Emotional skills in adolescents and young adults suffering from anorexia nervosa – an integrative approach

BACKGROUND: Although emotional difficulties are amongst the core deficits of individuals with anorexia nervosa, little is known about the specific emotional functioning. Therefore, this study used an integrative approach to examine the emotional skills of adolescents and young adults suffering from compared with healthy controls. METHODS: We compared the emotional skills of 32 females, aged between 14 and 35, with acute anorexia nervosa with 45 female healthy controls. In particular, we examined alexithymia (awareness and identification of their own emotions) using the TAS-20, the capacity for identifying basic emotions expressed dynamically using a computerised morphing task, the capacity for identifying complex emotions using the Reading the Mind in the Eyes task, and nine different strategies of cognitive emotion regulation using the CERQ. RESULT S: Participants with anorexia nervosa displayed higher levels of alexithymia. Both groups were able to recognise basic and complex emotions in others; however, participants with anorexia nervosa displayed higher sensitivity in identifying anger, disgust, sadness and surprise in others. Moreover, participants with anorexia nervosa reported use of specific emotion regulation strategies in comparison with healthy controls (“acceptance” and “rumination” more so than the emotion regulation strategies of “positive refocusing”, “catastrophising”, and “blaming others”). CONCLUSION: Our findings document a distinct pattern of emotional functioning of individuals with anorexia nervosa compared with (difficulties in ability to recognise their own emotions, hypersensitivity to certain emotions in others and use of certain cognitive emotion regulation strategies) even if no general deficits could be identified. These results highlight the importance of considering the specific dimensions of the emotional (dys)functioning of anorexia nervosa in multimodal treatment approaches.