The role of emotional intelligence and negative affect in bulimic symptomatology

Self-Esteem and Anxiety as Mediators in the Relationship Between Emotional Intelligence and Eating Disorder Symptoms

This study investigated the relationship between emotional intelligence (EI) and eating disorder symptoms (EDS) by testing the serial mediation model, with self-esteem and anxiety as mediators. A total of 923 participants (61.9% female) aged 15-60 years completed questionnaires assessing their EI, self-esteem, anxiety, and EDS. Correlational analyses were conducted to assess the relationship between the study variables, and a serial mediation analysis was conducted to test the possible mediating role of self-esteem and anxiety in the relationship between EI and EDS. Correlation analyses revealed significant bivariate relationships between EI, self-esteem, and anxiety, but no significant correlation between EI and EDS. The relationship between EI and EDS was serially mediated by self-esteem and anxiety. High levels of EI were associated with higher self-esteem, which, in turn, was associated with lower anxiety and less EDS. The results offer potential mechanisms that could explain the relationship between EI and EDS and highlight the importance of EI in regulating eating behavior through self-esteem and anxiety.

DETECTION OF EATING DISORDERS IN MALE AND FEMALE ARTISTIC GYMNASTS

The purpose of this study was to investigate the trend of eating disorders in competitive male and female artistic gymnasts. The study involved 23 male and 42 female gymnasts, aged 7-27, from sports clubs throughout Greece. The EAT-26 Diet Attitudes scale was used to investigate participants' eating habits. The data collection process included communication with sports organizations throughout Greece on the content and purpose of the research. After consultation, the questionnaire was due to the COVID-19 pandemic provided in an electronic form and also included the consent form for participation in the research. The results of the study indicated that eleven of the sixty-five gymnasts had a total score of >20 on the EAT-26, a rate higher among female gymnasts (~ 24%) compared to male gymnasts (~ 4.4%) (p <.05). Although female gymnasts develop more eating disorders and bulimia than male gymnasts, no significant differences were found in the subscales of the questionnaire (p > .05). Therefore, this finding in combination with the fact that most of the gymnasts were teenagers (15.23 ± 6.35 years old) requires particular importance and attention from coaches and the family environment.

Momentary fluctuations in emotional intelligence and stress predict changes in disordered eating

Objective: Low emotional intelligence and symptoms of disordered eating are connected, however, whether daily fluctuations in emotional intelligence predict daily changes in disordered eating symptoms has not been examined, nor has stress been explored as a potential moderator of this relationship. Participants: Participants were undergraduate students (n = 100). Methods: Participants completed baseline questionnaires, then responded to random ecological momentary assessment prompts 3 times daily for 2 weeks. Results: Results indicated that when individuals had higher momentary emotional intelligence, they had lower disordered eating at the same time point (within subjects estimate = -0.30, p < .001) and following time point (within subjects estimate = -0.08, p = 0.03). Momentary stress moderated the relationship between baseline emotional intelligence and momentary disordered eating (b = -0.02, p < .01). Conclusions: Changes in emotional intelligence predict day-to-day changes in disordered eating, and stress moderates the connection between emotional intelligence and disordered eating.

Exploring Correlates of Loss of Control Eating in a Nonclinical Sample

OBJECTIVE

Loss of control (LOC) eating has been directly related to the core aspects of the psychopathology of eating disorders and to different dimensions of emotion and behavior regulation and self-criticism. This study investigates a model representing the interplay between these dimensions to understand LOC eating among a nonclinical sample.

METHODS

A total of 341 participants, recruited in a college campus (mean age 23.21, SD = 6.02), completed a set of self-report measures assessing LOC eating, weight suppression, psychopathology of eating disorders, depression, negative urgency, emotion regulation difficulties, and self-criticism. Path analysis modeling tested a hypothesized model with 3 paths for LOC eating as follows: (1) psychopathology of eating disorders; (2) emotion and behavior regulation; and (3) interplay between these paths.

RESULTS

We found goodness-of-fit indexes to our data: χ2 = 17.11, df = 10, Comparative Fit Index (CFI) = 0.99, Tucker-Lewis index (TLI) = 0.98, Root Mean Square Error Approximation (RMSEA) = 0.045, Standardized Root Mean Square Residual (SRMR) = 0.041, suggesting that: (1) participants with higher weight suppression showed higher degrees of the psychopathology of eating disorders, which was linked to higher levels of LOC eating; (2) self-criticism was a mediator between emotion regulation and depression/negative urgency; (3) self-criticism was a mediator between emotion regulation and disorder eating, which was significantly associated with LOC eating via increased negative urgency.

CONCLUSION

Our model shows that LOC eating occurs for individuals with the psychopathology of higher eating disorders who experience depressive symptoms and act rashly under distress for their inability to cope adequately with negative feelings of self-devaluation. These findings point to the importance of negative self-evaluations and feelings of inadequacy or worthlessness to understand LOC eating among college students.

Direct and indirect effects of alexithymia on disordered eating in a non-clinical female sample: Determining the role of negative affect

BACKGROUND

Alexithymia is an independent predictor of symptoms of eating disorders, but also influences disordered eating in clinical samples indirectly via negative affect (depression and anxiety). The aim of the current work was to establish if alexithymia predicts disordered eating in a non-clinical sample directly and indirectly (via negative affect).

METHODS

A sample of healthy females (n = 248) completed measures of depression, anxiety, alexithymia, and disordered eating (drive for thinness, bulimia, and body dissatisfaction). Bias-corrected bootstrapping was used to conduct parallel mediation analyses to determine if negative affect (depression and anxiety) mediated the influence of alexithymia on disordered eating.

RESULTS

The relationship between alexithymia (difficulty identifying feelings) and drive for thinness was mediated by depression but not anxiety. The link between difficulty identifying feelings and bulimia was mediated by anxiety but not depression. The correlation between alexithymia (difficulty describing feelings) and body dissatisfaction was mediated by both depression and anxiety. However, after controlling for negative affect, difficulty identifying feelings remained an independent predictor of drive for thinness, and difficulty describing feelings remained an independent predictor of body dissatisfaction.

CONCLUSION

Facets of alexithymia (DIF and DDF) directly predict disordered eating in healthy participants as well as indirectly via depression and anxiety. These findings suggest that targeted interventions to improve the ability of individuals to identify and describe their feelings could be beneficial in reducing disordered eating, particularly in those "at risk" of developing eating disorders.

Emotional intelligence and eating disorders: a systematic review

BACKGROUND

Prior research indicates that deficits in emotional abilities are key predictors of the onset and maintenance of eating disorders (ED). As a relatively new emotion-related construct, emotional intelligence (EI) comprises a set of basic emotional abilities. Preliminary research suggests that deficits in EI are linked with disordered eating and other impulsive behaviours. Also, previous research reveals that emotional and socio-cognitive abilities, as well as ED symptomatology, varies across lifespan development. However, while the findings suggest promising results for the development of potential effective treatments for emotional deficits and disordered eating, it is difficult to summarise the relationship between EI and ED due to the diversity of theoretical approaches and variety of EI and ED measures.

OBJECTIVE

Our study, therefore, aimed to systematically review the current evidence on EI and ED in both the general and clinical populations and across different developmental stages.

METHODS

The databases examined were Medline, PsycInfo and Scopus, and 15 eligible articles were identified. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used.

RESULTS

All the studies reviewed indicated negative associations between EI and the dimensions of ED. Additionally, several mechanisms involved, namely adaptability, stress tolerance and emotional regulation were highlighted.

CONCLUSION

The systematic review suggests promising but challenging preliminary evidence of the associations between EI and the dimensions of ED across diverse stages of development. In addition, future research, practical implications and limitations are discussed.

LEVEL OF EVIDENCE I

Systematic review.

The Relationship between Emotional Intelligence, Obesity and Eating Disorder in Children and Adolescents: A Systematic Mapping Review

Eating and weight disorders often develop early in life and cause a long-standing significant health burden. Given the documented role of emotional intelligence (EI) in shaping the body image and predicting the onset of eating disorders, knowledge of the mechanisms involved in EI among youth is fundamental to designing specific interventions for screening and prevention of obesity and eating disorders (EDs). The present systematic mapping review was aimed to explore and quantify the nature and distribution of existing research investigating the impact of EI on EDs in young people. A systematic search for relevant articles was conducted using PubMed, Scopus, PsycINFO and Web of Science databases. The Appraisal tool for Cross-Sectional Studies (AXIS) was used to assess the included studies’ methodological quality. The included studies’ results were mapped based on stratification by age groups (children, preadolescents, and adolescents), population (clinical vs. non-clinical) and disordered eating outcomes. Nine studies were included, supporting the association between EI and body image dissatisfaction, ED risk and bulimic symptomatology, but not with anorexic symptoms. Research on children and clinical populations was scant. Further studies are needed to deepen the role of EI in the genesis and maintenance of EDs.

Eating Disorders among College Students in France: Characteristics, Help-and Care-Seeking

The aim of this paper was to identify the characteristics of broader categories of eating disorders (ED) and help- and care-seeking among college students. An online cross-sectional study was conducted among students of the University of Rouen-Normandy, France. The Expali-validated algorithmic tool, combining SCOFF test (Sick, Control, One stone, Fat, Food) and body mass index, was used to screen eating disorders into three diagnostic categories: restrictive eating disorders, bulimic eating disorders, and hyperphagic eating disorders. A total of 1493 college students were included; mean age was 20.1 years (SD = 1.9). The prevalence of likely cases of eating disorder was 24.8% (95% CI, 22.6-27.0). Percentage distributions of bulimic eating disorders, hyperphagic eating disorders, and restrictive eating disorders were 13.3%, 8.6%, and 2.9%, respectively. The two main resources for help-seeking in emotional stress situations were friends and family, whatever the ED. Students with eating disorders consulted their general practitioner more often for stress or anxiety than students without eating disorders: hyperphagic eating disorders (44.9%), restrictive eating disorders (35.1%), bulimic eating disorders (30.2%), and no eating disorder (20.4%) (p < 0.0001). The prevalence of healthcare renunciation was 21.9%, with a higher risk among students with bulimic eating disorders (AOR CI 95% 1.91 (1.34-2.72). The findings show one quarter of students screened positive for an eating disorder. Stress management was not necessarily different between students with eating disorders and students without eating disorders, but the former had a greater risk of renouncing treatment, especially related to a fear of seeing a general practitioner.

The Influence of Emotional Intelligence on Resilience, Test Anxiety, Academic Stress and the Mediterranean Diet. A Study with University Students

The academic transition to university is a turning point in young people’s lifestyles. However, studies to date have focused on student behaviour within the classroom context, rather than on the consequences it may have on their lifestyle. This study aims to analyze the influence of emotional intelligence of university students on their resilience, academic stress, exam anxiety, and eating habits related to the Mediterranean diet at the university stage. This study was carried out with the participation of 733 male and 614 female students from the University of Almeria, aged between 19 and 27. A structural equation model was made to explain the causal relationships between the variables. The results showed emotional intelligence positively predicted resilience. In turn, test anxiety and academic stress were negatively predicted by resilience. Finally, test anxiety and academic stress were negatively predicted by the Mediterranean diet. In short, the results of the present study have shown that academic transfer to university and grading pressure can generate maladaptive consequences for food consumption.

Emotional intelligence, empathy and alexithymia in anorexia nervosa during adolescence

PURPOSE

Socio-emotional difficulties have been observed on adult patients suffering from anorexia nervosa (AN). But researches with adolescents are scarce and non-congruent. The aim of this paper is to identify the socio-emotional difficulties that are encountered by AN during adolescence, and to isolate them from those encountered by control adolescents.

METHOD

41 AN and 38 control adolescents were assessed using the emotional quotient inventory by Bar-On, youth version (EQ-i: YV), the Toronto Alexithymia Questionnaire (TAS-20), the Interpersonal Reactivity Index (IRI), and anxiety and depression were controlled using the Hospital Anxiety and Depression Scale (HADS).

RESULTS

Personal distress remains the main difference between the two groups, even when depression and anxiety are controlled. Intrapersonal difficulties are observed in the AN group, as well as alexithymic traits.

CONCLUSION

Research on AN has to focus on the socio-emotional difficulties during adolescence, to properly identify which difficulties are linked to that life period, and which are a trait of AN.

LEVEL III

Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

Examining emotion-, personality-, and reward-related dispositional tendencies in relation to eating pathology and weight change over seven years in the Longitudinal Assessment of Bariatric Surgery (LABS) study

This study examined dispositional emotion-, personality/temperament-, and reward-related variables in relation to post-surgery eating pathology and weight-change among 107 adults who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB). As part of a prospective cohort study, annual post-surgical assessments were conducted to evaluate eating pathology, using the Eating Disorder Examination-Bariatric Surgery Version, and percent weight change from pre-surgery. Dispositional measures were administered at the 6- or 7-year assessment and included the Affect Intensity Measure, Difficulties in Emotion Regulation Scale, UPPS-P Impulsive Behavior Scale, Adult Temperament Questionnaire-Effortful Control Scale, and Sensitivity to Punishment/Sensitivity to Reward Questionnaire. Results from a series of linear mixed models revealed significant associations of emotion dysregulation, affect intensity, positive and negative urgency, effortful control, and reward sensitivity with eating pathology severity across 7 years; additionally, all but two of the subscales comprising the total scores were also significantly associated. Fewer statistically significant results were found in relation to weight change; emotion dysregulation and affect intensity (along with several subscales) were significantly associated with lower percent weight change (i.e., less weight loss), but of the reward-related and personality/temperament variables, only total effortful control emerged as significant. However, the associations of the other variables with both outcomes were consistently in the expected direction. Associations also appeared consistent across surgical procedures. Taken together, findings suggest that certain dispositional tendencies may relate to less optimal long-term outcomes following bariatric surgery and thus may be useful to assess in pre-surgical or early post-surgical evaluations to inform targeted recommendations.

A systematic review of blood-based serotonergic biomarkers in Bulimia Nervosa

Bulimia Nervosa (BN) is a serious eating disorder, which affects 0.8-2.9% of the young population. The etiology is unknown and biomarkers would support in understanding the pathophysiology of BN, and in identifying BN patients that may benefit from medical treatment. This systematic review aims to answer whether (a) BN deviate from healthy controls in terms of serotonin (5-HT) biomarkers in blood, and whether (b) blood-based 5-HT biomarkers could be used to tailor psychopharmacological treatment in BN. A literature search using PubMed, PsycINFO and Embase was done using the following search terms: "Bulimia Nervosa" AND "serotonin" AND "blood" OR "plasma" OR "serum". 32 studies were included in this systematic review. Several biomarkers and challenge tests were identified and all studies described an association with BN and dysregulation of the 5-HT system compared to healthy controls. Several studies pointed to an association also to borderline symptoms in BN. BN deviate from healthy controls in terms of 5-HT biomarkers in blood supporting an abnormal 5-HT system in BN. 5-HT biomarkers and associated methods could be used to tailor treatment in BN although as yet, most tests described are unpractical for bedside use.

'The body is a battleground for unwanted and unexpressed emotions': exploring eating disorders and the role of emotional intelligence

Emotional difficulties have been observed in individuals with eating disorders across awide range of studies, including poor interoceptive awareness, confusion of emotional states and difficulties with emotional language. Literature has linked these difficulties with emotional functioning as being an important factor related to the core aetiology ofeating disorders, however limited knowledge exists to how this impacts on professionalability to engage patients within treatment as a result of such dysfunction. Using aqualitative design this paper explores how facets of Emotional intelligence (EI) are related to the experience of an eating disorder. The study sampled a total of 32 participants with either a professional background working with eating disorders (n=27)or participants with personal lived experience (n=5), with a number of the participants (n=13) identified as having dual roles. The findings of the study show that aspects of EIsuch as emotional regulation and lack of an emotional language are considered to beat the core of the onset and maintenance of these disorders. Additional aspects of emotional awareness and expression were found to be related to treatment disengagement and difficulties. Building on previous literature, this paper found suchemotional deficits as a transdiagnostic issue rather than specifically anorexia nervosa. Furthermore, such dysfunction was seen by professionals to have a considerable impact on therapeutic relationships and successful treatment. These findings provide insight into the potential applications that EI may have in addressing aspects of theeating disorder to create better outcomes for treatment and intervention models.

Exploring the role of emotional intelligence on disorder eating psychopathology

PURPOSE

This study aims to explore the role of Emotional Intelligence (EI) and specific facets that may underpin the aetiology of disordered eating attitudes and behaviours, as a means to understand what aspects of these deficits to target within treatments.

METHODS

Participants were recruited from the UK and Ireland. Among the sample of 355 participants, 84% were women and 16% were men. Regarding age, 59% were between 18 and 29, 30% were between 30 and 49, and 11% were 50 or older. Using a cross-sectional design, participants completed the Schutte Self-Report Emotional Intelligence Test to measure levels of trait EI and The Eating Attitudes Test (EAT-26) as a measure of eating disorder risk and the presence of disordered eating attitudes.

RESULTS

EAT-26 scores were negatively correlated with total EI scores and with the following EI subscales: appraisal of own emotions, regulation of emotions, utilisation of emotions, and optimism. Also, compared to those without an eating disorder history, participants who reported having had an eating disorder had significantly lower total EI scores and lower scores on four EI subscales: appraisal of others emotions, appraisal of own emotions, regulation of emotions, and optimism.

CONCLUSIONS

Considering these findings, EI (especially appraisal of own emotions, regulation of emotions, and optimism) may need to be addressed by interventions and treatments for eating disorders.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional study.

Psychological Predictors of Unhealthy Eating Attitudes in Young Adults

The objective of this study was to determine the predictive role of psychological risk factors for restrained and compulsive eating in young women and men. We examined the relationship between resilience, impulsivity, emotional intelligence and self-esteem, and restrained and compulsive eating. It was assumed that resilience and impulsivity can directly explain unhealthy eating attitudes (restrained and compulsive: both emotional eating and external eating). The study group comprised 211 individuals (105 men and 106 women) aged 20-29, all of whom were living in southern Poland. Measures included the Resilience Measurement Scale (SPP-25), the Eysenck's Impulsivity Inventory (IVE), the Multidimensional Self-Esteem Inventory (MSEI), the Emotional Intelligence Questionnaire (INTE), and the Polish adaptation of the Dutch Eating Behavior Questionnaire (DEBQ). The statistical analysis showed significant and positive correlations between emotional eating and general self-esteem, impulsivity, and weaker (but still significant) correlations with physical attractiveness. External eating was positively and significantly correlated with impulsivity and self-esteem (including physical attractiveness). Restrained eating was also positively and significantly correlated with general self-esteem. Both types of compulsive eating attitudes (emotional and external eating) were significantly and negatively correlated with resilience. Women showed a significantly higher positive correlation between impulsivity and external eating compared to men. The level of intensity of other measures proved similar across the entire study group regardless of sex. Impulsivity had the strongest and most direct significant influence on both emotional eating and external eating, and a negative effect on emotional intelligence. Resilience proved to have a significant impact on all three examined types of eating attitude (a direct negative effect on emotional eating and external eating, and positive direct effect on restrained eating), self-esteem, and emotional intelligence. An important psychological intervening variable in generating unhealthy eating attitudes proved to be self-esteem among both men and women. Emotional intelligence, which remains correlated with resilience, proved independent, with no effect on unhealthy eating attitudes. These results suggest that preventive treatment and educational programs implemented particularly among adolescents and young adults may support development of their psychological resources.

Drunkorexia among adolescents: The role of motivations and emotion regulation

BACKGROUND

The co-occurrence of disordered eating and alcohol use and misuse has frequently been highlighted in literature.

METHOD

The first aim of the present study was to examine the association of drunkorexia with various disordered eating behaviors and alcohol consumption in a sample of male and female adolescents. The second goal was to investigate the motivations underlying drunkorexia and the third goal was to examine the relationship between drunkorexia and different dimensions of emotion regulation. One thousand adolescents (608 females and 392 males; range 16-21) completed a survey of self-report measures.

RESULTS

Results from hierarchical multiple regression analyses revealed that fasting and engaging in binge drinking and getting drunk were significant predictors of drunkorexia in both males and females; furthermore, females were found to engage in drunkorexia mainly for enhancement motives. Conversely, drunkorexia in males was significantly predicted by difficulties regulating emotions.

CONCLUSION

This research suggests that disordered eating and alcohol use similarly contribute to drunkorexia in male and female adolescents, even though highlights important gender differences.

Emotional intelligence, anxiety, and emotional eating: A deeper insight into a recently reported association?

Recent studies reported a negative association between emotional intelligence (EI: defined here as individual predispositions associated with effective identification and regulation of emotions) and emotional eating. Although theory provides some insights into how the concept represents mechanisms that may serve as protective factors, empirical evidence of the mechanism behind the association has yet to be presented. This study tested a proposed model in which anxiety levels mediate the association between emotional intelligence and emotional-eating patterns in a normative sample of women in Israel. A cross-sectional/correlational design was used to gather data from 208 generally healthy female participants who completed measures of trait emotional intelligence, anxiety, and tendency toward emotional eating, as well as demographics. Anxiety levels mediated the negative association between emotional intelligence and emotional eating. Background variables had only marginal involvement in this model. The results shed light on the mechanisms underlying the association between emotional intelligence and emotional eating. Should future studies corroborate the findings, they may serve as a basis for future screening protocols, prevention and interventions with individuals and groups at risk of EE and eating disorders.

Self-differentiation and eating disorders in early and middle adolescence: A cross-sectional path analysis

This study examines the impact of self-differentiation, alexithymia and psychological distress on eating disorder symptoms in young and middle adolescence. Four hundred fifty-one adolescents completed self-report measures. Early and middle adolescents were categorized into two groups (12-14 years and 15-17 years) to represent distinct developmental stages. Significant differences were found between younger and older adolescents. The association between low self-differentiation and both eating disorders symptoms and psychological dimensions related to eating attitudes was stronger in early adolescence than in middle adolescence. The association between low self-differentiation and eating disorder symptoms was mediated by alexithymia and psychological distress in middle adolescence. Taken together, these findings suggest that self-differentiation could be useful in understanding psychological distress and alexithymia in eating disorders.

Toward a qualitative understanding of binge-watching behaviors: A focus group approach

Background and aims Binge-watching (i.e., seeing multiple episodes of the same TV series in a row) now constitutes a widespread phenomenon. However, little is known about the psychological factors underlying this behavior, as reflected by the paucity of available studies, most merely focusing on its potential harmfulness by applying the classic criteria used for other addictive disorders without exploring the uniqueness of binge-watching. This study thus aimed to take the opposite approach as a first step toward a genuine understanding of binge-watching behaviors through a qualitative analysis of the phenomenological characteristics of TV series watching. Methods A focus group of regular TV series viewers (N = 7) was established to explore a wide range of aspects related to TV series watching (e.g., motives, viewing practices, and related behaviors). Results A content analysis identified binge-watching features across three dimensions: TV series watching motivations, TV series watching engagement, and structural characteristics of TV shows. Most participants acknowledged that TV series watching can become addictive, but they all agreed having trouble recognizing themselves as truly being an "addict." Although obvious connections could be established with substance addiction criteria and symptoms, such parallelism appeared to be insufficient, as several distinctive facets emerged (e.g., positive view, transient overinvolvement, context dependency, and low everyday life impact). Discussion and conclusion The research should go beyond the classic biomedical and psychological models of addictive behaviors to account for binge-watching in order to explore its specificities and generate the first steps toward an adequate theoretical rationale for these emerging problematic behaviors.

Emotion Regulation and Loss of Control Eating in Community-Based Adolescents

The current study investigated concurrent and prospective associations between emotion-related constructs and loss of control (LOC) eating in adolescents. Community-based females (N = 588) completed annual self-report assessments of LOC eating, emotional awareness, emotion regulation strategies, and neuroticism from ages 16 to 18 years. Linear regressions and a regression-based multiple mediation model using bootstrapping were computed to examine the relationships among emotion-related constructs and LOC eating frequency. In the concurrent model, age 18 emotional awareness and emotion regulation strategies were associated with age 18 LOC eating, F(6, 416) = 12.11, p < 0.001, accounting for 4.5 % of the variance after controlling for demographics, body mass index, and neuroticism, F change = 10.81, p < 0.001. In the prospective model, age 17 emotional awareness predicted age 18 LOC eating, F(7, 425) = 11.67, p < 0.001, accounting for 1.7 % of unique variance beyond the effects of age 16 LOC eating and age 17 demographics, body mass index, and neuroticism, F change = 4.26, p = 0.015. In the multiple mediation model, age 18 emotion regulation strategies mediated the association between age 17 neuroticism and age 18 LOC eating, indirect effect estimate = 0.003, 95 % confidence interval = 0.001-0.005, after controlling for age 16 LOC eating and age 17 demographics, body mass index, and emotion regulation variables. Results suggest that deficient emotion regulation may contribute to the onset and maintenance of LOC eating in adolescence (although effects were small), and may partially explain the well-established prospective relationship between negative emotionality and later LOC eating. Prevention and early intervention programs should seek to improve adaptive coping in at-risk populations.

Binge eating and binge drinking among adolescents: The role of drinking and eating motives

This study aimed to investigate the motivations underlying binge eating and binge drinking in a sample of 302 adolescents. Our findings showed that binge eating was significantly correlated with gender, environmental, emotional, and social eating. Hierarchical multiple regression analysis indicated that emotional and environmental eating were significant positive predictors of binge eating, whereas binge drinking was significantly correlated with enhancement, social, and coping motives. Only enhancement motives were significant predictors of binge drinking. Our results support the argument that the reasons underlying binge eating and binge drinking in adolescents may be similar and may perform the same function.

Psychometric properties of the French version of a scale measuring perceived emotional intelligence : the Trait Meta-Mood Scale (TMMS)

OBJECTIVE

The Trait Meta-Mood Scale (TMMS), a 30-item self-assessment questionnaire, has been developed to measure perceived emotional intelligence (EI) level in 3 dimensions: Attention, Clarity and Repair. This study aimed to explore the psychometric properties of the French version of this instrument.

METHOD

The instrument factor structure, normality, internal consistency, stability and concurrent validity were assessed in a sample of 824 young adults (456 female). Besides TMMS, participants completed self-assessment questionnaires for affectivity (Shortened Beck Depression Inventory, State and Trait Anxiety Inventory, Positive and Negative emotion scale), alexithymia (Bermond-Vorst Alexithymia Questionnaire-B) and interpersonal functioning (Empathy Quotient). Discriminant validity was tested in 64 female patients with anorexia nervosa, identified in literature as having difficulties with introspection, expression and emotional regulation.

RESULTS

Confirmatory factor analysis results replicate the 3-factor structure. Internal consistency and reliability indices are adequate. Direction and degree of correlation coefficients between TMMS dimensions and other questionnaires support the instrument concurrent validity. TMMS allows to highlight differences in perceived EI levels between men and women (Attention: p < 0.001 ; Clarity: p < 0.05) as well as between patients with anorexia nervosa and control subjects (p < 0.001 for all 3 dimensions).

CONCLUSION

This first validation study shows satisfying psychometric properties for TMMS French version.

Emotions and Emotion Regulation in Breast Cancer Survivorship

Emotional distress in cancer patients is an important outcome; however, emotional experience does not begin and end with emotion generation. Attempts to regulate emotions may lessen their potentially negative effects on physical and psychological well-being. Researchers have called for the study of emotion regulation (ER) in health psychology and psycho-oncology. Thus, this review has three aims. First, we discuss current understandings of emotion and ER across the cancer trajectory, including the principles of ER and methods for its assessment. Second, we present a model for examining the mediating effects of ER on psychosocial outcomes. Third, we “round out” the discussion with an example: new data on the role of ER in recurrent breast cancer. Taken together, these aims illustrate the impact of affective regulatory processes on cancer patients’ long-term outcomes. As survival rates increase, long-term follow-up studies are needed to characterize the dynamic, reciprocal effects of emotion and ER for cancer survivors. Further research on ER may help women with breast cancer better manage the challenges associated with diagnosis and treatment.

Alterations in emotion generation and regulation neurocircuitry in depression and eating disorders: A comparative review of structural and functional neuroimaging studies

Major depression and eating disorders (EDs) are highly co-morbid and may share liability. Impaired emotion regulation may represent a common etiological or maintaining mechanism. Research has demonstrated that depressed individuals and individuals with EDs exhibit impaired emotion regulation, with these impairments being associated with changes in brain structure and function. The goal of this review was to evaluate findings from neuroimaging studies of depression and EDs to determine whether there are overlapping alterations in the brain regions known to be involved in emotion regulation, evidence of which would aid in the diagnosis and treatment of these conditions. Our review of the literature suggests that depression and EDs exhibit common structural and functional alterations in brain regions involved in emotion regulation, including the amygdala, ventral striatum and nucleus accumbens, anterior cingulate cortex, insula, and dorsolateral prefrontal cortex. We present preliminary support for a shared etiological mechanism. Future studies should consider manipulating emotion regulation in a sample of individuals with depression and EDs to better characterize abnormalities in these brain circuits.

The role of sensation seeking and motivations for eating in female and male adolescents who binge eat

OBJECTIVES

Although different personality traits have been associated with the onset and maintenance of binge eating, the role of sensation seeking is still not well documented. The aim of the present study was to investigate the role of sensation seeking and motivations for eating in male and female adolescents who binge eat.

METHODS

336 adolescents (196 boys and 140 girls, mean age 17.48) completed a survey composed of Binge Eating Scale, Motivation for Eating Scale, and Brief Sensation Seeking Scale.

RESULTS

Our results showed that for female adolescents, binge eating was significantly correlated with age, body mass index (BMI), Environmental and Emotional Eating. Hierarchical multiple regression analysis indicated that BMI was a significant positive predictor of binge eating; Emotional and Physical Eating accounted for 34% of the variance. For male adolescents, binge eating was significantly correlated with age, BMI, Boredom susceptibility, Experience seeking, environmental, Social and Emotional Eating. The most significant variables that contribute to binge symptoms, were age and BMI (that accounted for 16% of the variance), Experience seeking and Boredom susceptibility (11%) and emotional eating (18%).

CONCLUSIONS

Our results provided support for emotional motivations as significant triggers for binge eating behavior in both male and female adolescents. Although two sensation seeking dimensions were significant predictors of binge eating in males, sensation seeking was not associated to binge eating in the female subsample.

Integrating emotion regulation and emotional intelligence traditions: a meta-analysis

Two relatively independent research traditions have developed that address emotion management. The first is the emotion regulation (ER) tradition, which focuses on the processes which permit individuals to influence which emotions they have, when they have them, and how they experience and express these emotions. The second is the emotional intelligence (EI) tradition, which focuses—among other things—on individual differences in ER. To integrate these two traditions, we employed the process model of ER (Gross, 1998b) to review the literature on EI. Two key findings emerged. First, high EI individuals shape their emotions from the earliest possible point in the emotion trajectory and have many strategies at their disposal. Second, high EI individuals regulate their emotions successfully when necessary but they do so flexibly, thereby leaving room for emotions to emerge. We argue that ER and EI traditions stand to benefit substantially from greater integration.

Psicodinâmica dos transtornos alimentares: indicadores do Teste das Pirâmides Coloridas de Pfister

É amplamente reconhecida a influência de fatores emocionais na gênese e manutenção dos transtornos alimentares (TAs). Este estudo teve como objetivo analisar o funcionamento lógico e afetivo de pessoas com diagnóstico de TAs. Participaram do estudo 27 pacientes (23 mulheres, média de idade de 17,5 anos, a maioria com bulimia nervosa). O instrumento utilizado foi o Teste das Pirâmides Coloridas de Pfister. Os dados foram cotados segundo recomendações da literatura. Os resultados evidenciaram que os aspectos racionais apresentam um padrão de boa capacidade de organização. Quanto aos aspectos emocionais, observou-se uma desregulação dos mecanismos de controle eficiente dos afetos e impulsos. Por não suportarem os estados de ansiedade decorrentes do descontrole dos afetos, os participantes denegam seus impulsos, gerando uma estabilidade emocional precária que dificulta a elaboração dos conflitos. Evidenciou-se o comprometimento psíquico no grupo investigado e, por conseguinte, a necessidade de oferecer acompanhamento psicológico conjugado com reabilitação nutricional.

Emotional dysregulation and anxiety control in the psychopathological mechanism underlying drive for thinness

Emotional dysregulation is a process which consists in mitigating, intensifying, or maintaining a given emotion and is the trigger for some psychological disorders. Research has shown that an anxiety control plays an important role in emotional expression and regulation and, in addition, for anorexia nervosa (AN) and, more in general, in drive for thinness. Scientific literature suggests that in AN there is a core of emotional dysregulation and anxiety control. The aim of this study is to explore the roles of emotional dysregulation and anxiety control as independent or third variables in a mediational regression model related to drive for thinness. One hundred fifty-four clinical individuals with anorexia participated in the study and all completed a set of self-report questionnaires: eating disorders inventory version 3 (EDI-3), DERS, and the anxiety control questionnaire. The data confirmed a mediational model in which the relation between emotional dysregulation and drive for thinness is mediated by anxiety control. The current study partially supports a clinical model in which emotional dysregulation is a distal factor in eating disorders while the mediator variable anxiety control is a proximal factor in the psychopathological process underlying it.

The role of trait and ability emotional intelligence in bulimic symptoms

Bulimia is characterized by poor affect regulation, yet the role of emotional intelligence (EI) is little understood. This study examined associations between EI and bulimic symptoms using 235 women from community and student populations. They completed measures of trait and ability EI, and the Eating Disorders Diagnostic Scale. Results showed that deficiencies in different aspects of trait EI and/or ability EI are a function of symptom type: binge eating, compensatory behaviours or weight and shape concerns. Consistent with affect regulation models, self-regulatory aspects of trait EI were related to two bulimic symptoms: binge eating and weight and shape concerns. Ability-based self-emotion management was not important, and explanatory power of lower-level EI facets (traits or abilities) was not superior to more broadly defined EI factors. Results support the conclusion that trait and ability EI may maintain subclinical levels of bulimic symptoms but have different paths.

Altered brain reward circuits in eating disorders: chicken or egg?

The eating disorders anorexia nervosa (AN) and bulimia nervosa (BN) are severe psychiatric disorders with high mortality. Our knowledge about the neurobiology of eating disorders is very limited, and the question remains whether alterations in brain structure or function in eating disorders are state related, remnants of the illness or premorbid traits. The brain reward system is a relatively well-characterized brain circuitry that plays a central role in the drive to eat and individuals with current or past eating disorders showed alterations in those pathways compared to controls. Here we propose that structural and functional alterations in the insula and frontal cortex, including orbitofrontal and cingulate regions, areas that contribute to reward and anxiety processing, could predispose to developing an eating disorder and that adaptive changes in those circuits in response to malnutrition or repeated binge eating and purging could further promote illness behavior, hinder recovery and contribute to relapse.

Emotional intelligence, personality, and gender as factors in disordered eating patterns

We examined the hypotheses that proposing higher levels of emotional intelligence (ability test and self-report) and lower neuroticism, extraversion, and agreeableness associate with lower levels of disordered eating. In a correlational study, 126 Israeli college students completed two measures of emotional intelligence, a brief five-factor personality test, demographic data questionnaires, and questionnaires assessing food preoccupation, namely, the Body Weight, Image and Self-Esteem Scale and the Appearance Schema Inventory. Results suggested that ability emotional intelligence is associated with disordered eating beyond gender and personality. Self-reported emotional intelligence did not associate with any of the outcomes after controlling for personality. Implications and applications are briefly discussed.

Alexithymia and eating disorders: a critical review of the literature

Alexithymia is characterized by difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. A number of theoretical models have suggested that individuals with eating disorders may find emotions unacceptable and/or frightening and may use their eating disorder symptoms (i.e., restricting food intake, bingeing, and/or purging) as a way to avoid or cope with their feelings. The current critical review synthesizes the literature on alexithymia and eating disorders and examines alexithymia levels across eating disorders (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified), the role of alexithymia in binge eating disorder, and the influence of alexithymia on the development of eating disorders as well as treatment outcome. The clinical implications of the research conducted to date and directions for future research are discussed.

Academic examination stress increases disordered eating symptomatology in female university students

BACKGROUND

It is well documented that stress and anxiety can affect eating behaviour and food intake in humans. The purpose of the current study was to explore the possible effect of academic examination stress on disordered eating attitudes, emotional eating, restraint eating, body image, anxiety levels and self-esteem in a group of female university students. The interrelationships of the above parameters were also examined.

METHODS

Sixty Greek female university students, 18-25 years old, have been recruited and completed, on two separate occasions: a) during an examination stress period, and b) during a control period, the following questionnaires: the Eating Attitudes Test (EAT-26), the Dutch Eating Behavior Questionnaire (DEBQ), the State-Trait Anxiety Inventory (STAI), the Rosenberg Self- Esteem Scale, the Body Image Pictorial Instrument Scale (COLLINS) and a specially designed General Background Questionnaire.

RESULTS

Subjects reported significantly higher levels of disordered eating attitudes (EAT-26, p=0.01), higher levels of anxiety (p=0.000) and lower levels of self-esteem (p=0.016) during the examination stress period compared to the control period. Disordered eating attitudes (EAT-26) were significantly positively correlated with emotional eating (p=0.04) and restrained eating (p=0.010) and negatively correlated with levels of self-esteem (p=0.05) and perceived desired body image (p=0.008) during the exam stress period. Finally, EAT-26 was significantly positively correlated with levels of anxiety in both study periods.

CONCLUSION

Academic examination stress seems to increase disordered eating symptomatology in female university students and is associated with lower levels of self-esteem, an important finding which warrants further investigation.

Advances in the diagnosis of anorexia nervosa and bulimia nervosa using brain imaging

INTRODUCTION: Anorexia and bulimia nervosa are severe psychiatric disorders and the availability of brain imaging techniques hold promise that those techniques will be useful in clinical practice. AREAS COVERED: In this review I describe currently available brain imaging techniques and focus on the brain imaging methods functional magnetic resonance imaging (fMRI) and positron emission tomography (PET). Those techniques have helped describe alterations in brain circuitry in AN and BN that related to anxiety and reward processing. Novel computational models help further define brain function in relation to particular neurotransmitters. EXPERT OPINION: Brain imaging techniques are exciting methods to learn about brain function and progress has been made to identify in healthy populations brain circuits that code behaviors. These techniques have been used in AN and BN over the past decade and have improved our understanding of brain function in those disorders. Still, human brain imaging is not at a point yet where it could be used diagnostically. However, with the refinement of imaging hardware as well as improved models that describe brain function we will get closer to our aims to not only better understand the neurobiology of those disorders, but predict illness development, treatment response and long term prognosis.

Avaliação psicológica de pacientes com anorexia e bulimia nervosas: indicadores do Método de Rorschach

Este estudo teve por objetivo avaliar o funcionamento lógico, afetivo e a adaptação social de pacientes com Anorexia Nervosa (AN) e Bulimia Nervosa (BN). A amostra foi composta por 27 participantes. Para coleta dos dados foi utilizado o Método de Rorschach. Os dados foram codificado e interpretados segundo as normas da Escola Francesa. Os resultados indicaram que os participantes apresentam capacidade produtiva e desejo de estabelecerem relacionamentos afetivos. Todavia, são facilmente invadidos por uma carga de afetos que não conseguem modular, o que os predispõe ao isolamento social, que gera acúmulo de inquietações e ansiedades introjetadas. A incapacidade de elaborar a tensão interna resultante os leva a escoar a ansiedade pela via somática. Evidenciou-se o comprometimento das funções psíquicas dos pacientes com AN e BN, o que indica a necessidade de acompanhamento psicoterapêutico integrado à assistência da equipe multiprofissional.

Heightened fear of uncertainty in anorexia and bulimia nervosa

OBJECTIVE

To test whether intolerance of uncertainty (IU) is related to eating disorder (ED) pathology.

METHOD

Thirty individuals with anorexia nervosa (AN), 19 with bulimia nervosa (BN), and 28 healthy control women (CW) completed the Intolerance of Uncertainty Scale (IUS).

RESULTS

AN and BN groups showed higher IU compared with CW. In AN and BN, Harm Avoidance and Depression scores were positively correlated with IU. In AN but not BN, IU was related positively to Drive for Thinness and Body Dissatisfaction.

DISCUSSION

Elevated IU is associated with AN and BN. Anxious traits may be inherent in EDs and IU could be a developmental factor contributing to anxiety, mood, and ED behavior in AN and BN.

The effects of serotonin transporter promoter and monoamine oxidase A gene polymorphisms on trait emotional intelligence

OBJECTIVE

The purpose of this study was to evaluate the influences of major serotonin-related genetic variants of the serotonin transporter-linked promoter region (5-HTTLPR), tryptophan hydroxylase 1 gene (TPH1) and monoamine oxidase A gene (MAOA-EcoRV) on trait emotional intelligence (EI).

METHODS

The Trait Meta-Mood Scale (TMMS) measuring trait EI and genotyping were performed in 336 healthy Korean college students (204 males, 132 females).

RESULTS

Among the male participants, those with the T genotype of MAOA (lower MAOA activity) had significantly lower subscale scores on the TMMS than those with the C genotype (higher MAOA activity) did. Additionally, male participants with the s/s genotype of the 5-HTTLPR gene had significantly lower attention subscale scores and total TMMS scores than those with the non-s/s (l/l + l/s) genotypes did. Among the female participants, there were no associations between any of the 5-HTTLPR, TPH1 or MAOA-EcoRV polymorphisms and any of the TMMS scores.

CONCLUSION

These findings suggest a potential genetic basis of EI with regard to attention to one's own feelings involving the serotonin system in males.

Emotion regulation moderates relationships between body image concerns and psychological symptomatology

The study investigated the moderating role of emotion regulation (ER) in relationships between body image concerns and psychological symptomatology. A community sample of 533 boys and girls (11-20 years) completed measures assessing body image thoughts and feelings, domain-specific and general ER strategies, drive for thinness, and bulimic, depressive and anxiety symptoms. Results indicated that ER moderated relationships between body image concerns and both bulimic and depressive symptoms, but not relationships between body image concerns and drive for thinness or anxiety symptoms. Adolescents who reported frequent body image concerns were more likely to have higher levels of bulimic symptoms if they tended to use avoidance and internal dysfunctional ER strategies. Furthermore, adolescents who reported frequent body image concerns were more likely to have higher levels of depressive symptoms if they used positive rational acceptance and internal functional strategies infrequently. Implications of the findings for prevention and intervention are discussed.

Emotion dysregulation and negative affect: association with psychiatric symptoms

OBJECTIVE

A growing body of research focuses on the development and correlates of emotion dysregulation, or deficits in the ability to regulate intense and shifting emotional states. Current models of psychopathology have incorporated the construct of emotion dysregulation, suggesting its unique and interactive contributions, along with childhood disruptive experiences and negative affect, in producing symptomatic distress. Some researchers have suggested that emotion dysregulation is simply a variant of high negative affect. The aim of this study was to assess the construct and incremental validity of self-reported emotion dysregulation over and above childhood trauma and negative affect in predicting a range of psychopathology.

METHOD

Five hundred thirty individuals aged 18 to 77 years (62% female) were recruited from the waiting areas of the general medical and obstetric/gynecologic clinics in an urban public hospital in Atlanta, Georgia. Participants completed a battery of self-report measures obtained by interview, including the Childhood Trauma Questionnaire, the Positive and Negative Affect Schedule, and the Emotion Dysregulation Scale. Regression analyses examined the unique and incremental associations of these self-report measurements of childhood traumatic experiences, negative affect, and emotion dysregulation with concurrent structured interview-based measurements of psychiatric distress and history of self-destructive behaviors. These measures included the Clinician-Administered PTSD Scale, the Alcohol Use Disorders Identification Test, the Short Drug Abuse Screening Test, the Beck Depression Inventory, and the Global Adaptive Functioning Scale from the Longitudinal Interval Follow-Up Evaluation. The presented data were collected between 2005 and 2009.

RESULTS

Regression models including age, gender, childhood trauma, negative affect, and emotion dysregulation were significantly (P ≤ .001) associated with each of the study's criterion variables, accounting for large portions of the variance in posttraumatic stress symptoms (R² = 0.21), alcohol and drug abuse (R² = 0.28 and 0.21, respectively), depression (R² = 0.55), adaptive functioning (R² = 0.14), and suicide history (omnibus χ² = 74.80, P < .001). Emotion dysregulation added statistically significant (P < .01) incremental validity to each regression model (β = 0.25, 0.34, 0.35, 0.34, and -0.18, and Wald = 24.43, respectively).

CONCLUSIONS

Results support the conceptualization of emotion dysregulation as a distinct and clinically meaningful construct associated with psychiatric distress that is not reducible to negative affect. Emotion dysregulation is a key component in a range of psychiatric symptoms and disorders and a core target for psychopharmacologic and psychosocial treatment interventions.

Reliability Generalization

The assessment of positive affect (PA) and negative affect (NA) by means of the Positive Affect and Negative Affect Schedule has received a remarkable popularity in the social sciences. Using a meta-analytic tool—namely, reliability generalization (RG)—population reliability scores of both scales have been investigated on the basis of a random effects model in 147 studies. Correcting for measurement errors, the results demonstrate moderate to high internal consistency coefficients and variations of the PA and NA reliability scores with regard to time frame instructions, language of items, and sample characteristics. The percentage of PA and NA true score variance differs in subpopulations up to 11%. RG analysis of test–retest coefficients illustrates state-like fluctuations and trait-like stability of both scales. Calculations of the fail-safe number point at the robustness of the results. Applications of RG coefficients compared to single-study coefficients highlight the relevance of population coefficients for research and assessment situations.

Psychosocial characteristics in relation to disordered eating attitudes in greek adolescents

The study explores possible links between eating attitudes in Greek adolescents and certain psychosocial characteristics such as self-esteem, empathy and anxiety. A total of 202 students (109 boys and 93 girls), 15-18 years old, have been recruited. The following questionnaires were used: the Eating Attitudes Test (EAT-26), the State-Trait Anxiety Inventory, the Self-Perception Profile for Adolescents, the Multidimensional Body-Self-Questionnaire-Overweight Preoccupation and the Index of Empathy of Children and Adolescents. The EAT-26 revealed that 18.3% of the total sample of students (12.8% of boys and 24.7% of girls) reported having disordered eating attitudes. Adolescents with disordered eating attitudes had significantly higher levels of anxiety and scored less in self-reported physical appearance and romantic appeal. Empathy and global self-esteem did not differ significantly between the two groups. Adolescents with disordered eating attitudes have certain psychosocial characteristics which differentiate them from the students with healthier eating attitudes.

Emotional intelligence and addictions: a systematic review

Since the millennium, an expanding number of research articles have examined the relationship between emotional intelligence (EI) and physical and mental health. The relationship between EI and addictive disorders has, however, remained relatively well-hidden. We therefore systematically reviewed and critically evaluated the literature on this relationship. We identified 51 articles on the topic of which 36 fulfilled our inclusion criteria. Results indicate that a lower level of EI is associated with more intensive smoking, alcohol use, and illicit drug use and two components of EI play a key role in addictions: "decoding and differentiation of emotions" and "regulation of emotions."

Emotion dysregulation as a mechanism through which parental magnification of sadness increases risk for binge eating and limited control of eating behaviors

The present study examined whether emotion dysregulation mediates the relation between parent responses to emotion and disordered eating behaviors (e.g., binge eating and compensatory actions). One hundred eighteen college students (48% racial/ethnic minority; mean age=21) reported on their current difficulties regulating emotions, current disordered eating behaviors, and perceptions of their parents' responses to their emotions when they were growing up. Five parental response types to two emotions and three types of disordered eating behaviors (i.e., binge eating, compensatory actions, and lack of control) were assessed. Difficulties regulating emotion partially mediated the relation of parental magnification of sadness (i.e., matching with greater intensity) to binge eating and limited control of eating behaviors. This study identified a specific parenting practice which may contribute to the development of disordered eating behaviors and a potential mechanism to explain this relation. These findings also highlight family emotion-related processes as important for better understanding disordered eating behaviors.