Emotionale aversive Anspannung bei Anorexia nervosa: Implikationen des Emotionsdysregulations-Störungsmodells
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Philipps-Universität Marburg
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Abstract
Recently, emotion dysregulation is considered to be a causing and maintaining factor of anorexia nervosa (AN). Current psychiatric research investigated the influence of momentary affective states in this condition. However, mostly adults with AN were studied. Aversive tension is a momentary variation of emotion dysregulation broadly investigated in Borderline personality disorder (BPD). Individuals with BPD report poorer momentary emotion identification when experiencing heightened levels of aversive tension. However, neither aversive tension nor momentary emotion identification have been previously investigated in AN. One causal factor to emotion dysregulation in AN might be a pervasive invalidation in Western nations regarding body image and emotion experience. Living in a Latin American environment might be a potential protective factor for developing an eating disorder. Therefore, three studies will be presented in this publication-based dissertation. The first two studies investigate aversive tension and emotion identification in juvenile AN. The third study compares prevalence rates of AN in Latin America with the rates in Western countries.
In the first publication, a smartphone-based ecological momentary assessment is presented, investigating whether female adolescents with AN report higher levels of aversive tension in daily life compared to healthy adolescents. Additionally, trigger events for aversive tension were assessed. Results indicate that adolescents with AN experience higher daily levels of aversive tension as healthy controls. Food-intake-related situations were correlated with an additional increase in aversive tension, but only in the AN group. Neither sports- nor school-related events were associated with an increase or decrease of aversive tension. Aversive tension is an important short-term factor of emotion dysregulation in AN. Teaching downregulation strategies for aversive tension during meal situations might improve weight restoration of adolescents.
The second publication investigated whether adolescents with AN experience lower emotion identification compared to healthy controls. In an exploratory analysis of the same sample as in publication one, significantly lower levels of emotion identification in adolescents with AN were found. Emotion identification improved during the day, but for the control group only. Neither in the control nor in the AN group was emotion identification influenced by current levels of aversive tension. Different to BPD, aversive tension and poor emotion identification might represent two separate pathways of emotion dysregulation. Improving emotion identification within the day by incorporating contextual cues might be an important goal in AN treatment.
Meta-analyses to assess the average prevalence rates of AN, bulimia nervosa and binge-eating disorder in Latin America were conducted separately for each of the disorders in the third publication. A lower point prevalence of AN in Latin America was found when compared to Western societies. However, significantly higher prevalence rates of bulimia nervosa and binge-eating disorder were found in Latin America. This indicates that Latin American culture might be less invalidating regarding body image than Western countries and might be considered as a protective factor for AN only. However, further cross-cultural studies are clearly needed.
In summary, several new facets of emotion dysregulation of AN where investigated in this dissertation. Future studies should focus on the influence of aversive tension and self-reported emotion identification on momentary disordered eating behavior, such as restrictive eating or binging/purging. In addition, the protective influence of Latin American culture on AN should be further investigated.
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Created: 2017Issued: 2017-05-24Updated: 2017-05-24
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Fachbereich Psychologie
Publisher
Philipps-Universität Marburg
Language
ger
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DoctoralThesis
Keywords
dialectical behaviour therapyappaversive Anspannungsmartphonedialektisch-behaviorale Therapie,ecological momentary assessmentEmotionsdysregulationEmotiondysregulationAnspannungtensionDBTaversive tensionDBT
DFG-subjects
EpidemiologieEmotionserkennungAnorexia NervosaEmotionsregulationEssstörungen,
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150
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Kolar, David Raphael: Emotionale aversive Anspannung bei Anorexia nervosa: Implikationen des Emotionsdysregulations-Störungsmodells. : Philipps-Universität Marburg 2017-05-24. DOI: https://doi.org/10.17192/z2017.0239.
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This item has been published with the following license: In Copyright