Persistence of friendly and submissive interpersonal styles among those with binge‐eating disorder: Comparisons with matched controls and outcomes after group therapy

Abstract

Interpersonal problems play a prominent role in the development of binge-eating disorder (BED), so reducing their intensity may be a key focus of many psychological interventions. In recent years, several interpersonal treatments for BED were developed, which posit that binge eating arises to manage relational problems. However, few studies have evaluated the prototypical interpersonal problems, and no studies evaluated the longitudinal changes in interpersonal functioning after treatment within this population. We investigated the severity and prototypicality of interpersonal problems of 101 overweight women with BED from pre-group psychodynamic-interpersonal psychotherapy (GPIP) to 12 months post-GPIP. At baseline, we compared patients' interpersonal problems with two groups of matched controls (46 overweight and 49 normal weight women without a diagnosis of BED) and examined circular correlations between relational problems, depressive symptoms, and binge-eating frequency. Results showed that participants with BED had significantly higher levels of interpersonal problems compared with the matched control samples, with predominantly nonassertive and exploitable styles. Depressive symptoms were related to the presence of friendly-submissive interpersonal problems only among those with BED. Although the intensity of nonassertive interpersonal problems of patients with BED decreased post-group treatment, their profiles remained prototypically nonassertive and exploitable across all time points. Women with BED experience higher levels of interpersonal difficulties exemplified by an exploitable/nonassertive style that significantly improve but continue to prevail even after treatment. Clinicians might modify interventions to focus on increasing interpersonal skills and decreasing interpersonal dysfunctions among those with BED. KEYWORDS binge-eating disorder, interpersonal circumplex, interpersonal problems, obesity, group psychodynamic-interpersonal psychotherapy, structural summary method

Anhedonia, positive affect dysregulation, and risk and maintenance of binge‐eating disorder

“…Consistent with this theory, evidence from general samples show bidirectional associations between momentary PA and adaptive behaviors, such that higher PA predicts healthy eating (e.g., increased fruit/vegetable intake), physical activity, and social interactions, and these behaviors predict higher subsequent PA (Conner, Brookie, Richardson, & Polak, 2015; Liao, Shonkoff, & Dunton, 2015; Liu, Xie, & Lou, 2019; Mason et al, 2019). Conversely, individuals with BED typically engage in less healthy eating patterns, consume fewer healthy foods, engage in less physical activity, and have more interpersonal difficulties (e.g., Brugnera, Carlucci, Compare, & Tasca, 2019; Engel et al, 2009; Hrabosky, White, Masheb, & Grilo, 2007; Masheb, Grilo, & Rolls, 2011), which may serve to maintain lower overall and within‐day PA. Binge eating may be used as a way to momentarily increase PA in individuals with BED.…”

Hunger games: Associations between core eating disorder symptoms and responses to rejection by peers during competition

“…It is unclear whether these characteristics are associated with a particular symptom of BN (i.e., binge‐eating, compensatory behavior) or the entire symptom profile. Research on individuals with BED suggests that these patients are more outwardly angry, domineering, and cold, but also more submissive, compared to overweight and non‐overweight controls, although there does not appear to be any research directly comparing individuals with BED to those with AN or BN (Brugnera et al, 2018; Brugnera, Carlucci, Compare, & Tasca, 2019; Fassino, Abbate‐Daga, Pierò, Leombruni, & Rovera, 2003).…”

Interpersonal difficulties in obesity: A systematic review and meta-analysis to inform a rejection sensitivity-based model

“…Furthermore, individuals with eating and weight disorders display increased sensitivity to others' negative feedback, as indicated by an attention and interpretation bias towards social threat (e.g. [21,22]) and unfavourable social comparison and submissive behaviours [13,23]. This evidence has led to the proposal that abnormal eating behaviours, such as overeating, can develop as strategies to deal with negative emotions associated with interpersonal difficulties (e.g.…”