Separating binge-eating disorder stigma and weight stigma: A vignette study.

OBJECTIVE: Vignette research on binge-eating disorder (BED) stigma is limited and lacking methodological rigor. Existing studies lack control vignettes and typically present characters with overweight or obesity, introducing the confound of weight stigma. This study examined BED stigma while addressing these limitations. METHOD: Participants (N = 421) were assigned to read one of six vignettes describing a woman with either BED or no BED as well as either no mention of weight, a recommended weight, or an obese weight. Four questionnaires examined personality stereotypes, emotional reactions to the character, desire for social distance from the character, and blame attributions. RESULTS: The character with BED was ascribed more negative personality characteristics and faced less positive emotional reactions than the character without BED, regardless of weight status. However, BED stigma did not emerge for social distance or blame attributions. Regarding weight stigma, evidence was limited and moderated by the presence of BED, suggesting no additive effect between BED stigma and weight stigma. In fact, blame attributions toward the character with obesity were reduced by the presence of BED. DISCUSSION: The results reveal that BED is a highly stigmatized eating disorder and suggest that weight stigma may be driven by assumptions about a person's eating behavior rather than their body size per se. Future studies must consider the relationship between BED stigma and weight stigma when assessing either form of stigma. The results also indicate new information to be integrated into anti-weight stigma campaigns as well as policy and public health initiatives.

Dialectical behavior therapy self-help for binge-eating disorder: A randomized controlled study.

OBJECTIVE: The objective of this study was to compare the relative effectiveness of dialectical behavior therapy guided self-help (DBT-GSH) and DBT unguided self-help (DBT-USH) with an unguided self-help control condition in the treatment of binge-eating disorder (BED). METHOD: Seventy-one participants who met diagnostic criteria for BED based on Eating Disorder Examination (EDE) interview were randomly assigned to DBT-GSH, DBT-USH or active control USH for 12 weeks. Assessments took place at baseline, 12 weeks and 3-month follow-up. Outcome measures included the EDE to assess binge frequency, the EDE-Questionnaire (EDE-Q), the Brief Symptom Inventory, and the Short Form 6D. RESULTS: The overall completion rate was 65% at post-treatment and 63% at 3-month follow-up. Intention to treat analyses showed that participants in all three conditions reported significant reductions in binge frequency with large effect sizes. A similar pattern emerged for secondary outcome variables including eating disorder psychopathology, general psychological distress, and health-related quality of life. DISCUSSION: Self-help may be an effective way to disseminate DBT for BED. However, future research should evaluate DBT self-help using a larger sample size, possibly in a multisite design.

Cognitive-behavioral therapy in the time of coronavirus: Clinician tips for working with eating disorders via telehealth when face-to-face meetings are not possible.

OBJECTIVE: The coronavirus pandemic has led to a dramatically different way of working for many therapists working with eating disorders, where telehealth has suddenly become the norm. However, many clinicians feel ill equipped to deliver therapy via telehealth, while adhering to evidence-based interventions. This article draws together clinician experiences of the issues that should be attended to, and how to address them within a telehealth framework. METHOD: Seventy clinical colleagues of the authors were emailed and invited to share their concerns online about how to deliver cognitive-behavioral therapy for eating disorders (CBT-ED) via telehealth, and how to adapt clinical practice to deal with the problems that they and others had encountered. After 96 hr, all the suggestions that had been shared by 22 clinicians were collated to provide timely advice for other clinicians. RESULTS: A range of themes emerged from the online discussion. A large proportion were general clinical and practical domains (patient and therapist concerns about telehealth; technical issues in implementing telehealth; changes in the environment), but there were also specific considerations and clinical recommendations about the delivery of CBT-ED methods. DISCUSSION: Through interaction and sharing of ideas, clinicians across the world produced a substantial number of recommendations about how to use telehealth to work with people with eating disorders while remaining on track with evidence-based practice. These are shared to assist clinicians over the period of changed practice.

Dialectical behavior therapy guided self-help for binge-eating disorder.

Binge-eating disorder (BED) is a prevalent and serious public health issue. BED is characterized by recurrent out-of-control binge eating episodes in the absence of extreme weight control behavior and is associated with significant psychosocial and physiological impairment. Dialectical Behavior Therapy (DBT), based on the affect regulation model of binge eating, is an evidence-based treatment (EBT) approach for BED. Unfortunately, access to EBTs is often limited due to geographical barriers (i.e., lack of local providers with specialized training in EBTs), lack of financial resources, and/or time constraints. Self-help approaches (via guided and unguided versions) to delivering DBT for BED offer a potentially effective means of more widely disseminating this treatment. Compared to traditional, higher intensity approaches, self-help DBT for BED is less time-consuming, less financially costly, and requires less need for specialized therapist-training. This paper will present how DBT for BED has been adapted for self-help delivery, review the limited but promising research on DBT self-help available to date, and provide directions for future research.

Symptoms of 'food addiction' in binge eating disorder using the Yale Food Addiction Scale version 2.0.

'Food addiction' refers to the idea that certain highly palatable foods can trigger an addictive-like process in susceptible individuals. The aim of this study was to assess the prevalence and clinical significance of 'food addiction' symptoms in binge eating disorder (BED) using the second version of the Yale Food Addiction Scale (YFAS 2.0). Participants were 71 individuals with BED and 79 individuals with no history of an eating disorder (NED). The Eating Disorder Examination 17.0 (EDE) was used to diagnose BED and to measure binge eating. Participants completed self-report measures of eating disorder psychopathology, psychological distress, and the YFAS 2.0. Results indicated that the BED group reported significantly higher 'food addiction' scores compared to the NED group after controlling for relevant covariates. In fact, 92% of the BED group met YFAS 2.0 criteria for at least mild 'food addiction' compared to only 6% of the NED group. BED participants who met criteria for Moderate/Severe 'food addiction' reported significantly higher eating disorder psychopathology (except dietary restraint) as well as higher levels of anxiety and depression than BED participants with No/Mild 'food addiction'. Scores on the YFAS 2.0 positively predicted binge frequency, but not global eating disorder psychopathology, in the BED group after controlling for body mass index (BMI), depression and anxiety. The high rate of 'food addiction' symptoms in the BED group may reflect overlap between the symptoms assessed by the YFAS 2.0 and the clinical features of BED. A focus on identifying overlapping and distinctive underlying mechanisms rather than similarities and differences in clinical features might be a more fruitful avenue for future research on BED and 'food addiction'.

Barriers to Purchasing Condoms in a High HIV/STI-Risk Urban Area.

The Centers for Disease Control and Prevention (CDC) have identified Atlanta, Georgia as a high-risk environment for STI/HIV infection. Condoms are an inexpensive and effective method for preventing STI/HIV infection. The majority of individuals acquire their condoms through purchase, rather than through free condom distribution programs. However, individuals purchasing condoms in stores encounter numerous barriers. This study assessed the environmental and physical barriers surrounding condom purchases in stores in downtown Atlanta. The findings revealed a combination of high environmental and physical barriers, low visibility of condoms in stores and limited selection of safer sex supplies. In the most densely populated area of the city, stores which sold condoms were few (n = 25), equating to 1 store per ~ 7000 people. In 80% of stores, personnel were required in order to access the condoms. In 28% of stores, condoms were hidden underneath the counter. The majority of stores offered only one brand of male condoms with a limited selection of lubricants and no dental dams or internal condoms. Barriers and discomfort surrounding purchasing condoms can contribute to embarrassment, which has a negative impact on condom acquisition and ultimately on condom use. Efforts must be made to lower barriers in Atlanta and make condoms more readily available to high-risk populations. Community advocacy has been effective in removing barriers to condoms. Access can furthermore be improved by: installing condom vending machines in public locations, offering self-check-out in stores that do not have physical barriers and encouraging individuals to order condoms online.

I weigh therefore I am: Implications of using different criteria to define overvaluation of weight and shape in binge-eating disorder.

OBJECTIVE: Research suggests that overvaluation of weight and shape is a clinical feature in binge-eating disorder (BED). However, this construct has been differentially defined in the literature even when using the same measure. Here we compare two cut-offs that have previously been used to differentiate clinical and subthreshold overvaluation using the EDE-Q. METHOD: Individuals with BED (n = 72, 93% female) and no history of an eating disorder (NED; n = 21, 91% female) completed measures of eating disorder (ED) and general psychopathology online. Individuals with BED were categorized as having clinical or subthreshold overvaluation using two different cut-offs used in previous studies. The clinical, subthreshold, and NED groups were compared on ED and general psychopathology. The association between overvaluation and psychopathology was also assessed in the BED and NED groups. RESULTS: The two cut-offs yielded identical results, with individuals in the clinical overvaluation group reporting greater ED psychopathology than those in the subthreshold and NED groups. When considered as a continuous variable, overvaluation was a significant predictor of both ED-related and general psychopathology. DISCUSSION: The two cut-offs yielded identical results, likely due to the high internal consistency between overvaluation items. Under such circumstances, the use of either cut-off seems appropriate. However, given the associations reported in the regression analyses, we propose that considering overvaluation as a dimensional variable, rather than a categorical one, may have greater utility.

Ultrafine particulate matter exposure impairs vasorelaxant response in superoxide dismutase 2-deficient murine aortic rings.

Studies have linked exposure to ultrafine particulate matter (PM) and adverse cardiovascular events. PM-induced oxidative stress is believed to be a key mechanism underlying observed adverse vascular effects. Advanced age is one factor known to decrease antioxidant defenses and confer susceptibility to the detrimental vascular effects seen following PM exposure. The present study was designed to investigate the vasomotor responses following ultrafine PM exposure in wild type (WT) and superoxide dismutase 2-deficient (SOD2+/-) mice that possess decreased antioxidant defense. Thoracic aortic rings isolated from young and aged WT and SOD2+/- mice were exposed to ultrafine PM in a tissue bath system. Aortic rings were then constricted with increasing concentrations of phenylephrine, followed by relaxation with rising amounts of nitroglycerin (NTG). Data demonstrated that ultrafine PM decreased the relaxation response in both young WT and young SOD2+/- mouse aortas, and relaxation was significantly reduced in young SOD2+/- compared to WT mice. Ultrafine PM significantly diminished the NTG-induced relaxation response in aged compared to young mouse aortas. After ultrafine PM exposure, the relaxation response did not differ markedly between aged WT and aged SOD2+/- mice. Data demonstrated that the greater vascular effect in aortic rings in aged mice ex vivo after ultrafine PM exposure may be attributed to ultrafine PM-induced oxidative stress and loss of antioxidant defenses in aged vascular tissue. Consistent with this conclusion is the attenuation of NTG-induced relaxation response in young SOD2+/- mice. ABBREVIATIONS: H2O2: hydrogen peroxide; NTG: nitroglycerin; PAH: polycyclic aromatic hydrocarbons; PE: l-phenylephrine; PM: particulate matter; ROS: reactive oxygen species; SOD2: superoxide dismutase 2 deficient; WT: wild type.

An examination of the relationship between binge eating disorder and insomnia symptoms.

OBJECTIVE: Although studies on sleep difficulties in binge eating disorder (BED) have produced inconsistent findings, research has linked poor sleep to the presence of related concerns (e.g., obesity, anxiety, and depression). To clarify the relationship between BED and sleep problems, this study aimed to compare insomnia symptoms in individuals with BED and those with no history of an eating disorder (NED). METHOD: An adult community sample of individuals with BED (N = 68) and NED (N = 78) completed measures of insomnia, depression and anxiety, and eating disorder symptoms. RESULTS: Individuals with BED reported significantly greater insomnia symptoms than the NED group. The relationship between BED and insomnia symptoms was partially mediated by anxiety. Depression fully mediated the positive association between insomnia symptom severity and binge frequency in the BED group. DISCUSSION: These findings suggest that depression, anxiety, and sleep are important constructs to consider in BED development and presentation.

Testing predictions of the emotion regulation model of binge-eating disorder.

OBJECTIVE: The emotion regulation (ER) model of binge eating posits that individuals with binge-eating disorder (BED) experience more intense emotions and greater difficulties in ER than individuals without BED, leading them to binge eat as a means of regulating emotions. According to this model, individuals with BED should report greater difficulties in ER than their non-BED counterparts, the severity of these difficulties should be positively associated with BED symptoms, and this association should be stronger when individuals experience persistent negative emotions (i.e., depression). Studies examining these hypotheses, however, have been limited. METHOD: Data were collected from adults meeting the DSM 5 criteria for BED (n = 71; 93% female) and no history of an eating disorder (NED; n =  79; 83.5% female). Participants completed self-report measures of difficulties in ER, eating disorder (ED) psychopathology, and depression. RESULTS: Individuals with BED reported greater difficulties in ER compared to those with NED. Moreover, difficulties in ER predicted unique variance in binge frequency and ED psychopathology in BED. Depression moderated the association between ER difficulties and binge frequency such that emotion dysregulation and binge frequency were positively associated in those reporting high, but not low, depression levels. DISCUSSION: The association between difficulties in ER and ED pathology in BED suggests that treatments focusing on improving ER skills may be effective in treating this ED; however, the moderating effect of depression underscores the need for research on individual differences and treatment moderators. These findings suggest the importance of ER in understanding and treating BED.

Le trouble de l'accès hyperphagique: Aperçu actualisé à l'intention des professionnels des soins primaires.

OBJECTIF: Fournir aux professionnels des soins primaires un aperçu actualisé du trouble de l'accès hyperphagique (TAH), qui comporte des recommandations pertinentes. QUALITÉ DES DONNÉES: Une recension a été effectuée dans PubMed, PsycInfo et Google Scholar, sans restrictions temporelles, à l'aide des expressions clés en anglais binge eating disorder, treatment, review, guidelines, psychotherapy, primary care et pharmacotherapy. Le niveau des données probantes pour toutes les recommandations varie de I à III. MESSAGE PRINCIPAL: Le trouble de l'accès hyperphagique est associé à une grande détresse et à une incapacité considérable chez le patient, ainsi qu'à des comorbidités médicales et psychiatriques; il a été ajouté dans la 5e édition du Manuel diagnostique et statistique des troubles mentaux, en 2013. Les médecins de soins primaires sont bien placés pour le dépistage, le diagnostic et l'amorce du traitement du TAH. Une approche par étapes du traitement commence par un développement personnel guidé, suivi par l'ajout ou le changement de la pharmacothérapie, ou par une psychothérapie individuelle, au besoin. Les psychothérapies dont l'efficacité est le plus corroborée par la recherche sont la thérapie cognitivo-comportementale, la thérapie interpersonnelle et la thérapie comportementale dialectique. CONCLUSION: Cet aperçu présente des conseils sur le dépistage, le diagnostic et les approches thérapeutiques fondés sur les données probantes actuellement disponibles, de même les avis d'un groupe diversifié d'experts, pour aider à orienter les cliniciens lorsque les données probantes sont limitées.

Adjunctive graded body image exposure for eating disorders: A randomized controlled initial trial in clinical practice.

OBJECTIVE: Graded body image exposure is a key component of CBT for eating disorders (EDs). However, despite being a highly anxiety-provoking intervention, its specific effectiveness is unknown. The aims of this initial study were to investigate the feasibility and preliminary effectiveness of individualized graded body image exposure to a range of feared/avoided body image-related situations in a sample of partially remitted ED patients. METHOD: Forty-five female adult participants were randomly assigned to maintenance treatment as usual (MTAU) only or MTAU plus five sessions of graded body image exposure. RESULTS: The graded body image exposure intervention led to large improvements in body avoidance as measured by two different methods. In addition, there was evidence of a significant impact of body image exposure on the overvaluation of shape, but not weight, 5 months after treatment. DISCUSSION: Taken together, the current results provide evidence of the feasibility of adjunctive individualized graded body image exposure within a clinical treatment program and suggest that graded body image exposure reduces body avoidance behaviors in partially remitted ED patients. Our findings suggest that individualized graded body image exposure shows promise as an intervention targeting the overvaluation of shape in EDs.

A Randomized controlled trial of motivational interviewing + self-help versus psychoeducation + self-help for binge eating.

OBJECTIVE: Motivational Interviewing (MI) is a collaborative therapy that focuses on strengthening a person's internal motivation to change. Research suggests that MI may be helpful for treating binge eating; however, findings are limited and little is known about how MI for binge eating compares to active therapy controls. The present study aimed to build on current research by comparing MI as a prelude to self-help treatment for binge eating with psychoeducation as a prelude to self-help treatment for binge eating. METHOD: Participants with full or subthreshold DSM-IV Binge Eating Disorder or nonpurging Bulimia Nervosa were randomly assigned to receive either 60 minutes of MI followed by a self-help manual (n = 24) or 60 minutes of psychoeducation followed by a self-help manual (n = 21). Questionnaires were completed pre- and postsession, and at 1 and 4 months postsession. RESULTS: MI significantly increased readiness to change and confidence in ability to control binge eating, whereas psychoeducation did not. No group differences were found when changes in eating disorder attitudes and behaviors were examined. DISCUSSION: MI offers benefits for increasing motivation and self-efficacy. However, it may not be a uniquely effective treatment approach for reducing binge eating.

Repeated measures of inflammation, blood pressure, and heart rate variability associated with traffic exposures in healthy adults.

BACKGROUND: Previous human exposure studies of traffic-related air pollutants have demonstrated adverse health effects in human populations by comparing areas of high and low traffic, but few studies have utilized microenvironmental monitoring of pollutants at multiple traffic locations while looking at a vast array of health endpoints in the same population. We evaluated inflammatory markers, heart rate variability (HRV), blood pressure, exhaled nitric oxide, and lung function in healthy participants after exposures to varying mixtures of traffic pollutants. METHODS: A repeated-measures, crossover study design was used in which 23 healthy, non-smoking adults had clinical cardiopulmonary and systemic inflammatory measurements taken prior to, immediately after, and 24 hours after intermittent walking for two hours in the summer months along three diverse roadways having unique emission characteristics. Measurements of PM2.5, PM10, black carbon (BC), elemental carbon (EC), and organic carbon (OC) were collected. Mixed effect models were used to assess changes in health effects associated with these specific pollutant classes. RESULTS: Minimal associations were observed with lung function measurements and the pollutants measured. Small decreases in BP measurements and rMSSD, and increases in IL-1ß and the low frequency to high frequency ratio measured in HRV, were observed with increasing concentrations of PM2.5 EC. CONCLUSIONS: Small, acute changes in cardiovascular and inflammation-related effects of microenvironmental exposures to traffic-related air pollution were observed in a group of healthy young adults. The associations were most profound with the diesel-source EC.

Autonomous and controlled motivation for eating disorders treatment: baseline predictors and relationship to treatment outcome.

OBJECTIVE: This study aimed to identify baseline predictors of autonomous and controlled motivation for treatment (ACMT) in a transdiagnostic eating disorder sample, and to examine whether ACMT at baseline predicted change in eating disorder psychopathology during treatment. METHOD: Participants were 97 individuals who met DSM-IV-TR criteria for an eating disorder and were admitted to a specialized intensive treatment programme. Self-report measures of eating disorder psychopathology, ACMT, and various psychosocial variables were completed at the start of treatment. A subset of these measures was completed again after 3, 6, 9, and 12 weeks of treatment. RESULTS: Multiple regression analyses showed that baseline autonomous motivation was higher among patients who reported more self-compassion and more received social support, whereas the only baseline predictor of controlled motivation was shame. Multilevel modelling revealed that higher baseline autonomous motivation predicted faster decreases in global eating disorder psychopathology, whereas the level of controlled motivation at baseline did not. CONCLUSION: The current findings suggest that developing interventions designed to foster autonomous motivation specifically and employing autonomy supportive strategies may be important to improving eating disorders treatment outcome. PRACTITIONER POINTS: The findings of this study suggest that developing motivational interventions that focus specifically on enhancing autonomous motivation for change may be important for promoting eating disorder recovery. Our results lend support for the use of autonomy supportive strategies to strengthen personally meaningful reasons to achieve freely chosen change goals in order to enhance treatment for eating disorders. One study limitation is that there were no follow-up assessments beyond the 12-week study and we therefore do not know whether the relationships that we observed persisted after treatment. Another limitation is that this was a correlational study and it is therefore important to be cautious about making causal conclusions when interpreting the results.

An investigation of the factor structure of the beck depression inventory-II in anorexia nervosa.

Symptoms of depression frequently co-occur with eating disorders and have been associated with negative outcomes. Self-report measures such as the Beck Depression Inventory-II (BDI-II) are commonly used to assess for the presence of depressive symptoms in eating disorders, but the instrument's factor structure in this population has not been examined. The purposes of this study were to explore the factor structure of the BDI-II in a sample of individuals (N = 437) with anorexia nervosa undergoing inpatient treatment and to examine changes in depressive symptoms on each of the identified factors following a course of treatment for anorexia nervosa in order to provide evidence supporting the construct validity of the measure. Exploratory factor analysis revealed that a three-factor model reflected the best fit for the data. Confirmatory factor analysis was used to validate this model against competing models and the three-factor model exhibited strong model fit characteristics. BDI-II scores were significantly reduced on all three factors following inpatient treatment, which supported the construct validity of the scale. The BDI-II appears to be reliable in this population, and the factor structure identified through this analysis may offer predictive utility for identifying individuals who may have more difficulty achieving weight restoration in the context of inpatient treatment. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Subcallosal cingulate deep brain stimulation for treatment-refractory anorexia nervosa: a phase 1 pilot trial.

BACKGROUND: Anorexia nervosa is characterised by a chronic course that is refractory to treatment in many patients and has one of the highest mortality rates of any psychiatric disorder. Deep brain stimulation (DBS) has been applied to circuit-based neuropsychiatric diseases, such as Parkinson's disease and major depression, with promising results. We aimed to assess the safety of DBS to modulate the activity of limbic circuits and to examine how this might affect the clinical features of anorexia nervosa. METHODS: We did a phase 1, prospective trial of subcallosal cingulate DBS in six patients with chronic, severe, and treatment-refractory anorexia nervosa. Eligible patients were aged 20-60 years, had been diagnosed with restricting or binge-purging anorexia nervosa, and showed evidence of chronicity or treatment resistance. Patients underwent medical optimisation preoperatively and had baseline body-mass index (BMI), psychometric, and neuroimaging investigations, followed by implantation of electrodes and pulse generators for continuous delivery of electrical stimulation. Patients were followed up for 9 months after DBS activation, and the primary outcome of adverse events associated with surgery or stimulation was monitored at every follow-up visit. Repeat psychometric assessments, BMI measurements, and neuroimaging investigations were also done at various intervals. This trial is registered with ClinicalTrials.gov, number NCT01476540. FINDINGS: DBS was associated with several adverse events, only one of which (seizure during programming, roughly 2 weeks after surgery) was serious. Other related adverse events were panic attack during surgery, nausea, air embolus, and pain. After 9 months, three of the six patients had achieved and maintained a BMI greater than their historical baselines. DBS was associated with improvements in mood, anxiety, affective regulation, and anorexia nervosa-related obsessions and compulsions in four patients and with improvements in quality of life in three patients after 6 months of stimulation. These clinical benefits were accompanied by changes in cerebral glucose metabolism (seen in a comparison of composite PET scans at baseline and 6 months) that were consistent with a reversal of the abnormalities seen in the anterior cingulate, insula, and parietal lobe in the disorder. INTERPRETATION: Subcallosal cingulate DBS seems to be generally safe in this sample of patients with chronic and treatment-refractory anorexia nervosa. FUNDING: Klarman Family Foundation Grants Program in Eating Disorders Research and Canadian Institutes of Health Research.

Are improvements in shame and self-compassion early in eating disorders treatment associated with better patient outcomes?

Compassion-focused therapy (CFT; Gilbert, 2005, 2009) is a transdiagnostic treatment approach focused on building self-compassion and reducing shame. It is based on the theory that feelings of shame contribute to the maintenance of psychopathology, whereas self-compassion contributes to the alleviation of shame and psychopathology. We sought to test this theory in a transdiagnostic sample of eating disorder patients by examining whether larger improvements in shame and self-compassion early in treatment would facilitate faster eating disorder symptom remission over 12 weeks. Participants were 97 patients with an eating disorder admitted to specialized day hospital or inpatient treatment. They completed the Eating Disorder Examination-Questionnaire, Experiences of Shame Scale, and Self-Compassion Scale at intake, and again after weeks 3, 6, 9, and 12. Multilevel modeling revealed that patients who experienced greater decreases in their level of shame in the first 4 weeks of treatment had faster decreases in their eating disorder symptoms over 12 weeks of treatment. In addition, patients who had greater increases in their level of self-compassion early in treatment had faster decreases in their feelings of shame over 12 weeks, even when controlling for their early change in eating disorder symptoms. These results suggest that CFT theory may help to explain the maintenance of eating disorders. Clinically, findings suggest that intervening with shame early in treatment, perhaps by building patients' self-compassion, may promote better eating disorders treatment response.

The relationship between difficulties in the regulation of positive and negative emotions and binge-eating symptoms in young adults.

It is well-established that binge-eating (BE) is linked to emotion regulation (ER) difficulties. However, research to date has focused almost exclusively on difficulties regulating negative emotions, with little attention to the relationship between positive emotion dysregulation and BE. Further, research is inconclusive regarding which specific facets of ER difficulties are most strongly associated with BE behaviour. Therefore, the current study examined whether difficulties regulating both negative as well as positive emotions explained unique variance in BE among young adults. The study also aimed to identify which particular dimensions of negative and positive ER difficulties were most strongly related to BE symptoms. Participants (N = 449) ages 18-25 completed self-report measures of difficulties regulating positive and negative emotions, BE symptoms, and psychological distress. Hierarchical regression analyses showed that BE was related to difficulties regulating both positive emotions and negative emotions, after controlling for psychological distress and BMI. Lack of emotional clarity and lack of access to ER strategies when faced with strong negative emotions were the facets of negative ER difficulties most strongly associated with BE. Impulsivity when experiencing strong positive emotions was the facet of positive ER difficulties most strongly associated with BE. These findings support the ER model of BE and suggest that difficulties regulating both positive and negative emotions contribute to BE among young adults.