Examination of the difficulties in emotion regulation scale and its relation to disordered eating in a young female sample

Emotion regulation difficulties and disordered eating in adolescents and young adults: a meta-analysis

Eating disorders and difficulties in regulating emotions are frequent among adolescents and serve as risk factors for several health issues. Nonetheless, the relationship remains ambiguous; investigating this connection will not only elucidate the associations between the two illnesses. Nevertheless, it will offer theoretical backing for interventions targeting the pertinent illnesses. This study seeks to examine the relationship between emotion management and disordered eating while assessing the moderating influences of Body Mass Index (BMI) and gender to enhance future interventions for eating disorders. We conducted a search in April 2024 and updated it in November of the same year, encompassing literature published from 2010 to November 2024 across five English and Chinese databases. A random effects model was conducted to analyze research outcomes. This meta-analysis encompassed 23 research, demonstrating a medium positive connection between difficulties in regulating emotions and disordered eating (r = 0.418). Subgroup analyses revealed medium positive relationships between difficulties in emotion regulation and disordered eating (r = 0.428), loss-of-control eating disorders (r = 0.410), and emotional eating (r = 0.370). The meta-regression analysis revealed that gender significantly moderates this association, but BMI does not. The present study indicated that adolescents or young adults with difficulties in emotional regulation are susceptible to displaying symptoms of eating disorders in both sexes; however, in females, emotional regulation issues are more likely to be associated with eating disorders. Future longitudinal or experimental researches are needed to reveal the causal relationship between the two variables and the similarities and variations between genders during adolescence and early adulthood.

A Longitudinal Network Analysis of Emotion Regulation, Interpersonal Problems, and Eating Disorder Psychopathology in Chinese Adolescents

OBJECTIVE

The present longitudinal study examined sex-specific, symptom-level relationships among emotion regulation (ER), interpersonal problems (IP), and eating disorder (ED) psychopathology in a large sample of Chinese adolescents.

METHOD

Data were from a project with four waves of data collection (N = 1540; 710 boys and 830 girls) at 6-month intervals over 18 months. Questionnaires assessed ED psychopathology, ER, and IP at each wave of data collection. Longitudinal network analyses were conducted separately for boys and girls. Sex differences in the network structures were also examined.

RESULTS

The results revealed pronounced heterogeneity in the presentation of ED psychopathology, ER, and IP across Chinese adolescent boys and girls longitudinally and intra-individually. For example, weight/shape preoccupation in ED psychopathology and awareness in ER emerged as important nodes in the temporal network for boys. However, weight/shape preoccupation and dissatisfaction in ED psychopathology were identified as the most important nodes in the temporal network for girls. Regarding bridge strength, awareness in ER emerged as the node with the highest connectivity in the temporal network for boys. At the same time, weight/shape dissatisfaction in ED psychopathology was the node with the highest connectivity for girls.

DISCUSSION

The current study extended network theory to better understand the longitudinal interplay among ER, IP, and ED psychopathology in Chinese adolescents and their sex differences in the importance of symptoms. Such insights may pave the way for developing targeted prevention and treatment strategies for adolescent boys and girls in China.

Meta-analysis of the Difficulties in Emotion Regulation Scale and its short forms: A two-part study

The Difficulties in Emotion Regulation Scale (DERS) is the most used self-report questionnaire to assess deficits in emotion regulation (ER), composed of 6 dimensions and 36 items. Many studies have evaluated its factor structure, not always confirming the original results, and proposed different factor models. A possible way to try to identify the dimensionality of the DERS could be through a meta-analysis with structural equation models (MASEM) of its factor structure. The MASEM indicated that a six-factor model with 32 items (DERS-32) was the most suitable to represent the dimensionality of the DERS (χ2 = 2095.96, df = 449, p < .001; root mean square error of approximation [RMSEA] = 0.024, 95% confidence interval [CI]: 0.023-0.025; comparative fit index [CFI] = 0.97; Tucker Lewis index [TLI] = 0.96; standardized root mean squared residual [SRMR] = 0.04). This result was also confirmed by a confirmatory factor analysis (χ2 = 3229.67, df = 449, p < 0.001; RMSEA = 0.075, 95% CI: 0.073-0.078; CFI = 0.94; TLI = 0.93; SRMR = 0.05) on a new sample (1092 participants; mean age: 28.28, SD = 5.82 years) recruited from the Italian population. Analyses and results from this sample are reported in the second study of this work. The DERS-32 showed satisfactory internal consistency (i.e., ordinal α, Molenaar Sijtsma statistic, and latent class reliability coefficient) for all its dimensions and correctly categorized individuals with probable borderline symptomatology. In conclusion, the DERS-32 has demonstrated to be the best model for the DERS among all the others considered in this work, as well as a reliable tool to assess deficits in ER.

Tension and disordered eating behaviors in the daily lives of adolescents and young adults from the general population: Associations and moderating role of trait emotion regulation

Experiences of tension and difficulties in emotion regulation have been linked to eating pathology in clinical samples and are targeted in respective treatment approaches. The present study aimed to investigate the impact of tension on engagement in disordered eating behaviors (DEBs) and potential moderating effects of trait emotion regulation in young people from the general population. A subsample of 971 adolescents and young adults from an epidemiological cohort study reported on levels of tension and four different DEBs (skipping eating, restrained eating, eating large amounts of food, loss-of-control-eating) via ecological momentary assessment (EMA), as well as on trait emotion regulation via questionnaire. In multilevel models, momentary tension did not predict levels of subsequent DEBs. However, higher average levels of tension across the EMA period predicted higher levels of all DEBs. No interactions with emotion regulation emerged. Individuals experiencing overall higher levels of tension appear to be more prone to engaging in DEBs.

Examining the Presence, Frequency, and Associated Characteristics of Nonsuicidal Self-Injury by Proxy: Initial Validation of the Nonsuicidal Self-Injury by Proxy Questionnaire (NSSIBPQ)

Nonsuicidal self-injury (NSSI) by proxy is the intentional destruction of one's own body tissue through the elicitation of another being's actions. Despite its clinical relevance, research on NSSI by proxy is limited and there are no available measures of this behavior. This research aimed to characterize NSSI by proxy among young adults and provide preliminary data on the validity of a new self-report measure, the NSSI by Proxy Questionnaire (NSSIBPQ). Two nationwide community samples of young adults (one general community sample and one with a history of traditional NSSI and suicidality) completed online studies. NSSI by proxy was reported by 18% of the general community sample and 45% of the self-injuring sample. Findings support the clinical relevance of NSSI by proxy and its potential to meet criteria for an NSSI disorder diagnosis. Results also provide preliminary support for the internal consistency and convergent, discriminant, and concurrent validity of the NSSIBPQ.

The Development and Validation of the Difficulties in Emotion Regulation Scale-8: Providing Respondents with a Uniform Context That Elicits Thinking About Situations Requiring Emotion Regulation

Emotion regulation difficulties are associated with a range of psychological disorders. A widely used measure of emotion regulation is the Difficulties in Emotion Regulation Scale (DERS-36). There are also three shortened DERS versions. Consistent with current efforts to build very brief versions of measures, the aim of this research is to develop a briefer DERS and evaluate its construct validity. Study 1 uses IRT methods coupled with content considerations to develop a briefer unidimensional DERS. Previous attempts to shorten the DERS have not considered how frame of reference may influence responses to items. The new DERS-8 includes only items prefaced with the phrase "When I'm upset," to provide respondents with a uniform context that elicits thinking about situations requiring regulation of negative emotion; answers to items are more likely to represent affect, thought, and actions in response to such situations. Study 2 showed that the DERS-8 performed well in an IRT analysis among adolescents with psychiatric disorders and showed similar group differences, sensitivity to change, and correlations with other variables compared to existing DERS versions, in both healthy adult and clinical adolescent samples. The DERS-8 offers a very brief unidimensional measure of difficulties in emotion regulation for adolescents and adults.

A longitudinal approach to understanding boredom during pandemics: The predictive roles of trauma and emotion dysregulation

Research during the COVID-19 pandemic and prior outbreaks suggest that boredom is linked to poor compliance with critical lifesaving social distancing and quarantine guidelines, as well as to numerous mental health difficulties. As such, continued understanding on what contributes to boredom is imperative. Extending beyond the roles of constraint, monotony, and trait dispositions (e.g., individual differences in boredom propensity), and informed by prior theories on the emotional contributors of boredom, the current longitudinal study examined the predictive role of "pandemic trauma" on people's boredom, with a focus on how emotion dysregulation mediates this relationship. Community participants (N = 345) completed questionnaires three times across an average of 3 1/2 weeks, rating their pandemic trauma, emotion dysregulation, and boredom over the past week each time. Pandemic trauma was assessed with items querying exposure to coronavirus, as well as the financial, resource-related, and interpersonal pandemic stressors that participants experienced. Emotion dysregulation was assessed with the Difficulties in Emotion Regulation Scale. Boredom was assessed with the short-form Multidimensional State Boredom Scale. The results of a theory-informed mediation model showed that participants' pandemic trauma at Time 1 positively and modestly predicted their boredom at Time 3 and that this relationship was partially and moderately mediated by participants' lack of emotional clarity and difficulties with engaging in goal-directed behaviors at Time 2. When people experience pandemic-related trauma, they subsequently struggle to understand their feelings and engage in goal-oriented actions, and, in turn, feel more bored. Theoretical and clinical implications as related to the emotional underpinnings of boredom are discussed.

Exploring two models of emotion regulation: how strategy use, abilities, and flexibility relate to well-being and mental illness

BACKGROUND AND OBJECTIVES

The process model of emotion regulation (ER) focuses on strategies used to manage emotions, while the abilities model emphasizes the extent one adaptively responds to negative emotions. We sought to clarify the relationships between components of ER based on both of the abilities (i.e., dysregulation) and process (i.e., strategy use) models, as well as ER flexibility (i.e., choosing the optimal strategy for a given situation) with well-being (happiness, flourishing), internalizing symptoms (depression, anxiety), and disordered eating. Gender differences were explored.

DESIGN AND METHOD

Participants included 612 undergraduate students (M_age = 20.24) who completed questionnaires measuring ER, well-being, and mental illness. Structural equation modeling was used on cross-sectional data to explore the associations between ER and psychological outcomes.

RESULTS

Dysregulation was associated with reduced well-being and greater psychopathology. In terms of strategy use, reappraisal was related to greater well-being and fewer internalizing symptoms, while the opposite relationships were found for suppression. Suppression was also linked to disordered eating. ER flexibility was related to well-being for men only. Further, dysregulation had the largest association with all outcomes.

CONCLUSIONS

Findings suggest that ER abilities may underlie other components of ER and are most central to mental health and illness.

Factor structure and clinical correlates of the original and 16-item version of the Difficulties In Emotion Regulation Scale in adolescent girls with eating disorders

OBJECTIVES

The Difficulties in Emotion Regulation Scale (DERS) is increasingly used in adolescents. This study is the first to examine the factor structure, measurement, and structural invariance across age, reliability, and validity of the original 36-item and 16-item version of the DERS in adolescents with eating disorders.

METHODS

Several models were examined using confirmatory factor analysis. Measurement and structural invariance were studied across age groups, and Omega, Omega Hierarchical, and criterion validity were examined.

RESULTS

A bifactor model, with five subscales, showed acceptable fit in both DERS versions. Measurement and structural invariance held across age. The general factor had high reliability and accounted for a large proportion of variance in eating pathology and emotional symptoms.

CONCLUSION

The Awareness subscale had a negative effect on fit in DERS, but both DERS versions were reliable and valid measures in both younger and older adolescents with eating disorders when using only five subscales.

Questionnaires used in complex trauma intervention evaluations and consideration of their utility for autistic adults with mild intellectual disability: A systematic review

INTRODUCTION

Research suggests some trauma symptoms e.g. avoidance are difficult to recognise in autistic people with intellectual disability while arousal/emotional and interpersonal difficulties may be useful signals. This review aims to (i) identify questionnaires used in general population complex trauma interventions to measure emotional and interpersonal difficulty and (ii) evaluate their psychometric properties to inform selection of a potential measure/s for use and/or adaptation for autistic people with mild intellectual disability and trauma related mental health conditions.

METHODS

Stage 1: we searched Medline, Cinahl, Embase and PsycInfo for general population and clinical complex trauma intervention studies. Stage 2: we used a search filter in Embase to identify psychometric evaluations of relevant questionnaires used in Stage 1 studies and assessed these with the COnsensus based Standards for the selection of health based Measurement Instruments (COSMIN) checklist.

RESULTS

five studies were identified in Stage 1 utilising three measures of emotion dysregulation and interpersonal difficulties. Thirty-three articles on their psychometric properties were identified in Stage 2. Strongest psychometric evidence was found for the Emotion Regulation Questionnaire (ERQ) and Difficulties in Emotion Regulation Scale (DERS).

CONCLUSIONS

Evaluating content validity/acceptability of the ERQ and DERS for autistic people with mild intellectual disability and trauma-related mental health conditions are useful next steps.

Emotion dysregulation moderates the relationship between alcohol use and eating pathology among heavy-drinking college men

OBJECTIVES

There is limited research examining the relationship between alcohol use and eating pathology in men or factors that may moderate this association. The current study investigated the relationship between alcohol use and eating pathology, and examined emotion dysregulation as a moderator of this association, among heavy-drinking college men.

METHOD

Men mandated to receive an alcohol intervention (N = 88; average age = 19 years) completed questionnaires related to alcohol use, emotion dysregulation, and eating pathology.

RESULTS

Results demonstrated positive relationships between alcohol use and some eating pathology, and a significant interaction between alcohol use and emotion dysregulation. However, results were contrary to hypotheses, such that there was a positive relationship between alcohol use and eating pathology at low levels of emotion dysregulation.

CONCLUSION

Future studies should continue to examine the overall presentation of eating pathology in men and investigate factors that may impact the relationship between alcohol use and eating pathology.

The relationship between emotion regulation and well-being in patients with mental disorders: A meta-analysis

BACKGROUND

The importance of both specific emotion regulation strategies and overall deficits in emotion regulation in the context of psychopathology is widely recognized. Besides alleviating psychological symptoms, improving mental well-being is increasingly considered important in treatment of people with mental disorders. However, no comprehensive meta-analysis on the relationship between emotion regulation and well-being in people with mental disorders has been conducted yet.

OBJECTIVE

The aim of the current study was to synthesize and meta-analyze evidence regarding the relationship between emotion regulation and well-being in clinical samples across studies.

METHOD

A systematic literature search was conducted in PsycINFO, PubMed and Scopus and 94 cross-sectional effect sizes from 35 studies were meta-analyzed to explore this relationship. To be eligible for the meta-analysis, studies had to include a clinical sample, assess at least one specific emotion regulation strategy or overall deficits in emotion regulation and include well-being as outcome.

RESULTS

The findings showed significant small to moderate negative relationships with well-being for the strategies avoidance (r = -0.31) and rumination (r = -0.19) and positive relationships with reappraisal (r = 0.19) and acceptance (r = 0.42). Grouping together putative adaptive and maladaptive strategies revealed similar sized relationships with well-being in the expected direction. Overall deficits in emotion regulation showed a negative moderate correlation with well-being (r = -0.47). No substantial difference in relationships was found when clustering studies into hedonic and eudaimonic well-being.

CONCLUSION

Our findings suggest that emotion regulation is not merely related with psychopathology, but also with well-being in general as well as hedonic and eudaimonic well-being. Therefore, it might also be important to improve emotion regulation when aiming to improve well-being in people with mental disorders.

Emotion dysregulation as a correlate of food and alcohol disturbance in undergraduate students

Disordered eating behaviors (e.g., binge eating, food restriction, self-induced vomiting, and laxative use) as well as alcohol use and related issues are prevalent in undergraduate students and are often comorbid with one another. Recently, the unique combination of these behaviors, termed food and alcohol disturbance (FAD), has received empirical attention. FAD involves compensatory behaviors performed in preparation for, or in response to, alcohol use in order to counteract calories consumed from alcohol and/or to increase intoxication. Research on FAD is sparse; in particular, there is a lack of consensus regarding potential gender differences in FAD and a lack of knowledge concerning psychological correlates of these behaviors. Emotion dysregulation is a transdiagnostic correlate of psychopathology, including disordered eating and alcohol use, and therefore may relate to FAD. The present study used a cross-sectional design to examine associations between emotion dysregulation and FAD, as well as gender differences in this relationship, in a sample of male and female undergraduate students (N = 417; 51.8% female). There were no gender differences in FAD, and the associations between emotion dysregulation and FAD did not vary among men and women. FAD was positively associated with emotion dysregulation at the bivariate level, but emotion dysregulation was not uniquely associated with FAD after accounting for disordered eating, alcohol use and problems, and body mass index. Future research should extend the current findings by examining temporal associations between emotions, emotion dysregulation, and FAD.

Structure and validity of the Clinical Perfectionism Questionnaire in female adolescents

BACKGROUND

Perfectionism is a transdiagnostic risk factor across psychopathology. The Clinical Perfectionism Questionnaire (CPQ) was developed to assess change in order to provide clinical utility, but currently the psychometric properties of the CPQ with adolescents is unknown.

AIMS

To assess the factor structure and construct validity of the CPQ in female adolescents.

METHOD

The CPQ was administered to 267 females aged 14-19 years of age. Confirmatory factor analysis (CFA) was used to examine the validity of the two-factor model and a second-order factor model. Pearson correlations were used to evaluate the relationships between the CPQ and a wide range of measures of perfectionism, psychopathology and personality traits.

RESULTS

The study demonstrated internal consistency, construct validity and incremental validity of the CPQ in a sample of female adolescents. The CFA in the present study confirmed the two-factor model of the CPQ with Factor 1 relating to perfectionistic strivings and Factor 2 representing perfectionistic concerns. The second-order two factor model indicated no deterioration in fit.

CONCLUSIONS

The two-factor model of the CPQ fits with the theoretical definition of clinical perfectionism where the over-dependence of self-worth on achievement and concern over mistakes are key elements. The CPQ is suitable for use with female adolescents in future research that seeks to better understand the role of perfectionism in the range of mental illnesses that impact youth.

Factor Structure of the Difficulties in Emotion Regulation Scale in Treatment Seeking Adults with Eating Disorders

The Difficulties in Emotion Regulation Scale (DERS) is extensively used as a measure of emotion (dys-)regulation ability in both clinical and nonclinical populations. This is the first study to examine the factor structure of both the original 36-item and short 16-item version of the DERS in adults with eating disorders and to test measurement invariance across diagnostic subgroups. The factor structure of the scale was examined using confirmatory factor analysis in a psychiatric sample of adults with eating disorders (N = 857). Four primary factor structures were fitted to the data: (1) a unidimensional model, (2) a six-factor correlated-traits model, (3) a higher-order factor solution, and (4) a bifactor model. Measurement invariance was tested for diagnostic subgroups of anorexia nervosa and bulimia nervosa and associations between factors and eating pathology were examined in each diagnostic group. Results indicated that a modified bifactor solution fitted the data adequately for both the 36-item and 16-item version of the DERS. A general factor explained most of the variance (86%) and reliability was high for the general factor of DERS (total) but lower for the subscales. Measurement invariance of the bifactor model was supported across diagnostic subgroups and test of factor means reveled that bulimia nervosa had a higher factor mean than anorexia nervosa on the general factor. The general factor accounted for a significant proportion of variance in eating pathology. Our results support the use of the total scale of both the 36-item and 16-item version among adults with eating disorders.

Psychometric properties of the Brazilian version of the Difficulties in Emotion Regulation Scale (DERS)

Abstract Introduction: Emotion regulation can be defined as the process by which individuals manage their emotional experience. It has been demonstrated that deficits in this ability are associated with various psychiatric disorders. In this direction, the Difficulties in Emotion Regulation Scale (DERS) was developed to measure difficulties in emotion regulation. Objective: To examine the psychometric properties of the Brazilian Portuguese version of the DERS. Method: A total of 377 individuals from the general population, selected by convenience, completed a sociodemographic form, the adapted Brazilian Portuguese DERS and the Depression Anxiety Stress Scale (DASS-21). Factor structure, reliability, and concurrent validity of the adapted version of the instrument were investigated. Results: The confirmatory factor analysis replicated the six-factor structure originally proposed for the instrument and confirmed the acceptability of a hierarchical model where all DERS subscales loaded on a general emotion dysregulation factor. Internal consistency indicators had adequate values for the general factor and subscales. The positive association between DERS and DASS-21 scores supports the instrument's concurrent validity. Conclusion: These results suggest that the Brazilian version of the DERS is reliable both as a general measure of difficulties in emotion regulation and as a measure of the constituents of this construct. Future research should investigate the psychometric properties of the scale in clinical and nonclinical populations, with equal gender proportions and diverse backgrounds, and preferably employing longitudinal designs.

Überprüfung der Gütekriterien der deutschen Version der Difficulties in Emotion Regulation Scale in einer klinischen und einer Schülerstichprobe Jugendlicher

Zusammenfassung. Theoretischer Hintergrund: Viele psychische Störungen gehen mit Emotionsregulationsdefiziten einher. Fragestellung: Ziel ist die Überprüfung der Gütekriterien der deutschsprachigen Übersetzung der Difficulties in Emotion Regulation Scale (DERS) bei Jugendlichen. Methode: Die DERS und weitere Fragebögen zur Validierung wurden in einer Schülerstichprobe von 324 Jugendlichen ( M = 15.15 Jahre, SD = 1.14, 57 % weiblich) und einer klinischen Stichprobe von 97 Jugendlichen ( M = 16.25 Jahre, SD = 1.28, 83 % weiblich) erhoben. Die Faktorenstruktur wurde mit einer Konfirmatorischen Faktorenanalyse und dem ESEM-Ansatz (Exploratory Structural Equation Modeling) überprüft. Ergebnisse: Die Reliabilität der DERS war in der Schülerstichprobe und in der klinischen Stichprobe sehr gut. Der ESEM-Ansatz ergab eine Sechs-Faktoren-Lösung mit einem zusätzlichen Methodenfaktor. Schlussfolgerungen: Zusammengefasst zeigt sich die DERS als ein geeignetes Verfahren zur Erfassung von Emotionsregulationsschwierigkeiten bei Jugendlichen.

Restrictive eating is associated with emotion regulation difficulties in a non-clinical sample

The relationship between emotion regulation difficulties and restrictive eating has not been established in non-clinical samples. In this study, undergraduates (n = 98) provided information regarding general and specific emotion regulation difficulties on the Difficulties in Emotion Regulation Scale (DERS) and whether they had engaged in recent restrictive eating. Generalized linear models were used to determine if individuals endorsing versus denying recent restrictive eating differed on emotion regulation problems. Results indicated that individuals endorsing restrictive eating had elevated DERS Total (p < .001), Goals (p = .001), Impulse (p < .001), and Strategies (p < .001) scores. Results remained primarily unchanged after controlling for the related construct of dietary restraint. Findings indicate that endorsement of restrictive eating among non-clinical individuals is uniquely associated with emotion regulation deficits, especially those reflecting emotional under-control. Interventions targeting emotion regulation may enhance prevention and treatment of restrictive eating across severity.

The effects of psychotherapy treatment on outcome in bulimia nervosa: Examining indirect effects through emotion regulation, self-directed behavior, and self-discrepancy within the mediation model

OBJECTIVE

The purpose of this investigation was to examine the indirect effects of Integrative Cognitive-Affective Therapy (ICAT-BN) and Cognitive-Behavioral Therapy-Enhanced (CBT-E) on bulimia nervosa (BN) treatment outcome through three hypothesized maintenance variables: emotion regulation, self-directed behavior, and self-discrepancy.

METHOD

Eighty adults with BN were randomized to 21 sessions of ICAT-BN or CBT-E. A regression-based bootstrapping approach was used to test the indirect effects of treatment on outcome at end of treatment through emotion regulation and self-directed behavior measured at mid-treatment, as well as the indirect effects of treatment at follow-up through emotion regulation, self-directed behavior, and self-discrepancy measured at end of treatment.

RESULTS

No significant differences in outcome between treatment conditions were observed, and no significant direct or indirect effects were found. Examination of the individual paths within the indirect effects models revealed comparable treatment effects. Across treatments, improvements in emotion regulation and self-directed behavior between baseline and mid-treatment predicted improvements in global eating disorder scores but not binge eating and purging frequency at end of treatment. Baseline to end of treatment improvements in emotion regulation and self-directed behavior also predicted improvements in global eating disorder scores at follow-up. Baseline to end of treatment improvements in emotion regulation predicted improvements in binge eating and baseline to end of treatment increases in positive self-directed behavior predicted improvements in purging at follow-up.

DISCUSSION

These findings suggest that emotion regulation and self-directed behavior are important treatment targets and that ICAT-BN and CBT-E are comparable in modifying these psychological processes among individuals with BN.

Associations between emotion regulation difficulties, eating disorder symptoms, non-suicidal self-injury, and suicide attempts in a heterogeneous eating disorder sample

BACKGROUND

This study examined the associations between specific dimensions of emotion dysregulation and eating disorder (ED) symptoms and behaviors, non-suicidal self-injury (NSSI), and suicide attempts in a heterogeneous ED sample.

METHODS

Participants (N=110) completed the Difficulties in Emotion Regulation Scale (DERS), the Eating Disorder Examination Questionnaire (EDE-Q), and self-reported the presence of lifetime NSSI and a lifetime suicide attempt.

RESULTS

The EDE-Q global score, a primarily cognitive measure of ED symptoms, was significantly positively correlated with DERS strategies, clarity, and awareness subscale scores and DERS total score (ps<0.01). Only the strategies subscale was uniquely positively associated with EDE-Q global score in a multivariate regression analysis. There was no association between the frequency of binge eating or frequency of driven exercise and any of the DERS subscale scores or total score (ps>0.01). Frequency of purging was significantly, positively associated with DERS impulse subscale score and total score (p<0.01). None of the DERS subscale scores were significantly different between those with and without NSSI or between those with and without a lifetime suicide attempt (ps>0.01).

CONCLUSIONS

Findings indicate that in a heterogeneous ED sample, emotion regulation deficits are more strongly associated with cognitively-oriented symptoms of EDs than behavioral symptoms such as a binge eating, purging, driven exercise, NSSI, or suicide attempts.

Adversity, emotion regulation, and non-suicidal self-injury in eating disorders

The comorbidity between non-suicidal self-injury and eating disorder behaviors suggests that psychosocial factors may play a role in both types of behaviors. This study aimed to assess the presence of non-suicidal self-injury in 66 eating disorder patients and to analyze the associations among adversity, emotion regulation, non-suicidal self-injury, and disordered eating behavior. A total of 24 participants (36.4%) reported non-suicidal self-injury. Patients endorsing self-injury had a higher severity of disordered eating behavior. More difficulties in emotion regulation and a greater number of methods of non-suicidal self-injury were associated with a higher severity of eating pathology. Clinicians should consider these relationships in the assessment and treatment of eating disorders.

Gender differences in the relationship between impulsivity and disordered eating behaviors and attitudes

OBJECTIVE

We investigated relationships among gender, impulsivity and disordered eating in healthy college students.

METHOD

Participants (N=1223) were healthy, undergraduate men (28.5%) and women (71.5%), who completed the Barratt Impulsiveness Scale - Version 11 (BIS-11) and a four-factor version of the Eating Attitudes Test (EAT-16).

RESULTS

As predicted, mean scores on all four EAT-16 factors were significantly higher for women than for men. Attentional impulsivity was related to poorer self-perception of body shape, more dieting, and a greater preoccupation with food for the sample as a whole. Moreover, motor impulsivity was related to poorer self-perceptions of body shape and a greater preoccupation with food. However, no gender differences emerged in the relationship between impulsivity and disordered eating attitudes.

DISCUSSION

This study elucidates the role of impulsivity in disordered eating behaviors among non-clinical college students. For both women and men, attentional and motor impulsivity were related to disordered eating attitudes and behaviors. Overall, these findings suggest that different facets of impulsivity are related to disordered eating attitudes and behaviors in a non-clinical college population.

Emotion regulation in disordered eating: Psychometric properties of the Difficulties in Emotion Regulation Scale among Spanish adults and its interrelations with personality and clinical severity

Objective: The aims of the study were to (1) validate the Difficulties in Emotion Regulation Scale (DERS) in a sample of Spanish adults with and without eating disorders, and (2) explore the role of emotion regulation difficulties in eating disorders (ED), including its mediating role in the relation between key personality traits and ED severity.

Methods: One hundred and thirty four patients (121 female, mean age = 29 years) with anorexia nervosa (n = 30), bulimia nervosa (n = 54), binge eating (n = 20), or Other Specified Feeding or Eating Disorders (n = 30) and 74 healthy control participants (51 female, mean age = 21 years) reported on general psychopathology, ED severity, personality traits and difficulties in emotion regulation. Exploratory and confirmatory factor analyses were conducted to examine the psychometrics of the DERS in this Spanish sample (Aim 1). Additionally, to examine the role of emotion regulation difficulties in ED (Aim 2), differences in emotion regulation difficulties across eating disorder subgroups were examined and structural equation modeling was used to explore the interrelations among emotion regulation, personality traits, and eating disorder severity.

Results: Results support the validity and reliability of the DERS within this Spanish adult sample and suggest that this measure has a similar factor structure in this sample as in the original sample. Moreover, emotion regulation difficulties were found to differ as a function of eating disorder subtype and to mediate the relation between two specific personality traits (i.e., high harm avoidance and low self-directedness) and ED severity.

Conclusions: Personality traits of high harm avoidance and low self-directedness may increase vulnerability to ED pathology indirectly, through emotion regulation difficulties.

Emotion dysregulation, self-image and eating disorder symptoms in University Women

BACKGROUND

We studied associations between emotion dysregulation, self-image and eating disorder (ED) symptoms in university women, and contrasted two indirect effect models to examine possible intervening mechanisms to produce ED symptoms.

METHODS

252 female Swedish university students completed the Difficulties in Emotion Regulation Scale (DERS), the Structural Analysis of Social Behavior (SASB) self-image measure, and the Eating Disorder Examination Questionnaire (EDE-Q). Correlations between scales were followed by five simple mediation analysis pairs with two possible pathways using five ED symptom variables as outcome. The models posited either self-image or emotion dysregulation as mediator or independent variable, respectively. ED symptoms were EDE-Q Global score, objective binge eating episodes (OBE), subjective binge eating episodes (SBE), and two variants of EDE-Q excessive exercise.

RESULTS

Emotion dysregulation and self-image were strongly correlated, and both correlated moderately with EDE-Q Global score. There were distinct indirect effects through self-image on the relationship between emotion dysregulation and ED symptoms, but not vice versa. These indirect effects were evident in relation to cognitive ED symptoms and both OBE and SBE, but not in relation to excessive exercise.

CONCLUSIONS

Results suggest that even if closely related, emotion dysregulation and self-image both contribute unique knowledge in relation to ED symptoms. Self-image as an intervening mechanism between emotion dysregulation and ED symptoms is relevant for models of the development, maintenance and treatment of ED, as well as treatment focus.