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Early adaptive schemas, emotional regulation, and cognitive flexibility in eating disorders : subtype specific predictors of eating disorder symptoms using hierarchical linear regression

Mitchell, J. S. ; Huckstepp, T. ; Allen, A. ; Louis, P. J. ; Anijärv, T. E. LU orcid and Hermens, D. F. (2024) In Eating and Weight Disorders 29(1).
Abstract

Purpose: Understanding how early adaptive schemas, cognitive flexibility, and emotional regulation influence eating disorder (ED) symptoms, and whether this differs across diagnostic subtypes is critical to optimising treatment. The current study investigated the relationship between these variables and ED symptomology in individuals self-reporting an ED diagnosis and healthy controls. Methods: A dataset of 1576 online survey responses yielded subsamples for anorexia nervosa (n = 155), bulimia nervosa (n = 55), binge eating disorder (n = 33), other specified feeding or eating disorder (n = 93), and healthy participants (n = 505). The hierarchical linear regression analysis included Eating Disorder Examination Questionnaire 6.0 Global... (More)

Purpose: Understanding how early adaptive schemas, cognitive flexibility, and emotional regulation influence eating disorder (ED) symptoms, and whether this differs across diagnostic subtypes is critical to optimising treatment. The current study investigated the relationship between these variables and ED symptomology in individuals self-reporting an ED diagnosis and healthy controls. Methods: A dataset of 1576 online survey responses yielded subsamples for anorexia nervosa (n = 155), bulimia nervosa (n = 55), binge eating disorder (n = 33), other specified feeding or eating disorder (n = 93), and healthy participants (n = 505). The hierarchical linear regression analysis included Eating Disorder Examination Questionnaire 6.0 Global Score as the dependent variable; Young Positive Schema Questionnaire, Emotional Regulation Questionnaire, and Cognitive Flexibility Inventory subscale scores as the independent variables; and demographic measures as the covariates. Results: The number of significant predictors varied considerably by ED sub-group. Amongst the anorexia nervosa, bulimia nervosa, and healthy subsamples, the adaptive schema Self-Compassion and Realistic Expectations was associated with lower ED symptom severity. In comparison, age and body mass index were the strongest predictors for binge eating disorder, whilst the Expressive Suppression (a subscale of the Emotional Regulation Questionnaire) was the strongest predictor for other specified feeding or eating disorders. Conclusion: Early adaptive schemas, cognitive flexibility, and emotional regulation vary across ED subtype, suggesting the need for tailored treatment that disrupts the self-reinforcing cycle of ED psychopathology. Future research investigating how early adaptive schemas may predict or be associated with treatment response across diagnostic subtypes is needed. Level of evidence: Level IV, evidence obtained from multiple time-series with or without the intervention, such as case studies.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cognitive flexibility, Early adaptive schemas, Eating disorders, Emotional regulation
in
Eating and Weight Disorders
volume
29
issue
1
article number
54
publisher
Kurtis
external identifiers
  • pmid:39210038
  • scopus:85202735722
ISSN
1124-4909
DOI
10.1007/s40519-024-01682-4
language
English
LU publication?
yes
id
98563d36-8bdb-4edf-8022-399cb23a4a6a
date added to LUP
2024-11-13 14:56:34
date last changed
2025-07-24 12:11:19
@article{98563d36-8bdb-4edf-8022-399cb23a4a6a,
  abstract     = {{<p>Purpose: Understanding how early adaptive schemas, cognitive flexibility, and emotional regulation influence eating disorder (ED) symptoms, and whether this differs across diagnostic subtypes is critical to optimising treatment. The current study investigated the relationship between these variables and ED symptomology in individuals self-reporting an ED diagnosis and healthy controls. Methods: A dataset of 1576 online survey responses yielded subsamples for anorexia nervosa (n = 155), bulimia nervosa (n = 55), binge eating disorder (n = 33), other specified feeding or eating disorder (n = 93), and healthy participants (n = 505). The hierarchical linear regression analysis included Eating Disorder Examination Questionnaire 6.0 Global Score as the dependent variable; Young Positive Schema Questionnaire, Emotional Regulation Questionnaire, and Cognitive Flexibility Inventory subscale scores as the independent variables; and demographic measures as the covariates. Results: The number of significant predictors varied considerably by ED sub-group. Amongst the anorexia nervosa, bulimia nervosa, and healthy subsamples, the adaptive schema Self-Compassion and Realistic Expectations was associated with lower ED symptom severity. In comparison, age and body mass index were the strongest predictors for binge eating disorder, whilst the Expressive Suppression (a subscale of the Emotional Regulation Questionnaire) was the strongest predictor for other specified feeding or eating disorders. Conclusion: Early adaptive schemas, cognitive flexibility, and emotional regulation vary across ED subtype, suggesting the need for tailored treatment that disrupts the self-reinforcing cycle of ED psychopathology. Future research investigating how early adaptive schemas may predict or be associated with treatment response across diagnostic subtypes is needed. Level of evidence: Level IV, evidence obtained from multiple time-series with or without the intervention, such as case studies.</p>}},
  author       = {{Mitchell, J. S. and Huckstepp, T. and Allen, A. and Louis, P. J. and Anijärv, T. E. and Hermens, D. F.}},
  issn         = {{1124-4909}},
  keywords     = {{Cognitive flexibility; Early adaptive schemas; Eating disorders; Emotional regulation}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Kurtis}},
  series       = {{Eating and Weight Disorders}},
  title        = {{Early adaptive schemas, emotional regulation, and cognitive flexibility in eating disorders : subtype specific predictors of eating disorder symptoms using hierarchical linear regression}},
  url          = {{http://dx.doi.org/10.1007/s40519-024-01682-4}},
  doi          = {{10.1007/s40519-024-01682-4}},
  volume       = {{29}},
  year         = {{2024}},
}