Micro-level de-coupling of negative affect and binge eating in relationship to macro-level outcomes in binge eating disorder treatment. Issue 1 (29th January 2022)

• Record Type: Journal Article
• Authors: Smith, Kathryn E.; Mason, Tyler B.; Schaefer, Lauren M.; Anderson, Lisa M.; Hazzard, Vivienne M.; Crosby, Ross D.; Engel, Scott G.; Crow, Scott J.; Wonderlich, Stephen A.; Peterson, Carol B.
• Is Part Of: Psychological medicine. Volume 52:Issue 1(2022)
• Page Start: 140
• Page End: 148
• Publication Date: 2022-01-29
• Subjects: Binge eating disorder -- ecological momentary assessment -- emotion regulation; Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S0033291720001804
• Languages: English
• ISSNs: 0033-2917

Abstract

Abstract: Background: While negative affect reliably predicts binge eating, it is unknown how this association may decrease or 'de-couple' during treatment for binge eating disorder (BED), whether such change is greater in treatments targeting emotion regulation, or how such change predicts outcome. This study utilized multi-wave ecological momentary assessment (EMA) to assess changes in the momentary association between negative affect and subsequent binge-eating symptoms during Integrative Cognitive Affective Therapy (ICAT-BED) and Cognitive Behavior Therapy Guided Self-Help (CBTgsh). It was predicted that there would be stronger de-coupling effects in ICAT-BED compared to CBTgsh given the focus on emotion regulation skills in ICAT-BED and that greater de-coupling would predict outcomes. Methods: Adults with BED were randomized to ICAT-BED or CBTgsh and completed 1-week EMA protocols and the Eating Disorder Examination (EDE) at pre-treatment, end-of-treatment, and 6-month follow-up (final N = 78). De-coupling was operationalized as a change in momentary associations between negative affect and binge-eating symptoms from pre-treatment to end-of-treatment. Results: There was a significant de-coupling effect at follow-up but not end-of-treatment, and de-coupling did not differ between ICAT-BED and CBTgsh. Less de-coupling was associated with higher end-of-treatment EDE global scores at end-of-treatment and higher binge frequency at follow-up. Conclusions: Both ICAT-BED and CBTgsh were associated with de-coupling of momentary negative affect and binge-eating symptoms, which in turn relate to cognitive and behavioral treatment outcomes. Future research is warranted to identify differential mechanisms of change across ICAT-BED and CBTgsh. Results also highlight the importance of developing momentary interventions to more effectively de-couple negative affect and binge eating.