A Prospective Investigation of the Relation between Emotion Awareness and Disordered Eating: Moderating and Mediating Factors

Abstract

Although research has shown that poor emotion awareness is significantly related to disordered eating, the majority of studies that have examined this relation have significant limitations. These limitations include lack of longitudinal data, little focus on the specificity of emotion awareness in predicting disordered eating versus general emotional distress, little focus on the roles of other emotional deficits, such as emotional avoidance and fear of emotions, an over-reliance on self-report data, a lack of research with sub-clinical populations, and a failure to examine possible interactions between emotion awareness and other known risk factors for disordered eating. The current study addressed some of these limitations by using a two-time point, prospective design to examine a variety of emotional processes, stress, dysfunctional appearance beliefs, and disordered eating in undergraduate females. At Time 1, participants (N = 187), ages 18-22, completed measures of emotion awareness, emotional avoidance, fear of emotions, depression, anxiety, dysfunctional appearance beliefs, life events/stress, and disordered eating. Three months later, at Time 2, participants (N = 158) repeated many of the Time 1 measures, in addition to completing a measure that assessed the frequency and subjective negative impact of life events experienced during the prospective period. Six main hypotheses were tested. As expected, emotion awareness was stable over time and was related to disordered eating cross-sectionally. Contrary to expectations, emotion awareness did not predict disordered eating prospectively, emotion awareness related more to depression and anxiety than to disordered eating, emotion awareness did not relate to disordered eating cross-sectionally or prospectively once emotional avoidance and fear of emotions were controlled, emotion awareness did not interact with life events/stress and dysfunctional appearance beliefs to predict disordered eating cross-sectionally or prospectively, and the ability to repair mood did not mediate the relation between emotion awareness and disordered eating. A notable finding involved the lack of specificity of emotion awareness to disordered eating versus depression and anxiety. In fact, depression and anxiety fully mediated the relation between poor emotion awareness and disordered eating. Following a review of the results, strengths and limitations, as well as clinical implications and potential future research directions are discussed.