The influence of social norms on anticipated snacking: An experimental study comparing different types of social norms.

Previous studies have found that social norms affect eating behavior for different types of social norm measures and manipulations as well as different types of eating behavior. The current study investigated the effects of descriptive, injunctive, and liking norms on intentions to consume healthy snacks and anticipated snack choice, compared to a no-norm control condition. Moreover, we distinguished between descriptive norms that stress the frequency versus the quantity of food consumption. An experiment was conducted among 189 young adults. It was hypothesized that participants who received a descriptive quantity or frequency norm would intend to consume, and make an anticipated selection of, more low-calorie snacks than participants who received a no-norm control message. Due to inconsistency or lacking evidence regarding the effects of the other types of norms on eating behavior, no hypotheses were formulated for the injunctive and liking norm conditions. The hypothesis was partly confirmed. Descriptive quantity and frequency norms did not result in a stronger intention to consume healthy snacks in the upcoming week, but they did result in lower-calorie snack choices when people were asked to select three snacks that they planned to eat on the following day. No other differences between the conditions were found. These findings show that emphasizing both how much and how often most other people consume healthy foods affects anticipated healthy food choices. This can provide health professionals more options to mobilize the power of descriptive social norms for affecting health behavior change.

Determinants of changes in women's and men's eating behavior across the transition to parenthood: a focus group study.

BACKGROUND: During the pregnancy and postpartum period, both women and men experience physiological and psychological changes, which may negatively impact their eating behavior. A clear understanding of determinants of changes in eating behavior during this period is needed to facilitate the development of targeted family-based interventions countering unfavorable dietary changes during this critical life period. METHODS: Thirteen focus group discussions targeting determinants of changes in eating behavior during pregnancy and postpartum were conducted, involving a total of 74 expecting and first-time parents. A semi-structured question guide was used to facilitate the discussions. An inductive thematic approach was used to derive main and sub-categories of determinants from the data. The Determinants of Nutrition and Eating (DONE)-framework was employed to systematically organize and label the categories and determinants. RESULTS: Two frameworks were developed; one for the pregnancy and one for the postpartum period, comprising determinants of changes in eating behavior in both women and men. Three main levels of determinants were identified: (1) the individual level, including psychological (e.g., 'health consciousness'), situational (e.g., 'effort and convenience') and biological (e.g., 'discomfort'); (2) the interpersonal level (e.g., 'social influence') and (3) the environmental level, including micro- and meso/macro (e.g., 'home/environment food availability'). Determinants acting as barriers (e.g., 'time constraints') or facilitators (e.g., 'being a role model') were identified. Many determinants were mentioned during both (e.g., 'food knowledge') or just one investigated period (e.g., 'physiological changes' during pregnancy, 'influence of the baby' postpartum). Finally, some were described by both parents (e.g., 'self-regulation'), whereas others were mentioned by women (e.g., '(perceived) food safety') or men (e.g., 'other priorities') only. CONCLUSION: The developed frameworks set the foundation for the development of future family-based interventions and may be used already by healthcare providers to provide dietary guidance and support for women and men transitioning into parenthood. A focus on the interplay of individual factors at the biological and psychological level together with situational difficulties during pregnancy is recommended. Postpartum, focus should go to support first-time parents to obtain balance of both maintaining one's own health and taking care of the baby, on improving self-regulation skills, and on coping with related situational constraints.

Measurement of availability and accessibility of food among youth: a systematic review of methodological studies.

BACKGROUND: Comprehensive and psychometrically tested measures of availability and accessibility of food are needed in order to explore availability and accessibility as determinants and predictors of dietary behaviors. The main aim of this systematic review was to update the evidence regarding the psychometric properties of measures of food availability and accessibility among youth. A secondary objective was to assess how availability and accessibility were conceptualized in the included studies. METHODS: A systematic literature search was conducted using Medline, Embase, PsycINFO and Web of Science. Methodological studies published between January 2010 and March 2016 and reporting on at least one psychometric property of a measure of availability and/or accessibility of food among youth were included. Two reviewers independently extracted data and assessed study quality. Existing criteria were used to interpret reliability and validity parameters. RESULTS: A total of 20 studies were included. While 16 studies included measures of food availability, three included measures of both availability and accessibility; one study included a measure of accessibility only. Different conceptualizations of availability and accessibility were used across the studies. The measures aimed at assessing availability and/or accessibility in the home environment (n = 11), the school (n = 4), stores (n = 3), childcare/early care and education services (n = 2) and restaurants (n = 1). Most studies followed systematic steps in the development of the measures. The most common psychometrics tested for these measures were test-retest reliability and criterion validity. The majority of the measures had satisfactory evidence of reliability and/or validity. None of the included studies assessed the responsiveness of the measures. CONCLUSIONS: The review identified several measures of food availability or accessibility among youth with satisfactory evidence of reliability and/or validity. Findings indicate a need for more studies including measures of accessibility and addressing its conceptualization. More testing of some of the identified measures in different population groups is also warranted, as is the development of more measures of food availability and accessibility in the broader environment such as the neighborhood food environment.

Developing a systems-based framework of the factors influencing dietary and physical activity behaviours in ethnic minority populations living in Europe - a DEDIPAC study.

BACKGROUND: Some ethnic minority populations have a higher risk of non-communicable diseases than the majority European population. Diet and physical activity behaviours contribute to this risk, shaped by a system of inter-related factors. This study mapped a systems-based framework of the factors influencing dietary and physical activity behaviours in ethnic minority populations living in Europe, to inform research prioritisation and intervention development. METHODS: A concept mapping approach guided by systems thinking was used: i. Preparation (protocol and terminology); ii. Generating a list of factors influencing dietary and physical activity behaviours in ethnic minority populations living in Europe from evidence (systematic mapping reviews) and 'eminence' (89 participants from 24 academic disciplines via brainstorming, an international symposium and expert review) and; iii. Seeking consensus on structuring, rating and clustering factors, based on how they relate to each other; and iv. Interpreting/utilising the framework for research and interventions. Similar steps were undertaken for frameworks developed for the majority European population. RESULTS: Seven distinct clusters emerged for dietary behaviour (containing 85 factors) and 8 for physical activity behaviours (containing 183 factors). Four clusters were similar across behaviours: Social and cultural environment; Social and material resources; Psychosocial; and Migration context. Similar clusters of factors emerged in the frameworks for diet and physical activity behaviours of the majority European population, except for 'migration context'. The importance of factors across all clusters was acknowledged, but their relative importance differed for ethnic minority populations compared with the majority population. CONCLUSIONS: This systems-based framework integrates evidence from both expert opinion and published literature, to map the factors influencing dietary and physical activity behaviours in ethnic minority groups. Our findings illustrate that innovative research and complex interventions need to be developed that are sensitive to the needs of ethnic minority populations. A systems approach that encompasses the complexity of the inter-related factors that drive behaviours may inform a more holistic public health paradigm to more effectively reach ethnic minorities living in Europe, as well as the majority host population.

The social image of food: Associations between popularity and eating behavior.

One factor that determines what we eat and why we eat is our social environment. In the present research, two online studies examined the relationship between food intake and social images. Specifically, the present research assessed the relationship between the food intake university students ascribed to peers who varied in popularity and own self-reported food intake, and whether this relationship was moderated by identification with the peer group. Participants (N = 97 in Study 1; N = 402 in Study 2) were randomly presented with one of four (Study 1) or two of eight (Study 2) vignettes describing a popular or unpopular student (male or female) from their university without receiving any information about the peer's eating behavior. Subsequently, healthy and unhealthy eating ascribed to the peers and own self-reported eating behavior were assessed. Results indicated that popular peers were perceived to eat more healthily than unpopular peers. Moreover, eating behavior ascribed to popular peers were associated with own healthy and unhealthy eating. Importantly, the relationship between healthy eating behavior ascribed to popular peers and own healthy eating behavior was moderated by identification with the student group - the more participants identified with their peers, the more their own eating was aligned with the healthy eating ascribed to a popular peer. Hence, the popularity of others seems to shape perceptions of the food they eat and may facilitate healthy eating via social influence.

Predictors of food decision making: A systematic interdisciplinary mapping (SIM) review.

The number of publications on consumer food decision making and its predictors and correlates has been steadily increasing over the last three decades. Given that different scientific disciplines illuminate this topic from different perspectives, it is necessary to develop an interdisciplinary overview. The aim of this study is to conduct a systematic interdisciplinary mapping (SIM) review by using rapid review techniques to explore the state-of-the-art, and to identify hot topics and research gaps in this field. This interdisciplinary review includes 1,820 publications in 485 different journals and other types of publications from more than ten disciplines (including nutritional science, medicine/health science, psychology, food science and technology, business research, etc.) across a period of 60 years. The identified predictors of food decision making were categorized in line with the recently proposed DONE (Determinants Of Nutrition and Eating behavior) framework. After applying qualitative and quantitative analyses, this study reveals that most of the research emphasizes biological, psychological, and product-related predictors, whereas policy-related influences on food choice are scarcely considered.

Hungry for an intervention? Adolescents' ratings of acceptability of eating-related intervention strategies.

BACKGROUND: Effective interventions promoting healthier eating behavior among adolescents are urgently needed. One factor that has been shown to impact effectiveness is whether the target population accepts the intervention. While previous research has assessed adults' acceptance of eating-related interventions, research on the opinion of adolescents is lacking. The current study addressed this gap in the literature. METHODS: Two thousand seven hundred sixty four adolescents (aged 10-17 years) from four European countries answered questions about individual characteristics (socio-demographics, anthropometrics, and average daily intake of healthy and unhealthy foods) and the acceptability of ten eating-related intervention strategies. These strategies varied in type (either promoting healthy eating or discouraging unhealthy eating), level of intrusiveness, setting (home, school, broader out-of-home environment), and change agent (parents, teacher, policy makers). RESULTS: Based on adolescents' acceptability ratings, strategies could be clustered into two categories, those promoting healthy eating and those discouraging unhealthy eating, with acceptability rated significantly higher for the former. Acceptability of intervention strategies was rated moderate on average, but higher among girls, younger, overweight and immigrant adolescents, and those reporting healthier eating. Polish and Portuguese adolescents were overall more accepting of strategies than UK and Dutch adolescents. CONCLUSIONS: Adolescents preferred intervention strategies that promote healthy eating over strategies that discourage unhealthy eating. Level of intrusiveness affected acceptability ratings for the latter type of strategies only. Various individual and behavioral characteristics were associated with acceptability. These findings provide practical guidance for the selection of acceptable intervention strategies to improve adolescents' eating behavior.

The proof is in the eating: subjective peer norms are associated with adolescents' eating behaviour.

OBJECTIVE: To investigate associations of self-perceived eating-related peer norms (called 'subjective peer norms') with adolescents' healthy eating intentions and intake of healthy and unhealthy food. DESIGN: Cross-sectional data were collected in a large international survey. SETTING: Two types of subjective peer norms were assessed: perceived peer encouragement of healthy eating and perceived peer discouragement of unhealthy eating. Outcome variables were healthy eating intentions, intake of healthy food (fruits and vegetables) and intake of unhealthy food (snacks and soft drinks). SUBJECTS: Over 2500 European (pre-)adolescents aged between 10 and 17 years participated. RESULTS: Subjective peer norms were associated with all three outcome variables. While both perceived encouragement of healthy eating and perceived discouragement of unhealthy eating were related to intentions, only peer encouragement of healthy eating was related to intakes of both healthy and unhealthy food. CONCLUSIONS: Subjective peer norms play a role in adolescent eating behaviour and as such are an important target for health promotion. Addressing norms that encourage healthy eating may be more promising in changing behaviour than norms that discourage unhealthy eating.

The habitual nature of unhealthy snacking: How powerful are habits in adolescence?

Many adolescents engage in unhealthy snacking behavior, and the frequency and amount of unhealthy consumption is increasing further. In this study, we aim to investigate the role that habit strength plays in unhealthy snacking during adolescence and whether self-regulation strategies can overcome habitual snacking. A total of 11,392 adolescents aged 10-17 years from nine European countries completed a cross-sectional survey about healthy eating intentions, snacking habit strength, eating self-regulation strategies, and daily intake of unhealthy snacks. The results showed that habit strength was positively associated with intake of unhealthy snack foods, also when healthy eating intentions were accounted for. Use of self-regulation strategies was negatively associated with unhealthy snacking. The interaction effect of habit strength and use of self-regulation strategies was significant. Strong snacking habits were associated with higher consumption, but this effect could be attenuated by use of temptation-oriented self-regulation strategies. The present study highlights that habit strength is associated with unhealthy snacking already in adolescents. The findings suggest that teaching self-regulation strategies may help adolescents to overcome unhealthy snacking habits.

Communicating eating-related rules. Suggestions are more effective than restrictions.

BACKGROUND: A common social influence technique for curbing unhealthy eating behavior is to communicate eating-related rules (e.g. 'you should not eat unhealthy food'). Previous research has shown that such restrictive rules sometimes backfire and actually increase unhealthy consumption. In the current studies, we aimed to investigate if a milder form of social influence, a suggested rule, is more successful in curbing intake of unhealthy food. We also investigated how both types of rules affected psychological reactance. METHOD: Students (N = 88 in Study 1, N = 51 in Study 2) completed a creativity task while a bowl of M&M's was within reach. Consumption was either explicitly forbidden (restrictive rule) or mildly discouraged (suggested rule). In the control condition, consumption was either explicitly allowed (Study 1) or M&M's were not provided (Study 2). Measures of reactance were assessed after the creativity task. Subsequently, a taste test was administered where all participants were allowed to consume M&M's. RESULTS: Across both studies, consumption during the creativity task did not differ between the restrictive- and suggested-rule-conditions, indicating that both are equally successful in preventing initial consumption. Restrictive-rule-condition participants reported higher reactance and consumed more in the free-eating taste-test phase than suggested-rule-condition participants and control-group participants, indicating a negative after-effect of restriction. DISCUSSION: RESULTS show that there are more and less effective ways to communicate eating-related rules. A restrictive rule, as compared to a suggested rule, induced psychological reactance and led to greater unhealthy consumption when participants were allowed to eat freely. It is important to pay attention to the way in which eating-related rules are communicated.

How to convince the vaccine-hesitant? An ease-of-access nudge, but not risk-related information increased Covid vaccination-related behaviors in the unvaccinated.

In this study, we contrast how different benefit and harm information formats and the presence or absence of an ease-of-access nudge may facilitate COVID vaccination uptake for a sample of 620 unvaccinated Dutch adults at a timepoint when the vaccine had been widely available for more than a month. Using a 2 × 2 between-subjects factorial design, we varied the information format on mRNA COVID vaccination statistics (generic text vs. facts box) and an affirmative nudge emphasizing the ease of making a vaccination appointment (absent vs. present). We assessed the acceptance of the vaccination information provided, perceptions on the vaccination, and whether participants directly visited a COVID vaccination appointment website. Whereas the facts box did not significantly affect participants' information acceptance, vaccination attitudes, intentions, and link clicking, the affirmative nudge alongside an online link systematically increased the likelihood of clicking on the link to make a vaccination appointment. A verbal nudge emphasizing the ease of vaccine accessibility is more likely to increase vaccination uptake in an unvaccinated population than informational campaigns on vaccine effectiveness.

Obedience induces agentic shifts by increasing the perceived time between own action and results.

The concept of 'agentic shift,' introduced by Stanley Milgram, suggests that obedience reduces the sense of agency. In a recent study simulating the seminal work of Milgram, Caspar et al., 2016 examined this idea in a financial harm context. They demonstrated that, compared to situations of voluntary decision-making, coercion increases the perceived time between action and outcomes-suggested as a marker of diminished agency. Importantly, in this study, participants were agent and victim (relying on a reciprocal relationship) and first experienced free choices, followed by forced choices. This diverts from Milgram's original study, where participants were no victims but only agents who were forced to harm. The current study replicates and extends findings from the 2016 study by Caspar et al. in an online meeting setting, where participants served only as agents-similar to the original Milgram studies-while controlling the order of free and forced choice blocks. Substantiating earlier findings, forced choices reduced temporal binding (increased time interval estimations) compared to free choices independent of the order. We briefly discuss the importance of replications of coercion effects on the sense of agency, particularly in online decision-making settings.

Choice effects on temporal binding of action and outcomes: Examining the role of outcome focus and measures of time interval estimation.

The ability to make one's own choices is vital to the experience of intentional behavior. Such agency experiences are reflected in the perceptual compression of time between actions and resulting outcomes. Whereas some studies show that choice limitations weaken temporal binding, other studies do not find such an effect. Reviewing the literature, we noted two potential factors that may moderate choice limitation effects on temporal binding: (a) the extent to which individuals represent their actions in terms of the consequences they produce; and (b) the response mode of the time interval estimation measurement where participants report numbers or use a slider to indicate time intervals. Testing these conceptual and methodological factors in two separate experiments yielded clear effects of choice limitation on temporal binding but no clear moderator role of the two factors. Interestingly, overall analyses showed that the choice limitation effect gradually vanishes over time.

Access to excess: how do adolescents deal with unhealthy foods in their environment?

PURPOSE: Easy access to unhealthy foods is believed to contribute to the current overweight epidemic. It remains unclear, however, how access to unhealthy foods is related to self-regulation of food intake. This study tests the hypothesis that using self-regulation strategies buffers the negative influences of easy access to unhealthy foods. METHODS: Cross-sectional survey data from 2764 adolescents aged 10-17 years from four European countries (The Netherlands, UK, Poland and Portugal) about use of self-regulation strategies, access to unhealthy foods and intake of unhealthy foods (sweet and salty snacks and sugar-sweetened beverages) were used. RESULTS: Both access to unhealthy foods and use of self-regulation strategies were independently, but in opposing directions, related to intake of unhealthy foods. Easy access to unhealthy food products was associated with higher consumption, but this effect could be attenuated by use of self-regulation strategies to facilitate healthy eating even when the food environment tempts one to do otherwise. CONCLUSIONS: Health promotion policy and programs should not only address the food environment but could also teach young people better strategies to deal with it.

At-home environment, out-of-home environment, snacks and sweetened beverages intake in preadolescence, early and mid-adolescence: the interplay between environment and self-regulation.

Obesity-related behaviors, such as intake of snacks and sweetened beverages (SSB), are assumed to result from the interplay between environmental factors and adolescents' ability to self-regulate their eating behaviors. The empirical evidence supporting this assumption is missing. This study investigated the relationships between perceptions of at-home and out-of-home food environment (including SSB accessibility, parental, and peers' social pressure to reduce intake of SSB), nutrition self-regulatory strategies (controlling temptations and suppression), and SSB intake. In particular, we hypothesized that these associations would differ across the stages of preadolescence, early and mid-adolescence. Self-reported data were collected from 2,764 adolescents (10-17 years old; 49 % girls) from 24 schools in the Netherlands, Poland, Portugal, and the United Kingdom. Path analysis indicated that direct associations between peers' social influence and SSB intake increased with age. Direct negative associations between at-home and out-of-home accessibility and SSB intake as well as direct positive associations between parental pressure and intake become significantly weaker with age. Accessibility was related negatively to self-regulation, whereas higher social pressure was associated with higher self-regulation. The effects of the environmental factors were mediated by self-regulation. Quantitative and qualitative differences in self-regulation were observed across the stages of adolescence. The associations between the use of self-regulatory strategies and lower SSB intake become significantly stronger with age. In preadolescence, SSB intake was regulated by means of strategies that aimed at direct actions toward tempting food. In contrast, early and mid-adolescents controlled their SSB intake by means of a combination of self-regulatory strategies focusing on direct actions toward tempting food and strategies focusing on changing the psychological meaning of tempting food.

A mapping of parenting support policies worldwide to prevent violence against children.

BACKGROUND: While recent systematic reviews indicate that parenting interventions reduce negative parenting behaviours, including child maltreatment, only 26 % of governments worldwide indicate that parenting support programs reach all parents in their country. OBJECTIVE: This mapping study investigates which countries have a government policy to provide such parenting support aimed at reducing child-directed violence. SETTING: To analyse parenting support within the broad cultural and historical contexts, this study covers all 194 countries and territories worldwide. METHODS: A systematic stepwise online search was conducted to establish the existence, or not, of a parenting support policy to prevent violence against children and in the case that a policy was identified, the sectoral policy portfolio in which the policy was published. RESULTS: Findings showed that almost half of countries globally have a policy relating to parenting support to prevent child maltreatment. The highest concentration of such policies is in the European, Southeast Asia and Western Pacific Regions and globally parenting support are mainly stand-alone policies or embedded within a child protection policy. CONCLUSIONS: Ideas around parenting support have evolved over time however the link between policy and practice as well as the reality of implementation modalities remains unclear. The translation of policy to practice merits further attention if we want to reach every parent in the world who needs it.

Understanding public support for COVID-19 pandemic mitigation measures over time: Does it wear out?

Background: COVID-19 mitigation measures intend to protect public health, but their adverse psychological, social, and economic effects weaken public support. Less favorable trade-offs may especially weaken support for more restrictive measures. Support for mitigation measures may also differ between population subgroups who experience different benefits and costs, and decrease over time, a phenomenon termed "pandemic fatigue." Methods: We examined self-reported support for COVID-19 mitigation measures in the Netherlands over 12 consecutives waves of data collection between April 2020 and May 2021 in an open population cohort study. Participants were recruited through community panels of the 25 regional public health services, and through links to the online surveys advertised on social media. The 54,010 unique participants in the cohort study on average participated in 4 waves of data collection. Most participants were female (65%), middle-aged [57% (40-69 years)], highly educated (57%), not living alone (84%), residing in an urban area (60%), and born in the Netherlands (95%). Results: COVID-19 mitigation measures implemented in the Netherlands remained generally well-supported over time [all scores >3 on 5-point scale ranging 1 (low)-5 (high)]. During the whole period studied, support was highest for personal hygiene measures, quarantine and wearing face masks, high but somewhat lower for not shaking hands, testing and self-isolation, and restricting social contacts, and lowest for limiting visitors at home, and not traveling abroad. Women and higher educated people were more supportive of some mitigation measures than men and lower educated people. Older people were more supportive of more restrictive measures than younger people, and support for more socially restrictive measures decreased most over time in higher educated people or in younger people. Conclusions: This study found no support for pandemic fatigue in terms of a gradual decline in support for all mitigation measures in the first year of the pandemic. Rather, findings suggest that support for mitigation measures reflects a balancing of benefits and cost, which may change over time, and differ between measures and population subgroups.

Taking stock of self-control: a meta-analysis of how trait self-control relates to a wide range of behaviors.

Given assertions of the theoretical, empirical, and practical importance of self-control, this meta-analytic study sought to review evidence concerning the relationship between dispositional self-control and behavior. The authors provide a brief overview over prominent theories of self-control, identifying implicit assumptions surrounding the effects of self-control that warrant empirical testing. They report the results of a meta-analysis of 102 studies (total N = 32,648) investigating the behavioral effects of self-control using the Self-Control Scale, the Barratt Impulsiveness Scale, and the Low Self-Control Scale. A small to medium positive effect of self-control on behavior was found for the three scales. Only the Self-Control Scale allowed for a fine-grained analysis of conceptual moderators of the self-control behavior relation. Specifically, self-control (measured by the Self-Control Scale) related similarly to the performance of desired behaviors and the inhibition of undesired behaviors, but its effects varied dramatically across life domains (e.g., achievement, adjustment). In addition, the associations between self-control and behavior were significantly stronger for automatic (as compared to controlled) behavior and for imagined (as compared to actual) behavior.

"I should remember I don't want to become fat": Adolescents' views on self-regulatory strategies for healthy eating.

Few studies have investigated the strategies adolescents identify to self-regulate eating behavior. Aiming to address this gap in the literature, the current article describes a bottom-up investigation of strategies adolescents identify for the successful self-regulation of eating behavior. Sixty-two adolescents generated statements about self-regulation strategies for eating and rated the utility of each statement. From an initial pool of 357 statements, thirteen overarching self-regulatory strategies were distilled (e.g. preparation; stimulus control). Significant differences were found between the strategies with regard to perceived utility. Findings indicate that, in apparent contradiction to growing obesity rates, adolescents have knowledge of various self-regulatory strategies. Possible explanations for this contradiction are discussed.

A double burden: emotional eating and lack of cognitive reappraisal in eating disordered women.

OBJECTIVE: To examine the influence of emotional eating and lack of cognitive reappraisal on eating pathology in women with binge-purge and restricting type eating disorders. METHOD: Women with a diagnosis of anorexia or bulimia nervosa according to the DSM-IV-tr (n = 50) and non-clinical women without eating disorders (n = 52) were asked about emotional eating tendencies, adaptive emotion regulation strategies (cognitive reappraisal) and eating pathology symptoms. RESULTS: In binge-purging women, emotional eating with limited use of cognitive reappraisal predicted level of eating pathology but not in the restricting and non-clinical women. DISCUSSION: Emotional eating tendencies in combination with a low tendency to use cognitive reappraisal may influence the severity of eating pathology in individuals with binge-purge behaviours. Evidently, patients with these characteristics require a therapy that addresses adaptive emotion regulation skills.