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Longitudinal associations between emotion regulation skills, negative affect, and eating disorder symptoms in a clinical sample of individuals with binge eating.

ABSTRACT: OBJECTIVE:Although deficits in emotion regulation have been implicated in the maintenance of binge eating, few prospective studies have examined longitudinal associations between emotion regulation and eating disorder symptoms, which are needed to test these theoretical models. METHOD:Using a naturalistic design, the current study utilized longitudinal multilevel analyses to examine whether improvements in emotion regulation during treatment are associated with decreased binge eating frequency and eating disorder cognitions in a heterogeneous sample of adults with binge eating (N?=?97). Analyses also accounted for between- and within-person differences in negative affect to inform specific targets for intervention. RESULTS:Significant within-person associations between emotion regulation, negative affect, and eating disorder severity support hypotheses that emotion dysregulation and negative affect co-occur with eating disorder psychopathology. Only between-person differences in negative affect demonstrated associations with binge eating frequency over time. DISCUSSION:Data suggest that momentary interventions targeting negative affect and emotion regulation skills may decrease eating disorder cognitions, but not binge eating frequency, among adults with binge eating.

SUBMITTER: Bodell LP

PROVIDER: S-EPMC7043891 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Longitudinal associations between emotion regulation skills, negative affect, and eating disorder symptoms in a clinical sample of individuals with binge eating.

Bodell Lindsay P LP Pearson Carolyn M CM Smith Kathryn E KE Cao Li L Crosby Ross D RD Peterson Carol B CB Crow Scott J SJ Berg Kelly C KC

Eating behaviors 20181228

<h4>Objective</h4>Although deficits in emotion regulation have been implicated in the maintenance of binge eating, few prospective studies have examined longitudinal associations between emotion regulation and eating disorder symptoms, which are needed to test these theoretical models.<h4>Method</h4>Using a naturalistic design, the current study utilized longitudinal multilevel analyses to examine whether improvements in emotion regulation during treatment are associated with decreased binge eat ...[more]

PMID: 30654193

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Project description:BackgroundInefficient mechanisms of emotional regulation appear essential in understanding the development and maintenance of binge-eating disorder (BED). Previous research focused mainly on a very limited emotion regulation strategies in BED, such as rumination, suppression, and positive reappraisal. Therefore, the aim of the study was to assess a wider range of emotional regulation strategies (i.e. acceptance, refocusing on planning, positive refocusing, positive reappraisal, putting into perspective, self-blame, other-blame, rumination, and catastrophizing), as well as associations between those strategies and binge-eating-related beliefs (negative, positive, and permissive), and clinical variables (eating disorders symptoms, both anxiety, depressive symptoms, and alexithymia).MethodsWomen diagnosed with BED (n = 35) according to the DSM-5 criteria and healthy women (n = 41) aged 22-60 years were assessed using: the Eating Attitudes Test-26, the Eating Beliefs Questionnaire-18, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20, the Cognitive Emotion Regulation Questionnaire, and the Difficulties in Emotion Regulation Scale. Statistical analyses included: Student t - tests or Mann-Whitney U tests for testing group differences between BED and HC group, and Pearson's r coefficient or Spearman's rho for exploring associations between the emotion regulation difficulties and strategies, and clinical variables and binge-eating-related beliefs in both groups.ResultsThe BED group presented with a significantly higher level of emotion regulation difficulties such as: nonacceptance of emotional responses, lack of emotional clarity, difficulties engaging in goal-directed behavior, impulse control difficulties, and limited access to emotion regulation strategies compared to the healthy controls. Moreover, patients with BED were significantly more likely to use maladaptive strategies (rumination and self-blame) and less likely to use adaptive strategies (positive refocusing and putting into perspective). In the clinical group, various difficulties in emotion regulation difficulties occurred to be positively correlated with the level of alexithymia, and anxiety and depressive symptoms. Regarding emotion regulation strategies, self-blame and catastrophizing were positively related to anxiety symptoms, but solely catastrophizing was related to the severity of eating disorder psychopathology.ConclusionsOur results indicate an essential and still insufficiently understood role of emotional dysregulation in BED. An especially important construct in this context seems to be alexithymia, which was strongly related to the majority of emotion regulation difficulties. Therefore, it might be beneficial to pay special attention to this construct when planning therapeutic interventions, as well as to the maladaptive emotion regulation strategies self-blame and catastrophizing, which were significantly related to BED psychopathology.

Project description:BackgroundBinge eating (BE), characterized by eating a large amount of food accompanied by a sense of loss of control over eating, is a public health crisis. Negative affect is a well-established antecedent for BE. The affect regulation model of BE posits that elevated negative affect increases momentary risk for BE, as engaging in BE alleviates negative affect and reinforces the behavior. The eating disorder field's capacity to identify moments of elevated negative affect, and thus BE risk, has exclusively relied on ecological momentary assessment (EMA). EMA involves the completion of surveys in real time on one's smartphone to report behavioral, cognitive, and emotional symptoms throughout the day. Although EMA provides ecologically valid information, EMA surveys are often delivered only 5-6 times per day, involve self-report of affect intensity only, and are unable to assess affect-related physiological arousal. Wearable, psychophysiological sensors that measure markers of affect arousal including heart rate, heart rate variability, and electrodermal activity may augment EMA surveys to improve accurate real-time prediction of BE. These sensors can objectively and continuously measure biomarkers of nervous system arousal that coincide with affect, thus allowing them to measure affective trajectories on a continuous timescale, detect changes in negative affect before the individual is consciously aware of them, and reduce user burden to improve data completeness. However, it is unknown whether sensor features can distinguish between positive and negative affect states, given that physiological arousal may occur during both negative and positive affect states.ObjectiveThe aims of this study are (1) to test the hypothesis that sensor features will distinguish positive and negative affect states in individuals with BE with >60% accuracy and (2) test the hypothesis that a machine learning algorithm using sensor data and EMA-reported negative affect to predict the occurrence of BE will predict BE with greater accuracy than an algorithm using EMA-reported negative affect alone.MethodsThis study will recruit 30 individuals with BE who will wear Fitbit Sense 2 wristbands to passively measure heart rate and electrodermal activity and report affect and BE on EMA surveys for 4 weeks. Machine learning algorithms will be developed using sensor data to distinguish instances of high positive and high negative affect (aim 1) and to predict engagement in BE (aim 2).ResultsThis project will be funded from November 2022 to October 2024. Recruitment efforts will be conducted from January 2023 through March 2024. Data collection is anticipated to be completed in May 2024.ConclusionsThis study is anticipated to provide new insight into the relationship between negative affect and BE by integrating wearable sensor data to measure affective arousal. The findings from this study may set the stage for future development of more effective digital ecological momentary interventions for BE.International registered report identifier (irrid)DERR1-10.2196/47098.

Project description:Depressive symptoms and binge eating are both prevalent in weight management populations and may be associated with reduced benefit from behavioral weight loss, including higher attrition, more perceived barriers, lower weight loss, and increased weight regain. These two potential risk factors for poor behavioral weight loss outcomes may also be associated with each other as depressive symptoms may trigger binge eating, and binge eating-related distress could increase depressive symptoms. The depressive symptom-binge eating link has not been well studied in weight management samples, and psychological processes involved in this relationship have not yet been elucidated. Psychological flexibility, an individual's ability to be connected with and conscious of the present moment and to engage in values-consistent behavior even in the presence of difficult internal experiences, may be one psychological process that changes the depressive symptom-binge eating relationship. High psychological flexibility may be a protective factor in the association of depressive symptoms with binge eating. This study examined the relationship between depressive symptom and binge eating and a potential interactive role of psychological flexibility. Participants (N = 468, 76% female) completed self-report questionnaires of binge eating, depressive symptoms, and psychological flexibility at baseline prior to initiating behavioral weight loss. Depressive symptoms were positively associated with binge eating (B = 1.00, p < 0.001). Psychological flexibility had an interactive role (B = -0.03, p = 0.005). Among participants with minimal to mild depressive symptoms, those with higher psychological flexibility had less severe binge eating. Findings suggest that psychological flexibility may be a protective factor in the association between depressive symptoms and binge eating in the majority of individuals initiating behavioral weight loss. Psychological flexibility is a psychological process to consider targeting for enhancing efficacy of weight loss treatment, especially among individuals with minimal to mild depressive symptoms and binge eating behavior.

Project description:Introduction:It is unclear whether core symptoms of attention deficit hyperactivity disorder (ADHD) relate to specific types of disordered eating and little is known about the mediating mechanisms. We investigated associations between core symptoms of ADHD and binge/disinhibited eating and restrictive eating behavior and assessed whether negative mood and/or deficits in awareness and reliance on internal hunger/satiety cues mediate these relationships. Methods:In two independent studies, we used a dimensional approach to study ADHD and disordered eating. In Study 1, a community-based sample of 237 adults (72.6% female, 18-60 years [M = 26.8, SE = 0.6]) completed an online questionnaire, assessing eating attitudes/behaviors, negative mood, awareness, and reliance on internal hunger/satiety cues and ADHD symptomatology. In Study 2, 142 students (80.3% female, 18-32 years [M = 19.3, SE = 0.1]) were recruited to complete the same questionnaires and complete tasks assessing interoceptive sensitivity and impulsivity in the laboratory. Results:In each study, core symptoms of ADHD correlated positively with both binge/disinhibited and restrictive eating and negative mood mediated the relationships. Deficits in awareness and reliance on internal hunger/satiety signals also mediated the association between inattentive symptoms of ADHD and disordered eating, especially binge/disinhibited eating. The results from both studies demonstrated that inattentive symptoms of ADHD were also directly related to binge/disinhibited eating behavior, while accounting for the indirect pathways of association via negative mood and awareness and reliance on internal hunger/satiety signals. Conclusion:This research provides evidence that core symptoms of ADHD are associated with both binge/disinhibited eating and restrictive eating behavior. Further investigation of the role of inattentive symptoms of ADHD in disordered eating may be helpful in developing novel treatments for both ADHD and binge eating.

Project description:Background and Aim: Eating Disorders (EDs) impact an estimated 15% of the global population and are linked to maladaptive defence-styles (coping strategies) and poorer mental health outcomes. Defence-styles have been grouped into immature, neurotic, and mature behaviours. Studies have yet to examine all three defence-styles in ED symptomatic individuals over an extended period of time. The current study aimed to investigate using converse analysis the relationships between defence-style and ED outcomes over a 5-years period. Methods: Participants (n = 216, mean age 33 years) were recruited through the Women's Eating and Health Literacy study, with the current study examining a 5-years period of two waves (year-4 and year-9). The current study tested associations over time between eating pathology (EDE-Q), psychological distress (K10), mental and physical health related quality of life (M/PHRQoL, SF-12), and defence-style (DSQ-40). Results: Mature, immature and neurotic defence-styles did not significantly change over 5 years. Over the same period, only PHRQoL significantly predicted mature defence-styles having positive effect. Both MHRQoL and PHRQoL significantly predicted immature defence-styles having positive and negative effects, respectively. Psychological distress, PHRQoL and weight concern significantly predicted neurotic defence-styles having positive effects except for psychological distress. PHRQoL, MHRQoL, restraint and eating concern significantly predicted overall eating pathology having positive effects except for PHRQoL and MHRQoL. Conversely, among the defence-style variables, over 5 years, both immature and neurotic defence-styles significantly predicted psychological distress having positive effects, immature and mature defence-styles significantly predicted MHRQoL having negative and positive effects, respectively, while only immature defence-styles significantly predicted overall eating pathology having positive effect. Conclusions: The results of the current study suggest that immaturity and neuroticism but not maturity were the defence-style variables predicting psychological distress over a 5-years period while conversely psychological distress predicted only neurotic defence styles. The findings of the current study may suggest that without intervention, mature, immature and neurotic defence-styles may largely remain immutable to significant shifts over time. Limitations in the current study included limited demographic representation. The current study is anticipated to generate considerations into treatments that could strengthen defence-styles in individuals with increased eating pathology.

Dataset Information

Longitudinal associations between emotion regulation skills, negative affect, and eating disorder symptoms in a clinical sample of individuals with binge eating.

Publications

Longitudinal associations between emotion regulation skills, negative affect, and eating disorder symptoms in a clinical sample of individuals with binge eating.

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