Early adaptive schemas, emotional regulation, and cognitive flexibility in eating disorders: subtype specific predictors of eating disorder symptoms using hierarchical linear regression.

J S Mitchell, T Huckstepp, A Allen, P J Louis, T E Anijärv, D F Hermens
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Abstract

Purpose: Understanding how early adaptive schemas, cognitive flexibility, and emotional regulation influence eating disorder (ED) symptoms, and whether this differs across diagnostic subtypes is critical to optimising treatment. The current study investigated the relationship between these variables and ED symptomology in individuals self-reporting an ED diagnosis and healthy controls.

Methods: A dataset of 1576 online survey responses yielded subsamples for anorexia nervosa (n = 155), bulimia nervosa (n = 55), binge eating disorder (n = 33), other specified feeding or eating disorder (n = 93), and healthy participants (n = 505). The hierarchical linear regression analysis included Eating Disorder Examination Questionnaire 6.0 Global Score as the dependent variable; Young Positive Schema Questionnaire, Emotional Regulation Questionnaire, and Cognitive Flexibility Inventory subscale scores as the independent variables; and demographic measures as the covariates.

Results: The number of significant predictors varied considerably by ED sub-group. Amongst the anorexia nervosa, bulimia nervosa, and healthy subsamples, the adaptive schema Self-Compassion and Realistic Expectations was associated with lower ED symptom severity. In comparison, age and body mass index were the strongest predictors for binge eating disorder, whilst the Expressive Suppression (a subscale of the Emotional Regulation Questionnaire) was the strongest predictor for other specified feeding or eating disorders.

Conclusion: Early adaptive schemas, cognitive flexibility, and emotional regulation vary across ED subtype, suggesting the need for tailored treatment that disrupts the self-reinforcing cycle of ED psychopathology. Future research investigating how early adaptive schemas may predict or be associated with treatment response across diagnostic subtypes is needed.

Level of evidence: Level IV, evidence obtained from multiple time-series with or without the intervention, such as case studies.

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饮食失调症的早期适应模式、情绪调节和认知灵活性:利用分层线性回归预测饮食失调症症状的亚型特异性。
目的:了解早期适应性图式、认知灵活性和情绪调节如何影响进食障碍(ED)症状,以及不同诊断亚型之间是否存在差异,对于优化治疗至关重要。本研究调查了自我报告被诊断为饮食失调症的个体和健康对照组中这些变量与饮食失调症症状之间的关系:1576份在线调查回复的数据集产生了神经性厌食症(n = 155)、神经性贪食症(n = 55)、暴饮暴食症(n = 33)、其他特定喂养或进食障碍(n = 93)和健康参与者(n = 505)的子样本。分层线性回归分析将进食障碍检查问卷 6.0 总分作为因变量;Young 积极模式问卷、情绪调节问卷和认知灵活性量表子量表得分作为自变量;人口统计学指标作为协变量:在不同的 ED 亚群中,重要的预测因子数量差异很大。在神经性厌食症、神经性贪食症和健康的子样本中,适应性模式 "自我同情 "和 "现实期望 "与较低的 ED 症状严重程度相关。相比之下,年龄和体重指数是暴饮暴食症的最强预测因子,而表达性压抑(情绪调节问卷的一个分量表)是其他特定进食或进食障碍的最强预测因子:结论:早期适应性图式、认知灵活性和情绪调节在不同的进食障碍亚型中存在差异,这表明有必要采取有针对性的治疗,以打破进食障碍精神病理学的自我强化循环。未来的研究需要调查早期适应性图式如何预测不同诊断亚型的治疗反应或与之相关:证据等级:IV级,从干预或不干预的多个时间序列(如个案研究)中获得的证据。
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来源期刊
CiteScore
6.50
自引率
10.30%
发文量
170
审稿时长
>12 weeks
期刊介绍: Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity is a scientific journal whose main purpose is to create an international forum devoted to the several sectors of eating disorders and obesity and the significant relations between them. The journal publishes basic research, clinical and theoretical articles on eating disorders and weight-related problems: anorexia nervosa, bulimia nervosa, subthreshold eating disorders, obesity, atypical patterns of eating behaviour and body weight regulation in clinical and non-clinical populations.
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