Limits...
A perfect storm: examining the synergistic effects of negative and positive emotional instability on promoting weight loss activities in anorexia nervosa.

Selby EA, Cornelius T, Fehling KB, Kranzler A, Panza EA, Lavender JM, Wonderlich SA, Crosby RD, Engel SG, Mitchell JE, Crow SJ, Peterson CB, Le Grange D - Front Psychol (2015)

Bottom Line: Using ecological momentary assessment methods, 118 participants with anorexia nervosa reported their emotional experiences and behaviors at least six times daily over 2 weeks using a portable digital device.Using generalized linear modeling, results indicated that high levels of both positive and negative emotional instability, and the interaction between the two, were associated with more frequent weight-loss activities, beyond anorexia subtype and mean levels of emotional intensity.The importance of addressing the role of both positive and negative emotion in anorexia treatment is discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, Rutgers University , Piscataway, NJ, USA.

ABSTRACT
Growing evidence indicates that both positive and negative emotion potentially influence the development and maintenance of anorexia nervosa, through both positive and negative reinforcement of weight loss activities. Such reactive emotional experience may be characterized by frequent and intense fluctuations in emotion, a construct known as "emotional instability." The purpose of this study was to investigate the association between positive emotional instability and weight loss activities in anorexia nervosa, and to investigate the synergistic effects of positive and negative emotional instability on promoting weight loss activities. Using ecological momentary assessment methods, 118 participants with anorexia nervosa reported their emotional experiences and behaviors at least six times daily over 2 weeks using a portable digital device. Using generalized linear modeling, results indicated that high levels of both positive and negative emotional instability, and the interaction between the two, were associated with more frequent weight-loss activities, beyond anorexia subtype and mean levels of emotional intensity. These findings indicate that when women with anorexia exhibit both high levels of both positive and negative emotional instability they are more prone to a variety of weight loss activities. The importance of addressing the role of both positive and negative emotion in anorexia treatment is discussed.

No MeSH data available.


Related in: MedlinePlus

Interaction between positive and negative emotional instability predicting increased weight loss activities in a sample of those with anorexia nervosa. High and low values represent two standard deviations above and below the mean. Solid dark lines represent high positive emotional instability, while dashed gray lines indicate low positive emotional instability.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4553383&req=5

Figure 1: Interaction between positive and negative emotional instability predicting increased weight loss activities in a sample of those with anorexia nervosa. High and low values represent two standard deviations above and below the mean. Solid dark lines represent high positive emotional instability, while dashed gray lines indicate low positive emotional instability.

Mentions: The interaction between negative and positive emotional instability was significant for all weight-loss activities, and the graphs of these interactions are displayed in Figure 1. The combination of both high levels of negative and positive emotional instability predicted the highest levels of weight-loss behaviors, including laxative misuse [B = 0.00008, SE = 0.000003, t(114) = 4.98, p < 0.001, RR = 1.0001]3, exercising [B = 0.0001, SE = 0.00001, t(114) = 5.94, p < 0.001, RR = 1.0001], checking for fat [B = 0.0002, SE = 0.00004, t(114) = 5.36, p < 0.001, RR = 1.0002], weighing [B = 0.0001, SE = 0.00001, t(114) = 8.27, p < 0.001, RR = 1.0001], and restricting [B = 0.00005, SE = 0.00002, t(114) = 5.87, p = 0.015, RR = 1.0001]. Although the interaction for vomiting was significant [B = –0.0001, SE = 0.00001, t(114) = –10.17, p < 0.001, RR = 0.999], graphing out this interaction indicated that those with high negative emotional instability and low positive emotional instability reported the highest number of vomits. Finally, we examined a z-scored composite variable which took into account total frequency of all weight loss behaviors reported during the study with the interaction between positive and negative emotional instability. This interaction was significant [B = 0.00003, SE = 0.00001, t(114) = 5.22, p < 0.001, RR = 1.0001], and as indicated in Figure 2, participants reporting high levels of both positive and negative emotional instability also reported the most weight loss behaviors during the study. All interaction analyses were re-examined with anorexia subtype included as a covariate. Although anorexia binge-purge subtype was associated with elevated levels of some behaviors, all interaction terms remained significant.


A perfect storm: examining the synergistic effects of negative and positive emotional instability on promoting weight loss activities in anorexia nervosa.

Selby EA, Cornelius T, Fehling KB, Kranzler A, Panza EA, Lavender JM, Wonderlich SA, Crosby RD, Engel SG, Mitchell JE, Crow SJ, Peterson CB, Le Grange D - Front Psychol (2015)

Interaction between positive and negative emotional instability predicting increased weight loss activities in a sample of those with anorexia nervosa. High and low values represent two standard deviations above and below the mean. Solid dark lines represent high positive emotional instability, while dashed gray lines indicate low positive emotional instability.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553383&req=5

Figure 1: Interaction between positive and negative emotional instability predicting increased weight loss activities in a sample of those with anorexia nervosa. High and low values represent two standard deviations above and below the mean. Solid dark lines represent high positive emotional instability, while dashed gray lines indicate low positive emotional instability.
Mentions: The interaction between negative and positive emotional instability was significant for all weight-loss activities, and the graphs of these interactions are displayed in Figure 1. The combination of both high levels of negative and positive emotional instability predicted the highest levels of weight-loss behaviors, including laxative misuse [B = 0.00008, SE = 0.000003, t(114) = 4.98, p < 0.001, RR = 1.0001]3, exercising [B = 0.0001, SE = 0.00001, t(114) = 5.94, p < 0.001, RR = 1.0001], checking for fat [B = 0.0002, SE = 0.00004, t(114) = 5.36, p < 0.001, RR = 1.0002], weighing [B = 0.0001, SE = 0.00001, t(114) = 8.27, p < 0.001, RR = 1.0001], and restricting [B = 0.00005, SE = 0.00002, t(114) = 5.87, p = 0.015, RR = 1.0001]. Although the interaction for vomiting was significant [B = –0.0001, SE = 0.00001, t(114) = –10.17, p < 0.001, RR = 0.999], graphing out this interaction indicated that those with high negative emotional instability and low positive emotional instability reported the highest number of vomits. Finally, we examined a z-scored composite variable which took into account total frequency of all weight loss behaviors reported during the study with the interaction between positive and negative emotional instability. This interaction was significant [B = 0.00003, SE = 0.00001, t(114) = 5.22, p < 0.001, RR = 1.0001], and as indicated in Figure 2, participants reporting high levels of both positive and negative emotional instability also reported the most weight loss behaviors during the study. All interaction analyses were re-examined with anorexia subtype included as a covariate. Although anorexia binge-purge subtype was associated with elevated levels of some behaviors, all interaction terms remained significant.

Bottom Line: Using ecological momentary assessment methods, 118 participants with anorexia nervosa reported their emotional experiences and behaviors at least six times daily over 2 weeks using a portable digital device.Using generalized linear modeling, results indicated that high levels of both positive and negative emotional instability, and the interaction between the two, were associated with more frequent weight-loss activities, beyond anorexia subtype and mean levels of emotional intensity.The importance of addressing the role of both positive and negative emotion in anorexia treatment is discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, Rutgers University , Piscataway, NJ, USA.

ABSTRACT
Growing evidence indicates that both positive and negative emotion potentially influence the development and maintenance of anorexia nervosa, through both positive and negative reinforcement of weight loss activities. Such reactive emotional experience may be characterized by frequent and intense fluctuations in emotion, a construct known as "emotional instability." The purpose of this study was to investigate the association between positive emotional instability and weight loss activities in anorexia nervosa, and to investigate the synergistic effects of positive and negative emotional instability on promoting weight loss activities. Using ecological momentary assessment methods, 118 participants with anorexia nervosa reported their emotional experiences and behaviors at least six times daily over 2 weeks using a portable digital device. Using generalized linear modeling, results indicated that high levels of both positive and negative emotional instability, and the interaction between the two, were associated with more frequent weight-loss activities, beyond anorexia subtype and mean levels of emotional intensity. These findings indicate that when women with anorexia exhibit both high levels of both positive and negative emotional instability they are more prone to a variety of weight loss activities. The importance of addressing the role of both positive and negative emotion in anorexia treatment is discussed.

No MeSH data available.


Related in: MedlinePlus