcohol expectancies were measured by the Eating Expectancy Inventory Eating Leads to Feeling Out of Control subscale (Hohlstein, Smith, & Atlas, 1998), Thinness and Restricting Expectancy Inventory (Hohlstein et al., 1998), and Comprehensive Effects of Alcohol Questionnaire Positive Expectancy factors (Fromme, Stroot, & Kaplan, 1993), respectively. The criterion variables of ED symptoms, alcohol use, and alcohol-related negative consequences were measured by the Eating Disorder Examination - Questionnaire 6.0 Global Score (Fairburn & Beglin, 2008), Timeline Followback - Alcohol (Sobell & Sobell, 1992), and Brief - Young Adult Alcohol Consequences Questionnaire (Kahler, Strong, & Read, 2005), respectively. Six hierarchical multiple linear regression analyses, with moderator variables, were used to examine the research questions. Three analyses were run utilizing a subsample of college women while three analyses were run utilizing a subsample of college men. Results revealed that mean (i.e., average) and high (i.e., one standard deviation above the mean) levels of eating and thinness/dieting expectancies moderated the relationship between negative urgency and ED symptoms among college women. Results also revealed that mean and high levels of alcohol expectancies moderated the relationship between negative urgency and alcohol-related negative consequences among college women. No other significant moderating relationships were found. Further, eating and thinness/dieting expectancies were associated with ED symptoms among both college women and men. Alcohol expectancies were associated with alcohol use as well as alcohol-related negative consequences among both college women and college men. Negative urgency also were associated with ED symptoms and alcohol-related negative consequences among college women and ED symptoms, alcohol use, and alcohol-related negative consequences among college men. The results of this study provide valuable implications for college administrators, faculty, and staff, as well as for mental health professionals working with college students with negative urgency, ED symptoms, and/or alcohol use. By identifying and challenging expectancies that are associated with ED symptoms, alcohol use, and alcohol-related negative consequences, these behaviors and consequences may be decreased. Further, by increasing college students' distress tolerance skills (i.e., increasing one's ability to manage negative urgency), ED symptoms, alcohol use, and alcohol-related negative consequences may also be avoided or decreased. Of utmost importance, dire and potentially fatal negative consequences of comorbid ED symptoms and alcohol use may be prevented.
