Examining the Relationship Between Emotion Regulation Flexibility and Disordered Eating Among a Treatment-Seeking Sample of Adolescents: A Daily Diary Study.

Objective

Disordered eating (DE) frequently emerges during adolescence and is associated with adverse health outcomes. While negative affect (NA) and emotion regulation (ER) disturbances are implicated in DE, limited research has examined ER flexibility (the ability to use varied regulatory strategies) as a risk factor for DE among adolescents.

Method

Adolescents receiving treatment for an eating disorder (N = 39; Mage = 15.4 ± 1.6; 13-18 years; 97.4% White) completed a 14-day daily diary protocol assessing NA, three indices of ER flexibility (number of ER strategies, strategy variability [the standard deviation of number of strategies index], strategy effectiveness), and DE behaviors (DEBs). Within- and between-person relationships between regulatory flexibility and daily DEBs were examined via multilevel models. Moderation analyses examined whether ER indices moderated the relationship between mean NA and daily DEBs.

Results

Endorsing a higher number of ER strategies was associated with greater DEBs at the within- and between-person levels. Conversely, greater strategy effectiveness at the within- and between-person levels was associated with fewer DEBs. Strategy variability moderated the relationship between mean NA and daily DEBs.

Discussion

Among a treatment-seeking sample of adolescents with eating disorders, this study highlights how greater overall use of ER strategies was associated with greater DEBs, whereas effective use of ER strategies was protective. Interventions aimed at helping adolescents master effective regulatory strategies should be prioritized over teaching a breadth of strategies.