Metacognition and emotion regulation as treatment targets in binge eating disorder: a network analysis study

Abstract Background: This study aims to examine the underlying associations between eating, affective and metacognitive symptoms in patients with binge eating disorder (BED) through network analysis (NA), in order to identify key variables that may be considered the target for psychotherapeutic interventions. Methods: One hundred and fifty-five patients with BED completed measures of eating psychopathology, affective symptoms, emotion regulation and metacognition. A cross-sectional network was inferred by means of Gaussian Markov random field estimation using graphical LASSO and extended Bayesian information criterion (EBIC-LASSO), and central symptoms of BED were identified by means of the strength centrality index. Results: Impaired self-monitoring metacognition and difficulties on impulse control emerged as the symptoms with the highest centrality. Conversely, eating and affective features were less central. The centrality stability coefficient of strength was above the recommended cut-off, thus indicating the stability of the network. Conclusions: According to present NA findings, impaired self-monitoring metacognition and difficulties on impulse control are the central nodes in the psychopathological network of BED while eating symptoms appear marginal. If further studies with larger samples replicate these results, metacognition and impulse control could represent new targets of psychotherapeutic interventions in the treatment of BED. In light of this, Metacognitive Interpersonal Therapy (MIT) could be a promising aid in clinical practice to develop an effective treatment for BED.

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Metacognition and emotional regulation as treatment targets in binge eating disorder: a network analysis study

10.21203/rs.3.rs-80617/v2 ◽

2021 ◽

Author(s):

Matteo Aloi ◽

Marianna Rania ◽

Elvira Anna Carbone ◽

Mariarita Caroleo ◽

Giuseppina Calabrò ◽

...

Keyword(s):

Eating Disorder ◽

Network Analysis ◽

Binge Eating ◽

Binge Eating Disorder ◽

Emotional Regulation ◽

Impulse Control ◽

Information Criterion ◽

Cross Sectional ◽

Self Monitoring ◽

Psychotherapeutic Interventions

Abstract Background: This study aims to examine the underlying associations between eating, affective and metacognitive symptoms in patients with binge eating disorder (BED) through network analysis (NA), in order to identify key variables that may be considered the target for psychotherapeutic interventions. Methods: One hundred and fifty-five patients with BED completed measures of eating psychopathology, affective symptoms, emotion regulation and metacognition. A cross-sectional network was inferred by means of Gaussian Markov random field estimation using graphical LASSO and extended Bayesian information criterion (EBIC-LASSO), and central symptoms of BED were identified by means of the strength centrality index. Results: Impaired self-monitoring metacognition and difficulties on impulse control emerged as the symptoms with the highest centrality. Conversely, eating and affective features were less central. The centrality stability coefficient of strength was above the recommended cut-off, thus indicating the stability of the network. Conclusions: According to present NA findings, impaired self-monitoring metacognition and difficulties on impulse control are the central nodes in the psychopathological network of BED while eating symptoms appear marginal. If further studies with larger samples replicate these results, metacognition and impulse control could represent new targets of psychotherapeutic interventions in the treatment of BED. In light of this, Metacognitive Interpersonal Therapy (MIT) could be a promising aid in clinical practice to develop an effective treatment for BED.

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The effect of cognitive symptoms in binge eating disorder on depression and self-esteem: a cross-sectional study

Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity ◽

10.1007/s40519-020-00966-9 ◽

2020 ◽

Author(s):

Selçuk Özdin ◽

Aytül Karabekiroğlu ◽

Gökhan Selçuk Özbalcı ◽

Arzu Alptekin Aker

Keyword(s):

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder ◽

Self Esteem ◽

Cross Sectional Study ◽

Cognitive Symptoms ◽

Sectional Study ◽

Cross Sectional

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Emotion regulation difficulties in binge eating disorder with and without the overvaluation of weight and shape

Psychiatry Research ◽

10.1016/j.psychres.2016.09.005 ◽

2016 ◽

Vol 245 ◽

pp. 436-442 ◽

Cited By ~ 13

Author(s):

Carmel Harrison ◽

Deborah Mitchison ◽

Elizabeth Rieger ◽

Bryan Rodgers ◽

Jonathan Mond

Keyword(s):

Emotion Regulation ◽

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder

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Prospective associations of negative mood and emotion regulation in the occurrence of binge eating in binge eating disorder

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2019.05.005 ◽

2019 ◽

Vol 115 ◽

pp. 61-68 ◽

Cited By ~ 6

Author(s):

Jennifer Svaldi ◽

Dustin Werle ◽

Eva Naumann ◽

Eva Eichler ◽

Matthias Berking

Keyword(s):

Emotion Regulation ◽

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder ◽

Negative Mood

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Micro-level de-coupling of negative affect and binge eating in relationship to macro-level outcomes in binge eating disorder treatment

Psychological Medicine ◽

10.1017/s0033291720001804 ◽

2020 ◽

pp. 1-9

Author(s):

Kathryn E. Smith ◽

Tyler B. Mason ◽

Lauren M. Schaefer ◽

Lisa M. Anderson ◽

Vivienne M. Hazzard ◽

...

Keyword(s):

Emotion Regulation ◽

Eating Disorder ◽

Negative Affect ◽

Binge Eating ◽

Binge Eating Disorder ◽

Behavioral Treatment ◽

Future Research ◽

End Of Treatment ◽

Pre Treatment

Abstract Background While negative affect reliably predicts binge eating, it is unknown how this association may decrease or ‘de-couple’ during treatment for binge eating disorder (BED), whether such change is greater in treatments targeting emotion regulation, or how such change predicts outcome. This study utilized multi-wave ecological momentary assessment (EMA) to assess changes in the momentary association between negative affect and subsequent binge-eating symptoms during Integrative Cognitive Affective Therapy (ICAT-BED) and Cognitive Behavior Therapy Guided Self-Help (CBTgsh). It was predicted that there would be stronger de-coupling effects in ICAT-BED compared to CBTgsh given the focus on emotion regulation skills in ICAT-BED and that greater de-coupling would predict outcomes. Methods Adults with BED were randomized to ICAT-BED or CBTgsh and completed 1-week EMA protocols and the Eating Disorder Examination (EDE) at pre-treatment, end-of-treatment, and 6-month follow-up (final N = 78). De-coupling was operationalized as a change in momentary associations between negative affect and binge-eating symptoms from pre-treatment to end-of-treatment. Results There was a significant de-coupling effect at follow-up but not end-of-treatment, and de-coupling did not differ between ICAT-BED and CBTgsh. Less de-coupling was associated with higher end-of-treatment EDE global scores at end-of-treatment and higher binge frequency at follow-up. Conclusions Both ICAT-BED and CBTgsh were associated with de-coupling of momentary negative affect and binge-eating symptoms, which in turn relate to cognitive and behavioral treatment outcomes. Future research is warranted to identify differential mechanisms of change across ICAT-BED and CBTgsh. Results also highlight the importance of developing momentary interventions to more effectively de-couple negative affect and binge eating.

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Examining emotion regulation in binge-eating disorder

Borderline Personality Disorder and Emotion Dysregulation ◽

10.1186/s40479-021-00166-6 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Anna Walenda ◽

Barbara Kostecka ◽

Philip S. Santangelo ◽

Katarzyna Kucharska

Keyword(s):

Emotion Regulation ◽

Eating Disorder ◽

Depressive Symptoms ◽

Binge Eating ◽

Binge Eating Disorder ◽

Emotional Regulation ◽

Emotion Regulation Strategies ◽

Self Blame ◽

Difficulties In Emotion Regulation ◽

Regulation Strategies

Abstract Background Inefficient mechanisms of emotional regulation appear essential in understanding the development and maintenance of binge-eating disorder (BED). Previous research focused mainly on a very limited emotion regulation strategies in BED, such as rumination, suppression, and positive reappraisal. Therefore, the aim of the study was to assess a wider range of emotional regulation strategies (i.e. acceptance, refocusing on planning, positive refocusing, positive reappraisal, putting into perspective, self-blame, other-blame, rumination, and catastrophizing), as well as associations between those strategies and binge-eating-related beliefs (negative, positive, and permissive), and clinical variables (eating disorders symptoms, both anxiety, depressive symptoms, and alexithymia). Methods Women diagnosed with BED (n = 35) according to the DSM-5 criteria and healthy women (n = 41) aged 22–60 years were assessed using: the Eating Attitudes Test-26, the Eating Beliefs Questionnaire-18, the Hospital Anxiety and Depression Scale, the Toronto Alexithymia Scale-20, the Cognitive Emotion Regulation Questionnaire, and the Difficulties in Emotion Regulation Scale. Statistical analyses included: Student t - tests or Mann–Whitney U tests for testing group differences between BED and HC group, and Pearson’s r coefficient or Spearman’s rho for exploring associations between the emotion regulation difficulties and strategies, and clinical variables and binge-eating-related beliefs in both groups. Results The BED group presented with a significantly higher level of emotion regulation difficulties such as: nonacceptance of emotional responses, lack of emotional clarity, difficulties engaging in goal-directed behavior, impulse control difficulties, and limited access to emotion regulation strategies compared to the healthy controls. Moreover, patients with BED were significantly more likely to use maladaptive strategies (rumination and self-blame) and less likely to use adaptive strategies (positive refocusing and putting into perspective). In the clinical group, various difficulties in emotion regulation difficulties occurred to be positively correlated with the level of alexithymia, and anxiety and depressive symptoms. Regarding emotion regulation strategies, self-blame and catastrophizing were positively related to anxiety symptoms, but solely catastrophizing was related to the severity of eating disorder psychopathology. Conclusions Our results indicate an essential and still insufficiently understood role of emotional dysregulation in BED. An especially important construct in this context seems to be alexithymia, which was strongly related to the majority of emotion regulation difficulties. Therefore, it might be beneficial to pay special attention to this construct when planning therapeutic interventions, as well as to the maladaptive emotion regulation strategies self-blame and catastrophizing, which were significantly related to BED psychopathology.

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