Date of Award




Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Psychology


Clinical Psychology

Content Description

1 online resource (x, 116 pages) : illustrations (some color)

Dissertation/Thesis Chair

Julia M Hormes

Committee Members

James F Boswell, Drew A Anderson


chocolate, contextual, craving, gender, psychological, sociocultural, Food habits, Food, Compulsive eating, Body image in women, Chocolate, Body mass index

Subject Categories

Clinical Psychology | Medicine and Health Sciences | Psychology


The notion of addiction pervades Western vernacular. While firmly established in the substance and drug literature, the concept of addiction is now increasingly associated with other ingested substances (coffee, chocolate, highly processed foods) and a range of compulsive behaviors (gambling, sex, online social networking, gaming). Addiction is associated with substantial morbidity and mortality, and a greater understanding of its etiology has significant public health implications. The physiological mechanisms thought to contribute to the development and maintenance of addiction (tolerance, withdrawal, and, possibly, craving) are widely considered hallmark features and primary treatment targets, while psychological and contextual factors are often underappreciated and misunderstood. The Elaborated Intrusion (EI) Theory of Desire posits that craving, a strong, irresistible urge for a specific substance or behavior that is subjectively difficult or impossible to resist, is a primarily cognitively motivated state. A growing body of research on craving shows that there are important and nontrivial differences in craving both across gender and culture, pointing to the need to expand current biomedical models of addiction. Within the theoretical framework of EI Theory, attitudinal ambivalence (conflicting approach/avoidance tendencies) driven by cultural norms regarding appetitive targets promotes craving, and women and those familiar with U.S. culture may be especially susceptible to their effects. Three studies examine the overarching hypothesis that psychological and sociocultural factors play a critical role in our understanding of craving, and, in turn, addiction across various domains. Study 1, a series of in-depth interviews with non-U.S. informants, demonstrates that the notion of “addiction” is less likely to be medicalized and less commonly associated with problematic eating behaviors outside the U.S. In addition, these informants reported less avoidance of food because of concerns related to weight and calorie content, and greater likelihood of giving in to cravings for indulgent and hyperpalatable food. Study 2 is the first study to examine the prevalence and nature of food craving taking into consideration both gender and cultural background of respondents and using psychometrically sound measures of food craving and acculturation. Findings confirm that craving is experienced differently across genders, showing that women experience heightened ambivalence, and guilt in response to craving and that highly acculturated 2nd generation and foreign born participants were less likely to yield to the negative effects of craving. Study 3 is a pilot study that examines the feasibility of quantifying aspects of U.S. culture hypothesized to play a role in craving etiology. We experimentally manipulated the salience of the thin-ideal of female beauty to assess its role in increasing ambivalence about “forbidden” foods and, in turn, the strength of craving. Preliminary results support the feasibility of study procedures, and hint at the role of the thin-ideal in promoting ambivalence and thus chocolate craving. Taken together, findings provide further support for the role of psychological and sociocultural factors in craving, including dietary restraint, ambivalence, and culturally-promoted ways of interacting with highly palatable foods. Evidence from these three studies contribute to the growing evidence in support of expanding the medicalized notion of addiction to incorporate the sociocultural and psychological underpinnings of craving.