Gender-Related Patterns of Emotion Regulation among Patients with Eating Disorders
Abstract
:1. Introduction
2. Experimental Section
2.1. Participants
2.2. Assessment
2.3. Statistical Analysis
3. Results
3.1. Sample Characteristics
3.2. ER and Negative Affect Measures and Comparison between Groups
3.3. Comparison of ER between ED Subtypes
3.4. Predictive Capacity of the Study Variables on ER
3.5. Pathways Analysis
4. Discussion
Limitations and Strengths
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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ED Females | ED Males | HC Females | HC Males | ||||||
---|---|---|---|---|---|---|---|---|---|
(n = 656) | (n = 62) | (n = 286) | (n = 78) | ||||||
n | % | n | % | n | % | n | % | p-Value | |
Civil status | |||||||||
Single | 486 | 74.1% | 42 | 67.7% | 278 | 97.2% | 77 | 98.7% | <0.001 * |
Married-partner | 114 | 17.4% | 17 | 27.4% | 3 | 1.0% | 0 | 0.0% | |
Separated-divorced | 56 | 8.5% | 3 | 4.8% | 5 | 1.7% | 1 | 1.3% | |
Education | |||||||||
Primary | 261 | 39.8% | 28 | 45.2% | 6 | 2.1% | 2 | 2.6% | <0.001 * |
Secondary | 271 | 41.3% | 22 | 35.5% | 276 | 96.5% | 75 | 96.2% | |
University | 124 | 18.9% | 12 | 19.4% | 4 | 1.4% | 1 | 1.3% | |
Employed | |||||||||
Student | 259 | 39.5% | 22 | 35.5% | 120 | 42.0% | 42 | 53.8% | 0.077 |
Unemployed | 397 | 60.5% | 40 | 64.5% | 166 | 58.0% | 36 | 46.2% | |
Mean | SD | Mean | SD | Mean | SD | Mean | SD | p-Value | |
Age (years-old) | 29.78 | 11.07 | 33.56 | 12.73 | 21.06 | 4.19 | 21.30 | 4.53 | <0.001 * |
ED Women | ED Men | HC Women | HC Men | ED Women vs. ED Men | HC Women vs. HC Men | ED Women vs. HC Women | ED Men vs. HC Men | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(n = 656) | (n = 62) | (n = 286) | (n = 78) | |||||||||||||
Mean | SD | Mean | SD | Mean | SD | Mean | SD | p-Value | |d| | p-Value | |d| | p-Value | |d| | p-Value | |d| | |
DERS scales | ||||||||||||||||
Non-acceptance | 19.63 | 6.87 | 17.33 | 6.68 | 12.35 | 5.29 | 10.99 | 4.59 | 0.007 * | 0.34 | 0.089 | 0.27 | <0.001 * | 1.19 † | <0.001 * | 1.11 † |
Pursuing goals | 17.64 | 5.03 | 16.07 | 4.89 | 12.98 | 4.12 | 12.47 | 4.31 | 0.013 * | 0.32 | 0.402 | 0.12 | <0.001 * | 1.01 † | <0.001 * | 0.78 † |
Impulse behaviors | 17.00 | 6.47 | 14.69 | 6.23 | 10.71 | 4.01 | 9.89 | 3.16 | 0.003 * | 0.36 | 0.267 | 0.23 | <0.001 * | 1.17 † | <0.001 * | 0.97 † |
Emotional awareness | 17.91 | 5.10 | 18.25 | 4.51 | 14.56 | 4.12 | 14.29 | 4.31 | 0.594 | 0.07 | 0.659 | 0.06 | <0.001 * | 0.72 † | <0.001 * | 0.90 † |
Emotional regulation | 25.54 | 8.24 | 22.39 | 8.05 | 15.13 | 5.87 | 14.26 | 5.47 | 0.002 * | 0.39 | 0.370 | 0.15 | <0.001 * | 1.45 † | <0.001 * | 1.18 † |
Emotional clarity | 14.76 | 5.07 | 13.51 | 5.08 | 10.22 | 3.63 | 9.42 | 3.67 | 0.043 * | 0.25 | 0.182 | 0.22 | <0.001 * | 1.03 † | <0.001 * | 0.92 † |
Total score | 112.46 | 26.94 | 102.25 | 26.02 | 75.95 | 19.27 | 71.31 | 16.95 | 0.002 * | 0.39 | 0.143 | 0.26 | <0.001 * | 1.56 † | <0.001 * | 1.41 † |
EDI-2 scales | ||||||||||||||||
Drive for thinness | 14.23 | 6.02 | 10.51 | 5.60 | 3.74 | 5.04 | 2.75 | 3.45 | <0.001 * | 0.64 † | 0.206 | 0.23 | <0.001 * | 1.89 † | <0.001 * | 1.67 † |
Body dissatisfaction | 17.22 | 7.88 | 11.10 | 8.32 | 6.37 | 6.75 | 4.63 | 4.87 | <0.001 * | 0.75 † | 0.094 | 0.30 | <0.001 * | 1.48 † | <0.001 * | 0.95 † |
Interoceptive awareness | 11.83 | 7.06 | 8.32 | 6.43 | 2.83 | 2.89 | 1.94 | 1.99 | <0.001 * | 0.52 † | 0.249 | 0.36 | <0.001 * | 1.67 † | <0.001 * | 1.34 † |
Bulimia | 7.21 | 5.59 | 3.74 | 4.15 | 1.49 | 1.68 | 1.01 | 0.93 | <0.001 * | 0.70 † | 0.454 | 0.35 | <0.001 * | 1.39 † | 0.001 * | 0.91 † |
Interpersonal distrust | 5.76 | 4.81 | 5.67 | 4.52 | 2.54 | 2.92 | 2.57 | 2.76 | 0.880 | 0.02 | 0.969 | 0.01 | <0.001* | 0.81 † | <0.001 * | 0.83 † |
Ineffectiveness | 11.90 | 7.70 | 8.21 | 7.22 | 2.26 | 3.05 | 2.02 | 2.65 | <0.001 * | 0.51 † | 0.788 | 0.09 | <0.001 * | 1.65 † | <0.001 * | 1.14 † |
Maturity fears | 8.79 | 5.97 | 7.33 | 5.03 | 4.46 | 3.72 | 4.20 | 3.38 | 0.036 * | 0.27 | 0.725 | 0.07 | <0.001 * | 0.87 † | 0.001 * | 0.73 † |
Perfectionism | 6.18 | 4.36 | 5.05 | 4.00 | 3.99 | 3.55 | 4.08 | 3.34 | 0.037 * | 0.27 | 0.874 | 0.03 | <0.001 * | 0.55 † | 0.186 | 0.27 |
Impulse regulation | 6.84 | 6.03 | 5.55 | 5.21 | 1.28 | 2.27 | 1.47 | 3.06 | 0.047 * | 0.23 | 0.783 | 0.07 | <0.001 * | 1.22 † | <0.001 * | 0.95 † |
Ascetism | 7.36 | 4.09 | 5.81 | 4.25 | 2.35 | 2.22 | 2.57 | 2.10 | 0.001 * | 0.37 | 0.653 | 0.10 | <0.001 * | 1.52 † | <0.001 * | 0.96 † |
Social insecurity | 8.11 | 5.37 | 6.56 | 4.74 | 2.63 | 2.85 | 2.40 | 2.82 | 0.013 * | 0.31 | 0.725 | 0.08 | <0.001 * | 1.28 † | <0.001 * | 1.07 † |
Total score | 105.43 | 42.63 | 77.88 | 42.60 | 33.89 | 21.52 | 29.50 | 15.65 | <0.001 * | 0.65 † | 0.355 | 0.23 | <0.001 * | 2.12 † | <0.001 * | 1.51 † |
Binge eating/purging | ||||||||||||||||
Binge episodes | 3.76 | 6.32 | 1.86 | 2.60 | --- | --- | --- | --- | 0.019 * | 0.39 | --- | --- | --- | --- | --- | --- |
Purging episodes | 3.96 | 8.75 | 1.29 | 3.60 | --- | --- | --- | --- | 0.018 * | 0.40 | --- | --- | --- | --- | --- | --- |
n | % | n | % | n | % | n | % | p-Value | |d| | p-Value | |d| | p-Value | |d| | p-Value | |d| | |
1 NSSI | 290 | 44.2% | 10 | 16.1% | 62 | 21.8% | 19 | 25.0% | <0.001 * | 0.64 † | 0.544 | 0.08 | <0.001 * | 0.50 † | 0.260 | 0.22 |
Subsample | AN | BN | BED | OSFED | AN-BN | AN-BED | AN-OSFED | BN-BED | BN-OSFED | BED-OSFED | ||||||||||
n = 140 | n = 236 | n = 100 | n = 180 | |||||||||||||||||
Women | Mean | SD | Mean | SD | Mean | SD | Mean | SD | p-Value | |d| | p-Value | |d| | p-Value | |d| | p-Value | |d| | p-Value | |d| | p-Value | |d| |
Nonacceptance | 17.62 | 7.26 | 20.99 | 6.42 | 19.36 | 6.68 | 19.70 | 6.89 | <0.001 * | 0.52 † | 0.046 * | 0.25 | 0.007 * | 0.29 | 0.042 * | 0.25 | 0.046 * | 0.19 | 0.700 | 0.05 |
Pursuing goals | 16.47 | 5.16 | 18.55 | 4.76 | 17.51 | 5.11 | 17.18 | 5.05 | <0.001 * | 0.42 | 0.128 | 0.20 | 0.209 | 0.14 | 0.092 | 0.21 | 0.006 * | 0.28 | 0.606 | 0.07 |
Impulse behavior | 15.44 | 6.97 | 18.56 | 6.03 | 16.51 | 6.47 | 16.39 | 6.26 | <0.001 * | 0.51 † | 0.225 | 0.16 | 0.186 | 0.14 | 0.010 * | 0.33 | 0.001 * | 0.35 | 0.893 | 0.02 |
Emot-awareness | 17.44 | 5.27 | 18.01 | 4.87 | 18.58 | 5.15 | 17.62 | 5.24 | 0.295 | 0.11 | 0.042 * | 0.22 | 0.749 | 0.03 | 0.367 | 0.11 | 0.443 | 0.08 | 0.155 | 0.18 |
Emot-regulation | 23.16 | 8.79 | 27.29 | 7.97 | 25.31 | 7.75 | 24.95 | 7.97 | <0.001 * | 0.50 † | 0.041 * | 0.26 | 0.049 * | 0.21 | 0.049 * | 0.25 | 0.004 * | 0.29 | 0.739 | 0.05 |
Emot-clarity | 13.77 | 5.50 | 15.22 | 5.00 | 14.49 | 4.53 | 14.77 | 5.02 | 0.008 * | 0.28 | 0.303 | 0.14 | 0.042 * | 0.19 | 0.241 | 0.15 | 0.371 | 0.09 | 0.673 | 0.06 |
Total score | 103.9 | 29.7 | 118.6 | 24.8 | 111.7 | 25.5 | 110.6 | 26.3 | <0.001 * | 0.54 † | 0.032 * | 0.28 | 0.025 * | 0.24 | 0.035 * | 0.27 | 0.003 * | 0.31 | 0.752 | 0.04 |
Subsample | AN | BN | BED | OSFED | AN-BN | AN-BED | AN-OSFED | BN-BED | BN-OSFED | BED-OSFED | ||||||||||
n = 16 | n = 12 | n = 15 | n = 19 | |||||||||||||||||
Men | Mean | SD | Mean | SD | Mean | SD | Mean | SD | p-Value | |d| | p-Value | |d| | p-Value | |d| | p-Value | |d| | p-Value | |d| | p-Value | |d| |
Nonacceptance | 16.14 | 7.86 | 17.95 | 5.65 | 17.90 | 7.78 | 17.79 | 5.46 | 0.507 | 0.26 | 0.499 | 0.22 | 0.494 | 0.24 | 0.985 | 0.01 | 0.950 | 0.03 | 0.965 | 0.02 |
Pursuing goals | 13.69 | 4.68 | 15.83 | 5.17 | 16.66 | 4.52 | 17.32 | 4.75 | 0.266 | 0.53 † | 0.048 * | 0.65 † | 0.035 * | 0.77 † | 0.661 | 0.17 | 0.415 | 0.30 | 0.711 | 0.14 |
Impulse behavior | 11.66 | 4.22 | 16.11 | 6.33 | 14.07 | 6.24 | 16.85 | 6.64 | 0.043 * | 0.83 † | 0.286 | 0.51 † | 0.015 * | 0.93 † | 0.386 | 0.32 | 0.740 | 0.12 | 0.203 | 0.51 † |
Emot-awareness | 17.96 | 4.75 | 18.21 | 3.55 | 19.28 | 4.73 | 17.21 | 4.81 | 0.893 | 0.06 | 0.455 | 0.28 | 0.644 | 0.16 | 0.561 | 0.26 | 0.570 | 0.24 | 0.227 | 0.52 † |
Emot-regulation | 20.43 | 9.44 | 21.45 | 7.05 | 21.68 | 6.53 | 24.66 | 8.14 | 0.737 | 0.12 | 0.668 | 0.15 | 0.049 * | 0.53 † | 0.942 | 0.03 | 0.275 | 0.52 † | 0.293 | 0.50 † |
Emot-clarity | 14.31 | 6.38 | 12.20 | 5.19 | 13.75 | 4.63 | 12.71 | 4.27 | 0.315 | 0.36 | 0.777 | 0.10 | 0.387 | 0.29 | 0.458 | 0.31 | 0.798 | 0.11 | 0.591 | 0.23 |
Total score | 94.2 | 29.3 | 101.7 | 25.1 | 103.3 | 24.1 | 106.5 | 25.0 | 0.466 | 0.28 | 0.356 | 0.34 | 0.180 | 0.55 † | 0.878 | 0.06 | 0.628 | 0.19 | 0.737 | 0.13 |
ED Women (n = 656) | ED Men (n = 62) | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Coefficients (Model Obtained in the Fifth Block-Step) | Change | Coefficients (Model Obtained in the Fifth Block-Step) | Change | |||||||||||||
B | SE | Beta | p-Value | 95% CI (B) | ΔR2 | p-Value | B | SE | Beta | p-Value | 95% CI (B) | ΔR2 | B | |||
Covariates | 0.009 | 0.131 | 0.055 | 0.395 | ||||||||||||
Age (years-old) | −0.13 | 0.19 | −0.054 | 0.497 | −0.51 | 0.25 | 0.11 | 0.43 | 0.053 | 0.809 | −0.77 | 0.98 | ||||
Civil status (married) | 3.33 | 1.95 | 0.055 | 0.089 | −0.50 | 7.15 | −0.51 | 5.42 | −0.009 | 0.926 | −11.45 | 10.44 | ||||
Education level | 1.51 | 0.94 | 0.041 | 0.107 | −0.33 | 3.36 | 2.65 | 2.43 | 0.077 | 0.283 | −2.27 | 7.56 | ||||
ED variables | 0.533 | <0.001 * | 0.488 | <0.001 * | ||||||||||||
EDI-2 total | 0.19 | 0.03 | 0.294 | <0.001 * | 0.13 | 0.24 | 0.09 | 0.07 | 0.158 | 0.183 | −0.05 | 0.24 | ||||
Onset of ED | −0.02 | 0.21 | −0.005 | 0.934 | −0.42 | 0.39 | −0.17 | 0.35 | −0.076 | 0.635 | −0.88 | 0.54 | ||||
Duration of ED | 0.05 | 0.20 | 0.017 | 0.798 | −0.34 | 0.44 | −0.37 | 0.28 | −0.155 | 0.196 | −0.94 | 0.20 | ||||
Psychopathology | 0.073 | <0.001 * | 0.219 | <0.001 * | ||||||||||||
SCL-90R GSI | 14.61 | 1.55 | 0.397 | <0.001 * | 11.57 | 17.65 | 19.39 | 3.72 | 0.609 | <0.001 * | 11.88 | 26.91 | ||||
Fourth block/step | 0.001 | 0.946 | 0.006 | 0.268 | ||||||||||||
NSSI (0 = no; 1 = yes) | 0.20 | 0.84 | 0.006 | 0.809 | −1.45 | 1.86 | −0.28 | 2.97 | −0.007 | 0.924 | −6.29 | 5.72 | ||||
TCI-R | 0.025 | <0.001 * | 0.076 | 0.018 * | ||||||||||||
Novelty seeking | 0.08 | 0.05 | 0.048 | 0.044 * | 0.01 | 0.17 | 0.06 | 0.15 | 0.042 | 0.688 | −0.24 | 0.35 | ||||
Harm avoidance | 0.00 | 0.05 | −0.004 | 0.926 | −0.10 | 0.09 | 0.00 | 0.17 | 0.000 | 0.997 | −0.34 | 0.34 | ||||
Reward dependence | −0.09 | 0.05 | −0.054 | 0.047 * | −0.18 | −0.01 | −0.11 | 0.15 | −0.060 | 0.470 | −0.40 | 0.19 | ||||
Persistence | −0.05 | 0.04 | −0.039 | 0.174 | −0.12 | 0.02 | −0.41 | 0.14 | −0.256 | 0.005 * | −0.69 | −0.13 | ||||
Self-directedness | −0.25 | 0.05 | −0.197 | <0.001 * | −0.34 | −0.15 | −0.21 | 0.16 | −0.189 | 0.195 | −0.54 | 0.11 | ||||
Cooperativeness | 0.12 | 0.05 | 0.070 | 0.023 * | 0.02 | 0.22 | 0.13 | 0.17 | 0.075 | 0.456 | −0.21 | 0.47 | ||||
Self-transcendence | −0.04 | 0.05 | −0.026 | 0.335 | −0.14 | 0.05 | 0.02 | 0.13 | 0.012 | 0.891 | −0.25 | 0.28 |
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Agüera, Z.; Paslakis, G.; Munguía, L.; Sánchez, I.; Granero, R.; Sánchez-González, J.; Steward, T.; Jiménez-Murcia, S.; Fernández-Aranda, F. Gender-Related Patterns of Emotion Regulation among Patients with Eating Disorders. J. Clin. Med. 2019, 8, 161. https://doi.org/10.3390/jcm8020161
Agüera Z, Paslakis G, Munguía L, Sánchez I, Granero R, Sánchez-González J, Steward T, Jiménez-Murcia S, Fernández-Aranda F. Gender-Related Patterns of Emotion Regulation among Patients with Eating Disorders. Journal of Clinical Medicine. 2019; 8(2):161. https://doi.org/10.3390/jcm8020161
Chicago/Turabian StyleAgüera, Zaida, Georgios Paslakis, Lucero Munguía, Isabel Sánchez, Roser Granero, Jessica Sánchez-González, Trevor Steward, Susana Jiménez-Murcia, and Fernando Fernández-Aranda. 2019. "Gender-Related Patterns of Emotion Regulation among Patients with Eating Disorders" Journal of Clinical Medicine 8, no. 2: 161. https://doi.org/10.3390/jcm8020161