Category: Eating Disorders
It is estimated that there is an 18-fold increase in the risk for bulimic symptoms during college (Lofrano-Prado et al., 2015). Bulimic symptoms are associated with numerous negative consequences, including an increased risk for mortality and comorbid psychiatric disorders. Problematic alcohol use is one of the most prevalent co-occurring disorders, with co-occurrence rates among community samples ranging from 31% to 43% (Dunn et al., 2002). Further, women with bulimic symptoms are more likely to report problematic alcohol use compared to women with no history of disordered eating (Dyck & Reist, 2011). Given this high comorbidity, research has attempted to elucidate factors that might moderate the relationship between bulimic symptoms and problematic alcohol use. Emotion dysregulation is a robust correlate of bulimic symptoms and problematic alcohol use, and it is posited that individuals with bulimic symptoms engage in maladaptive behaviors, such as alcohol use, to cope with negative affect (Stice et al., 1998). Thus, women with bulimic symptoms who experience greater emotion dysregulation might be at an increased risk for problematic alcohol use. However, no known research has examined this hypothesis. In the current study it was hypothesized that bulimic symptoms would be related to problematic alcohol use at high, but not low, levels of emotion dysregulation.
The current study included cross-sectional data from 132 women enrolled at a large southeastern university. Bulimic Symptoms were assessed with the Eating Disorder Examination Questionnaire (EDEQ; Fairburn & Beglin, 1994) total score; emotion dysregulation was assessed with the Difficulties in Emotion Regulation Scale (DERS; Gratz, 2004) total score; and alcohol use and problems was assessed with the Alcohol Use Disorders Identification Test (AUDIT; Saunders et al., 1993).
In order to examine whether different levels of emotion regulation influenced the relationship between bulimic symptoms and problematic alcohol use, hierarchical multiple regression using Hayes’ and Matthes’ (2009) macro for SPSS was utilized. Moderation analysis indicated that
the interaction between bulimic symptoms and emotion dysregulation predicting problematic alcohol use was significant (ΔR2 = .02 with the addition of the interaction term). At high levels of emotion dysregulation, bulimic symptoms predicted problematic alcohol use (B = .05, p = .03); however, at low levels of emotion dysregulation this relationship was no longer significant (B = -.03, p = .20).
Results indicate that enhancing emotion regulation skills among college students, particularly among students with bulimic symptoms and/or problematic alcohol use, may be warranted. Implications for treatment and prevention will be discussed.
JoAnna Elmquist– Graduate Student, University of Tennessee, Knoxville, Tennessee
Hannah Grigorian– University of Tennessee
Meagan Brem– Graduate Research Assistant, University of Tennessee, Knoxville, Tennessee
Autumn Rae Florimbio– Graduate Research Assistant, University of Tennessee
Ryan Shorey– Assistant Professor, Ohio University, Athens, Ohio
Gregory Stuart– Professor, University of Tennessee