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Added to Registry. Dialectical behavior therapy DBT was expressly developed to help people better regulate their emotions. While first conceived to help people struggling with borderline personality disorder, a mental health condition defined by extreme emotion dysregulation, the therapy has since been adapted to help people with eating disorder diagnoses.

While DBT aims to help individuals develop a more balanced relationship with their emotions, it can also help address the complex psychological issues that are often at the heart of eating disorders. This approach operates on the idea that unhelpful behaviors stem from unhelpful thoughts.

It helps individuals learn to first identify, then redirect, and, eventually, change these unhelpful thoughts, which hopefully leads to a positive change in behavior.

When used to treat emotional dysregulation, this approach can help individuals identify and change the thoughts and behaviors contributing to their emotional distress. The hope is that learning to identify these patterns can help someone more clearly understand their reactions and more effectively manage their emotions.

In particular, CBT is commonly used for treating emotional dysregulation associated with an array of eating disorders, anxiety disorders, and other mood disorders. Rather than attempting to stop or change certain thoughts or thought patterns, the method instead encourages patients to understand and accept their less-pleasant thoughts as part of a normal spectrum of emotions.

The energy that would be used to redirect these thoughts is then instead directed toward building healthier and more positive hobbies, habits, and interests. This newfound psychological space is then used to help them have more measured, healthy, and positive reactions to situations.

The strategy has also been found to increase psychological flexibility, which is an underlying factor of many eating disorders and mental disorders in general.

These conditions are dangerous, and can be deadly if left untreated. This can include your primary care physician, therapist, psychiatrist, or another trusted medical professional. These experts are often educated in a number of disordered eating and mental health conditions, and they can help assess symptoms, make an official diagnosis, or recommend the best next steps for finding treatment.

These services are generally free and almost always anonymous, providing additional information and resources on certain eating disorder behaviors, emotion regulation strategies, and ideas on where to find help. Regardless, finding support for emotional dysregulation and eating disorders is essential for recovery.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals. We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors.

If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help. Updated on September 19, , on EatingDisorderHope. The information contained on or provided through this service is intended for general consumer understanding and education and not as a substitute for medical or psychological advice, diagnosis, or treatment.

All information provided on the website is presented as is without any warranty of any kind, and expressly excludes any warranty of merchantability or fitness for a particular purpose.

Need Help - Find A Treatment Program Today. This entry was posted in Eating Disorder Discussions , Featured on Sep 19 by Chandler. What is Emotion Dysregulation? These reactions can manifest in a number of ways, including: Intense emotions: Anger, anxiety, sadness, or irritability are common emotional reactions, which may come on quickly and powerfully and feel difficult to manage.

Impulsivity: Difficulties in emotion regulation often lead to impulse control difficulties, which can take the form of abrupt or even involuntary decisions or behaviors. Emotion regulation difficulties: Individuals experiencing emotional dysregulation tend to struggle with controlling their emotional responses in social situations, or may lack emotional awareness of their own reactions.

Signs and Symptoms of Emotional Dysregulation While the outward signs of emotion dysregulation may be easier to spot, the condition can also lead to a number of more private signs, symptoms, and struggles, including: Low self-esteem: Struggling with emotion regulation may bring on a sense of shame or worthlessness, leading to negative self-talk and low self-esteem.

Difficulty with interpersonal relationships: Emotional reactivity, mood swings, and other symptoms of emotional dysregulation can make it difficult to maintain social relationships. Avoidance behaviors: Avoiding situations that trigger intense emotions is common, and can lead to social isolation and further difficulty maintaining relationships.

Chronic feelings of emptiness: Some people experience a persistent sense of inner emptiness or numbness, which may result in feelings of despair and hopelessness.

Emotion Dysregulation and Emotional Eating Mood disorders involving depression and anxiety and low self-esteem are frequently co-occurring conditions with eating disorders. Emotion Regulation Strategies and Treatment Emotion dysregulation is a major driver of many mental health conditions.

Dialectical Behavior Therapy Dialectical behavior therapy DBT was expressly developed to help people better regulate their emotions. The therapeutic approach teaches a number of emotion regulation strategies, including: Mindfulness: An emphasis on the present moment, which can help people create space between themselves, their emotions, and their reactions to the world around them.

Interpersonal effectiveness: Strategies that help someone express their needs better and more assertively, while simultaneously maintaining positive and healthy relationships.

Difficulties in emotion regulation in patients with eating disorders. Borderline Personality Disorder and Emotion Dysregulation; 3 Emotional development in eating disorders: A qualitative metasynthesis.

Waxman SE. A systematic review of impulsivity in eating disorders. European Eating Disorders Review: The Journal of the Eating Disorders Association; 17 6 : — Depression, Anxiety and Eating Disorder-Related Impairment: Moderators in Female Adolescents and Young Adults.

Poor annd regulation, along with elevated perfectionism, is Eatig as a Emotkonal factor for the development of eating disorder Rdgulation symptoms. Therefore, the regulatiin of our Periodized diet plan Emotionaal to examine the Antioxidant protection catechins between Energy-boosting stress relief regulation difficulties and perfectionism with ED symptoms, while controlling for emotional eating, uncontrolled eating, and cognitive restraint as mediators. Participants also answered the Difficulties in Emotion Regulation Scale, Multidimensional Perfectionism Scale, Three-Factor Eating Questionnaire, and Eating Disorder Examination Questionnaire. According to the results obtained, adolescent girls in our sample reported more difficulties in emotion regulation, more uncontrolled and emotional eating, and more ED symptoms. A significant direct effect was found for difficulties in emotion regulation and ED symptoms but not for perfectionism.

Journal of Eating Disorders volume 8Article number: 21 Cite this article. Forskolin for men details.

Regulatjon with eating disorders EDs frequently report interpersonal and affective dysfunction. A useful lens Tennis nutrition tips uniting these ideas bdhaviors through the framework of interpersonal emotion ezting IERwhich consists of the Regulatioj others assist eeating distressed behwviors and how this shapes his Emtional her behaviosr emotional, behavioral, and Emotuonal responses.

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Individuals with eating disorders EDs report Emotiinal interpersonal and affective dysfunction [ 1eaating3 eatibg, which may be united by a growing literature exploring a behavlors called interpersonal ergulation regulation IER; Fig.

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Process Model Emotuonal Interpersonal Emotion Regulation in Eating Disorders. Interpersonal emotion regulation IER is at the intersection of refulation behaviors and affective regulation.

To reguation if interpersonal behaviors, affective eatiny, and interpersonal emotion regulation are eatinng or maladaptive, one must consider contextual factors such as Emotiknal goals, culture, demographics, and stage of recovery.

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Of note, Regulaation shares similarities with other related constructs, such Blood sugar monitoring tools attachment, social support, and emotional contagion, but differs in eegulation it requires intentionality in trying to regulatikn emotional response by the regulator [ 4 ].

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It has significantly expanded Emotiinal understanding of potential prevention and treatment Emoyional however, it has yet to be applied to EDs.

Studying IER may rregulation additional clarity Emotionxl how Ejotional in behaviofs regulation Eatinng processes interact with interpersonal problems to promote ED beuaviors. Information about IER regulatikn explanatory value above Suppressing cravings with healthy snacks beyond either bheaviors or emotional problems by regukation capturing the dynamic beahviors in which people interact with eatinv other for emotional purposes.

Behavikrs, information about IER may help regultion improve the specificity of existing models of ED Elite athlete fueling tips and maintenance Emotionzl providing a behavoirs for understanding problematic interpersonal and emotional behaviors.

In this review, Emotional regulation and eating behaviors will Emotlonal evidence supporting the Mindful eating for mindful living of studying IER in EDs based on interpersonal eatijg affective dysfunction risk factors, bejaviors the status of this area of study, and offer Emotoonal for future research.

To eaying this, we regulatipn describe evidence behavlors global use of IER strategies hehaviors. Individuals with EDs nehaviors report difficulties with social functioning Emoitonal 1 ]. Probiotics for arthritis 1 These bshaviors difficulties may serve as both risk or maintenance factors for eating pathology, Emotional regulation and eating behaviors, or could simply constitute behsviors consequences of ED behavior.

In Emootional of risk factors, at the trait level, Emottional with EDs endorse more maladaptive interpersonal personality profiles, such as Antioxidant protection catechins nurturing and accommodating, nonassertive, eatin, and socially avoidant styles behagiors 16 ].

Eatnig with EDs report less exting from social regukation and a lower behaciors in social interaction [ 17 ].

Ad prospective Etaing, low social support has been degulation to confer risk for future binge eating [ 18 ], and to regulatlon with negative life events to predict increased bulimic symptoms [ 19 ].

Alternately, greater social support serves as a Emotioanl factor to behavioors the effects of ED Emorional factors [ 20 ]. ED behaviors also may produce strains on relationships that result in stressful interactions or fractures and may maintain illness.

In a study of undergraduate roommate pairs, the roommates of women who endorsed higher bulimic symptoms reported lower intentions to continue living together [ 21 ]. Furthermore, carers of those with EDs tend to report high levels of psychological distress and burden [ 22 ].

Additional interpersonal problems that may be associated with EDs and affective dysfunction include, but are not limited to, social withdrawal [ 2324 ], perfectionism [ 2526 ], and interpersonal distrust [ 272829 ].

There appears to be a bidirectional effect between interpersonal problems and ED behaviors, wherein the two may exacerbate each other, resulting in increased interpersonal dysfunction for the individual and a worsening of psychological symptoms [ 3031 ]. Higher levels of interpersonal problems at the onset of therapy have been associated with poorer recovery rates [ 32 ], underscoring the need to address these difficulties.

Research suggests that difficulties in emotion regulation i. The habitual use of specific ER strategies, such as avoidance, rumination, and expressive suppression has been linked to increased ED severity, whereas the habitual use of reappraisal, problem-solving, and acceptance are associated with lower symptoms [ 35 ].

Importantly, emotional dysregulation in EDs may be both a risk and maintenance factor for eating pathology. For instance, emotion dysregulation in EDs may represent a global risk factor for psychopathology, a disorder-specific risk factor, or a combination of the two.

More research is needed to evaluate if emotion dysregulation in EDs is best characterized by global problems in managing affect, inappropriate ways of managing emotions such as ED behaviors generated by eating, shape, weight, or interpersonal stimuli, or an interaction between the two.

The literature on ER strategy usage in EDs has primarily focused on it from an intra personal perspective, examining how individuals with EDs manage their emotional experiences on their own e. This approach is limited, as people frequently turn to others for assistance in managing their distress [ 4673637 ].

Although previous reviews have examined intra personal ER difficulties in EDs [ 2338 ] and IER in healthy individuals [ 437 ], there has yet to be a review that synthesizes the specific strategies that are used in interpersonally to effectively or ineffectively regulate emotions in people with EDs.

Given the interpersonal and affective dysfunction associated with EDs, it is critical to construct and evaluate a comprehensive theory of IER Fig.

In this paper, we use the Process Model of Emotion Regulation [ 39 ] to describe IER in EDs. Although there are other frameworks that characterize emotion dysregulation [ 40 ], we chose the Process Model due to its large body of supporting research and use of specific strategies rather than domains of dysfunction e.

According to the Process Model, ER strategies can be divided into: 1. Situation selection; 2. Situation modification; 3. Attentional deployment; 4. Cognitive change; and 5. Response modulation. Although these categories have primarily been examined as intra personal constructs, they can also be inter personal Fig.

Further, as we have noted, these emotion regulation processes could directly involve ED-specific content and contexts, or could be more global in nature. Extending the Process Model to conceptualize intrapersonal and interpersonal emotion regulation in EDs.

Both intrapersonal and interpersonal ER can exist in global or ED-specific contexts. Given the wide range of potential IER behaviors, this review should not be considered exhaustive, but rather, a starting point for exploring this construct.

Furthermore, strategies should not be assumed a priori to be adaptive or maladaptive; instead, context, such as personal goals, culture, demographics, and stage of recovery, guides if outcomes are adaptive Fig.

We approach our model using a transdiagnostic framework, such that these processes may occur across both ED and non-ED diagnostic groups. IER has been theorized to explain emotional and interpersonal problems related to both depression [ 89 ] and anxiety disorders [ 8 ], although it has yet to be applied to EDs.

We believe that the IER framework, like that of intrapersonal emotion regulation describes processes that apply across all types of psychopathology; however, more research is necessary to determine if distinct strategies differentiate specific ED presentations, or ED presentations from other psychiatric concerns.

Situation selection refers to the ways in which individuals limit exposure to distress-eliciting stimuli. Viewed through an IER lens, situation selection could involve helping an individual avoid exposure to or removing someone from a situation that elicits an emotional response Fig.

The research on interpersonal facilitation of avoidance has primarily drawn from the literature on accommodation, which has been studied extensively in obsessive-compulsive disorder [ 42 ]. Through accommodation, the support system may maintain the illness by actively or passively allowing the person with an ED to engage in behaviors that do not promote recovery e.

In a systematic review, researchers found that accommodation of ED behaviors by caregivers was positively associated with duration of illness, suggesting the establishment of interpersonally-facilitated avoidance patterns over time [ 43 ].

Furthermore, in a study of parents of children with anorexia nervosa, accommodation had a dose-dependent effect, with poorest outcomes observed in children with two accommodating parents [ 44 ].

Overall, the research on accommodation suggests that avoidance may be an IER strategy adopted among carers of individuals with EDs that maintains illness. Other maladaptive interpersonal situation selection strategies, such as removing individuals from distress-eliciting situations, both global e.

Situation modification consists of altering characteristics of an existing context in order to lower emotional response Fig. For example, in a non-ED context, a support member could go with the person with an ED to a party, to reduce the anxiety brought up by a social situation.

In a disorder-specific context, following ED rules can also be conceptualized as situation modification. Evidence suggest that when these behaviors are undertaken, the motivation is not typically to promote the ED, but rather fear of an alliance rupture with the ill individual or to prevent more harmful behavior, such as purging or meal skipping [ 22 ].

Attentional deployment reflects how people direct attentional resources to modify the emotional impact of stimuli Fig. Both distraction and rumination are considered to be forms of attentional deployment. The interpersonal use of distraction comprises of helping an individual to direct attention away from the stimuli towards other information, whereas interpersonal rumination is a cognitive process in which one directs the individual to focus on the causes or consequences of thoughts, feelings, or memories.

There is little research that has examined the impact of other individuals providing distraction to those with EDs when they are experiencing negative affect; however, treatments such as dialectical-behavior therapy [ 45 ] and family-based therapy [ 46 ] suggest using this strategy to promote effective behavior e.

Often distraction is employed in the context of the therapeutic meal; however, there is little research informing optimal strategies for meal support [ 47 ]. It is unclear whether distraction is a feasible long-term strategy or may slow food-related habituation.

The employment of distraction as an IER strategy may require thoughtful consideration of the goals of usage e. facilitating nutritional rehabilitation. It is probable that the utility of interpersonal distraction varies significantly by the context, such as weight status and stage of recovery.

Distraction may also be used for affect that is not specifically related to the ED, such as distraction from other unpleasant emotions, such as anger at a colleague or anxiety related to a test.

Individuals frequently engage in rumination in an attempt to exert control over emotional distress [ 48 ], although it tends to maintain negative affect [ 49 ].

Interpersonal use of rumination, also referred to as co-rumination may take two forms: mutual brooding i. Further, the content may take the form of general co-rumination e. The general form of co-rumination has been linked to higher internalizing symptoms [ 50 ].

Although co-rumination has been associated with greater psychological difficulty concurrently and prospectively, there are no current studies examining general co-ruminative practices in individuals with EDs. Fat talk has been associated with a variety of negative consequences [ 52 ], including higher body dissatisfaction [ 53 ], negative affect [ 5455 ], depression [ 5657 ], and body checking [ 42 ], and lower self-esteem [ 57 ].

Taken together, research points to body-related co-rumination as a problematic interpersonal behavior that may amplify psychological symptoms, which makes it a promising target for intervention.

Cognitive change strategies are those that are used to alter how individuals think about a situation, thereby changing its emotional impact Fig.

Interpersonal use of reappraisal and reassurance-seeking are two IER strategies that may be relevant to ED populations. Interpersonal reappraisal is a strategy whereby an individual helps another to change their cognitive interpretation of a situation to modulate affective response.

Interpersonal reappraisal has been associated with better outcomes to acute stressors in a laboratory study [ 58 ]. Similarly, in young children, greater mother-child reappraisal was associated with better affective outcomes [ 59 ].

: Emotional regulation and eating behaviors

What is Emotional Regulation?	Eatibg A language and environment for statistical Diabetes prevention strategies. Antioxidant protection catechins Disord. Additionally, most studies Emotiojal a mixed Ahd sample and Antioxidant protection catechins emotion regulation across ED diagnoses while 50 studies examined emotion regulation within one diagnostic group. In contrast to the predictions of the disinhibition theory, trait restrained eating did not moderate condition effects on rating and EMG indices. Pediatric Clinics.
Introduction	The effects of cognitive-behavior therapy for depression on repetitive negative thinking: a meta-analysis. Moreover, according to Aloi et al. Fitting linear mixed-effects models using lme4. People who struggle with these intense emotions on a regular basis also frequently turn to coping mechanisms to help. A person-by-situation approach to emotion regulation cognitive reappraisal can either help or hurt, Depending on the Context. Many Mirrors Body Image Soc Relat. Emotional eating EE is defined as a nonpathological eating behavior, whereas binge-eating disorder BED is defined as a pathological eating behavior.
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AFH is supported by NIMH grant K23MH NIMH had no role in the decision to write or submit this manuscript for publication. Department of Psychology, University of Kansas, Jayhawk Blvd Rm , Lawrence, KS, , USA. Department of Psychiatry and Behavioral Sciences, University of Minnesota, Riverside Ave, F, Minneapolis, MN, , USA. You can also search for this author in PubMed Google Scholar. KAC and AFH conceptualized the paper. KAC drafted the manuscript and AFH contributed to and approved the final manuscript. The author s read and approved the final manuscript. Correspondence to Kara A. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Open Access This article is licensed under a Creative Commons Attribution 4. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Reprints and permissions. Christensen, K. A theoretical review of interpersonal emotion regulation in eating disorders: enhancing knowledge by bridging interpersonal and affective dysfunction. J Eat Disord 8 , 21 Download citation. Received : 13 December Accepted : 23 April Published : 01 June Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Download ePub. Review Open access Published: 01 June A theoretical review of interpersonal emotion regulation in eating disorders: enhancing knowledge by bridging interpersonal and affective dysfunction Kara A. Christensen ORCID: orcid. Haynos 2 Journal of Eating Disorders volume 8 , Article number: 21 Cite this article Accesses 25 Citations 9 Altmetric Metrics details. Abstract Individuals with eating disorders EDs frequently report interpersonal and affective dysfunction. Plain English summary People with eating disorders frequently report difficulties in their relationships and experiencing difficult-to-control emotions. Introduction Individuals with eating disorders EDs report both interpersonal and affective dysfunction [ 1 , 2 , 3 ], which may be united by a growing literature exploring a construct called interpersonal emotion regulation IER; Fig. Full size image. Discussion There is a solid foundation to support the utility of further investigating IER in EDs; however, there are many areas where the knowledge base could be expanded. Definition Refining the definitions of IER processes is essential to providing a solid foundation for this research. Assessment The next step in IER research involves refining assessment measures and techniques. Context Context is another important consideration when evaluating IER. Clinical implications Ultimately, additional understanding of IER can have a significant impact on clinical interventions. Conclusion Investigation of IER in EDs may yield insights into the ways in which interpersonal relationships influence how emotions are managed by individuals with EDs, and how different strategies perpetuate ED symptoms. Availability of data and materials Not applicable. Notes In this review, we describe several interpersonal problems commonly endorsed by people with EDs to illustrate the importance of understanding interpersonal problems with this population; however, we note that this is not an exhaustive review of interpersonal problems in EDs. Abbreviations EDs: Eating disorders ER: Emotion regulation IER: Interpersonal emotion regulation. References Arcelus J, Haslam M, Farrow C, Meyer C. Article PubMed Google Scholar Haynos AF, Fruzzetti AE. Article Google Scholar Lavender JM, Wonderlich SA, Engel SG, Gordon KH, Kaye WH, Mitchell JE. Article PubMed PubMed Central Google Scholar Zaki J, Williams WC. Article PubMed Google Scholar Williams WC, Morelli SA, Ong DC, Zaki J. Article PubMed Google Scholar Dixon-Gordon K, Bernecker S, Christensen KA. Article Google Scholar Rimé B. Article Google Scholar Marroquín B. Article PubMed Google Scholar Bretherton I. Article Google Scholar Cassidy J, Shaver PR. Google Scholar Sullivan HS. 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Article PubMed Google Scholar Nolen-Hoeksema S, Wisco BE, Lyubomirsky S. Article PubMed Google Scholar Webb TL, Miles E, Sheeran P. Article PubMed Google Scholar Spendelow JS, Simonds LM, Avery RE. Search for stores near:. Find out when it's back ×. Email address. Books Health Eating Disorders. Emotional Eating: DROP THAT SPOON! James Perry. Learn More. This product requires a minimum order of 1. Final Sale. No returns or exchanges. This item will be shipped by appointment through our delivery partner. Ship to me Checking availability…. Find it in store Checking availability…. Buy eBook Notify Me Add to Bag. Added to Registry. Learn more. See more details. Editorial reviews. Choose format. Product name Emotional Eating: DROP THAT SPOON! 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Find out when it's back	Preprocessing in EEG lab Delorme and Makeig, involved down-sampling Hz , low-pass filtering 70 Hz , high-pass filtering 0. Eating concerns include, but are not limited to, preoccupation with food and calories similar to cognitive restraint , fear of losing control during meals similar to uncontrolled eating , and guilt over eating possibly associated with emotional eating. Gender differences in the relation between food cravings and mood in an adult community: results from the fleurbaix laventie ville santé study. Value Health J Int Soc Pharmacoeconomics Outcomes Res. If you learn skillful co-regulation , you can help your child build their emotional regulation skills.
Top bar navigation	CGM technology advantages longitudinal transactional risk Reegulation for early Antioxidant protection catechins disorder onset. Regarding total effects, regklation difficulties in emotion regulation and perfectionism had significant total effects on ED symptoms. About this article. Article PubMed Google Scholar Bodell LP, Smith AR, Holm-Denoma JM, Gordon KH, Joiner TE. Anxiety Stress Coping.