Examining the associations between emotion regulation difficulties, anxiety, and eating disorder severity among inpatients with anorexia nervosa

Abstract

Objective There is growing interest in the role of emotion regulation in anorexia nervosa (AN). Although anxiety is also hypothesized to impact symptoms of AN, little is known about how emotion regulation, anxiety, and eating disorder symptoms interact in AN. In this study, we examined the associations between emotion regulation, anxiety, and eating disorder symptom severity in AN. Methods Questionnaires and interviews assessing emotion regulation difficulties, anxiety, eating disorder symptoms, and eating disorder-related clinical impairment were collected from group of underweight individuals with AN (n = 59) at admission to inpatient treatment. Hierarchical linear regressions were used to examine the associations of emotion regulation difficulties, anxiety, and the interaction of these constructs with eating disorder symptoms and eating disorder-related clinical impairment. Results Emotion regulation difficulties were significantly positively associated with eating disorder symptoms and related clinical impairment only when anxiety levels were low and anxiety was significantly positively associated with eating disorder symptoms and related clinical impairment only when emotion regulation problems were not elevated. Conclusions This study adds to a growing literature suggesting that emotion regulation deficits are associated with eating disorder symptoms in AN. Certain individuals with AN may especially benefit from a focus on developing emotion regulation skills in the acute stages of illness.

Testing predictions of the emotion regulation model of binge‐eating disorder

“…Interestingly, our findings also showed that difficulties in ER contribute unique variance, above and beyond BMI, age, depression, and anxiety, to both binge frequency and ED psychopathology. Specifically, greater difficulties in ER were associated with more frequent binge episodes-as has been reported in a nonclinical sample (Whiteside et al, 2007)-and greater ED psychopathology, consistent with research examining other EDs (Haynos, Roberto, & Attia, 2015;Woltz et al, 2015). However, this is one of the first studies to show these associations in individuals with BED.…”

Emotion Regulation as a Transdiagnostic Feature Among Eating Disorders: Cross‐sectional and Longitudinal Approach

“…Emotion regulation difficulties are widely acknowledged in patients with EDs (Gianini et al, ; Haynos, Roberto, & Attia, ; Lavender et al, ; Wolz et al, ) with some studies also suggesting emotion dysregulation as a transdiagnostic risk factor for developing ED symptomatology (Brockmeyer et al, ; Svaldi, Griepenstroh, Tuschen‐Caffier, & Ehring, ). However, it is still unclear whether there are significant differences on how the different ED types regulate emotions (Brockmeyer et al, ; Danner et al, ) or whether they can be modified by current first‐line treatment.…”

Attention deficit hyperactivity disorder symptoms and disordered eating in the English general population

“…ADHD and BPD often coexist (Matthies & Philipsen, 2014), and one longitudinal study showed that individuals with childhood ADHD are at a 13-fold increased risk for BPD in adolescence (Miller et al, 2008). ADHD and BPD are both characterized by emotional/affective instability and impulsive behavior (Matthies & Philipsen, 2014), which may lead to disordered eating behavior (Dawe & Loxton, 2004;Haynos et al, 2015). ADHD and BPD are both characterized by emotional/affective instability and impulsive behavior (Matthies & Philipsen, 2014), which may lead to disordered eating behavior (Dawe & Loxton, 2004;Haynos et al, 2015).…”

“…On the other hand, women with BPD have been reported to have a higher likelihood of ED diagnosis than women without this condition (Reas, Rø, Karterud, Hummelen, & Pedersen, 2013). ADHD and BPD are both characterized by emotional/affective instability and impulsive behavior (Matthies & Philipsen, 2014), which may lead to disordered eating behavior (Dawe & Loxton, 2004;Haynos et al, 2015). In one study, the mood of women with high borderline personality traits was improved with food consumption, suggesting that individuals with this personality trait might be at a particularly high risk for subclinical ED (Ambwani & Morey, 2015).…”