Daily mood patterns and bulimic behaviors in the natural environment

Abstract

Objective-Negative affect has been purported to play an important role in the etiology and maintenance of bulimic behaviors. The objective of this study was to identify daily mood patterns in the natural environment exhibited by individuals with bulimia nervosa and to examine the relationship between these patterns and bulimic behaviors.Method-One hundred thirty-three women aged 18-55 meeting DSM-IV criteria for bulimia nervosa were recruited through clinical referrals and community advertisements. Ecological momentary assessment was used to collect multiple ratings of negative affect, binge eating and purging each day for a two-week period using palmtop computers. Latent growth mixture modeling was used to identify daily mood patterns.Results-Nine distinct daily mood patterns were identified. The highest rates of binge eating and purging episodes occurred on days characterized by stable high negative affect or increasing negative affect over the course of the day.Conclusions-These findings support the conclusion that negative mood states are intimately tied to bulimic behaviors and may in fact precipitate such behavior. Keywords bulimia nervosa; ecological momentary assessment; latent growth mixture model A number of sources of information converge to suggest that negative affect is an antecedent to binge eating and purging. Several theoretical models contend that negative affect plays an important role in the etiology and maintenance of bulimic behaviors. Heatherton and Baumeister (1991) proposed that binge eating serves as a mechanism to "escape from selfawareness," thereby allowing an individual with bulimia nervosa (BN) to reduce the subjective experience of negative affect. Masking theory (Polivy & Herman, 1999) contends that BN patients avoid dealing with the actual source of their negative affect by engaging in binge eating, which provides a more acceptable source to which they can attribute negative affect.Corresponding Author: Ross D. Crosby, Ph.D., Director of Biomedical Statistics, Neuropsychiatric Research Institute, 120 Eighth St. South, Box 1415, Fargo, ND 58107. Tel: (701) Fax: (701) 293-3226, E-mail: rcrosby@nrifargo.com. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptBehav Res Ther. Author manuscript; available in PMC 2010 March 1. Regardless of the specific model to which one adheres, increasing empirical evidence suggests that negative affect plays a role in the etiology and maintenance of eating disorders. For example, there is neurobiological support for the notion that patients with anorexia nervosa (...

A cross‐sectional analysis of the cognitive model of bulimia nervosa

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Non-suicidal Self-Injury and Eating Disorders: Dimensions of Self-Harm

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Emotional Eating, Binge Eating and Animal Models of Binge-Type Eating Disorders

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