Emotional intelligence and symptoms of eating disorders in Spanish adults: Mediating role of cognitive emotional regulation strategies

Emotional intelligence and symptoms of eating disorders in Spanish adults: Mediating role of cognitive emotional regulation strategies

Main Article Content

Juana Romero-Mesa
María Angeles Peláez-Fernández
Natalio Extremera

Abstract

Emotional intelligence (EI) and regulation strategies are relevant personal resources for the prevention of eating disorders (ED). Specifically, maladaptive cognitive emotional regulation strategies (CERS) are positively associated with ED criteria. However, no studies have yet analyzed the potential mediating role of CERS in the relationship between EI and ED. Therefore, our objective was to analyze the mediating role of CERS between EI and ED. The sample consisted of 516 Spanish adults from a community and university population. They completed a battery administered online that included measures of EI, CERS and symptoms of ED. Our results showed that high levels of EI were positively associated with adaptive CERS and negatively with maladaptive CERS and ED symptoms. Additionally, mediation analyzes showed that maladaptive CERS mediated the relationship between EI and ED symptoms. These findings suggest that people high in EI may report fewer ED symptoms, in part due to less use of maladaptive CERS. Finally, the implications for evaluating and improving these psychological resources in ED prevention and treatment programs are discussed.

References

Aldao, A., Nolen-Hoeksema S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Pub.

Bennett, D. A., & Cooper, C. L. (1999). Eating disturbance as a manifestation of the stress process: A review of the literature. Stress Medicine, 15(3), 167-182. https://doi.org/10.1002/(SICI)1099-1700(199907)15:3<167::AID-SMI812>3.0.CO;2-7

Brockmeyer, T., Skunde, M., Wu, M., Bresslein, E., Rudofsky, G., Herzog, W., & Friederich, H. (2014). Difficulties in emotion regulation across the spectrum of eating disorders. Comprehensive Psychiatry, 55, 565–571. https://doi.org/10.1016/j.comppsych.2013.12.001

Conceição, E. M., Gomes, F. V., Vaz, A. R., Pinto-Bastos, A., & Machado, P. P. (2017). Prevalence of eating disorders and picking/nibbling in elderly women. International Journal of Eating Disorders, 50, 793–800. https://doi.org/10.1002/eat.22700

Corstorphine, E. (2006). Cognitive–Emotional–Behavioural Therapy for the eating disorders: working with beliefs about emotions. European Eating Disorders Review, 14(6):448 – 461. https://doi.org/10.1002/erv.747

Domínguez-Sánchez, F. J., Lasa-Aristu, A., Amor, P. J., & Holgado-Tello, F. P. (2011). Psychometric properties of the Spanish version of the Cognitive Emotion Regulation Questionnaire. Assessment, 20, 253–261. https://doi.org/10.1177/1073191110397274

Extremera, N., Rey, L., & Sánchez-Álvarez, N. (2019). Validation of the Spanish version of the Wong Law Emotional Intelligence Scale (WLEIS-S). Psicothema, 31(1), 94-100. https://doi.org/10.7334/psicothema2018.147

Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509–528. https://doi.org/10.1016/S0005-7967(02)00088-8

Fox, J. R. E., & Froom, K. (2009). Eating disorders: A basic emotion perspective. Clinical Psychology & Psychotherapy, 16(4), 328–335. https://doi.org/10.1002/cpp.622

Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000–2018 period: a systematic review literature. The American Journal of Clinical Nutrition, 109(5), 1402-1413. https://doi.org/10.1093/ajcn/nqy342

Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual Differences, 30, 1311–1327. https://doi.org/10.1016/S0191-8869(00)00113-6

Garnefski, N., & Kraaij, V. (2007). The Cognitive Emotion Regulation Questionarie: Psychometric features and prospective relationships with depression and anxiety in adults. European Journal of Psychological Assessment, 23(3), 141-149.

Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The Eating Attitudes Test: psychometric features and clinical correlates. Psychological Medicine, 12(4), 871–878. https://doi.org/10.1017/s0033291700049163

Giusti, E. M., Manna, C., Scolari, A., Mestre, J. M., Prevendar, T., Castelnuovo, G., & Pietrabissa, G. (2021). The Relationship between Emotional Intelligence, Obesity and Eating Disorder in Children and Adolescents: A Systematic Mapping Review. International Journal of Environmental Research and Public Health, 18(4), 2054. https://doi.org/10.3390/ijerph18042054

Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299. https://doi.org/10.1037/1089-2680.2.3.271

Hay, P., Mitchison, D., Collado, A. E. L., González-Chica, D. A., Stocks, N., & Touyz, S. (2017). Burden and health-related quality of life of eating disorders, including Avoidant/Restrictive Food Intake Disorder (ARFID), in the Australian population. Journal of Eating Disorders, 5(1), 21. https://doi.org/10.1186/s40337-017-0149-z

Hayes, A. F. (2018). Introduction to Mediation, Moderation, and Conditional Process Analysis Second Edition: A Regression-Based Approach. New York, NY: The Guilford Press.

Haynos, A. F., & Fruzzetti, A. E. (2011). Anorexia Nervosa as a Disorder of Emotion Dysregulation: Evidence and Treatment Implications. Clinical Psychology-Science and Practice, 18(3), 183- 202. https://doi.org/10.1111/j.1468-2850.2011.01250.x

Jauregui, P., Herrero-Fernández, D., & Estévez, A. (2016). Estructura factorial del “Inventario de estrategias de afrontamiento” y su relación con la regulación emocional, ansiedad y depresión. Behavioral Psychology, 24(2), 319-340.

Keski-Rahkonen, A., & Mustelin, L. (2016). Epidemiology of eating disorders in Europe: prevalence, incidence, comorbidity, course, consequences, and risk factors. Current Opinion in Psychiatry, 29(6), 340-345. https://doi.org/10.1097/YCO.0000000000000278

Koole, S. L. (2009). The psychology of emotion regulation: An integrative review. Cognition and Emotion, 23(1), 4–41. https://doi.org/10.1080/02699930802619031

Kraaij, V., & Garnefski, N. (2019). The behavioral emotion regulation questionnaire: development, psychometric properties and relationships with emotional problems and the cognitive emotion regulation questionnaire. Personality and Individual Differences, 137, 56–61. https://doi.org/10.1016/j.paid.2018.07.036

Lavender, J. M., Wonderlich, S. A., Engel, S. G., Gordon, K. H., Kaye, W. H. & Mitchell, J. E. (2015). Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature. Clinical Psychology Review, 40, 111-122. https://doi.org/10.1016/j.cpr.2015.05.010

Mallorquí-Bagué, N., Vintró-Alcaraz, C., Sánchez, I., Riesco, N., Agüera, Z., Granero, R., Jiménez-Múrcia, S., Menchón, J. M., Treasure, J., & Fernández-Aranda, F. (2018). Emotion Regulation as a Transdiagnostic Feature Among Eating Disorders: Cross-sectional and Longitudinal Approach. European eating disorders review: the journal of the Eating Disorders Association, 26(1), 53–61. https://doi.org/10.1002/erv.2570

Martínez, A. E., Piqueras, J. A. & Inglés, C. J. (2011) Relaciones entre Inteligencia Emocional y Estrategias de Afrontamiento ante el Estrés. Revista electrónica de motivación y emoción, 37, 20-21.

Mayer, J. D., & Salovey, P. (1997). What is emotional intelligence? In P. Salovey and D. Sluyter (Eds.). Emotional development and emotional intelligence: Implications for educators (pp. 3-31). New York, NY: Basic Books.

Mayer, J. D., Caruso, D. R., & Salovey, P. (2016). The ability model of emotional intelligence: principles and updates. Emotion Review, 8, 290-300. https://doi.org/10.1177/1754073916639667

Micali, N., Martini, M. G., Thomas, J. J., Eddy, K. T., Kothari, R., Russell, E., Bulik, C. M., & Treasure, J. (2017). Lifetime and 12-month prevalence of eating disorders amongst women in mid-life: a population-based study of diagnoses and risk factors. BMC medicine, 15(1), 12. https://doi.org/10.1186/s12916-016-0766-4

Millum, J., Wendler, D., & Emanuel, E. J. (2013). The 50th anniversary of the declaration of Helsinki: Progress but many remaining challenges. JAMA Journal of the American Medical Association, 310, 2143–2144. https://doi.org/10.1001/jama.2013.281632

Nolen-Hoeksema, S., Stice, E., Wade, E., & Bohon, C. (2007). Reciprocal relations between rumination and bulimic, substance abuse ad depressive symptoms in female adolescents. Journal of Abnormal Psychology, 116, 198–207. https://doi.org/10.1037/0021-843X.116.1.198

Overton, A., Selway, S., Strongman, K., & Houston, M. (2005). Eating disorders—The regulation of positive as well as negative emotion experience. Journal of Clinical Psychology in Medical Settings, 12, 39–56. https://doi.org/10.1007/s10880-005-0911-2

Polivy, J., & Herman, C. P. (1993). Etiology of binge eating: psychological mechanisms. Guilford Press, London.

Quiles-Marcos, Y., & Terol-Cantero, M. C. (2010). Afrontamiento y trastornos de la conducta alimentaria: un estudio de revisión. Revista Latinoamericana de Psicología, 40(2), 259-280.

Rivas, T., Bersabé, R., Jiménez, M., & Berrocal, C. (2010). The eating Attitudes Test (EAT-26): Reliability and Validity in Spanish Female Samples. The Spanish Journal of Psychology, 13(2), 1044-1056. https://doi.org/10.1017/S1138741600002687

Romero-Mesa, J., Peláez-Fernández, M. A., & Extremera, N. (2020). Emotional intelligence and eating disorders: a systematic review. Eating and Weight Disorders, 26, 1287-1301. https://doi.org/10.1007/s40519-020-00968-7

Rowsell, M., MacDonald, D. E., & Carter, J. C. (2016). Emotion regulation difficulties in anorexia nervosa: associations with improvements in eating psychopathology. Journal of Eating Disorders, 4(17). https://doi.org/10.1186/s40337-016-0108-0

Silén, Y., Sipilä, P. N., Raevuori, A., Mustelin, L., Marttunen, M., Kaprio, J., & Keski-Rahkonen, A. (2020). DSM-5 eating disorders among adolescents and young adults in Finland: A public health concern. The International journal of eating disorders, 53(5), 520–531. https://doi.org/10.1002/eat.23236

Schmidt, U., Tiller, J., and Treasure, J. (1993). Psychosocial factors in the origins of bulimia nervosa. International Review of Psychiatry, 5(1), 51-60. https://doi.org/10.3109/09540269309028294

Schmidt, U., Troop, N. A., & Treasure, J. (1999). Events and the onset of eating disorders: correcting an “age old” myth. International Journal of Eating Disorders, 25, 83-88. https://doi.org/10.1002/(SICI)1098-108X(199901)25:1<83::AID-EAT10>3.0.CO;2-1

Schmidt, U., & Treasure, J. (2006). Anorexia Nervosa: Valued and Visible. A Cognitive-Interpersonal Maintenance Model and its Implications for Research and Practice. British Journal of Clinical Psychology, 45(3), 343-366. https://doi.org/10.1348/014466505X53902

Smink, F. R. E., Van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates. Current Psychiatry Reports, 14, 406-414. https://doi.org/10.1007/s11920-012-0282-y

Smith, K. E., Mason, T. B., & Lavender, J. M. (2018). Rumination and eating disorder psychopathology: A meta-analysis. Clinical psychology review, 61, 9–23. https://doi.org/10.1016/j.cpr.2018.03.004

Sundquist, J., Ohlsson, H., Winkleby, M. A., Sundquist, K., & Crump, C. (2016). School Achievement and Risk of Eating Disorders in a Swedish National Cohort. Journal of the American Academy of Child and Adolescent Psychiatry, 55(1), 41–46.e1. https://doi.org/10.1016/j.jaac.2015.09.021

Striegel-Moore, R. H., Rosselli, F., Perrin, N., DeBar, L., Wilson, G. T., May, A., & Kraemer, H. C. (2009). Gender difference in the prevalence of eating disorder symptoms. The International journal of eating disorders, 42(5), 471–474. https://doi.org/10.1002/eat.20625

Troop, N. A., Holbrey, A., Trowler, R., & Treasure, J. L. (1994). Ways of coping in women with eating disorders. Journal of Nervous and Mental Disease, 182(10), 535–540. https://doi.org/10.1097/00005053-199410000-00001

Troop, N. A., Holbrey, A., & Treasure, J. L. (1998). Stress, coping, and crisis support in eating disorders. The International journal of eating disorders, 24(2), 157–166. https://doi.org/10.1002/(sici)1098-108x(199809)24:2<157::aid-eat5>3.0.co;2-d

Udo, T., & Grilo, C. M. (2018). Prevalence and Correlates of DSM-5-Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults. Biological psychiatry, 84(5), 345–354. https://doi.org/10.1016/j.biopsych.2018.03.014

Verschueren, M., Claes, L., Palmeroni, N., Raemen, L., Buelens, T., Moons, P., & Luyckx, K. (2021). Identity Functioning and Eating Disorder Symptomatology: The Role of Cognitive Emotion Regulation Strategies. Frontiers in psychology, 12, 667235. https://doi.org/10.3389/fpsyg.2021.667235

Wheeler, A. R., Shanine, K. K., Leon, M. R., & Whitman, M. V. (2014). Student‐recruited samples in organizational research: A review, analysis, and guidelines for future research. Journal of Occupational and Organizational Psychology, 87(1), 1-26. https://doi.org/10.1111/joop.12042

Wong, C. S., & Law, K. S. (2002). The effects of leader and follower emotional intelligence on performance and attitude: An exploratory study. The Leadership Quarterly, 13(3), 243-274. https://doi.org/10.1016/ S1048-9843(02)00099-1

Zhang, J., Wang, Y., Wu, C., & He, J. (2022). The relationship between emotional intelligence and eating disorders or disordered eating behaviors: A meta-analysis. Personality and Individual Differences, 185(2):111239 https://doi.org/10.1016/j.paid.2021.111239