title: Emotion regulation difficulties in anorexia nervosa: associations with improvements in eating psychopathology.
abstract: BACKGROUND
  Difficulties with emotion regulation have been established as a core deficit in anorexia nervosa (AN). However, limited research has evaluated whether weight gain is associated with improvements in emotion regulation difficulties in AN and whether improvements in emotion regulation are associated with reductions in eating disorder psychopathology. The aims of this study were threefold: 1) to examine the nature and extent of emotion regulation difficulties in AN; 2) to determine whether these difficulties improved during intensive treatment for the eating disorder; and 3) to study whether improvements in emotion regulation were associated with improvements in eating disorder psychopathology.
  
  
  METHODS
  The participants were 108 patients who met DSM-IV-TR criteria for AN and were admitted to a specialized intensive treatment program. Self-report measures of eating disorder symptoms and difficulties with emotion regulation were administered at admission to and discharge from the program.
  
  
  RESULTS
  Patients with the binge-purge subtype of AN reported greater difficulties with impulse control when upset and more limited access to emotion regulation strategies when experiencing negative emotions than those with the restricting subtype. Among those who completed treatment and became weight restored, improvements in emotion regulation difficulties were observed. Greater pre-to-post treatment improvements in emotional clarity and engagement in goal directed behaviours when upset were associated with greater reductions in eating disorder psychopathology during treatment.
  
  
  CONCLUSIONS
  These findings add to growing evidence suggesting that eating disorder symptoms may be related to emotion regulation difficulties in AN and that integrating strategies to address emotion regulation deficits may be important to improving treatment outcome in AN.
authors.affiliation: Department of Psychology, Memorial University of Newfoundland, St. John's, NL A1B 3X9 Canada.
authors.forename: Marsha
authors.initials: M
authors.lastname: Rowsell
authors.affiliation: Department of Psychology, Ryerson University, Toronto, Ontario M5G 2C4 Canada ; Department of Psychiatry, University Health Network, Toronto, Ontario M5G 2C4 Canada.
authors.forename: Danielle E
authors.initials: DE
authors.lastname: MacDonald
authors.affiliation: Department of Psychology, Memorial University of Newfoundland, St. John's, NL A1B 3X9 Canada.
authors.forename: Jacqueline C
authors.initials: JC
authors.lastname: Carter
keywords: Anorexia nervosa; Emotion regulation