title: Dynamic longitudinal relations between emotion regulation difficulties and anorexia nervosa symptoms over the year following intensive treatment.
abstract: OBJECTIVE
  Emotion regulation difficulties have been implicated in theoretical models of anorexia nervosa (AN) development/maintenance, and several treatments for AN have been designed to target emotion dysregulation. However, no research has used longitudinal methodology to examine whether emotion regulation difficulties predict the maintenance of AN symptoms, or vice versa. The current study evaluated dynamic longitudinal relations between emotion dysregulation and AN symptom severity over the year following discharge from intensive treatment in order to enhance theoretical models and treatments for AN.
  
  
  METHODS
  Participants were 191 patients with AN recruited during intensive treatment. Assessments including the Eating Disorders Examination and the Difficulties in Emotion Regulation Scale were completed at discharge from treatment and at 3-, 6-, and 12-month follow-ups. Bivariate latent change score models were used to examine the direction of associations between emotion dysregulation and AN symptom severity across time.
  
  
  RESULTS
  Emotion dysregulation predicted change in AN symptom severity, but the reverse relationship did not occur. Individuals with high levels of emotion dysregulation experienced an increase and subsequent maintenance of AN psychopathology, whereas low emotion dysregulation predicted a decreasing AN symptom trajectory. Importantly, these dynamic temporal relationships could not be accounted for by body mass index or depressive symptoms and were present for patients with the restricting and binge-eating/purging subtypes of AN.
  
  
  CONCLUSIONS
  Emotion regulation difficulties appear to be involved in the maintenance of AN symptom severity over time. Findings provide support for an increasing emphasis on emotion regulation in the development of novel treatments for AN.
authors.affiliation: Department of Psychology, Ohio University.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Racine
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Wildes
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology* / Q000628:therapy; D015992:Body Mass Index; D002032:Bulimia / Q000523:psychology; D003863:Depression; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D000068356:Self-Control; D012720:Severity of Illness Index; D055815:Young Adult