Emotional Intolerance and Core Features of Anorexia Nervosa: A Dynamic Interaction during Inpatient Treatment? Results from a Longitudinal Diary Study

PLoS One

Beate Wild¹  Wolfgang Herzog¹  Esther Stroe-Kunold¹  Michael Schwab¹  Hans-Christoph Friederich¹  Daniela Wesche²  Tatjana Stadnitski³ 

[1] Department of General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Heidelberg, Germany;Department of Psychological Methods and Statistics, University Ulm, Ulm, Germany;Department of Psychosomatic Medicine and Psychotherapy, LVR-Clinics, University Düsseldorf, Düsseldorf, Germany

关键词: Emotions;    Anorexia nervosa;    Eating;    Inpatients;    Behavior;    Fear;    Psychometrics;    Patients;   

DOI  :  10.1371/journal.pone.0154701

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Objective The role of emotion dysregulation with regard to the psychopathology of anorexia nervosa (AN) is increasingly discussed. It is both assumed that AN symptoms have an impact on difficulties in tolerating aversive emotions and that—conversely—emotion dysregulation influences AN. To date, such conclusions are drawn on the basis of cross-sectional data not allowing for inferences on the temporal dynamics. The current study investigates the longitudinal interaction between emotional intolerance and core AN symptoms over the course of inpatient treatment by comparing patients with high (BMI<15 kg/m2) vs. low symptom severity (HSS vs. LSS). Method The study adopted a longitudinal, process-oriented design with N = 16 analysed electronic diaries. Throughout the course of their inpatient treatment, the patients answered questions daily about emotional intolerance and their AN-specific cognitions and behaviours. The temporal dynamics between emotional intolerance and these variables were analysed using a multivariate time series approach. Results The time series of the processes under investigation adequately reflected the individual treatment courses. The majority of significant linear time trends was found for HSS patients. Most importantly, analysis revealed significant temporal interactions between emotional intolerance and AN symptoms in almost 70% of HSS patients. Thereby, up to 37% of variance in eating restraint and up to 23% in weight concern could be attributed to changes in emotional intolerance. Conclusions The findings support the notion that intolerable unpleasant emotions in severely affected AN patients influence their psychopathology. Additionally, time series analysis outlined the inter-individual heterogeneity of psychosomatic treatment courses of AN patients.

【 授权许可】

CC BY