The DOI matches its Crossref record; 162 of the 163 references it cites were found in a registry or an index, and 1 are not checked yet.
Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature
Open accessAbstract
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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“One recent review concluded that both AN and BN had demonstrated consistent associations with particular emotion regulation difficulties, including lack of awareness of emotions, lack of acceptance of emotions, negative beliefs about emotions or coping, and avoidance/suppression of emotions.”
From The Renfrew Unified Treatment for Eating Disorders and Comorbidity: Long-Term Effects of an Evidence-Based Practice Implementation in Residential Treatment (2021) · cites this paper as [15]
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Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
Diagnostic and Statistical Manual of Mental Disorders
&NA; (1988) · Alzheimer Disease & Associated Disorders · doi:10.1097/00002093-198802020-00022 · Cited by 12,603
Gross, J. J., & John, O. P. (2003) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.85.2.348 · Cited by 11,929
The emerging field of emotion regulation: an integrative review
Gross, J. J. (1998) · Review of General Psychology · doi:10.1037/1089-2680.2.3.271 · Cited by 9,916 · cited 1×
“A potential alternative framework would have been based on another model of emotion regulation, such as Gross’ (1998a; 1998b) process model, which classifies regulatory processes as antecedent-focused (i.e., those employed early in the emotion generation process) or response-focused (i.e., those…”
MethodGratz, K. L., & Roemer, L. (2004) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/b:joba.0000007455.08539.94 · Cited by 8,942 · cited 2×
“Dimensions of the Gratz and Roemer (2004) Multidimensional Model Dimension 1: To what extent is one able to flexibly use adaptive and situationally appropriate strategies to modulate emotional duration/intensity?”
BackgroundResultCarver, C. S., & White, T. L. (1994) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.67.2.319 · Cited by 7,306
Emotion-regulation strategies across psychopathology: A meta-analytic review
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.11.004 · Cited by 6,686
How do you feel — now? The anterior insula and human awareness
(Bud) Craig, A. D. (2009) · Nature Reviews Neuroscience · doi:10.1038/nrn2555 · Cited by 6,657 · cited 2×
“…speculation that the insula, a brain region that is important for emotional processing and self-awareness, may play a critical role in altered interoceptive awareness and ED symptoms in AN and BN (Craig, 2009; Nunn, Frampton, Fuglset, Törzsök-Sonnevend, & Lask, 2011; Wagner et al., 2008).”
BackgroundBagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(94)90005-1 · Cited by 5,293
The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication
Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.03.040 · Cited by 4,973 · cited 1×
“For instance, high rates of co-occurring mood and anxiety disorders have been reported in both AN and BN (e.g., Hudson et al., 2007; Kaye et al., 2004; Lilenfeld, 2004).”
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Sloan, E., Hall, K., Moulding, R., Bryce, S., Mildred, H., & Staiger, P. K. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.09.002 · Cited by 1,052
“…ER strategies that predominantly examine non-clinical samples, overall difficulties in ER are more frequently examined within clinical treatment-seeking populations, including individuals with eating related pathology (Lavender et al., 2015) and BPD (Bornovalova et al., 2008; Stepp et al., 2014).”
BackgroundGuendelman, S., Medeiros, S., & Rampes, H. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00220 · Cited by 577
“, 2015), and anorexia and bulimia nervosa (Lavender et al., 2015).”
BackgroundCan interoception improve the pragmatic search for biomarkers in psychiatry?
Khalsa, S. S., & Lapidus, R. C. (2016) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2016.00121 · Cited by 366
“Interoceptive dysfunction in AN can also be located within descriptions of “emotion dysregulation” (190), “poor distress tolerance,” (191) and perhaps most tellingly, “alexithymia” or the inability to discriminate between emotional states and bodily sensations (192, 193).”
BackgroundSakiris, N., & Berle, D. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.101751 · Cited by 369
Emotion regulation across eating pathology: A meta-analysis
Prefit, A.-B., Cândea, D. M., & Szentagotai-Tătar, A. (2019) · Appetite · doi:10.1016/j.appet.2019.104438 · Cited by 341
Metadata
- 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.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2015-08
- Volume
- 40
- Pages
- 111-122
- ISSN
- 0272-7358 (ISSN-L)
- 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
- 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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