Difficulties with positive emotion regulation in anorexia nervosa.

Abstract

Individuals with anorexia nervosa (AN) have well-documented difficulties regulating negative emotions, but less is known about positive emotion regulation in this population. To address this gap, we compared responses on the Difficulties in Emotion Regulation Scale-Positive questionnaire and the traditional DERS questionnaire (measuring negative affect dysregulation) between females with AN (n=30) and demographically-matched controls without an eating disorder history (NC; n=30) and examined relations between positive emotion regulation and clinical symptoms. Results indicated that individuals with AN demonstrated greater difficulty regulating negative (p<0.001, d=2.75) and positive (p<0.001, d=1.08) emotions compared to NC participants. Specifically, the AN group reported heightened positive emotion nonacceptance (p=0.004, d=0.78) and impulsivity (p=0.003, d=0.81). Greater positive emotion nonacceptance was associated with higher anxiety (p=0.015) and depression (p=0.022) among individuals with AN. Unexpectedly, more positive emotion impulsivity was associated with less restrictive eating in AN (p<0.001). Findings were largely maintained even after controlling for negative emotion dysregulation and psychotropic medication use. The results suggest that reducing shame related to positive emotions could improve mood in AN; alternatively, relinquishing control when experiencing positive emotion could reduce restriction. More research is warranted on positive emotion regulation as a treatment target for AN.