Distress tolerance across self-report, behavioral and psychophysiological domains in women with eating disorders, and healthy controls
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Abstract
Background and objectives The tendency to engage in impulsive behaviors when distressed is linked to disordered eating. The current study comprehensively examines emotional responses to a distress tolerance task by utilizing self-report, psychophysiological measures (respiratory sinus arrhythmia [RSA], skin conductance responses [SCRs] and tonic skin conductance levels [SCLs]), and behavioral measures (i.e., termination of task, latency to quit task).Methods 26 healthy controls (HCs) and a sample of treatment-seeking women with Bulimia Nervosa (BN), Binge Eating Disorder (BED) and Anorexia Nervosa (AN) (N = 106) completed the Paced Auditory Serial Addition Task- Computerized (PASAT-C). Psychophysiological measurements were collected during baseline, PASAT-C, and recovery, then averaged for each time period. Self-reported emotions were collected at baseline, post-PASAT-C and post-recovery.Results Overall, we found an effect of Time, with all participants reporting greater negative emotions, less happiness, lower RSA, more SCRs and higher tonic SCLs after completion of the PASAT-C relative to baseline. There were no differences in PASAT-C performance between groups. There was an effect of Group for negative emotions, with women with BN, BED and AN reporting overall higher levels of negative emotions relative to HCs. Furthermore, we found an effect of Group for greater urges to binge eat and lower RSA values among BED, relative to individuals with BN, AN and HCs.Limitations This study is cross-sectional and lacked an overweight healthy control group.Conclusion During the PASAT-C, individuals with eating disorders (EDs) compared to HCs report higher levels of negative emotions, despite similar physiological and behavioral manifestations of distress.
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The emphasis placed on DT in the occurrence of DEB has not been supported by robust findings.
“However, consistent with the literature on the relationship between DT and PSU, the emphasis placed on DT in the occurrence of DEB has not been supported by robust findings.”
From Distress tolerance across substance use, eating, and borderline personality disorders: A meta-analysis (2022) · cites this paper as Yiu et al., 2018
The Results (Hypothesis 2; page unavailable) found no differences between eating-disorder groups and healthy controls in behavioral distress tolerance. The Discussion (page unavailable) notes that this conflicts with another study, supporting a characterization of the findings as mixed. But this study did not test whether distress tolerance contributes to the occurrence of disordered eating behaviors, so the broader claim exceeds its evidence. (LLM, conf=0.83)
Experimental — accuracy not yet measuredOther studies have not been able to replicate the negative association between DT and DEB.
“While several studies have demonstrated the expected negative association between DT and DEB (Anestis et al., 2007(Anestis et al., , 2012b;;Eichen et al., 2017), others have not been able to replicate this relationship (Kelly et al., 2014;Yiu et al., 2018).”
From Distress tolerance across substance use, eating, and borderline personality disorders: A meta-analysis (2022) · cites this paper as Yiu et al., 2018
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- Authors
- Yiu, A., Christensen, K., Arlt, J. M., & Chen, E. Y.
- Affiliations
- Temple University (US)
- The Ohio State University (US)
- Corresponding author
- Chen, Eunice Y.
- ORCID
- Christensen, Kara
- Venue
- Journal of Behavior Therapy and Experimental Psychiatry
- Publisher
- Elsevier BV
- Published
- 2018-12
- Volume
- 61
- Pages
- 24-31
- ISSN
- 0005-7916 (ISSN-L)
- OpenAlex
- W2951175284
- Cited by
- 25
- References
- 83
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 1
- FWCI
- 2.35
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Journal of Behavior Therapy and Experimental Psychiatry (publishedVersion)
- bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion)
- PubMed (publishedVersion)
- Funders
- NIMH (1K23 MH081030-01, R21MH093932-01A1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- distress tolerance, eating disorders, bulimia nervosa, binge eating disorder, anorexia nervosa, negative emotions, respiratory sinus arrhythmia, skin conductance response, Paced Auditory Serial Addition Test, task termination, women
- MeSH terms
- Adult, Anorexia Nervosa, Feeding and Eating Disorders, Cross-Sectional Studies, Emotions, Female, Galvanic Skin Response, Humans, Middle Aged, Neuropsychological Tests, Stress, Psychological, Bulimia Nervosa, Young Adult, Binge-Eating Disorder, Self Report, Respiratory Sinus Arrhythmia
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