DClinPsy Portfolio Volume 1 of 3 - University of Hertfordshire ...

Feelings of depression/ high levels of negative affect have been found to be significantly
related to the onset of disordered eating and bulimic symptoms (e.g. Killen et al., 1996;
Stice et al, 2001). Indeed, negative affect and stress have been identified as the most
common triggers of a binge-episode (Polivy et al, 2002) and conclusions drawn from
these studies state that negative affect mediates the relationship between body
dissatisfaction and disordered eating (Stice, 2002). Thus, these findings imply that there
may be a psychological process that is common to eating disorders and depression in
those with a negative body image such as emotional regulation difficulties.
How one processes or regulates their emotions i.e. identifies their emotional states, and
generates adaptive coping strategies, (Saarni, 1999) has been found to discriminate those
with and without bulimia. Individuals with bulimia exhibit poorer emotional awareness
and emotion identification skills (Sim and Zeman, 2004). Furthermore, research suggests
that individuals who have eating disorders exhibit high levels of alexithymia, a construct
that includes difficulties discriminating between emotional states and bodily sensations
and trouble expressing feelings, (Jimerson, Wolfe, Franko, Covino, & Sifneos, 1994).
Sim et al (2004) suggested that girls may use dietary restriction, binge-eating and other
eating disorder behaviours as a way to manage negative affect that they cannot identify or
with which they cannot cope, so that binge eating, purging, and restricting may be used as
strategies to regulate emotional states that they have difficulty identifying. Without the
ability to ascertain the specific emotion one is experiencing, choosing an effective coping
strategy to alter this state of arousal will be unlikely. For example, counting to 10 may be
an effective method to lessen the intensity of anger, yet it would provide little relief in
managing sadness. Thus, over time, binge eating and purging may develop as an
immediate, all-purpose response for alleviating negative, indistinct emotional states.
Furthermore, over time negative affect can become associated with body dissatisfaction,
and eating disorder symptoms may develop as a way of alleviating any negative
emotional state that may be difficult to identify.
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