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Micro-level de-coupling of negative affect and binge eating in relationship to macro-level outcomes in binge eating disorder treatment

Published online by Cambridge University Press:  29 June 2020

Kathryn E. Smith Open the ORCID record for Kathryn E. Smith [Opens in a new window] ,
Tyler B. Mason ,
Lauren M. Schaefer ,
Lisa M. Anderson ,
Vivienne M. Hazzard ,
Ross D. Crosby ,
Scott G. Engel ,
Scott J. Crow ,
Stephen A. Wonderlich  and
Carol B. Peterson
Kathryn E. Smith*
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, US
Tyler B. Mason
Affiliation:
Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
Lauren M. Schaefer
Affiliation:
Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota, USA
Lisa M. Anderson
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
Vivienne M. Hazzard
Affiliation:
Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota, USA
Ross D. Crosby
Affiliation:
Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota, USA Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
Scott G. Engel
Affiliation:
Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota, USA Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
Scott J. Crow
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA The Emily Program, Saint Paul, Minnesota, USA
Stephen A. Wonderlich
Affiliation:
Center for Bio-behavioral Research, Sanford Research, Fargo, North Dakota, USA Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
Carol B. Peterson
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA The Emily Program, Saint Paul, Minnesota, USA
*
Author for correspondence: Kathryn E. Smith, E-mail: ksmith41@usc.edu
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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.

Keywords

Binge eating disorderecological momentary assessmentemotion regulation
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 1 , January 2022 , pp. 140 - 148
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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