Mood changes and affective disorder in the bulimic binge—Purge cycle

Abstract

Mood changes over the bulimic binge–purge cycle were studied in retrospective questionnaire reports of patients, 16 with and 34 without concurrent affective disorder. Moods clearly differed over phases. Mood reports depicted the period between the binge and purge as most unpleasant, with low energy/excitement and security/relief and high panic/helplessness and guilt/disgust/anger. Feelings after the purge were relatively calm and pleasurable, with low panic/helplessness and excitement/energy and high security/relief. Patients with affective disorder did not differ from those without affective disorder in their mood changes during the cycle.

Longitudinal investigation of the abstinence violation effect in binge eaters.

“…Subjects attributed binges to internal, global, and uncontrollable factors. Consistent with previous studies, subjects experienced intense negative affect, guilt, all-or-none thinking about dieting, and low self-efficacy (Arnow et al, 1992; Cooper et al, 1988; Kaye et al, 1986; Lingswiler et al, 1989b; Zotter & Crowther, 1991).…”

Longitudinal investigation of the abstinence violation effect in binge eaters.

“…Subjects attributed binges to internal, global, and uncontrollable factors. Consistent with previous studies, subjects experienced intense negative affect, guilt, all-or-none thinking about dieting, and low self-efficacy (Arnow et al, 1992; Cooper et al, 1988; Kaye et al, 1986; Lingswiler et al, 1989b; Zotter & Crowther, 1991).…”

Ecological momentary assessment of purging disorder

“…Although purging does not appear to be triggered by unique increases in negative affect, decreased negative affect following purging was significantly different from the trajectory of negative affect on non-purge days. This is consistent with previous retrospective (Cooper et al, 1988;Rosen & Leitenberg, 1982) and EMA (Alpers & Tuschen-Caffier, 2001;Corstorphine et al, 2006;Powell & Thelen, 1996) studies finding decreases in negative affect following purging in BN participants. Thus, purging in PD may be maintained through negative reinforcement by reducing negative affect.…”

Binge eating as escape from self-awareness.

“…L. Cooper et al, 1988; Johnson & Larson, 1982; Willmuth, Leitenberg, Rosen, & Cado, 1988), and others have found reductions in affect and anxiety during both the binge and purge (Kaye et al, 1986; Steinberg et al, 1990). Additionally, there have been some reports of increased anxiety during the binge (J. L. Cooper et al, 1988; Johnson & Larson, 1982; Willmuth et al, 1988), contrary to the escape model.…”

Longitudinal investigation of the abstinence violation effect in binge eaters.

“…Subjects attributed binges to internal, global, and uncontrollable factors. Consistent with previous studies, subjects experienced intense negative affect, guilt, all-or-none thinking about dieting, and low self-efficacy (Arnow et al, 1992; Cooper et al, 1988; Kaye et al, 1986; Lingswiler et al, 1989b; Zotter & Crowther, 1991).…”

Ecological momentary assessment of purging disorder

“…Although purging does not appear to be triggered by unique increases in negative affect, decreased negative affect following purging was significantly different from the trajectory of negative affect on non-purge days. This is consistent with previous retrospective (Cooper et al, 1988;Rosen & Leitenberg, 1982) and EMA (Alpers & Tuschen-Caffier, 2001;Corstorphine et al, 2006;Powell & Thelen, 1996) studies finding decreases in negative affect following purging in BN participants. Thus, purging in PD may be maintained through negative reinforcement by reducing negative affect.…”

Binge eating as escape from self-awareness.

“…L. Cooper et al, 1988; Johnson & Larson, 1982; Willmuth, Leitenberg, Rosen, & Cado, 1988), and others have found reductions in affect and anxiety during both the binge and purge (Kaye et al, 1986; Steinberg et al, 1990). Additionally, there have been some reports of increased anxiety during the binge (J. L. Cooper et al, 1988; Johnson & Larson, 1982; Willmuth et al, 1988), contrary to the escape model.…”

Longitudinal investigation of the abstinence violation effect in binge eaters.

“…Subjects attributed binges to internal, global, and uncontrollable factors. Consistent with previous studies, subjects experienced intense negative affect, guilt, all-or-none thinking about dieting, and low self-efficacy (Arnow et al, 1992; Cooper et al, 1988; Kaye et al, 1986; Lingswiler et al, 1989b; Zotter & Crowther, 1991).…”

Ecological momentary assessment of purging disorder

“…Although purging does not appear to be triggered by unique increases in negative affect, decreased negative affect following purging was significantly different from the trajectory of negative affect on non-purge days. This is consistent with previous retrospective (Cooper et al, 1988;Rosen & Leitenberg, 1982) and EMA (Alpers & Tuschen-Caffier, 2001;Corstorphine et al, 2006;Powell & Thelen, 1996) studies finding decreases in negative affect following purging in BN participants. Thus, purging in PD may be maintained through negative reinforcement by reducing negative affect.…”

Binge eating as escape from self-awareness.

“…L. Cooper et al, 1988; Johnson & Larson, 1982; Willmuth, Leitenberg, Rosen, & Cado, 1988), and others have found reductions in affect and anxiety during both the binge and purge (Kaye et al, 1986; Steinberg et al, 1990). Additionally, there have been some reports of increased anxiety during the binge (J. L. Cooper et al, 1988; Johnson & Larson, 1982; Willmuth et al, 1988), contrary to the escape model.…”