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

The role of emotion regulation in the development of eating disorders has indicated that
feelings of depression and high levels of negative affect lead to disordered eating and
bulimic symptoms (e.g. Killen et al., 1996; Stice, 2001). Negative affect and stress have
also been identified as the most common triggers of a binge-episode (Polivy et al, 2002)
and other research suggests that negative affect mediates the relationship between body
dissatisfaction and disordered eating (Stice, 2002).
Emotion regulation is a complex process that involves a discrete set of variables
including level of negative affect, identification of emotional states, and generation of
adaptive coping strategies (Saarni, 1999). A study comparing girls diagnosed with
Bulimia Nervosa (BN) with girls diagnosed with depression and girls from the
community, found that girls diagnosed with BN exhibit poorer emotional awareness and
identification skills (Sim and Zeman, 2004). Further, 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. Women who reported eating disorder symptoms were more likely to
use maladaptive coping methods and less likely to use social support strategies than
individuals who did not report these symptoms, (Bybee, Zigler, Berliner, and Merisca,
1996).
Sim and Zeman (2004) suggested that girls may use dietary restriction, binge-eating and
other eating disorder behaviors as a way to manage negative affect that they cannot
identify or with which they cannot cope. 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. Girls, who
reported high levels of disordered eating, also experienced increased frequency of
negative affect, had significantly greater difficulty identifying emotion, and had less
constructive coping in response to negative emotion. It is possible that negative affect is
more aversive if it is ambiguous, requiring an increased need to escape from this emotion.
They suggested that future studies of this model may benefit from testing whether
emotion awareness was a moderator between negative affect and disordered eating.
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