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

J. S. Mitchell; T. Huckstepp; A. Allen; P. J. Louis; T. E. Anijärv; D. F. Hermens

doi:10.1007/s40519-024-01682-4

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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

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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

J. S. Mitchell, T. Huckstepp, A. Allen, P. J. Louis, T. E. Anijärv and D. F. Hermens

Eating and Weight Disorders, Vol.29(1), pp.1-16

2024

DOI: https://doi.org/10.1007/s40519-024-01682-4

PMCID: PMC11362190

PMID: 39210038

Appears in Thompson Institute Research Collection

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Abstract

eating disorders

early adaptive schemas

cognitive flexibility

emotional regulation

Thompson Institute Special Collection

Other Collaborations

UniSC Diversity Area - Disability and Inclusion

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.

Details

Title: Early adaptive schemas, emotional regulation, and cognitive flexibility in eating disorders: subtype specific predictors of eating disorder symptoms using hierarchical linear regression
Authors: J. S. Mitchell (Corresponding Author) - University of the Sunshine Coast, Queensland, Thompson Institute
T. Huckstepp (Author) - University of the Sunshine Coast, Queensland, Thompson Institute
A. Allen (Author) - University of the Sunshine Coast, Queensland, School of Health - Psychology
P. J. Louis (Author) - USCI University (Malaysia)
T. E. Anijärv (Author) - University of the Sunshine Coast, Queensland, Thompson Institute
D. F. Hermens (Author) - University of the Sunshine Coast, Queensland, Thompson Institute
Publication details: Eating and Weight Disorders, Vol.29(1), pp.1-16
Publisher: Springer Milano
Date published: 2024
DOI: 10.1007/s40519-024-01682-4
ISSN: 1590-1262
PMID: 39210038; PMC11362190
Copyright note: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Data Availability: An example of the study analysis code is provided in the supplementary materials. The package used for the primarily analysis can be accessed at https://github.com/teanijarv/HLR, and the code to reproduce the supplementary material example analysis can be found at https://github.com/JulesMitchell/SchemaHLR. The (de-identified) data that support the findings of this study are available from the corresponding author upon request.
Organisation Unit: School of Health - Biomedicine; Thompson Institute; School of Health - Psychology; Student Services and Engagement; Sexual Violence Research and Prevention Unit
Language: English
Record Identifier: 991058398902621
Output Type: Journal article

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