Emotion Regulation Strategies In Binge Eating Disorder: Rumination, Distress Tolerance, And Expectancies For Eating
Binge Eating Disorder (BED) is characterized by recurrent episodes of binge eating without the use of compensatory behaviors. Functional accounts of BED propose that negative affect is an antecedent to binge eating because binge eating serves to alleviate negative affect. However, previous studies investigating the association between negative affect and binge eating have yielded inconsistent findings, perhaps due to individual vulnerability factors that moderate the effects of negative affect on binge eating behavior. As one candidate, the current study investigated emotion regulation strategies that may be implicated in the maintenance of binge eating in BED, particularly under conditions of negative affect: brooding rumination, distress tolerance, and mood-related expectancies for eating. These emotion regulation strategies were: a) compared in 38 women with BED vs. 36 non-eating disordered female controls, b) examined in relation to markers of current binge eating severity among BED women, and c) used as predictors of caloric intake and urge to eat in response to a personally-relevant dysphoric mood induction upon presentation of snack foods in a "taste task." Results revealed that women with BED endorsed higher brooding rumination, more positive expectancies that eating serves to ameliorate negative affect, and lower distress tolerance than controls. Among women with BED, higher brooding rumination was associated with greater binge eating severity, and stronger expectancies that eating reduces negative affect were associated with more frequent binge eating episodes and greater urge to eat in response to depression. Surprisingly, better distress tolerance was associated with more frequent binge eating episodes. Women with BED consumed more calories and reported greater loss of control as well as a greater sense of guilt in response to the taste task relative to control participants. Contrary to hypothesis, there were no direct or indirect effects of any of the three emotion regulation strategies on change in urge to eat or calories consumed on the taste task following sad mood induction in BED women. In controls, better distress tolerance and stronger expectancies that eating alleviates negative affect were associated with decreased caloric intake on the taste task after mood induction. Overall, these findings highlight the importance of considering trans-diagnostic processes in BED as well as the need to identify other theoretically-relevant factors that contribute to the cognitive and behavioral features of BED. Limitations and directions for future studies are discussed.