Emotion and eating disorder symptoms in patients with anorexia nervosa: An experimental study (original) (raw)
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The Link Between Negative Emotions and Eating Disorder Behaviour in Patients with Anorexia Nervosa
European Eating Disorders Review, 2012
Background: Several theoretical models suggest that deficits in emotional regulation are central in the maintenance of anorexia nervosa (AN). Few studies have examined how patients view the relationship between negative affect and anorectic behaviour. We explored how patients with AN manage the aversive emotions sadness, anger, fear and disgust, and how they link these experiences to their eating disorder behaviours. Methods: Qualitative data were collected through semi-structured interviews with 14 women aged 19-39 years diagnosed with AN (DSM-IV). Interviews were analyzed using Grounded Theory methods. Results: The participants tended to inhibit expression of sadness and anger in interpersonal situations and reported high levels of anger towards themselves, self-disgust and fear of becoming fat. Different emotions were managed by means of specific eating disorder behaviours. Sadness was particularly linked to body dissatisfaction and was managed through restrictive eating and purging. Anger was avoided by means of restrictive eating and purging and released through anorectic self-control, self-harm and exercising. Fear was linked to fear of fatness and was managed through restrictive eating, purging and body checking. Participants avoided the feeling of disgust by avoiding food and body focused situations. Conclusion: Treatment models of eating disorders highlight the significance of working with emotional acceptance and coping in this patient group. Knowledge about how patients understand the relationships between their negative emotions and their anorectic behaviour may be an important addition to treatment programmes for AN.
An Experimental Investigation of Verbal Expression of Emotion in Anorexia and Bulimia Nervosa
European Eating Disorders Review, 2012
Objective: This study aims to use an experimental design to investigate verbal expression of emotion in anorexia nervosa (AN) and bulimia nervosa (BN). Method: Forty-two patients with AN, 26 patients with BN and 34 healthy controls (HCs) were videoed talking about discrete emotional experiences. Talks were analysed using the Linguistic Inquiry and Word Count. Participants also completed the Emotion Regulation Questionnaire (ERQ). Results: People with AN used fewer words when describing their emotional experiences and fewer positive affect words than HCs. People with BN were indistinguishable from HCs. Both ED groups had higher scores on the suppression subscale of the ERQ compared with HCs. Suppression was negatively correlated with negative verbal expression. Discussion: This study highlights differences between AN and BN in emotion expression. It supports a model of AN, which highlights emotion inhibition as a maintaining factor of the illness. Methods of emotion regulation in EDs may contribute to increased negative mood and poorer social functioning.
The effect of suppressing negative emotions on eating behavior in binge eating disorder
Appetite, 2009
Overeating may be a consequence of the suppression of negative emotions, by depleting self-control resources. This experiment investigated whether (a) there is a causal relationship between the suppression of negative emotions, negative mood, and overeating in people with binge eating disorder (BED) and whether (b) this relationship is increased in depressed people with BED. Sixty-six women with (full and sub-threshold) BED were shown an upsetting movie and then asked either to suppress their emotions or to react naturally. Subsequently, everyone participated in a taste task. After a decline, initial mood before watching the movie was restored after eating. Depressive symptomatology was positively correlated with caloric intake. Within the clinically depressed (Beck Depression Inventory-score > 19) BED group, those who were most affected by the negative mood induction consumed the most calories. No differences were found between the two conditions with regard to caloric intake. No interaction effect was found between depressive symptoms and mood suppression. The hypothesis that suppression of negative emotion leads to overeating in (depressed) binge eaters was not born out. Overeating may serve as a means to (temporary) repair negative mood. ß
Obesity Reviews, 2015
SummaryThere is utility in understanding the antecedents of binge eating (BE), with a view to explaining poorer weight loss treatment responses in this subgroup. A systematic review was completed according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines with the aim of exploring associations between emotions and eating behaviour in a population affected by obesity and binge eating disorder (BED). A comprehensive literature search of four electronic databases (2004–2014) yielded 15 studies for inclusion. Included studies performed poorly on data quality analysis with respect to controlling for confounding variables, and sample size. Included papers largely focused on negative emotions as antecedents of BE; depression was consistently associated with a BED‐obese classification and BE. Negative mood, sadness, tension and instability of emotions were found to be antecedents of BE in an adult BED‐obese sample. However, findings were mixed regardi...
Neuropsychiatrie, 2013
Emotional aspects of anorexia nervosa: results of prospective naturalistic cognitive behavioral group therapy 1 Summary Background Anorexic girls have difficulties in handling their emotions. We examined emotional problems of adolescent girls with anorexia nervosa (AN) during the course of cognitive behavioral group therapy (G-CBT). Methods Overall, 29 girls with AN (age 13-17 years) participated in four groups of manual based G-CBT. We assessed the body mass index (BMI), eating behavior psychopathology, emotions, depression, hedonistic activities, self-care and-efficacy, social phobia, sense of coherence (SOC), and alexithymia before, during and up to 1 year after therapy. Results Out of 29, 16 (55 %, intent to treat, or 76 %, per protocol) girls were successfully treated, 5 (17 or 24 %) had a "poor outcome", and 8 (28 %) dropped out. BMI, eating behavior, mood, social anxiety, self-care, and self-efficacy persistently improved. Anorexic girls had multiple emotional deficits, low self-confidence, and exaggerated needs of control and of being accepted. Emotional deficits were resistant to change. Hedonistic activities, social skills, and recovery from depression were positive, comorbid disorders and parental psychopathology negative prognostic factors. Keywords Eating disorders • Anorexia nervosa • Emotional processing • Psychotherapeutic research • Cognitive behavioral group therapy Emotionale Aspekte der Anorexia Nervosa-Ergebnisse einer prospektiven kognitiv behavioralen Gruppentherapie Zusammenfassung Hintergrund Mädchen mit Anorexia nervosa (AN) haben Probleme im Umgang mit ihren Emotionen. Wir haben die emotionalen Probleme adoleszenter Mädchen mit AN im Rahmen einer kognitiv verhaltenstherapeutischen Gruppentherapie (G-KVT) untersucht. Methoden Insgesamt 29 Mädchen mit AN (Alter 13-17 Jahre) haben an vier Manual basierten G-KVT Gruppen teilgenommen. Wir haben Körpergewicht (Body Mass Index, BMI), essensbezogene Psychopathologie und Emotionen (Depression, Genussfähigkeit, soziale Ängste, Selbstfürsorge, Selbstwirksamkeit, Kohärenzgefühl sowie Ausdruck von Emotionen (Alexithymie)) vor, während und bis ein Jahr nach Ende der Therapie untersucht. Ergebnisse 16/29 Mädchen (55 % im Verhältnis zur Gesamtzahl bzw. 76 % nach Protokoll) beendeten die G-KVT erfolgreich, 5 Mädchen (17 bzw. 24 %) verbesserten sich nur teilweise und 8 Mädchen (28 %) beendeten die Therapie vorzeitig. BMI, Essverhalten, Stimmung, soziale Ängste, Selbstfürsorge und Selbstwirksamkeit besserten sich nachhaltig bei den erfolgreich behandelten Mädchen. Mädchen mit AN zeigten vielfache emotionale Defizite, geringes Selbstvertrauen, verstärkte Kontrollbedürfnisse sowie den großen Wunsch, akzeptiert zu werden. Emotionale Defizite zeigten sich veränderungsresistent. Besserung von Depression, Genussfähigkeit und sozialem Verhalten waren positive, komorbide Erkrankungen und elterliche Psychopathologie negative prognostische Faktoren.
Anorexia Nervosa as a Disorder of Emotion Regulation: Theory, Evidence, and Treatment Implications
This is a commentary on Haynos and Fruzzetti (2011). The commentary begins with a discussion of how emotion has been included in the conceptualization of anorexia nervosa (AN) for some time, although this has not culminated into an experimental science on somaticaffective arousal in this patient population. Important gaps in our knowledge of how individuals with AN experience signals from the body (including emotion) are highlighted, as is the lack of attention in the Haynos and Fruzzetti model to differences in emotional experience in the acute and chronic stages of the illness. Final comments are made about the focus of AN intervention, specifically how the functional significance of the symptoms can be an afterthought because of the need to restore nutrition, and the utility of identifying common and distinct processes across eating disorder diagnoses.
Orvosi hetilap, 2009
The continuum model of the eating disorders proposes that eating disorders can be described on a continuous spectrum from restrictive anorexia to stable obesity. Previous studies suggested that emotional disturbances (depression, anxiety and alexithymia), cognitive impairments and distortion of body image are frequently associated with anorexia nervosa. However, obesity is mostly regarded as a weight management problem. We investigated common deficits in cognition, emotion and body image underlying the pathology of the two extreme sides of eating spectrum (restriction and excessive eating). Neuropsychological tasks assessed cognitive deficits; questionnaires were used to evaluate mood and explicit attitudes and Affective Priming paradigm to assess implicit attitudes. Neuropsychological tasks showed common deficit in attention capacity. Obese patients, both children and adult showed impaired shifting capacity and mental rigidity associated with frontal lobe based executive functions....
Why Study Positive Emotions in the Context of Eating Disorders?
Current Psychiatry Reports, 2014
Experimental research, supported by systematic reviews, establishes that people with eating disorders have emotional difficulties in terms of recognising, regulating and expressing their emotions. These emotional difficulties contribute to poor social functioning and problems with relationships. The existing literature includes a broad range of studies, many of which have utilised self-report measures, but experimental studies of emotions in eating disorders are still limited. The primary aim of this paper is to highlight gaps in the clinical research on emotions in eating disorders, focusing on experimental investigations from our lab and highlighting potentially useful future directions for further basic research and its translation into new developments in treatment and prevention. Recent findings using experimental paradigms to study the expression of emotions along with neuroimaging research exploring differences in facial emotion processing are discussed, and clinical implications are presented.
Anorexia Nervosa : Emotion, Cognition, and Treatment
2011
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