Emotion Regulation Difficulties During and After Partial Hospitalization Treatment Across Eating Disorders☆,☆☆,☆☆☆
Section snippets
participants
The sample consisted of 241 adult patients in a partial hospital ED treatment program at the University of California, San Diego (UCSD) from February 2011 to May 2016. All participants met the 2010 draft criteria for the Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (DSM-5; American Psychiatric Association, 2013) AN, BN, or subthreshold AN or subthreshold BN as assessed by one of three facility psychiatrists via semistructured interview. Subthreshold AN was diagnosed if
Results
Demographic and clinical characteristics of the full sample at admission, discharge, and follow-up are reported in Table 1. The majority of the sample (78.8%, n = 182) self-identified as non-Hispanic. A total of 74.9% identified as Caucasian, 5.0% as Asian, 1.3% as Black, 0.4% as Native American or Alaska Native, and 18.4% as “other race.” Diagnostic groups did not differ on distributions of race (p = 0.38) or ethnicity (p = 0.96). Mood and anxiety disorders were the most common comorbidities
Discussion
The present study sought to examine changes in emotion regulation over the course of partial hospital treatment and at follow-up for adult patients with EDs. Patients with BN demonstrated significant improvements across all facets of emotion dysregulation, as measured by the DERS, from admission to discharge that were maintained over follow-up. Although patients with AN-BP demonstrated similar significant improvements in DERS Total, Nonacceptance, Impulse, Awareness, and Clarity emotion
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Cited by (20)
A systematic review and meta-analysis of intensive treatment options for adults with eating disorders
2023, Clinical Psychology ReviewWhich dimensions of emotion dysregulation predict the onset and persistence of eating disorder behaviours? A prospective study
2022, Journal of Affective DisordersCitation Excerpt :However, much of this research has been conducted in clinical samples undergoing psychological treatments. Numerous studies have shown that early improvements in global emotion regulation skills during treatment were associated with greater reductions in eating disorder symptoms in individuals with anorexia nervosa (Brown et al., 2020), bulimia nervosa (Peterson et al., 2017), and binge-eating disorder (Wallace et al., 2014). Furthermore, lower baseline levels of global emotion dysregulation scores predicted greater reductions in binge eating six months following cognitive treatments for binge-eating disorder (Anderson et al., 2020).
A review of sex differences in the mechanisms and drivers of overeating
2021, Frontiers in NeuroendocrinologyCitation Excerpt :Furthermore, preclinical studies suggest a role for corticotrophin-releasing factor in the amygdala in mediating “comfort eating” in both male and female rodents (Hu et al., 2016; Iemolo et al., 2013; Samarghandian et al., 2003). In fact, less activation of the amygdala and impaired emotional processing has been reported in patients with anorexia or that have recovered from anorexia (Bang et al., 2016; Brown et al., 2020), highlighting the role of emotional dysregulation in not only overeating but also hypophagia. Overall, these studies demonstrate the involvement of important brain networks for feeding behavior and emotion processing in emotional eaters, but sex differences remain underexplored.
Differences in the use of emotion regulation strategies between anorexia and bulimia nervosa: A systematic review and meta-analysis
2021, Comprehensive PsychiatryCitation Excerpt :Of the 33 studies reporting the use of (non-)acceptance between AN and BN patients, 8 studies found no differences in the use of this adaptive ER strategy between AN and BN patients [6,23,26,45–48] or between restrictive and binging/purging ED subtypes [27]. However, some studies did find differences on the use of acceptance: higher scores on the non-acceptance scale were found in BN (and AN-BP) patients compared to AN(−R) [8,49–52]. One study compared gender-related differences in ER and found more use of non-acceptance in BN compared to AN in a female sample, however this difference was not found in male participants [53].
Reconceptualizing emotion regulation and coping strategy usage in eating disorders research: The utility of a regulatory flexibility framework
2023, International Journal of Eating Disorders
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The authors would like to thank and acknowledge the current and past clinical staff for their clinical expertise and support of this research. We would also like to thank all of the patients that contributed to this research.
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Preparation of this manuscript was supported in part by the National Institute of Mental Health [F32MH108311] to Laura A. Berner.
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The authors declare that there are no conflicts of interest.
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Authors contributed equally.