The mediating role of self-criticism, experiential avoidance and negative urgency on the relationship between ED-related symptoms and difficulties in emotion regulation

Objective: Difficulties in emotion regulation are thought to play a transdiagnostic role across eating disorders (ED). In the current study, we explored with a path analysis the mediating role of self-criticism, experiential avoidance and negative urgency on the relationship between ED-related symptoms and dimensions of difficulties in emotion regulation. Method: Participants were 103 female outpatients recruited at a Portuguese ED hospital unit, diagnosed with an ED, aged 14–60 years old (M = 28.0, SD = 10.5), body mass index (BMI) ranging from 11.72 to 39.44 (M = 20.1, SD = 5.4). Results: The path analysis resulted in a model with an adequate fit to the data (SRMR = 0.05; RMSEA = 0.07 [0.00, 0.12], PCLOSE = 0.269; TLI = 0.97; IFI = 0.99; GFI = 0.95). A final model in which the relationship between ED-related symptoms and dimensions of difficulties in emotion regulation was mediated by self-criticism, experiential avoidance and negative urgency, accounted for a variance of 71% for strategies, 57% for non-acceptance, 62% for impulses, 56% for goals and 20% for clarity. Conclusion: Results suggest that self-criticism, experiential avoidance and negative urgency, combined, are relevant in the relationship between ED-related symptoms and difficulties in emotion regulation. ED treatment and emotion regulation skills may be enhanced through the inclusion of specific components that target self-criticism, experiential avoidance and negative urgency, as they become prominent during the therapeutic process.FCT - Fundação para a Ciência e a Tecnologia(POCI‐01‐0145‐FEDER‐028145

Anorexia nervosa: trajectories of change and predictors of outcome

Dissertação de mestrado integrado em PsicologiaO presente estudo teve como objetivos a identificação de variáveis preditoras de gravidade clínica da Anorexia Nervosa na apresentação ao tratamento e a identificação de variáveis preditoras de Remissão Parcial 12 meses após o início do tratamento. Adicionalmente, pretendeu-se descrever as trajetórias de mudança do peso e da psicopatologia associada à perturbação alimentar ao longo das sessões. A amostra foi constituída por 37 pacientes diagnosticadas com Anorexia Nervosa que realizavam o tratamento habitual para esta perturbação em dois centros hospitalares portugueses. Os resultados obtidos mostraram que nenhuma variável se mostrou preditora da gravidade clínica na apresentação e que apenas o IMC se mostrou preditor de Remissão Parcial após 12 meses. Foi também verificado um efeito preditor do IMC nas trajetórias de peso (B=2.02, p=.000) e nas trajetórias de preocupação com a alimentação ao longo do tratamento (B=.255; p=.041). Este estudo pretende contribuir para a identificação das variáveis que estão associadas com os resultados terapêuticos obtidos na Anorexia Nervosa e para a compreensão do curso da doença ao longo do tratamento. Estas são questões essenciais para o desenvolvimento de futuras intervenções de maior eficácia.The purpose of the present study was to identify preditors of severity for Anorexia Nervosa at baseline and predictors of remission 12 months after initiation of treatment. In addition, it was intended to describe the trajectories of weight change and psychopathology associated with food disturbance throughout the sessions. The sample consisted of 37 patients diagnosed with Anorexia Nervosa who underwent standard treatment for this disease in two portuguese hospitals. The results showed that no variable was predictive of clinical severity at presentation and that only the BMI was a predictor of Partial Remission after 12 months. It was also verified a predictive effect of BMI on weight trajectories (B=2.02, p = .000) and trajectories of concern with feeding throughout the treatment (B=.255; p=.041). This study aims to contribute to the identification of the variables that are associated with the therapeutic results obtained in Anorexia Nervosa and to the understanding of the course of the disease throughout the treatment. These are key issues for the development of interventions more effective in the future