Affective lability and impulsivity in a clinical sample of women with bulimia nervosa: The role of affect in severely dysregulated behavior

Anestis, Michael D.; Peterson, Carol B.; Bardone‐Cone, Anna M.; Klein, Marjorie H.; Mitchell, James E.; Crosby, Ross D.; Wonderlich, Stephen A.; Crow, Scott J.; Grange, Daniel Le; Joiner, Thomas E.

doi:10.1002/eat.20606

Cited by 76 publications

(57 citation statements)

References 27 publications

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“…However, this analytic approach cannot provide information regarding the specificity of changes in affect and the presence/absence of a particular behavior, such as purging. Individuals with eating disorders report a great deal of affective variability (Anestis et al, 2009; Anestis et al, 2010; Benjamin & Wulfert, 2005) and may experience changes in affect over time on days that they do not purge. Supporting this, previous EMA research in BN suggests significant diurnal variation in affect (Smyth et al, 2009).…”

Section: Limitations Of Previous Researchmentioning

confidence: 99%

Affect regulation and purging: An ecological momentary assessment study in purging disorder.

Haedt‐Matt

Keel

2015

Journal of Abnormal Psychology

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Research suggests that affect may play an important role in the propensity to purge among women with Purging Disorder (PD). However, prior work has been constrained to cross-sectional or laboratory designs which impact temporal interpretations and ecological validity. This study examined the role of negative affect (NA) and positive affect (PA) in triggering and maintaining purging in PD using ecological momentary assessment. Women with PD (N=24) made multiple daily ratings of affect and behavior for two weeks. Multilevel models examined associations between affect and purging at different levels of analysis, including a novel analytic approach to address the specificity of changes in affect relative to purging behavior by comparing trajectories of change on purge versus non-purge days. For trajectories of affect over time, NA increased before purging and decreased following purging on purge days; however, only the decrease in NA following purging was significantly different from the trajectory of NA on non-purge days. Conversely, PA failed to increase before purging on purge days compared to a matched time-point on non-purge days. These findings suggest unique roles of PA in triggering and NA in maintaining purging in PD and support models in which purging functions to regulate affect. For comparisons of ratings before and after purging, NA increased and PA decreased after purging, highlighting how different analytic strategies produce different findings requiring integration into affect regulation models. These data provide insight into why women with PD purge after consuming normal amounts of food, a crucial first step for developing effective interventions.

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Section: Limitations Of Previous Researchmentioning

confidence: 99%

Affect regulation and purging: An ecological momentary assessment study in purging disorder.

Haedt‐Matt

Keel

2015

Journal of Abnormal Psychology

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“…cognitions and affect. These processes also display a variety of sex differences, and there are well-developed methods to assess them in animals and humans (6,49,50,62,183,225,238,542,624,644,653,658,703,720). The study of interactions among such psychological processes and physiological sex differences in eating seem to us to be profitable avenues of investigation.…”

Section: R1247 Sex Differences In the Physiology Of Eatingmentioning

confidence: 99%

Sex differences in the physiology of eating

Asarian

Geary²

2013

American Journal of Physiology-Regulatory, Integrative and Comp

414

349

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(HPG) axis function fundamentally affects the physiology of eating. We review sex differences in the physiological and pathophysiological controls of amounts eaten in rats, mice, monkeys, and humans. These controls result from interactions among genetic effects, organizational effects of reproductive hormones (i.e., permanent early developmental effects), and activational effects of these hormones (i.e., effects dependent on hormone levels). Male-female sex differences in the physiology of eating involve both organizational and activational effects of androgens and estrogens. An activational effect of estrogens decreases eating 1) during the periovulatory period of the ovarian cycle in rats, mice, monkeys, and women and 2) tonically between puberty and reproductive senescence or ovariectomy in rats and monkeys, sometimes in mice, and possibly in women. Estrogens acting on estrogen receptor-␣ (ER␣) in the caudal medial nucleus of the solitary tract appear to mediate these effects in rats. Androgens, prolactin, and other reproductive hormones also affect eating in rats. Sex differences in eating are mediated by alterations in orosensory capacity and hedonics, gastric mechanoreception, ghrelin, CCK, glucagon-like peptide-1 (GLP-1), glucagon, insulin, amylin, apolipoprotein A-IV, fatty-acid oxidation, and leptin. The control of eating by central neurochemical signaling via serotonin, MSH, neuropeptide Y, Agouti-related peptide (AgRP), melanin-concentrating hormone, and dopamine is modulated by HPG function. Finally, sex differences in the physiology of eating may contribute to human obesity, anorexia nervosa, and binge eating. The variety and physiological importance of what has been learned so far warrant intensifying basic, translational, and clinical research on sex differences in eating.neuroendocrinology; estrogens; testosterone; eating disorders; obesity SEX DIFFERENCES ARE PERVASIVE in physiology and medicine (51,64,73,109,110,466,797,826). The controls of eating and energy homeostasis are no exceptions. It was observed approximately 100 years ago that removal of the ovaries leads to marked accretion of adipose tissue in rats (697), that daily food intake expressed as kilocalories per gram body weight differs between male and female rats (778), and that food intake varies regularly through the ovarian cycle in intact female rats (674, 779). Sex differences in eating have been the subject of physiological research ever since. The clinical relevance of this work is increasingly evident. In the United States, women are approximately threefold more vulnerable than men to psychiatric eating disorders (346,351) and approximately twofold more vulnerable to severe and morbid obesity (BMI Ն 35 and 40 kg/m 2 , respectively, mass/height 2 ) (226). Women also appear to suffer more from these disorders in terms of physical and psychological functioning and quality of life (24,84,273,292,465,531,762). The increased obesity burden suffered by women is reflected in the fact that Ͼ80% of bariatric surgery patients in the U...

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“…In addition to the direct effect of narcissistic vulnerability (noted by a frail self-image, self-adequacy concerns, hypersensitivity to criticism, and withdrawal when narcissistic needs are not met) on future bulimic behaviours, narcissistic grandiosity (that best captures the representation of narcissistic PD) increases the likelihood of engaging in dieting behaviours, which in turn increases the likelihood of engaging in bulimic behaviours [35]. Certain personality traits, such as affective liability, are related to impulsive behaviours [36] and interact with elevated compulsivity to predict extreme exercise behaviours [37]. In both clinical and non-clinical samples [38,39], perfectionism was found to interact with body dissatisfaction 1 3 (i.e., an established risk and maintenance factor of EWDs [4,40]) and insecure attachment to predict higher levels of dieting, binge-eating, and compensatory behaviours.…”

Section: Multi-factor Nature Of Eating and Weight Disorder And Personmentioning

confidence: 99%

Personality and eating and weight disorders: an open research challenge

Gaudio

Dakanalis

2017

Eat Weight Disord

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Affective lability and impulsivity in a clinical sample of women with bulimia nervosa: The role of affect in severely dysregulated behavior

Abstract: The degree to which individuals with BN experience labile emotions is associated with several indicators of dysregulated behavior such that higher levels of affective lability predict a more severely dysregulated behavioral profile.

Cited by 76 publications

References 27 publications

Affect regulation and purging: An ecological momentary assessment study in purging disorder.

Affect regulation and purging: An ecological momentary assessment study in purging disorder.

Sex differences in the physiology of eating

Personality and eating and weight disorders: an open research challenge

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