Maintenance of binge eating through negative mood: A naturalistic comparison of binge eating disorder and bulimia nervosa

Abstract

Affect regulation difficulties likely lead to binge eating in both disorders, but binge eating may not be effective for regulating overall mood.

Testing the cognitive-behavioural maintenance models across DSM-5 bulimic-type eating disorder diagnostic groups: a multi-centre study

“…Moreover, the present study indicated that the dietary restraint-binge eating relationship is fully mediated and explained by mood intolerance. Although this indirect effect was unexpected, it appears consistent with findings from studies indicating that dietary manipulations that transiently deplete tryptophan levels (and consequently 5-HT synthesis in the brain) contribute to dysphoric mood in bulimic-type ED subjects [61,62], increasing the likelihood that an individual might binge eat to relieve dysphoria [21,22,48,60,61]. Furthermore, based on the results of neurobiological, molecular-genetic, and brain-imaging studies, Steiger and colleagues [63] postulated that factors affecting 5-HT functional activity may indirectly influence susceptibility to binge eating by heightening affective instability.…”

“…While clinical perfectionism was the only maintaining variable directly linked to dietary restraint, interpersonal problems and mood intolerance were directly linked to binge eating, emphasizing the direct key role that both factors may have in its occurrence [11,21,22,44,48,52,53]. The positive and significant relationships between mood intolerance and binge eating are in accordance with CB-E model, which postulate that binge eating has a regulatory function and occur in an attempt to reduce the negative affective states [13].…”

“…The final maintenance factor of mood intolerance (i.e. inability to appropriately cope with adverse affective states followed by dysfunctional impulsive behaviours) [13] is believed to directly affect and maintain binge eating [12,17,[21][22][23][24]. The CB-E approach is consistent with research that documented two subtypes of patients with BN and binge eating disorder (BED) based on purely dietary restraint (i.e.…”

“…In fact, the only study with a clinical sample of individuals with DSM-IV-including sub-threshold-anorexia nervosa (AN), and BN investigated only the mutual relationships between each maintenance factor, and their associations with OSW [15]. Moreover, since the CB-E model was developed to expand and improve the original CB model [13], an empirical comparison of the two CB models, in an attempt to evaluate whether the predictive ability of the original model would be improved by the inclusion of the four additional maintenance factors (CB-E model), could potentially have implications for understanding the persistence of bulimic-type EDs and provide indirect support for the utility of the CBT-E [7,15,17,[22][23][24].…”

Emotion regulation and binge eating in children

“…Emotion regulation is assumed to play an important role for the initiation and maintenance of binge eating in adults with binge eating disorder (BED). [1][2][3] Also, children with symptoms of BED engage in eating in response to negative affect. [4][5][6] Yet, it is unclear whether binge eating in children is associated with deficits in emotion regulation and which emotion regulation strategies are problematic.…”