Low emotion differentiation: An affective correlate of binge eating?

Associations between affect dynamics and eating regulation in daily life: a preliminary ecological momentary assessment study

Disordered eating behaviors consistently associated with emotion regulation difficulties. However, most studies have focused on affect intensity without considering dynamic affective patterns. We examined these patterns in relation to daily overeating, loss of control eating (LOCE), dietary restraint, and food craving in young adults using ecological momentary assessment (EMA).Adults (N = 24) completed a 10-day EMA protocol during which they reported momentary affect and eating patterns. Generalized linear mixed-models examined each index in relation to eating variable.Higher PA instability (within-person) was associated with higher ratings of binge-eating symptoms (B = 0.15, SE = 0.06, p = 0.007). Lower NA differentiation (within-person) was associated with higher levels of food craving (B = -10.11, SE = 4.74, p = 0.033).Our results support previous findings suggesting that acute fluctuations in PA may increase risk of binge-eating symptoms. Further, inability to differentiate between momentary states of NA was associated with cravings. This study highlights the importance of examining multiple facets of NA and PA in relation to eating regulation.Trial registration: ClinicalTrials.gov identifier: NCT02945475.

Effects of scaffolding emotion language use on emotion differentiation and psychological health: an experience-sampling study

Emotion differentiation (ED) - complexity in the mental representation and description of one's emotional experiences - is important for mental health. However, less is known whether ED can be enhanced in adults. We investigated if scaffolding emotion language use during affect labelling - initial provision of emotion word prompts (close-ended) followed by free response (open-ended) - impacts ED and psychological health. Utilising a crossover design, 92 college students completed questionnaires assessing psychological health at three time-points and ecological momentary assessment of emotions, affect valence and emotional self-efficacy for 14 days. Participants were randomised to the "scaffolding" group, where they reported emotions using the close-ended (7 days) followed by open-ended (7 days) approach, or the reverse sequence (control group). We extracted two ED indices: traditional intraclass correlation coefficient from close-ended reports and novel specificity index from open-ended reports. Primary analyses examined group differences across weeks while exploratory analyses examined moment-to-moment differences using multilevel modelling. Relative to controls, the scaffolding group demonstrated greater ED during open-ended emotion reporting of negative emotions and associated shifts in negative affect and emotional self-efficacy. There were no significant group differences in psychological symptoms. Results provide preliminary evidence that scaffolding may enhance ED and have implications for psychological intervention.

The association between negative emotion differentiation and emotion regulation flexibility in daily life

Emotion differentiation emphasises labelling emotional experiences in a precise and context-sensitive way. Negative emotion differentiation (NED) has been found to be associated with mental health, where emotion regulation (ER) may act as a pathway. The current study aims to explore the association between NED and flexible ER implementation in daily life. Specifically, we examined how NED was associated with two aspects of ER flexibility: contextual synchrony and temporal ER variability. 101 college students (54% female; Mage = 20.24 years) reported their momentary emotions via a 7-day experience sampling protocol, and the intraclass correlation coefficients were calculated to reflect NED. In 10-day daily diaries, they also reported information about the most negative event during the day (i.e. event type, event intensity and ER goal) and how they regulated their emotions. The results revealed that individuals with high NED showed higher levels of synchrony between change in ER use and change in event type and ER goal. In addition, NED was positively associated with both within- and between-strategy variability in ER use. The results demonstrated that the ability to differentiate between negative emotions was related to higher ER flexibility, which shed new light on understanding the role of emotion differentiation in well-being.

The roles of negative affect and emotion differentiation in the experience of 'feeling fat' among undergraduate students: An ecological momentary assessment study

'Feeling fat' is the somatic experience of being overweight not fully explained by objective body mass. According to the body displacement hypothesis, 'feeling fat' occurs when diffuse negative emotions are projected onto the body in lieu of adaptive emotion regulation. Emotion differentiation, the ability to experience and label discrete emotions, is an important skill for adaptively addressing emotion that may reduce 'feeling fat.' We hypothesized that individuals with better negative emotion differentiation would be less likely to report 'feeling fat' when experiencing high negative emotion. We collected ecological momentary assessment data from 198 undergraduate students (52.24% female). Multilevel modeling revealed that both within-person increases in negative emotions and the tendency to experience greater negative emotion were associated with greater 'feeling fat.' Of the specific types of negative emotion, guilt and sadness predicted 'feeling fat.' Contrary to hypotheses, individuals with better emotion differentiation were more likely to report 'feeling fat' after experiencing elevated negative affect. These findings contradict the primary clinical conceptualization of 'feeling fat,' suggesting that factors beyond displacement of negative emotions onto the body may be responsible for 'feeling fat'. Results in a sample with pronounced shape/weight concern may better support the traditional clinical understanding of 'feeling fat.'

Predictors of neurofeedback treatment outcome in binge-eating disorder: An exploratory study

OBJECTIVE

Knowledge on predictors for treatment response to psychotherapy in binge-eating disorder (BED) is mixed and not yet available for increasingly popular neurofeedback (NF) treatment targeting self-regulation of aberrant brain activity. This study examined eating disorder- and psychopathology-related predictors for NF treatment success in BED.

METHOD

Patients with BED (N = 78) were randomized to 12 sessions of real-time functional near-infrared spectroscopy (rtfNIRS)-NF, targeting individual prefrontal cortex signal up-regulation, electroencephalography (EEG)-NF, targeting down-regulation of fronto-central beta activity, or waitlist (WL). The few studies assessing predictors for clinical outcomes after NF and evidenced predictors for psychotherapy guided the selection of baseline eating disorder-related predictors, including objective binge-eating (OBE) frequency, eating disorder psychopathology (EDP), food cravings, and body mass index (BMI), and general psychopathology-related predictors, including depressive and anxiety symptoms, impulsivity, emotion dysregulation, and self-efficacy. These questionnaire-based or objectively assessed (BMI) predictors were regressed on outcomes OBE frequency and EDP as key features of BED at post-treatment (t1) and 6-month follow-up (t2) in preregistered generalized mixed models (https://osf.io/4aktp).

RESULTS

Higher EDP, food cravings, and BMI predicted worse outcomes across all groups at t1 and t2. General psychopathology-related predictors did not predict outcomes at t1 and t2. Explorative analyses indicated that lower OBE frequency and higher self-efficacy predicted lower OBE frequency, and lower EDP predicted lower EDP after the waiting period in WL.

DISCUSSION

Consistent with findings for psychotherapy, higher eating disorder-related predictors were associated with higher EDP and OBE frequency. The specificity of psychopathological predictors for NF treatment success warrants further examination.

PUBLIC SIGNIFICANCE

This exploratory study firstly assessed eating disorder- and psychopathology-related predictors for neurofeedback treatment outcome in binge-eating disorder and overweight. Findings showed an association between higher eating disorder symptoms and worse neurofeedback outcomes, indicating special needs to be considered in neurofeedback treatment for patients with a higher binge-eating disorder symptom burden. In general, outcomes and assignment to neurofeedback treatment may be improved upon consideration of baseline psychological variables.

Interactions between emotions and eating behaviors: Main issues, neuroimaging contributions, and innovative preventive or corrective strategies

Emotional eating is commonly defined as the tendency to (over)eat in response to emotion. Insofar as it involves the (over)consumption of high-calorie palatable foods, emotional eating is a maladaptive behavior that can lead to eating disorders, and ultimately to metabolic disorders and obesity. Emotional eating is associated with eating disorder subtypes and with abnormalities in emotion processing at a behavioral level. However, not enough is known about the neural pathways involved in both emotion processing and food intake. In this review, we provide an overview of recent neuroimaging studies, highlighting the brain correlates between emotions and eating behavior that may be involved in emotional eating. Interaction between neural and neuro-endocrine pathways (HPA axis) may be involved. In addition to behavioral interventions, there is a need for a holistic approach encompassing both neural and physiological levels to prevent emotional eating. Based on recent imaging, this review indicates that more attention should be paid to prefrontal areas, the insular and orbitofrontal cortices, and reward pathways, in addition to regions that play a major role in both the cognitive control of emotions and eating behavior. Identifying these brain regions could allow for neuromodulation interventions, including neurofeedback training, which deserves further investigation.

The roles of negative emotion intensity, negative emotion differentiation, and self-compassion in loss of control eating

OBJECTIVE

Negative affect intensity is robustly related to binge eating, but the relationship between negative emotion differentiation (i.e., the ability to differentiate negatively-valenced emotions) and binge eating is unclear. Further, little is known about factors that might reduce emotion intensity and/or enhance emotion differentiation, thereby reducing binge eating. Self-compassion is consistently linked to less binge eating, which may be due to decreased negative affect and/or an enhanced ability to differentiate emotions. The current study examined the roles of negative emotion intensity, negative emotion differentiation, and self-compassion in binge eating using ecological momentary assessment.

METHOD

Participants were 201 university students (52.2% female) who completed questionnaires assessing affect seven times a day, and engagement in loss of control (LOC) eating episodes at the end of each day, for 10 days. The average of sadness, fear, guilt, and hostility subscales represented negative emotion intensity; intraclass correlations across negative affect subscales defined negative emotion differentiation. Both daily (i.e., within-person) and trait (i.e., between-person) emotion variables were examined as predictors.

RESULTS

Between-person negative emotion intensity, but not negative emotion differentiation, significantly predicted LOC eating occurrence. Self-compassion had a significant effect on LOC eating frequency, and this relationship was partially mediated via negative emotion intensity, but not via negative emotion differentiation.

DISCUSSION

Lower levels of negative emotion intensity partially account for the relationship between greater self-compassion and less frequent LOC eating. These findings highlight the importance of cultivating self-compassion to down-regulate negative emotions and to reduce LOC eating.

PUBLIC SIGNIFICANCE STATEMENT

Our findings suggest that university students who approach their limitations compassionately experience fewer negative emotions in daily life and engage in less loss of control eating. Lower levels of negative affect partially explain this relationship between self-compassion and loss of control eating. These results highlight the importance of cultivating an understanding and a compassionate attitude toward oneself for reducing eating pathology.

The Association of Daily Stressors and Daily Emotions to Daily Optimism

Abstract. Daily life events often trigger and co-occur with various emotional reactions, which activate self-regulatory processes. One possible outcome of self-regulatory processes is optimism. Limited research has examined optimism in daily life and potential daily predictors, including stressors, negative emotions, and positive emotions. Emotion differentiation – the ability to identify and label discrete emotional states – has the potential to change the association between daily predictors and optimism. The current study contextualized optimism in the emotion-laden daily life and examined the association of daily stressors and daily negative and positive emotional states to daily optimism and the role of negative and positive emotion regulation on these relationships. The current study adopted a daily diary design and collected self-reported daily responses from a sample of 248 college students over a 7-day study period. The results included concurrent and lagged effects and showed that daily negative affect and positive affect predicted both concurrent daily optimism and the next day’s optimism. Greater negative emotion differentiation predicted higher daily optimism. A better ability to differentiate positive emotions predicted a stronger relation between positive affect and daily optimism. The findings underscored the importance of daily affect and emotion differentiation being important markers for optimism interventions and daily practices.

From Knowledge to Differentiation: Increasing Emotion Knowledge Through an Intervention Increases Negative Emotion Differentiation

Labeling emotions with a high degree of granularity appears to be beneficial for well-being. However, there are individual differences in the level of emotion differentiation, and some individuals do not appear to differentiate much between different emotions. Low differentiation is associated with maladaptive outcomes, therefore such individuals might benefit from interventions that can increase their level of emotion differentiation. To this end, we tested the effects of an emotion knowledge intervention on the level of emotion differentiation. One hundred and twenty participants were assigned to either an experimental or a control condition. Emotion differentiation was assessed with a Scenario Rating Task before and after the intervention, and at follow-up. As predicted, negative emotion differentiation increased significantly after the emotion knowledge intervention, and this increase was not observed in the control group. Positive emotion differentiation also increased slightly; however, it did not reach significance level. This finding suggests that an emotion knowledge intervention might be beneficial for increasing negative emotion differentiation and may have implications for the clinical context.

Too hot to handle: Mood states moderate implicit approach vs. avoidance tendencies toward food cues in patients with obesity and active binge eating disorder

Patients with binge eating disorder (BED) display recurring episodes of eating large amounts of food in a short period of time, especially during negative mood states. However, the psychological processes linking negative mood to binge eating behavior have not been sufficiently explored. This study investigated the effects of experimentally inducing a negative (sad) mood state upon reaction times in a computerized Approach-Avoidance-Task (AAT) using images of foods and compared to a neutral control procedure in which negative mood was not induced. Differences in reaction times between "pulling" and "pushing away" food cues in the AAT were considered surrogates for fast, automatic (i.e., implicit) preferences ("bias") for either the approach or avoidance of foods. Obese patients with BED (n = 40), weight-matched (obese) individuals (n = 40), and norm-weight controls (n = 29) were asked to approach ("pull") or avoid ("push") images of high- and low-calorie foods following the induction of a negative mood state vs. the neutral control procedure. Sample size was within the common range of previous investigations of the kind. Similar to previous findings, obese patients with BED exhibited an avoidance bias (i.e., faster reaction times in "pushing" compared to "pulling") during the neutral control condition. However, a contrast analysis revealed that negative mood was associated with decreased avoidance bias in obese patients with BED, but not in obese and norm-weight controls. Mood status exerted no effect on BED patients' self-reported (i.e., explicit) ratings of the urge to consume foods. These findings may help to advance current understanding of how negative (sad) mood states may affect binge eating behaviors. Implications of these findings for developing novel treatment approaches are discussed.

Emotion Differentiation and Youth Mental Health: Current Understanding and Open Questions

A growing body of research identifies emotion differentiation-the ability to specifically identify one's emotions-as a key skill for well-being. High emotion differentiation is associated with healthier and more effective regulation of one's emotions, and low emotion differentiation has been documented in several forms of psychopathology. However, the lion's share of this research has focused on adult samples, even though approximately 50% of mental disorders onset before age 18. This review curates what we know about the development of emotion differentiation and its implications for youth mental health. I first review published studies investigating how emotion differentiation develops across childhood and adolescence, as well as studies testing relations between emotion differentiation and mental health in youth samples. Emerging evidence suggests that emotion differentiation actually falls across childhood and adolescence, a counterintuitive pattern that merits further investigation. Additionally, several studies find relations between emotion differentiation and youth mental health, but some instability in results emerged. I then identify open questions that limit our current understanding of emotion differentiation, including (i) lack of clarity as to the valid measurement of emotion differentiation, (ii) potential third variables that could explain relations between emotion differentiation and mental-health (e.g., mean negative affect, IQ, personality, and circularity with outcomes), and (iii) lack of clear mechanistic models regarding the development of emotion differentiation and how it facilitates well-being. I conclude with a discussion of future directions that can address open questions and work toward interventions that treat (or even prevent) psychopathology.

High emotion differentiation buffers against internalizing symptoms following exposure to stressful life events in adolescence: An intensive longitudinal study

Exposure to stressful life events is strongly associated with internalizing psychopathology, and identifying factors that reduce vulnerability to stress-related internalizing problems is critical for development of early interventions. Drawing on research from affective science, we tested whether high emotion differentiation-the ability to specifically identify one's feelings-buffers adolescents from developing internalizing symptoms when exposed to stress. Thirty adolescents completed a laboratory measure of emotion differentiation before an intensive year-long longitudinal study in which exposure to stress and internalizing problems were assessed at both the moment-level (n=4,921 experience sampling assessments) and monthly-level (n=355 monthly assessments). High negative and positive emotion differentiation attenuated moment-level coupling between perceived stress and feelings of depression, and high negative emotion differentiation eliminated monthly-level associations between stressful life events and anxiety symptoms. These results suggest that high emotion differentiation buffers adolescents against anxiety and depression in the face of stress, perhaps by facilitating adaptive emotion regulation.

Affect Dysregulation in Context: Implications and Future Directions of Experience Sampling Research on Affect Regulation Models of Loss of Control Eating

Loss of control eating is a core, transdiagnostic eating disorder symptom associated with psychological distress, functional impairment, and reduced quality of life. However, the factors that contribute to persistent loss of control eating despite negative consequences are not fully understood. Understanding the mechanisms that maintain loss of control eating is crucial to advance treatments that interrupt these processes. Affect regulation models of loss of control eating hypothesize that negative emotions trigger loss of control eating, and that loss of control eating is negatively reinforced because it temporarily decreases negative affect. Several variations on this basic affect regulation model have been proposed, including theories suggesting that negative affect decreases during loss of control eating rather than afterwards (escape theory), and that loss of control eating replaces one negative emotion with another that is less aversive (trade-off theory). Experience sampling designs that measure negative affect and eating behavior multiple times per day are optimally suited to examining the nuanced predictions of these affect regulation models in people's everyday lives. This paper critically reviews experience sampling studies examining associations between negative affect and loss of control eating, and discusses the implications for different affect regulation models of loss of control eating. The review concludes by proposing an expanded affect-focused model of loss of control eating that incorporates trait-level individual differences and momentary biological and environmental variables to guide future research. Clinical implications and recommendations are discussed.

Evidence of fNIRS-Based Prefrontal Cortex Hypoactivity in Obesity and Binge-Eating Disorder

Obesity (OB) and associated binge-eating disorder (BED) show increased impulsivity and emotional dysregulation. Albeit well-established in neuropsychiatric research, functional near-infrared spectroscopy (fNIRS) has rarely been used to study OB and BED. Here, we investigated fNIRS-based food-specific brain signalling, its association with impulsivity and emotional dysregulation, and the temporal variability in individuals with OB with and without BED compared to an age- and sex-stratified normal weight (NW) group. Prefrontal cortex (PFC) responses were recorded in individuals with OB (n = 15), OB + BED (n = 13), and NW (n = 12) in a passive viewing and a response inhibition task. Impulsivity and emotional dysregulation were self-reported; anthropometrics were objectively measured. The OB and NW groups were measured twice 7 days apart. Relative to the NW group, the OB and OB + BED groups showed PFC hyporesponsivity across tasks, whereas there were few significant differences between the OB and OB + BED groups. Greater levels of impulsivity were significantly associated with stronger PFC responses, while more emotional dysregulation was significantly associated with lower PFC responses. Temporal differences were found in the left orbitofrontal cortex responses, yet in opposite directions in the OB and NW groups. This study demonstrated diminished fNIRS-based PFC responses across OB phenotypes relative to a NW group. The association between impulsivity, emotional dysregulation, and PFC hypoactivity supports the assumption that BED constitutes a specific OB phenotype.