Differences in the use of emotion regulation strategies between anorexia and bulimia nervosa: A systematic review and meta-analysis

Puttevils, Louise; Vanderhasselt, Marie‐Anne; Horczak, Paula; Vervaet, Myriam

doi:10.1016/j.comppsych.2021.152262

Cited by 23 publications

(26 citation statements)

References 145 publications

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“…Interestingly, our meta-regression also found a significant effect of BMI, such that the associations were generally weaker among those with lower BMI. This is somewhat in contrast with previous reviews suggesting that there are no significant differences in the associations between emotion regulation methods and ED psychopathology between different ED diagnostic groups characterised by low and high BMI (Prefit et al, 2019;Puttevils et al, 2021). However, some studies have reported that starvation impacts emotion regulation in such a way that those with very low BMI in the acute stage of AN report fewer difficulties (Brockmeyer et al, 2012).…”

Section: Discussioncontrasting

confidence: 73%

“…Over the years there has been a great deal of interest in exploring emotion regulation within EDs; it has been proposed that difficulties in emotion regulation is one of the social-emotional factors contributing to the development and maintenance of disordered eating (Dingemans, Danner, & Parks, 2017;Oldershaw et al, 2015;Prefit, Cândea, & Szentagotai-Tătar, 2019;Puttevils, Vanderhasselt, Horczak, & Vervaet, 2021). Large scale systematic reviews and meta-analyses have reported links between ED symptomatology and difficulties in emotion regulation among people with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), both when assessed under laboratory conditions and under naturalistic conditions in studies using ecological momentary assessments (EMAs) (Dingemans et al, 2017;Oldershaw et al, 2015;Puttevils et al, 2021). Recently a meta-analytic review by Prefit et al (2019) examined correlations between the use of various emotion regulation strategies and ED psychopathology across all ED diagnoses.…”

Section: Introductionmentioning

confidence: 99%

“…The objective was to identify aspects of emotion regulation that have closest association with ED symptomatology to identify useful targets for therapeutic interventions. As previous work has suggested that difficulties in emotion regulation may be trans-diagnostic (Prefit et al, 2019;Puttevils et al, 2021), we assessed the associations between the use of different emotion regulation strategies and ED symptomatology across ED diagnoses. Because findings from previous metaanalyses have reported very similar associations between different emotion regulation strategies and ED symptomatology, we did not have a priori expectations regarding which one or more emotion regulation strategies would emerge as being most closely associated with ED psychopathology.…”

Section: Introductionmentioning

confidence: 99%

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The role of emotion regulation in eating disorders: a network meta-analysis approach

Leppänen¹,

Brown²,

McLinden³

et al. 2021

Preprint

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Background: Previous theoretical models and reviews have documented a strong connection between emotion dysregulation eating disorder (ED) psychopathology among the general and clinical populations. The aim of this review was to build on this previous work by conducting a network meta-analysis to explore associations between specific emotion regulation strategies and ED psychopathology trans-diagnostically across the ED spectrum to identify areas of emotion dysregulation that have the strongest association with symptomatology.Methodology: A total of 105 studies were included in the meta-analysis and correlation coefficient representing the associations between specific emotion regulation strategies and ED symptomatology were extracted. We ran a Bayesian random effects network meta-analysis and the initial network was well connected with each emotion regulation strategy being linked to at least one other strategy. We also conducted a network meta-regression to explore whether between-study differences in body mass index (BMI), age, and whether the sample consisted of solely female participants explained any possible network inconsistency. Results: The network meta-analysis revealed that ruminations and non-acceptance of emotions were most closely associated with ED psychopathology. There was no significant network inconsistency but two comparisons approached significance and thus meta-regressions were conducted. The meta-regressions revealed a significant effect of BMI such that the associations between different emotion regulation strategies and ED symptomatology were weaker among those with low BMI. Discussion: The present findings build on previous work and highlight the role of rumination and difficulties with accepting emotions as key emotion regulation difficulties in EDs. Additionally, the finding that the associations were weaker among ED patients with low BMI may point towards a complex relationship between ED behaviours and emotion regulation. Taken together, our findings call for interventions that target emotion regulation, specifically rumination and difficulties accepting emotions, in the treatment of EDs.

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Section: Discussioncontrasting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The role of emotion regulation in eating disorders: a network meta-analysis approach

Leppänen¹,

Brown²,

McLinden³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Over the years there has been a great deal of interest in exploring emotion regulation within EDs; it has been proposed that difficulties in emotion regulation is one of the social-emotional factors contributing to the development and maintenance of disordered eating (9,(11)(12)(13). Large scale systematic reviews and meta-analyses have reported links between ED symptomatology and dispositional tendency toward maladaptive emotion regulation and emotion dysregulation among people with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), both when assessed under laboratory conditions and under naturalistic conditions in studies using ecological momentary assessments (EMAs) (9,11,13). Recently a meta-analytic review by Prefit et al (12) examined correlations between the use of various emotion regulation strategies and ED psychopathology across all ED diagnoses.…”

Section: Introductionmentioning

confidence: 99%

“…The objective was to identify aspects of emotion regulation that have closest association with ED symptomatology to identify useful targets for therapeutic interventions. As previous work has suggested that difficulties in emotion regulation may be trans-diagnostic ( 12 , 13 ), we assessed the associations between the use of different emotion regulation strategies and ED symptomatology across ED diagnoses. Because findings from previous meta-analyses have reported very similar associations between different emotion regulation strategies and ED symptomatology, we did not have a priori expectations regarding which one or more emotion regulation strategies would emerge as being most closely associated with ED psychopathology.…”

Section: Introductionmentioning

confidence: 99%

The Role of Emotion Regulation in Eating Disorders: A Network Meta-Analysis Approach

et al. 2022

View full text Add to dashboard Cite

BackgroundPrevious theoretical models and reviews have documented a strong connection between emotion dysregulation eating disorder (ED) psychopathology among the general and clinical populations. The aim of this review was to build on this previous work by conducting a network meta-analysis to explore associations between adaptive and maladaptive emotion regulation strategies and ED psychopathology trans-diagnostically across the ED spectrum to identify areas of emotion dysregulation that have the strongest association with symptomatology.MethodologyA total of 104 studies were included in the meta-analysis and correlation coefficient representing the associations between specific emotion regulation strategies and ED symptomatology were extracted. We ran a Bayesian random effects network meta-analysis and the initial network was well-connected with each emotion regulation strategy being linked to at least one other strategy. We also conducted a network meta-regression to explore whether between-study differences in body mass index (BMI), age, and whether the sample consisted of solely female participants explained any possible network inconsistency.ResultsThe network meta-analysis revealed that ruminations and non-acceptance of emotions were most closely associated with ED psychopathology. There was no significant network inconsistency but two comparisons approached significance and thus meta-regressions were conducted. The meta-regressions revealed a significant effect of BMI such that the associations between different emotion regulation strategies and ED symptomatology were weaker among those with low BMI.DiscussionThe present findings build on previous work and highlight the role of rumination and difficulties with accepting emotions as key emotion regulation difficulties in EDs. Additionally, the finding that the associations were weaker among ED patients with low BMI may point toward a complex relationship between ED behaviors and emotion regulation. Taken together, our findings call for interventions that target emotion regulation, specifically rumination and difficulties accepting emotions, in the treatment of EDs.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021249996, PROSPERO, identifier: CRD42021249996.

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Emotional non‐acceptance mediates the relationship between insecure attachment and specific psychopathology in women with eating disorders

Cascino

Ceres

Donato

et al. 2023

Euro Eating Disorders Rev

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Objective: Insecure attachment is considered a general risk factor for eating disorders (ED). Emotion dysregulation has been proposed as one of the possible mechanisms by which attachment insecurity may affect ED psychopathology. Aim of the present study was to investigate whether difficulties in acceptance of emotions or emotional clarity may mediate the connection between insecure attachment and ED psychopathology.Method: One hundred and twenty patients participated and completed the Italian version of Eating Disorder Inventory-2, Experience in Close Relationship questionnaire and Difficulties in Emotion Regulation Scale. A mediator path model was performed, in which insecure attachment dimensions were set as independent variables, ED specific psychopathology measures as dependent variables, and non-acceptance of emotion and lack of emotional clarity as mediators. Results:The association between both attachment avoidance and anxiety and ED specific symptoms was mediated by emotional non-acceptance, but not by emotional clarity. Conclusions:This study showed the importance to address emotion regulation in individuals with ED, focussing on improving emotional acceptance.Exploring early developmental processes which lead to non-acceptance of emotions could improve this psychological trait in people with ED.

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Differences in the use of emotion regulation strategies between anorexia and bulimia nervosa: A systematic review and meta-analysis

Cited by 23 publications

References 145 publications

The role of emotion regulation in eating disorders: a network meta-analysis approach

The role of emotion regulation in eating disorders: a network meta-analysis approach

The Role of Emotion Regulation in Eating Disorders: A Network Meta-Analysis Approach

Emotional non‐acceptance mediates the relationship between insecure attachment and specific psychopathology in women with eating disorders

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