Emotion regulation variability and flexibility across the eating disorder spectrum

• Applicants: Professor Dr. Stefan Ehrlich, Ph.D.; Dr. Maria Seidel
• Subject Area: Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry
• Term: since 2022
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 502010784

Individuals with eating disorder (ED) symptoms including those with full-syndrome EDs such as Anorexia nervosa (AN) Bulimia nervosa (BN) or Binge-eating disorder (BED) self-report limited access to adaptive emotion regulation (ER) strategies. Instead, they frequently employ ER strategies (e.g. rumination) that are considered to have only short-lasting effects and are associated with negative consequences. However, experimental evidence is scarce and the few existing studies have delivered mixed results. Nonetheless, some findings including our own give rise to the novel assumption that there might not be a general deficit in executing more effective ER strategies per se, but rather that individuals with ED symptoms might have difficulties related to the flexible context-dependent selection of the right strategies in the right moment. Newer models of ER haveincorporated a more dynamic approach by suggesting that successful ER might be related to 1. ER variability (e.g. the size of the strategy repertoire), 2. sensitivity to contextual changes and 3. ER flexibility, the covariation of the two. The proposed project will investigate each of these concepts, in both patients with EDs (AN and BN/BED syndrome using a laboratory assessment), as well as subclinical individuals with increased ED symptoms (dimensional approach using an online platform). Aim 1 investigates whether ER deficits are related to reduced ER variability. To this end, we apply ecological momentary assessment (via smartphones) to investigate the number of different ER strategies applied in real life. Aim 2 addresses sensitivity to contextual factors that have recently been shown to influence ER strategy choice in healthy individuals using an established ER strategy choice paradigm. To investigate influences of different stimulus characteristics (such as high/low negative intensity, or high/low caloric food) on strategy choice, the laboratory assessment not only includes strategy choice, but also objective measures of emotional reactivity and ER choice as well as success (pupil dilation and fMRI including MVPA). Influences of perceived effort and goalmanipulation on ER strategy choice will be assessed using adaptions of the same task in a large crowdsourced online sample. Aim 3 combines the data of Aim 1 and 2. Analyses will focus on a) whether there are associations between ER flexibility (covariation between ER variability and context changes) and ED symptoms or groups and b) whether ER variability and flexibility are associated with short- and long term success of applied strategies. The 3 aims of the proposed project promise to deliver a better understanding and more finegrained description of the apparent ER deficit in EDs as well as individuals with ED symptoms which can be used to develop new treatment approaches and preventative measures.

• DFG Programme: Research Grants