Emotion Dysregulation and Eating Disorder Symptoms: Examining Distinct Associations and Interactions in Adolescents

Nora Trompeter,Deborah Mitchison,Scott Griffiths,Christopher Thornton,Miriam K Forbes,Susan Byrne,Phillipa Hay,Mandy Goldstein,Christopher Basten,Marion Roberts,Kay Bussey,Alexandra Lonergan,Gabriella Heruc

doi:10.1007/s10802-022-00898-1

Abstract

Emotion dysregulation has been posited as a key transdiagnostic factor of mental health difficulties, including eating disorders. However, how this transdiagnostic factor interacts with the disorder-specific factor of weight and shape concerns remains unclear. The current study examined whether emotion dysregulation is associated with eating disorder behaviors over and above the association between weight and shape concerns and whether these two factors interacted. The current study used data from two samples, a community sample of high school students (n = 2699), and a clinical sample of adolescents receiving outpatient treatment for an eating disorder (n = 149). Participants completed self-report measures on their eating behaviors, weight/shape concerns, and emotion dysregulation. Findings showed that emotion dysregulation had a unique association with engaging in binge eating and purging (community sample only). Weight and shape concerns were found to have a unique association with engaging in binge eating, fasting, purging, and driven exercise (community sample only). Additionally, weight and shape concerns moderated the association between emotion dysregulation and the probability of engaging in binge eating and driven exercise, whereby the strongest association between emotion dysregulation and these behaviors were observed among adolescents with the lowest levels of weight and shape concerns. Regarding the frequency of eating disorder behaviors, emotion dysregulation had a unique association with severity of binge eating and fasting. Weight and shape concerns were uniquely associated with severity of fasting and driven exercise (community sample only). Findings suggest that emotion dysregulation is a distinct factor of eating disorder behaviors among adolescents.

Highlights

Association, 2013) and typically develop during adolescence (Hudson et al, 2007; Nagl et al, 2016)
In addition to examining whether emotion dysregulation is uniquely associated with eating disorder behaviors, we seek in the current study to examine whether high levels of weight and shape concerns strengthen these associations
The association between emotion dysregulation and mental health symptoms more broadly has been found to be stronger in clinical as opposed to community samples (Aldao et al, 2010). To address this gap in the literature, the current study aimed to examine whether emotion dysregulation was associated with eating disorder behaviors over and above the association between weight and shape concerns, in both a community and clinical sample of adolescents

Summary

Introduction

Association, 2013) and typically develop during adolescence (Hudson et al, 2007; Nagl et al, 2016). We have previously argued that the model should capture mood intolerance, but emotion dysregulation more broadly, and pathways should connect to other behaviors including fasting and driven exercise (Trompeter et al, 2021a) Such approaches are in line with more recent treatment models, including Integrative Cognitive-Affective Therapy (Wonderlich et al, 2008), whereby emotion dysregulation is posited as a key aspect of eating disorder behaviors. We have proposed that research should examine the interplay between emotion dysregulation (a transdiagnostic factor) and weight and shape concerns (a disorderspecific factor) when investigating eating disorder behaviors among adolescents (Trompeter et al, 2021a). In addition to examining whether emotion dysregulation is uniquely associated with eating disorder behaviors, we seek in the current study to examine whether high levels of weight and shape concerns strengthen these associations

Methods

Results

Conclusion