Strategies of emotion regulation in adolescents and young adults with substance dependence or eating disorders

Abstract

Some authors argue that both substance dependence and eating disorders should be considered as dependent behaviours. Similarities and differences between these disorders, however, remain unclear. This study compares processes of emotion regulation in adolescents and young adults (15 to 25 years old) with substance dependence (SD) or eating disorders (ED). One hundred and thirteen SD, 50 ED and 86 non-clinical subjects (NC), recruited in four French and Swiss locations, completed a self-report questionnaire of emotion regulation strategies. This questionnaire addresses the subjects' relationships, concerning past and present family, and refers to Main's (1990) concept of primary strategy (balanced activation and deactivation of attachment behaviours), and of secondary strategies (hyperactivation or excessive deactivation of the attachment system). Participants were also questioned in structured interviews, about life events and DSM-IV classification criteria. SD reported more adverse events than ED and NC. SD and ED reported using fewer primary strategies than NC, and SD had secondary strategies that were different from those of ED. Patients with eating disorders reported more hyperactivation, and SD reported more deactivation of the attachment system. It is hypothesized that while subjects with SD and ED have in common poorly regulated strategies, they differ in the way they process emotion or relationship-related information.

The relationship between attachment styles and internalizing or externalizing symptoms in clinical and nonclinical adolescents

“…Based on the CaMir, an individual exhibiting secure attachment values social support and relational security, a person with an avoidant attachment strategy values independence at the expense of social support, whereas a person with a preoccupied strategy values interpersonal involvement at the expense of autonomy (Pierrehumbert et al, 1996;Pierrehumbert et al, 2002). With the CaMir, the subject responds to each item twice.…”

“…The second distribution is used to calculate the attachment style. The Q-sort responses that are obtained for each participant are correlated with the three prototypes corresponding to the secure, avoidant, and preoccupied attachment styles and provide three correlation coefficients (Q indexes) that reflect the similarity of the individual"s answer to each of the three types of attachment (Pierrehumbert et al, 2002).…”

“…Studies of clinical samples of adolescents that have demonstrated relationships between particular attachment styles and specific aspects of psychopathology found that a preoccupied attachment style was associated with depression (Allen et al, 2006;Kobak, Sudler, & Gamble, 1991;Rosenstein & Horowitz, 1996), suicidal ideation (Adam, SheldonKeller, & West, 1996), eating disorders (Miljkovitch, Pierrehumbert, Karmaniola, Bader, & Halfon, 2005;Pierrehumbert et al, 2002), more interpersonal difficulties, and more overall symptoms than other attachment strategies (Brown & Wright, 2003), Moreover, an avoidant attachment style has been associated with conduct disorders and drug abuse (Pierrehumbert et al, 2002;Rosenstein & Horowitz, 1996).…”

Cognitive and physiological dissociations in response to emotional pictures in patients with anorexia

“…A study by Zonneville-Bender et al [23] confirmed this possible disconnection between the physiological and cognitive self-reported responses to emotional stimuli both in patients with anorexia and in alexithymic participants. In patients with anorexia, Pierrehumbert et al [24] observed a higher level of emotional physiological activation, whereas Zonnevylle-Bender et al [23] reported a discordance between self-reported emotional and neurophysiological arousal as measured by heart rate (HR) and cortisol levels during the psychosocial stress.…”

Eating Disorder Behavior and Early Maladaptive Schemas in Subgroups of Eating Disorders

“…Recent models of eating disorders conceptualize EDBs as maladaptive coping mechanisms to attachment-related distress and negative emotions (Pierrehumbert et al, 2002;Luck et al, 2005;Smyth et al, 2007). Dietary restraint and physical exercise with the aim of body shaping are coping mechanisms for body dissatisfaction-related shame and negative self-esteem, which is correlated with insecure attachment in women with eating disorders (Troisi et al, 2006).…”