Differences in eating disorder symptoms and affect regulation for residential eating disorder patients with problematic
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BRIEF REPORT
Differences in eating disorder symptoms and affect regulation for residential eating disorder patients with problematic substance use Megan L. Michael1 · Adrienne Juarascio2 Received: 6 August 2019 / Accepted: 27 September 2019 © Springer Nature Switzerland AG 2019
Abstract Purpose The aim of the current study was to investigate differences in treatment outcomes for residential eating disorder (ED) treatment patients diagnosed with comorbid substance use disorders (SUDs), particularly differences in ED pathology and affect dysregulation. Method Secondary data analysis was conducted on data from a previous study of 140 patients at a residential ED facility. SUD was diagnosed by a staff psychiatrist upon admission, and SUD diagnosis was extracted from electronic health records for the current study. Self-report measures of eating pathology and affect dysregulation from pre-treatment and post-treatment assessments were analyzed. Results 20.1% of the sample (n = 29) were diagnosed with a substance use disorder at the start of treatment. Contrary to hypotheses, those with comorbid SUD did not significantly differ in eating pathology severity, depression symptoms, emotion dysregulation, or psychological acceptance at baseline. Also contrary to hypotheses, individuals with comorbid SUD and ED evidenced slightly larger improvements in certain areas of eating pathology and affect dysregulation throughout treatment than those with ED diagnosis only. Conclusions These findings suggest that residential ED treatment is an appropriate treatment choice for individuals with comorbid SUD. The observed improvements in affect dysregulation combined with a period of forced abstinence from maladaptive affect regulation behaviors may explain these positive results, though more research is needed to test the mechanisms of action of residential treatment for this population. Level of evidence IV, multiple time series analysis. Keywords Addiction · Eating disorder · Residential treatment · Substance use disorder
Introduction Eating disorders (EDs) and substance use disorders (SUDs) have been found to be highly comorbid in both clinical and sub-clinical populations [1–3], and researchers have begun investigating theoretical models of shared risk factors. The article is part of the Topical Collection on Food and Addiction. * Megan L. Michael [email protected] 1
Center for Weight and Lifestyle Sciences, Drexel University, Philadelphia, PA 19104, USA
Department of Psychology, Drexel University, Philadelphia, PA 19104, USA
2
Existing etiological models commonly hypothesize that affect dysregulation (i.e., deficits in awareness, acceptance, and regulation of negative emotional states; [4]) is a shared risk factor for both EDs and SUDs [5]. Affect dysregulation has been found to be associated with both disordered eating behaviors and problematic substance use [6, 7], and some studies have found that individuals with comorbid ED and SUD have difficulty accepting negative emotions [8, 9]. In addition, one s
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