The Role of Attachment and Maladaptive Emotion Regulation Strategies in the Development of Bulimic Symptoms in Adolescents.

Following the theoretical propositions of the Emotion Regulation model of attachment, the current study investigated whether attachment anxiety and attachment avoidance might play a differential contributing role in the development of bulimic symptoms, through assumed differences in adopting specific maladaptive emotion regulation strategies in a sample of adolescents. Developmentally appropriate self-report questionnaires were administered to a community sample of 397 adolescents (Mean age: 14.02; 62.7% female) and this at 2 time points with a 1-year time lag. Results provided longitudinal evidence for the Emotion Regulation model of attachment in confirming the differential contributing role of the attachment dimensions on the development of bulimic symptoms in a sample of adolescents. More specifically, attachment anxiety seemed to be related to bulimic symptoms through rumination, while attachment avoidance through emotional control. These results may have clinical implications for assessment and treatment of bulimic symptoms in adolescents.

Do changes in affect moderate the association between attachment anxiety and body dissatisfaction in children? An experimental study by means of the Trier Social Stress Test.

OBJECTIVE: Previous studies have already found a positive association between attachment and disordered eating attitudes and behaviors in children and adolescents. However, to our knowledge, no experimental studies have examined whether changes in negative and/or positive affect moderate the association between attachment anxiety and body dissatisfaction in children. METHOD: A controlled laboratory setting was used to investigate whether changes in state negative and/or positive affect moderate the association between attachment anxiety and body satisfaction in a sample of 81 children (Mage=11.74). The changes in state affect were caused by the exposure to a performance-related stressor using the Trier Social Stress Test for Children. RESULTS: Children with high levels of attachment anxiety reported a decrease in body satisfaction, but only if the TSST-C led to a decrease in their positive affect. DISCUSSION: Early detection and intervention programs may benefit from addressing insecure attachment and maladaptive emotion regulation in children.

Loss of control eating in adolescents: Associations with adaptive and maladaptive emotion regulation strategies.

OBJECTIVE: To examine differences in the use of emotion regulation strategies in adolescents with and without loss of control over eating (LOC). METHOD: A community-based sample of 524 adolescents from 12 to 18years old (70.6% girls; Mage=15.08; SD=1.59) reported on LOC and the use of several maladaptive and adaptive emotion regulation strategies. RESULTS: Adolescents who experience LOC (28%) report more use of maladaptive strategies. With regard to adaptive strategies a significant group X gender interaction effect was found with girls who report LOC using less adaptive strategies. More specifically, based on the FEEL-KJ less problem-oriented action, distraction, humor enhancement, acceptance and cognitive problem solving were observed in girls who report LOC compared to those who do not report LOC. Boys with LOC report more use of adaptive strategies compared to those who do not report LOC. DISCUSSION: LOC in adolescents is associated with increased use of maladaptive emotion regulation strategies as well as a decreased use of adaptive strategies although the latter is only specific for girls. These results may inform prevention and treatment of emotion regulation problems in adolescents with LOC.

Validation of the FEEL-KJ: An Instrument to Measure Emotion Regulation Strategies in Children and Adolescents.

Although the field of emotion regulation in children and adolescents is growing, there is need for age-adjusted measures that assess a large variety of strategies. An interesting instrument in this respect is the FEEL-KJ because it measures 7 adaptive and 5 maladaptive emotion regulation strategies in response to three different emotions. However, the FEEL-KJ has not yet been validated extensively. Therefore, the current study aims to test the internal structure and validity of the FEEL-KJ in a large sample of Dutch-speaking Belgian children and adolescents (N = 1102, 8-18 years old). The investigation of the internal structure confirms earlier reports of a two-factor structure with Adaptive and Maladaptive Emotion Regulation as overarching categories. However, it also suggests that the two-factor model is more complex than what was previously assumed. The evaluation of the FEEL-KJ validity furthermore provides evidence for its construct and external validity. In sum, the current study confirms that the FEEL-KJ is a valuable and reliable measure of emotion regulation strategies in children and adolescents.

Continuity in primary school children's eating problems and the influence of parental feeding strategies.

Eating problems are highly prevalent and seem to show continuity in children. Nevertheless, the effect of different maternal and paternal feeding practices on changes in these problems is not fully understood yet. This study examines short-term continuity in primary school children's overeating, loss of control (over eating), restraint and concerns (about eating, body shape and weight) and the predictive value of parental feeding strategies on change in these eating problems. Children (8-12 years, n = 613, 46.5 % girls) completed the Child Eating Disorder Examination Questionnaire (ChEDE-Q) twice with the second measurement (T2) taking place 6 months after the first (T1). Parents (n = 714, 57.7 % mothers) completed the Child Feeding Questionnaire (CFQ) at T1 to assess the level of controlling feeding strategies. More overeating, restraint and concerns at T1 predicted higher levels of the same eating problems 6 months later, whereas more of loss of control at T1 predicted lower levels of loss of control 6 months later. Additionally, the interaction between maternal pressure and the gender of the child was predictive for increases in overeating, whereas the interaction between paternal monitoring and gender of the child was a marginally significant predictor for decreases in overeating. These findings point to the possible negative and positive effects of parental feeding practices as well as to the possible larger influence of mothers on their daughters' and of fathers on their sons' eating behaviors. The importance of studying mothers and fathers, as well as daughters and sons, and of including different feeding strategies and eating problems is discussed.

The parent-child relationship as predictor of eating pathology and weight gain in preadolescents.

The present study examined the role of attachment toward mother and father as a predictor of eating pathology and weight gain among preadolescent boys and girls. Self-report questionnaires and adjusted body mass index (BMI) were administered from a community sample of 601 preadolescents (8-11 years; 48% female) at baseline and once again 1 year later. Significant baseline associations were found between attachment toward both parents and several features of eating pathology. No baseline correlations were found between the attachment variables and adjusted BMI. However, after controlling for gender and baseline levels of eating pathology and weight, an insecure attachment toward mother significantly predicted increases in dietary restraint, eating concerns, weight concerns, and shape concerns, and adjusted BMI in the children 1 year later. An insecure attachment toward father was predictive for persistence in children's subjective binge eating episodes. The present study provides preliminary evidence for the longitudinal association between attachment and eating pathology and weight gain in preadolescents. Moreover, attachment toward mother and attachment toward father appear to be differently associated with their children's disordered eating attitudes and adjusted BMI. Future research should further elucidate the mechanisms underlying this differential association.

Adolescent aesthetic athletes: a group at risk for eating pathology?

Previous research shows that leanness- and weight-dependent sports increase the risk of developing disturbed eating behaviour. This study investigated whether adolescent aesthetic athletes (n=68, M=14.6 years), particularly ballet dancers and figure skaters, exhibit more eating pathology compared to the general population. Furthermore, it was investigated whether sport-related factors have explanatory value for the dieting behaviour of aesthetic athletes. To asses eating pathology, reliable and valid self-report questionnaires were used including the Eating Disorder Inventory-II, the Children's Eating Disorder Examination-Questionnaire and the Dutch Eating Behaviour Questionnaire. Results show that female aesthetic athletes show more drive for thinness, features of bulimia, dieting behaviour and concerns about weight and shape compared to female adolescents from the general population. Concerning the explanation of dieting behaviour in aesthetic athletes, both sport-related factors (competition state anxiety) and general risk factors (eating concern) seem to be relevant. These results suggest that female aesthetic athletes show more disturbed eating behaviour and thoughts than female adolescents from the general population and therefore may have an enhanced risk of developing clinical eating disorders.