Abstract
Background: Emotion-regulation (ER) difficulties among individuals with eating disorders (EDs) are thought to contribute to the development and maintenance of eating disorders. Aims: The present study explores the differences in ER difficulties along the eating disorders spectrum, to reveal the basing emotional mechanism in each subtype. Method: In this case-control study, 91 girls, aged 11–18, diagnosed with eating disorders (EDs) according to DSM-V (35 ANRT, 29 ANBP, and 27 BN) were compared to 41 age-matched healthy controls (HC). Comparisons between the following ER dimensions were performed: alexithymia, anxiety, depression, DERS’s components (awareness and clarity of emotional states), acceptance of emotional distress; ability to engage in goal-directed behavior and refrain from impulsive behavior as well as access to appropriate strategies that are perceived as effective to modulate the duration and/or intensity of emotional responses. Results: The overall level of eating pathology was similar in BN and ANBP and higher than the ANRT group (p<0.001). The ANBP group reported significant higher level of alexithymia and depressive symptoms than the ANRT group and similar to the BN group (p<0.001). The anxiety levels of all patient groups were similar and higher in comparison to the HC (p<0.001). ANRT group presented significantly higher levels of alexithymia, depressive symptoms, anxiety and impulse control in comparison to HC (p<0.001) and significantly lower levels of alexithymia, depressive symptoms, and impulse control in comparison to ANBP (p<0.001). ANBP reported greater ER significant difficulties than ANRT (p<0.001) indicated by greater DERS total scores and DERS subscale scores non-acceptance, clarity and impulse control. ANBP and BN did not differ from each other on the DERS total score. Conclusion: ANBP and BN seem to be originated from combination of defects in the emotional regulation as well as the impulse regulation system and both should be targeted during treatment.
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