Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-24T14:36:11.121Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  29 June 2020

Kathryn E. Smith Open the ORCID record for Kathryn E. Smith [Opens in a new window] ,
Tyler B. Mason ,
Lauren M. Schaefer ,
Lisa M. Anderson ,
Vivienne M. Hazzard ,
Ross D. Crosby ,
Scott G. Engel ,
Scott J. Crow ,
Stephen A. Wonderlich  and
Carol B. Peterson
Kathryn E. Smith*
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, US
Tyler B. Mason
Affiliation:
Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
Lauren M. Schaefer
Affiliation:
Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota, USA
Lisa M. Anderson
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
Vivienne M. Hazzard
Affiliation:
Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota, USA
Ross D. Crosby
Affiliation:
Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota, USA Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
Scott G. Engel
Affiliation:
Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota, USA Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
Scott J. Crow
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA The Emily Program, Saint Paul, Minnesota, USA
Stephen A. Wonderlich
Affiliation:
Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota, USA Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
Carol B. Peterson
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA The Emily Program, Saint Paul, Minnesota, USA
*
Author for correspondence: Kathryn E. Smith, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Binge eating disorderecological momentary assessmentemotion regulation
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 1 , January 2022 , pp. 140 - 148
Check for updates
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Accurso, E. C., Wonderlich, S. A., Crosby, R. D., Smith, T. L., Klein, M. H., Mitchell, J. E., … Peterson, C. B. (2016). Predictors and moderators of treatment outcome in a randomized clinical trial for adults with symptoms of bulimia nervosa. Journal of Consulting and Clinical Psychology, 84(2), 178. doi: 10.1037/ccp0000073CrossRefGoogle Scholar
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Google Scholar
Berg, K. C., & Wonderlich, S. A. (2013). Emerging psychological treatments in the field of eating disorders. Current Psychiatry Reports, 15(11), 407. doi: 10.1007/s11920-013-0407-yCrossRefGoogle ScholarPubMed
Bodell, L. P., Pearson, C. M., Smith, K. E., Cao, L., Crosby, R. D., Peterson, C. B., … Berg, K. C. (2019). Longitudinal associations between emotion regulation skills, negative affect, and eating disorder symptoms in a clinical sample of individuals with binge eating. Eating Behaviors, 32, 69–73.CrossRefGoogle Scholar
Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. New York: Guilford Press.Google ScholarPubMed
Fairburn, C. G. (2013). Overcoming binge eating: The proven program to learn why you binge and how you can stop (2nd ed.). New York, NY: Guilford Press.Google Scholar
Fairburn, C., & Cooper, Z. (1993). The eating disorder examination. In Fairburn, C. G. & Wilson, G. T. (Eds.), Binge eating: Nature, assessment, and treatment (pp. 317–360). New York, NY: Guilford Press.Google Scholar
Gardner, B. (2015). A review and analysis of the use of ‘habit’in understanding, predicting and influencing health-related behaviour. Health Psychology Review, 9(3), 277–295.CrossRefGoogle ScholarPubMed
Gratz, K. L., Bardeen, J. R., Levy, R., Dixon-Gordon, K. L., & Tull, M. T. (2015). Mechanisms of change in an emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Behavior Research and Therapy, 65, 29–35. doi: 10.1016/j.brat.2014.12.005CrossRefGoogle Scholar
Gratz, K. L., & Tull, M. T. (2010). Emotion regulation as a mechanism of change in acceptance-and mindfulness-based treatments. Assessing mindfulness and acceptance processes in clients: Illuminating the theory and practice of change, pp. 107–133.Google Scholar
Grilo, C. M. (2017). Psychological and behavioral treatments for binge-eating disorder. The Journal of Clinical Psychiatry, 78, 20–24. doi: 10.4088/JCP.sh16003su1c.04CrossRefGoogle ScholarPubMed
Haedt-Matt, A. A., & Keel, P. K. (2011). Revisiting the affect regulation model of binge eating: A meta-analysis of studies using ecological momentary assessment. Psychological Bulletin, 137(4), 660. doi: 10.1037/a0023660CrossRefGoogle ScholarPubMed
Hayes, S. C., Villatte, M., Levin, M., & Hildebrandt, M. (2011). Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology, 7, 141–168. doi: 10.1146/annurev-clinpsy-032210-104449CrossRefGoogle ScholarPubMed
Heatherton, T. F., & Baumeister, R. F. (1991). Binge eating as escape from self-awareness. Psychological Bulletin, 110(1), 86–108.CrossRefGoogle ScholarPubMed
Juarascio, A. S., Parker, M. N., Lagacey, M. A., & Godfrey, K. M. (2018). Just-in-time adaptive interventions: A novel approach for enhancing skill utilization and acquisition in cognitive behavioral therapy for eating disorders. International Journal of Eating Disorders, 51(8), 826–830. doi: 10.1002/eat.22924CrossRefGoogle ScholarPubMed
Kahl, K. G., Winter, L., & Schweiger, U. (2012). The third wave of cognitive behavioural therapies: What is new and what is effective? Current Opinion in Psychiatry, 25(6), 522–528. doi: 10.1097/YCO.0b013e328358e531CrossRefGoogle ScholarPubMed
Kan, C., Cardi, V., Stahl, D., & Treasure, J. (2019). Precision psychiatry-what it means for eating disorders? European Eating Disorders Review, 27(1), 3–7. doi: 10.1002/erv.2651CrossRefGoogle ScholarPubMed
Lavender, J. M., Wonderlich, S. A., Engel, S. G., Gordon, K. H., Kaye, W. H., & Mitchell, J. E. (2015). Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature. Clinical Psychology Review, 40, 111–122. doi: 10.1016/j.cpr.2015.05.010CrossRefGoogle ScholarPubMed
Leehr, E. J., Krohmer, K., Schag, K., Dresler, T., Zipfel, S., & Giel, K. E. (2015). Emotion regulation model in binge eating disorder and obesity—a systematic review. Neuroscience & Biobehavioral Reviews, 49, 125–134.CrossRefGoogle ScholarPubMed
Linardon, J. (2018). Rates of abstinence following psychological or behavioral treatments for binge-eating disorder: Meta-analysis. International Journal of Eating Disorders, 51(8), 785–797. doi: 10.1002/eat.22897CrossRefGoogle ScholarPubMed
Linardon, J., Gleeson, J., Yap, K., Murphy, K., & Brennan, L. (2019). Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns: Implications for eating disorder prevention. Cognitive Behavior Therapy, 48(1), 15–38. doi: 10.1080/16506073.2018.1517389.CrossRefGoogle ScholarPubMed
Mennin, D. S., & Fresco, D. M. (2010). Emotion regulation as an integrative framework for understanding and treating psychopathology. In Kring, A. M., & Sloan, D. M. (Eds.), Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment (pp. 356–379). The Guilford Press.Google Scholar
Mitchell, J. E. (2016). Medical comorbidity and medical complications associated with binge-eating disorder. International Journal of Eating Disorders, 49(3), 319–323. doi: 10.1002/eat.22452CrossRefGoogle ScholarPubMed
Peterson, C. B., Berg, K. C., Crosby, R. D., Lavender, J. M., Accurso, E. C., Ciao, A. C., … Wonderlich, S. A. (2017). The effects of psychotherapy treatment on outcome in bulimia nervosa: Examining indirect effects through emotion regulation, self-directed behavior, and self-discrepancy within the mediation model. International Journal of Eating Disorders, 50(6), 636–647. doi: 10.1002/eat.22669CrossRefGoogle ScholarPubMed
Peterson, C., Engel, S., Crosby, R. D, Crow, S., Smith, T., Klein, M., … Wonderlich, S.A. (2019, September). A randomized comparison of ICAT-BED and CBT-GSH to treat binge eating disorder using standard and naturalistic momentary outcome measures. Paper presented at the Annual Meeting of the Eating Disorders Research Society, Chicago, IL.Google Scholar
Peterson, C. B., Engel, S. G., Crosby, R. D., Strauman, T., Smith, T. L., Klein, M., ... Wonderlich, S. A. (in press). Comparing Integrative Cognitive-Affective Therapy and guided selfhelp cognitive-behavioral therapy to treat binge eating disorder using standard and naturalistic momentary outcome measures: A randomized controlled trial. International Journal of Eating Disorders.Google Scholar
Racine, S. E., & Wildes, J. E. (2015). Dynamic longitudinal relations between emotion regulation difficulties and anorexia nervosa symptoms over the year following intensive treatment. Journal of Consulting and Clinical Psychology, 83(4), 785. doi: 10.1037/ccp0000011CrossRefGoogle ScholarPubMed
Robinson, A., Safer, D. L., Austin, J. L., & Etkin, A. (2015). Does implicit emotion regulation in binge eating disorder matter? Eating Behaviors, 18, 186–191. doi: 10.1016/j.eatbeh.2015.05.011CrossRefGoogle ScholarPubMed
Slee, N., Spinhoven, P., Garnefski, N., & Arensman, E. (2008). Emotion regulation as mediator of treatment outcome in therapy for deliberate self-harm. Clinical Psychology & Psychotherapy, 15(4), 205–216. doi: 10.1002/cpp.577CrossRefGoogle ScholarPubMed
Smyth, J. M., Wonderlich, S. A., Heron, K. E., Sliwinski, M. J., Crosby, R. D., Mitchell, J. E., & Engel, S. G. (2007). Daily and momentary mood and stress are associated with binge eating and vomiting in bulimia nervosa patients in the natural environment. Journal of Consulting and Clinical Psychology, 75(4), 629.CrossRefGoogle ScholarPubMed
Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin, 128(5), 825. doi: 10.1037/0033-2909.128.5.825CrossRefGoogle ScholarPubMed
Thompson, E. R. (2007). Development and validation of an internationally reliable short-form of the Positive and Negative Affect Schedule (PANAS). Journal of Cross-Cultural Psychology, 38(2), 227–242. doi: 10.1177/0022022106297301CrossRefGoogle Scholar
Van Riet, J., Sijtsema, S. J., Dagevos, H., & De Bruijn, G. J. (2011). The importance of habits in eating behaviour. An overview and recommendations for future research. Appetite, 57(3), 585–596.CrossRefGoogle Scholar
Wheeler, L., & Reis, H. T. (1991). Self-recording of everyday life events: Origins, types, and uses. Journal of Personality, 59, 339–354. doi: 10.1111/j.1467-6494.1991.tb00252.xCrossRefGoogle Scholar
Wilson, G. T., Wilfley, D. E., Agras, W. S., & Bryson, S. W. (2010). Psychological treatments of binge eating disorder. Archives of General Psychiatry, 67, 94–101. doi: 10.1001/archgenpsychiatry.2009.170CrossRefGoogle ScholarPubMed
Wonderlich, S. A., Peterson, C. B., Crosby, R. D., Smith, T. L., Klein, M. H., Mitchell, J. E., & Crow, S. J. (2014). A randomized controlled comparison of integrative cognitive-affective therapy (ICAT) and enhanced cognitive-behavioral therapy (CBT-E) for bulimia nervosa. Psychological Medicine, 44(3), 543–553. doi: 10.1017/S0033291713001098CrossRefGoogle ScholarPubMed
Wonderlich, S. A., Peterson, C. B., & Smith, T. L. (2015). Integrative cognitive-affective therapy for bulimia nervosa: A treatment manual. New York: Guilford Publications.Google Scholar
Supplementary material: File

Smith et al. Supplementary Materials

Smith et al. Supplementary Materials

Download Smith et al. Supplementary Materials(File)
File 54.8 KB