title: Voluntary emotion regulation in anorexia nervosa: A preliminary emotion-modulated startle investigation.
abstract: Emotion regulation difficulties are implicated in the development and maintenance of anorexia nervosa (AN). However, research has been limited by an almost exclusive reliance on self-report. This study is the first to use the emotion-modulated startle paradigm (EMSP) to investigate emotional reactivity and voluntary emotion regulation in individuals with AN. Twenty women with AN viewed negative, positive, neutral, and food images and were asked to enhance, suppress, or maintain their emotional responses mid-way through picture presentation. Startle eyeblink magnitudes in response to startle probes administered prior, and subsequent, to regulation instructions indexed emotional reactivity and regulation, respectively. On emotional reactivity trials, startle magnitudes were greater for negative, positive, and food images, compared to neutral images. Participants had difficulty suppressing startle responses to negative and food images, as indicated by non-significant suppress-maintain comparisons. In contrast, startle responses to enhance and suppress cues during presentation of pleasant images were comparable and significantly lower than maintain cues. Findings converge with self-report data to suggest that patients with AN have difficulties with voluntary emotion regulation. The EMSP may be a promising trans-diagnostic method for examining emotion regulation difficulties that underlie risk for eating disorders and other psychiatric conditions.
authors.affiliation: Department of Psychology, Ohio University, Athens, OH, USA. Electronic address: racine@ohio.edu.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Racine
authors.affiliation: Department of Psychology, University of Kansas, Lawrence, KS, USA.
authors.forename: Kelsie T
authors.initials: KT
authors.lastname: Forbush
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Wildes
authors.affiliation: Department of Psychology, University of Kansas, Lawrence, KS, USA.
authors.forename: Kelsey E
authors.initials: KE
authors.lastname: Hagan
authors.affiliation: Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA.
authors.forename: Lauren O
authors.initials: LO
authors.lastname: Pollack
authors.affiliation: Department of Psychology, University of North Carolina-Greensboro, Greensboro, NC, USA.
authors.forename: Casey
authors.initials: C
authors.lastname: May
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000503:physiopathology / Q000523:psychology*; D001767:Blinking / Q000502:physiology; D004576:Electromyography; D004644:Emotions; D005152:Facial Muscles / Q000503:physiopathology; D005260:Female; D005502:Food; D006801:Humans; D010775:Photic Stimulation; D011581:Psychological Tests; D013216:Reflex, Startle / Q000502:physiology; D014796:Visual Perception; D014836:Volition
keywords: Anorexia nervosa; Emotion; Emotion regulation; Emotion-modulated startle; Startle-blink reflex; Voluntary regulation