Emotion dysregulation and eating disorder outcome: Prediction, change and contribution of self‐image

Abstract

Objectives Eating disorders (EDs) are severe disorders with unsatisfactory outcome. Emotion dysregulation and self‐image are suggested maintenance factors; this study examined emotion dysregulation as potential predictor and/or mechanism of change in relation to ED outcome, and associations between change in emotion dysregulation and self‐image in relation to outcome. Design Registry data from initial and 1‐year follow‐up assessments for 307 patients with a wide range of EDs in specialized ED treatment were used. Methods Initial and change (∆) in emotion dysregulation were examined as predictors of 1‐year outcome. Direct and indirect associations between ∆emotion dysregulation and ∆self‐image as either independent variable or mediator in relation to ∆ED psychopathology as dependent were also examined. Results Higher initial emotion dysregulation was weakly associated with higher follow‐up ED psychopathology, but not remission, while relative increase in emotion dysregulation was associated with both higher follow‐up psychopathology and increased risk of still having a diagnosis. Change in emotion dysregulation primarily had an indirect effect (through change in self‐image), while change in self‐image had a direct effect, on change in ED psychopathology improvement (such that improvement in one was associated with improvement in the other). Conclusions Results identify emotion dysregulation as a potential mechanism of change in relation to ED outcome. However, this association was mainly mediated by change in self‐image. Results indicate that, in order to improve emotion regulation as a means to reduce ED psychopathology, improving self‐image is essential.

Emotional regulation and body dissatisfaction: the mediating role of anger in young adult women

“…In turn, negative emotions or negative affect have been shown to increase body dissatisfaction ( 1 ). Furthermore, these results can also be explained by the fact that difficulties in emotional regulation influence the change in self-image ( 58 ). Likewise, specific negative emotional states such as anxiety and depression mediate the relationship between emotional regulation difficulties and dysfunctional eating behaviors such as emotional eating ( 59 ).…”

Brain Correlates of Eating Disorders in Response to Food Visual Stimuli: A Systematic Narrative Review of FMRI Studies

“…Indeed, it is a widely held and shared belief that food can help manage an emotional state by evoking an immediate sense of well-being and relaxation. However, it is equally clear that this associative schema, when applied with rigidity and regularity or in a dysregulated manner, can lead to states of psychophysical decompensation characterized by an inability to recognize and modulate negative emotional states, such as anxiety, sadness, anger and stress [ 3 , 4 , 5 , 6 , 7 , 8 ]. From this perspective, anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED), which are part of the nutrition and eating disorders cluster (DSM-V: APA, 2013) [ 9 ], are complex pathologies that affect both mental state and physical functioning [ 10 ].…”