Emotion regulation in disordered eating: Psychometric properties of the Difficulties in Emotion Regulation Scale among Spanish adults and its interrelations with personality and clinical severity.

Ines Wolz,Zaida Agüera,Kim L Gratz,Fernando Fernández-Aranda,Roser Granero,José M Menchón,Susana Jiménez-Murcia

doi:10.3389/fpsyg.2015.00907

Abstract

Objective: The aims of the study were to (1) validate the Difficulties in Emotion Regulation Scale (DERS) in a sample of Spanish adults with and without eating disorders, and (2) explore the role of emotion regulation difficulties in eating disorders (ED), including its mediating role in the relation between key personality traits and ED severity.Methods: One hundred and thirty four patients (121 female, mean age = 29 years) with anorexia nervosa (n = 30), bulimia nervosa (n = 54), binge eating (n = 20), or Other Specified Feeding or Eating Disorders (n = 30) and 74 healthy control participants (51 female, mean age = 21 years) reported on general psychopathology, ED severity, personality traits and difficulties in emotion regulation. Exploratory and confirmatory factor analyses were conducted to examine the psychometrics of the DERS in this Spanish sample (Aim 1). Additionally, to examine the role of emotion regulation difficulties in ED (Aim 2), differences in emotion regulation difficulties across eating disorder subgroups were examined and structural equation modeling was used to explore the interrelations among emotion regulation, personality traits, and eating disorder severity.Results: Results support the validity and reliability of the DERS within this Spanish adult sample and suggest that this measure has a similar factor structure in this sample as in the original sample. Moreover, emotion regulation difficulties were found to differ as a function of eating disorder subtype and to mediate the relation between two specific personality traits (i.e., high harm avoidance and low self-directedness) and ED severity.Conclusions: Personality traits of high harm avoidance and low self-directedness may increase vulnerability to ED pathology indirectly, through emotion regulation difficulties.

Highlights

Difficulties in emotion regulation have been identified as a transdiagnostic risk factor for the development and maintenance of numerous forms of psychopathology (Aldao et al, 2010; Hechtman et al, 2013), including eating disorders (ED; Svaldi et al, 2012)
Preliminary analysis to identify possible covariates indicated that the demographic factors sex, age, and education were each significantly related to some of the dependent variables (DERS, Temperament and Character Inventory Revised (TCI-R), and Eating Disorders Inventory-2 (EDI-2)) in the whole sample and partly in the ED sample
Results of the Structural Equation Modeling (SEM) suggest that the relation of the personality traits of harm avoidance and self-directedness to ED severity is mediated by difficulties in emotion regulation

Summary

Introduction

Difficulties in emotion regulation have been identified as a transdiagnostic risk factor for the development and maintenance of numerous forms of psychopathology (Aldao et al, 2010; Hechtman et al, 2013), including eating disorders (ED; Svaldi et al, 2012). There is a lack of data on the relevance of emotion regulation difficulties to the group of patients diagnosed as Eating Disorder Not Otherwise Specified/Other Specified Eating or Feeding Disorders (EDNOS/OSFED, as characterized in the 4th and 5th editions of the Diagnostic and Statistical Manual of Mental Disorders, respectively; American Psychiatric Association, 2000, 2013) Because this category includes patients who do not meet full criteria for AN, BN, or BED, individuals included in this category may be more functional, showing subthreshold, or less severe forms of ED. The criteria for ED in general have changed and OSFED differs from EDNOS, evidence suggests emotion regulation difficulties may be just as relevant to OSFED as to the full syndrome ED

Methods

Results

Conclusion