The role of affect in the maintenance of binge-eating disorder: Evidence from an ecological momentary assessment study.

Schaefer, Lauren M.; Smith, Kathryn E.; Anderson, Lisa M.; Cao, Li; Crosby, Ross D.; Engel, Scott G.; Crow, Scott J.; Peterson, Carol B.; Wonderlich, Stephen A.

doi:10.1037/abn0000517

Cited by 112 publications

(98 citation statements)

References 38 publications

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“…Binge eating may be used as a way to momentarily increase PA in individuals with BED. Consistently, in a recent EMA study of adults with BED, trajectories of PA surrounding binge eating showed that, on average, PA decreased prior to binge eating and stabilized following binge eating, providing evidence for a PA‐enhancing effect of binge eating in BED (Schaefer et al, 2020).…”

Section: Anhedonia As a Maintenance Factor For Bedmentioning

confidence: 56%

“…Although little research has explicitly examined the role of anhedonia in binge‐eating disorder (BED), some work has investigated the more general and dimensional role of PA. Consistent with affect regulation models of eating pathology, evidence indicates that low PA is an antecedent of binge‐eating episodes among individuals with BED (Schaefer et al, 2020). Baseline PA dynamics have also been found to predict BED treatment outcomes, including changes in binge‐eating frequency and weight (Mason et al, 2020; Mason et al, in press).…”

Section: Introductionmentioning

confidence: 88%

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

Mason

Anderson

Hazzard

2020

Intl J Eating Disorders

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Low positive affect has been identified as an antecedent of binge‐eating episodes among individuals with binge‐eating disorder (BED), yet positive affect has received far less attention in eating disorders research than its counterpart, negative affect. In this article, we argue that the low levels of positive affect which occur with anhedonia (i.e., loss of interest or pleasure in activities) may contribute to the onset and maintenance of BED. We introduce a theoretical model in which anhedonia increases the risk for BED through its interrelationships with dysregulated eating and weight gain, and we describe potential direct (e.g., reward‐related processes) as well as indirect (e.g., influences on depressive symptoms and physical activity) pathways by which anhedonia may lead to adverse eating‐ and weight‐related outcomes. We also propose a momentary maintenance model in which low positive affect and positive affect dysregulation occurring with anhedonia maintain binge eating directly and indirectly through maladaptive health behaviors, such as decreased physical activity, less healthy eating, and fewer social interactions, which in turn maintain anhedonia. We draw upon outside literature to present evidence that aligns with the proposed risk and maintenance models and conclude by outlining avenues for future research—including methodological/measurement, theoretical, and clinical research directions.

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Section: Anhedonia As a Maintenance Factor For Bedmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 88%

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

Mason

Anderson

Hazzard

2020

Intl J Eating Disorders

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“…For example, irritability is linked to starvation in anorexia nervosa (AN; Sidiropoulos, 2007), and fear (e.g., fear of weight gain) is a core symptom in EDs (Levinson, Brosof, Ma, Fewell, & Lenze, 2017). Shame (i.e., negative internal, global, and stable feelings about oneself; Tangney & Dearing, 2003) and guilt (i.e., internal negative feelings about a specific behavior; Tangney & Dearing, 2003) have also been linked to ED behaviors such as binge eating (Schaefer et al, 2020). However, no research has incorporated many unique NA states in one integrated model to understand the complex associations across NA and a variety of ED symptoms.…”

Section: Introductionmentioning

confidence: 99%

Network investigation of eating disorder symptoms and positive and negative affect in a clinical eating disorder sample

Wong

Christian

Hunt

et al. 2021

Intl J Eating Disorders

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Objective Growing literature suggests that emotions influence the maintenance of eating disorder (ED) symptoms. However, most research has studied the relationship between ED symptoms and affect broadly (i.e., negative affect [NA], positive affect [PA]), rather than examining models comprised of multiple specific affective states (e.g., upset, proud). Method The current study (N = 196 individuals with EDs) used network analysis to examine the most interconnected (i.e., central) NA and PA states in EDs and test the complex associations between specific NA, PA, and ED symptoms. We estimated two networks: one with affective states only and another with affective states and ED symptoms. Results Feeling distressed, afraid, attentive, and determined were the most central symptoms in the affect‐only network. ED symptoms related to overvaluation of weight and shape, including affect‐based ED symptoms (i.e., guilt about eating), were central in the network of affect and ED symptoms. Guilt about eating and shame were central bridge symptoms across affect and ED symptom clusters, meaning that they were each strongly connected across clusters, and may represent important pathways among affect and ED symptoms. Discussion Limitations include the cross‐sectional and between‐person nature of these analyses, from which we cannot derive causal or within‐persons processes. Clinical interventions that target central and bridge symptoms (e.g., fear, shame) may disrupt the reinforcing cycle of NA in EDs that may contribute to ED behaviors. Future research should examine relationships among affective states and ED symptoms in longitudinal and intraindividual network models to develop more effective treatments for EDs.

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“…A total of eight NA items were included in EMA AN (Engel et al, 2013), 11 NA items in EMA BN (Smyth et al, 2007), and 20 NA items in EMA BED (Peterson et al, 2019). Reliability estimates (coefficient α) for the selected NA items in each study ranged from good (.80 in EMA BED) to excellent (.92 for EMA AN and BN; Engel et al, 2013; Schaefer et al, 2019; Smyth et al, 2007). Seven NA items were used in all three studies and were subsequently used for the affective dynamics calculations in the current study: afraid, angry at self, ashamed, disgusted, dissatisfied with self, nervous, and sad.…”

Section: Methodsmentioning

confidence: 96%

Differences in Affective Dynamics Among Eating-Disorder Diagnostic Groups

Williams-Kerver

Wonderlich

Crosby

et al. 2020

Clinical Psychological Science

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Emotion-regulation theories suggest that affect intensity is crucial in the development and maintenance of eating disorders. However, other aspects of emotional experience, such as lability, differentiation, and inertia, are not as well understood. This study is the first to use ecological momentary assessment (EMA) to examine differences in several daily negative affect (NA) indicators among adults diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or binge-eating disorder (BED). We used EMA data from three large studies to run a series of linear mixed models; the results showed that participants in the AN and BN groups experienced significantly greater NA intensity and better emotion differentiation than participants in the BED group. Alternatively, the BN group demonstrated significantly greater NA lability than the AN group and greater NA inertia than the BED group. These results suggest that several daily affective experiences differ among eating-disorder diagnostic groups and have implications toward distinct conceptualizations and treatments.

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The role of affect in the maintenance of binge-eating disorder: Evidence from an ecological momentary assessment study.

Abstract: consistent with affect regulation models of eating pathology and suggest that binge-eating episodes may be maintained through a process of negative reinforcement.

Cited by 112 publications

References 38 publications

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

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

Network investigation of eating disorder symptoms and positive and negative affect in a clinical eating disorder sample

Differences in Affective Dynamics Among Eating-Disorder Diagnostic Groups

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