Academic journal article Journal of Eating Disorders

Emotion Dysregulation, Self-Image and Eating Disorder Symptoms in University Women

Academic journal article Journal of Eating Disorders

Emotion Dysregulation, Self-Image and Eating Disorder Symptoms in University Women

Article excerpt

Author(s): Elin Monell[sup.1,2], Louise Hogdahl[sup.1], Emma Forsnn Mantilla[sup.1] and Andreas BirgegA[yen]rd[sup.1]


Eating disorders (EDs) are relatively common among young women. A recent cohort-based study using Swedish population and healthcare registers found that adolescence is a high-risk period for the development of an ED, where the incidence of any ED by 2009 was 457.4 cases per 100,000 persons in the peak 16-17 year old age category in women [1]. A recent meta-analysis of community- and health-care based studies on prevalence of EDs found that the expected lifetime prevalence for any ED in women varies between 4.3 and 8.6 % depending on diagnosis and diagnostic criteria [2]. A comprehensive understanding of the etiology and maintenance of EDs is yet to be developed. Many researchers emphasize emotion regulation as important to move forward, although the longitudinal data needed for causal models is as yet largely lacking [3-5]. The present study related ED symptoms to emotion regulation and self-image, two factors previously shown to be related to ED when examined separately [6-8]. Briefly, emotion regulation is the ability to make sense of and manage one's emotions, and self-image is an organizing principle guiding habitual intrapersonal behavior and interpretation of and responses in social interaction. Both emotion regulation and self-image are thought to be formed in interaction with significant others [9, 10], and both relate to social behavior and self-directed behavior, suggesting that the constructs might be interconnected or partly overlapping. Emotion regulation and self-image have been proposed to contribute to both development and maintenance of EDs [11-13]. However, the interrelationships between emotion regulation, self-image and EDs are currently unclear.

Emotion regulation

Emotion regulation refers to the acquired ability to recognize, understand, and accept one's emotions, as well as strategies to modulate the experience and expression of emotions in line with long-term goals and values [14]. This ability develops over time, and early childhood interactions with caregivers seem to be of great importance [10, 15]. Emotion dysregulation is suggested to be a central factor in the development and maintenance of various problematic behaviors like self-harm and violence towards others, where the most comprehensive theoretical work is Linehan's bio-psychosocial model of emotion dysregulation in borderline personality disorder (BPD) [16]. This model has also been used to describe similar processes in anorexia nervosa (AN) [3]. The model describes the development of emotion dysregulation as a transactional process between individual emotional vulnerabilities and invalidating responses from the social and family environment [15, 17]. Individual emotional vulnerability consists of relatively stable influences of temperamental affective tendencies (e.g. emotional sensitivity, reactivity, and time needed to recover from emotional events) as well as more transient factors related to sleeping habits, diet, physical health, etc. Invalidating response relates to interpersonal interactions where an individual's emotional and cognitive experiences are overlooked, misunderstood, or criticized by others. A vicious circle of vulnerability and invalidation where increased emotional arousal, and ensuing increased difficulty to accurately communicate emotional states, then risks maintaining and reinforcing emotion dysregulation and usage of dysfunctional regulatory strategies, for example self-harm in BPD patients [3, 15]. In sum, unfortunate transactional processes over time are thought to create pervasive trait-like patterns of emotion dysregulation. In everyday life, high intensity and/or long duration of emotional arousal tend to heighten the risk of emotion dysregulation in response to everyday emotional events [3].

Emotion dysregulation and EDs

The ability to identify and describe emotions is decreased among women with EDs [4, 18]. …

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