Cited by 512Eating Disorders and BehaviorsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPersonality Disorders and Psychopathology

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Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature

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Lavender, Jason M., Wonderlich, Stephen A., Engel, Scott G., Gordon, Kathryn H., Kaye, Walter H., Mitchell, James E.·2015·Clinical Psychology Review

DOI 10.1016/j.cpr.2015.05.010PMC PMC4537813

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Abstract

Several existing conceptual models and psychological interventions address or emphasize the role of emotion dysregulation in eating disorders. The current article uses Gratz and Roemer's (2004) multidimensional model of emotion regulation and dysregulation as a clinically relevant framework to review the extant literature on emotion dysregulation in anorexia nervosa (AN) and bulimia nervosa (BN). Specifically, the dimensions reviewed include: (1) the flexible use of adaptive and situationally appropriate strategies to modulate the duration and/or intensity of emotional responses, (2) the ability to successfully inhibit impulsive behavior and maintain goal-directed behavior in the context of emotional distress, (3) awareness, clarity, and acceptance of emotional states, and (4) the willingness to experience emotional distress in the pursuit of meaningful activities. The current review suggests that both AN and BN are characterized by broad emotion regulation deficits, with difficulties in emotion regulation across the four dimensions found to characterize both AN and BN, although a small number of more specific difficulties may distinguish the two disorders. The review concludes with a discussion of the clinical implications of the findings, as well as a summary of limitations of the existing empirical literature and suggestions for future research.

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Peres, V. (2017) · theses.fr (ABES) · doi:10.70675/41bc830ezf6eez48c0z81c5z8e254da05b56
Anorexie, boulimie et quête de l'identité : de l’exploration des souvenirs et des projections futures définissant le soi à la mise en application d’un dispositif thérapeutique par réminiscences sensorielles
Castellon, P. (2019) · theses.fr (ABES) · doi:10.70675/2016a5fcza24cz44a7za7c1zdf4721723a5b
Disordered Eating Behaviors Among U.S. Children With Neuropsychiatric Conditions: A Nationally Representative Study
Casseus, M. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70100
“Emotional dysregulation is associated with impulsive eating disorder behaviors and attention-deficit/hyperactivity disorder (ADHD) (Reinblatt 2015) and is also common in the psychopathology of eating disorder and eating-related symptoms (Lavender et al. 2015; Prefit et al. 2019).”
Eating Disorder Symptomatology and Self-Concept in Late Childhood and Early Adolescence: A Cross-Lagged Longitudinal Approach
Raemen, L., Tahiri, M. J. B., Claes, L., & Luyckx, K. (2026) · The Journal of Early Adolescence · doi:10.1177/02724316261445441
Dalle esperienze infantili avverse (ACE) ai disturbi del comportamento alimentare: il ruolo dei sintomi post-traumatici e della disregolazione emotiva
Camisasca, E. (2026) · MALTRATTAMENTO E ABUSO ALL INFANZIA · doi:10.3280/mal2026-001005
The Bonny Method of Guided Imagery and Music as a trauma-informed approach in eating disorder treatment: theoretical framework and case illustrations
Heiderscheit, A. (2026) · Journal of Eating Disorders · doi:10.1186/s40337-026-01625-7
“Difficulty with emotional regulation is a common feature of EDs, that can contribute to restriction, bingeing, purging, and compulsive behaviors [77, 78].”
References
(2026) · Wiley eBooks · doi:10.1002/9781394461691.refs
Psychological and motivational correlates of orthorexia nervosa: the role of perfectionism, emotion regulation, and health attitudes
Fanelli, J. E., Pardini, S., Brytek‐Matera, A., & Novara, C. (2026) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-026-01867-z
“Rigid control over food intake may function as a maladaptive strategy to manage negative emotional states, similarly to what has been reported in other forms of eating psychopathology [21, 22].”
Cognitive behavioral enhanced approach to eating
Rabarbari, E., & Pizzoli, S. F. M. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-36741-0.00012-7
Examining the Factor Structure and Subgroup Invariance of the Deliberate Denial of Disordered Eating Behaviors Scale
Howard, L., Hawn, S. E., Pitchford, K., McGrath, R., Farniok, A., Sesma, A., & Heron, K. E. (2026) · Behavioral Sciences · doi:10.3390/bs16060898
“…behavioral (Vandereycken & Van Humbeeck, 2008) and theory that suggests restrictive eating and overeating often serve different functions, with restrictive eating related to a drive for thinness and overeating serving an emotion regulation function (Thompson & Stice, 2001; Lavender et al., 2015).”
Pupil diameter during cognitive reappraisal predicts the desire to eat
Levy, S., Hochman, S., Cohen, N., & Weinbach, N. (2026) · Eating Behaviors · doi:10.1016/j.eatbeh.2026.102105
Norms we inhabit, bodies we monitor: Associations between heterosexual scripts, self-objectification, and eating behaviors
Beni, L. G., & Meneguzzo, P. (2026) · Eating Behaviors · doi:10.1016/j.eatbeh.2026.102106
Ansiedad social, depresión, violencia intrafamiliar y orientación sexual como predictores de la alimentación emocional en adolescentes durante la pandemia por COVID-19
Acevedo, S. P., Saldaña, R. M. E. G., Aragón, S. R., Pineda-García, G., Gutiérrez, M. L. E., Rojas-Solís, J. L., & Gómez‐Peresmitré, G. (2026) · Revista Mexicana de Trastornos Alimentarios/Mexican Journal of Eating Disorders · doi:10.22201/fesi.20071523e.2026.e.985
A Transdiagnostic Comparison of Emotional Regulation, Executive Functions, and Empathy in Three Groups of Female Adolescents: With Anorexia Nervosa, Attention Deficit Hyperactivity Disorder, and Comorbid Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder
Olzi, F., Raucci, D., Narzisi, A., Valente, E., Ditaranto, F., Belmonti, V., Tancredi, R., Pfanner, C., Inguaggiato, E., Villafranca, A., et al. (2026) · Brain Sciences · doi:10.3390/brainsci16070676
“At the same time, in recent years, a growing body of literature has identified broad emotion regulation problems in individuals with AN [23,24].”
Assessing the Influence of Rumination and Eating Disorder Symptoms on Feasibility Outcomes of a VR-Based Distress Tolerance Training
Rojas-Rincón, J., Ampatzoglou, A., Gámiz, M., Fernández-Cardellach, C., Medrano, S. N., Soler-Dominguez, J. L., Márquez, A. C., Fernández-Capo, M., Garolera, M., Pons-Tomas, P., et al. (2026) · Lecture notes in computer science · doi:10.1007/978-3-032-31421-5_24
Vasoconstriction as a translational target in eating disorders: Autonomic dysregulation, insular mechanisms, and a novel multimodal detection system
Torres, R., Harris, L. M., & Levinson, C. A. (2026) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2026.106879
Identifying Affective Patterns in Patients With Eating Disorders: A Latent Profile Analysis
Fasolato, R., Bonetto, C., Dall’Agnola, R. B., Boifava, E., Bonora, F., Castellazzi, M., Castelli, S., Cristofalo, D., Danese, S., Ferlin, M., et al. (2026) · European Eating Disorders Review · doi:10.1002/erv.70154
Rethinking mental disorders in COVID-19: evidence from prepandemic longitudinal data
Czepiel, D., van der Ven, E., Sijbrandij, M., & Hoek, H. W. (2026) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000001103
Clinical Trajectories Associated with Pharmacological Treatment Patterns in Female Adolescents with Anorexia Nervosa: A 12-Month Retrospective Study in Italian Real-World Clinical Practice
Fantozzi, P., Fossati, B., Apicella, F., Belmonti, V., Ditaranto, F., Tancredi, R., Muratori, P., Levantini, V., & Calderoni, S. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15145644
“Furthermore, difficulties in emotion regulation are frequently observed in individuals with AN, with greater impairments being associated with increased eating disorder severity [12].”
Eating‐Disorder and Exercise Addiction Symptoms Among Recreational Exercisers: Differentiated Patterns of Attachment and Emotion Regulation
Arey, D. L., & Livni, T. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70173
Dialectical Behaviour Therapy for Eating Disorders With Comorbid Borderline Personality Disorder: A Systematic Review and Clinical Implications
Ozdemir, S. Z., Turkan, C., Dikmen, L. S., & Sevi, O. M. (2026) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70315
“However, substantial heterogeneity exists both within and across diagnostic categories, and emotion dysregulation processes cannot be fully captured by DSM classification alone (Lavender et al. 2015).”
Emotion Dysregulation, Weight Self-Stigma, Body Dissatisfaction, and Self-Compassion in Disordered Eating Attitudes: A Serial Mediation Study Among Bangladeshi University StudentPreprint
Ahmed, M. F., Hasnat, S. I., & Sweety, K. T. H. (2026) · Research Square · doi:10.21203/rs.3.rs-10397765/v1
Emotion regulation and state body image during daily body-exposure situations: A pilot ecological momentary assessment study.
Rojas-Rincón, J., Gámiz-Sanfeliu, M., Ampatzoglou, A., Carballo-Márquez, A., Garolera, M., Fernández-Capo, M., & Porras-Garcia, B. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.122447
Examining Culturally Specific Predisposing and Maintaining Factors Associated with Eating Disorders Among Clinically Diagnosed Adults in Pakistan
Rehman, F., Ehsan, N., & Khalily, M. T. (2026) · Qlantic journal of social sciences. · doi:10.55737/qjss.vii-iv.26538
The interplay between interoceptive sensibility and mindfulness in eating behaviors and psychological distress: A person-centered study in a French community sample
Marinelli, L., Berthoz, S., Décamps, G., Bourdier, L., Fatseas, M., & Dantzer, C. (2026) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2026.09.001
Psychometric Properties of the Bangla Version of the Difficulties in Emotion Regulation Scale‐Short Form (DERS‐SF): A Cross‐Sectional Study on University Students
Huzzatullah, M., & Hasan, M. T. (2026) · Health Science Reports · doi:10.1002/hsr2.73209
Bridging Eating Disorder Psychopathology and Suicidality: A Network Comparison of Anorexia Nervosa and Bulimia Nervosa
Kim, S. T., Kang, S., Lee, J., Song, Y. J., Kang, S., Park, C. I., Kim, S. J., & Kang, J. I. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70196
Emotion Regulation in Response to Stress in the Daily Lives of Women With and Without Eating Disorders: An Ecological Momentary Assessment Study
Racine, S. E., Biçaker, E., Miller, A. E., Trolio, V., & Zhu, L. Y. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70207

Authors: Lavender, J. M., Wonderlich, S. A., Engel, S. G., Gordon, K. H., Kaye, W. H., & Mitchell, J. E.
Affiliations: University of North Dakota (US)
North Dakota State University (US)
University of California San Diego (US)
Corresponding author: Lavender, Jason M.
ORCID: Lavender, Jason M.
Wonderlich, Stephen A.
Gordon, Kathryn H.
Kaye, Walter H.
Mitchell, James E.
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2015-08
Volume: 40
Pages: 111-122
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2015.05.010
PMC: PMC4537813
OpenAlex: W585778545
Cited by: 512
References: 156
Citations by year: 2026: 45 · 2025: 45 · 2024: 45 · 2023: 38 · 2022: 58 · 2021: 69 · 2020: 52 · 2019: 50 · 2018: 40 · 2017: 38 · 2016: 26 · 2015: 5
FWCI: 5.22
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Psychology Review (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: U.S. Public Health Service (K23 101342)
National Institute of Mental Health (K23MH101342, T32MH082761)
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords: emotional dysregulation, anorexia nervosa, bulimia nervosa, eating disorders, emotion regulation, emotional awareness, emotional acceptance, emotional distress, goal-directed behavior, psychological intervention
MeSH terms: Self-Control, Anorexia Nervosa, Emotions, Humans, Bulimia Nervosa

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Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature

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