Although the increased attention to affect regulation in bulimia nervosa is encouraging, most theoretical models describing the relationship between binge-eating and emotion dysregulation neglect to place their observations in the context of the growing knowledge base on normal emotional development. Because the nature of abnormal functioning is best understood in relation to normal development, integrating these fields of research would identi@ deficient skills in bulimia nervosa, suggesting new avenues for treatment. The present study compared 16 adolescent girls with a DSM-IV diagnosis of bulimia nervosa to 16 age- and SES-matched girls without a psychiatric disorder, on three aspects of the information processing model (Garber, Braafladt, & Zeman, 1991) of emotional regulation, a model chosen for its description of the numerous skills that comprise normative emotion regulation. Because they share conceptual characteristics, girls with bulimia were also compared to 16 age- and SES-matched girls with a DSM-IV diagnosis of unipolar depression. Diagnosed girls were recruited from treatment programs at a large Midwestern medical center and nondiagnosed participants were recruited through advertisements in a local newspaper. The study took place over a six month period. Emotion regulation skills were assessed through questionnaire and interview measures, as well as response latencies to various questions. Compared to those with depression and those without a disorder, girls with bulimia: described poor awareness of emotional states; displayed difficulty discriminating between emotional states; exhibited nonspecific verbal labels to describe their feelings; displayed a limited repertoire of emotion regulation strategies and ability to access these strategies under high emotional arousal. Compared to girls without a diagnosis, girls with bulimia: reported decreased motivation to express negative emotion to others; took longer to describe their emotional state; evaluated themselves as less competent at implementing strategies to decrease their emotional state; and, rated the expected outcome of their strategies as less effective in decreasing their emotional state. These findings suggest adolescent females with bulimia may rely on binge-eating and purging in an environment of inadequate emotion regulation skills. Treatment implications of these findings include interventions targeted towards remediating deficient skills. Longitudinal research is recommended to clarify the role of these deficiencies
