Elizabeth A. Velkoff

Remembering the Good Ole Days: Fear of Positive Emotion Relates to Affect Repair Using Positive Memories

Recalling positive autobiographical memories is a powerful strategy to repair affect. Positive memory recall operates as a reparative strategy by enhancing positive affect, which facilitates the down-regulation of negative affect. There are individual differences, however, in the ability to use positive material to repair mood. Participants with elevated depression scores, for example, are less likely to profit from this strategy. Depression has been associated with elevated fear of positive emotion and the current study examined whether elevated fear of positive emotion is associated with depression-related difficulties in mood repair. Ninety-four participants first underwent a mood repair task in which a sad mood induction was followed by a cue to recall positive autobiographical memories. Subjective measures of state happiness and sadness were collected across the mood induction and positive memory recall procedures. Results revealed that greater fear of positive emotion was linked to less ability to enhance positive affect and down-regulate negative affect using positive memories. Results also provided preliminary support for a mediation model in which greater depressive symptoms predicted elevated fear of positive emotion, which in turn predicted less ability to repair positive affect. These findings highlight fear of positive emotion as a potential target for interventions aimed at improving affect regulation.

Out of touch: Interoceptive deficits are elevated in suicide attempters with eating disorders

ABSTRACT People with eating disorders have elevated interoceptive deficits and risk for self-injurious behaviors (SIBs). Across two eating disorder samples, the relationship between interoceptive deficits (IDs) and SIBs was tested. Study 1 (n = 100) found that suicide attempters and those engaging in non-suicidal self-injury (NSSI) had greater IDs than those with no self-injury history. Lack of access to emotion regulation strategies accounted for the link between IDs and SIBs. In Study 2 (n = 92) multiple suicide attempters had greater IDs than single attempters and those engaging in NSSI; however, the latter two groups did not differ from one another. Interoceptive deficits may differentiate those who engage in severe SIBs from those who do not, and thus be a useful determinant of suicide risk severity among patients with eating disorders. Lack of access to emotion regulation strategies appears to be one pathway linking interoceptive deficits and self-injury.

Are Eating Disorders and Related Symptoms Risk Factors for Suicidal Thoughts and Behaviors? A Meta-analysis

This meta-analysis addressed whether eating disorders (EDs) are risk factors (i.e., longitudinal predictors) for suicidal thoughts and behaviors. We identified 2,611 longitudinal studies published through August 1, 2017. Inclusion required studies include at least one longitudinal analysis predicting suicide ideation, attempt, or death using an ED diagnosis and/or symptom. Fourteen studies (42 prediction cases) met criteria. Results indicated that clinically diagnosed EDs and disordered eating symptoms were significant but weak predictors of suicide attempts but not death. Effects remained weak when moderators were considered. By reviewing the methodological limitations of previous research, these results highlight avenues for future research.

Beauty in the eye of the beholder: Using facial electromyography to examine the association between eating disorder symptoms and perceptions of emaciation among undergraduate women

Thin-ideal internalization, drive for thinness, and over-evaluation of the importance of thinness are associated with eating disorders (EDs). However, little research has examined to what extent perceptions of emaciation are also associated with ED symptoms. In the present study, 80 undergraduate women self-reported on ED symptomatology and perceptions of emaciated, thin, and overweight female bodies. While participants viewed images of these different body types, facial electromyography was used to measure activation of facial muscles associated with disgust reactions. Emaciated and overweight bodies were rated negatively and elicited facial responses consistent with disgust. Further, ED symptomatology was associated with pronounced aversion to overweight bodies (assessed via self-report pleasantness ratings), and attenuated negative affect to emaciated bodies (assessed via facial electromyography). The latter association was significant even when controlling for self-reported perceptions of emaciation, suggesting that psychophysiological methods in ED research may provide valuable information unavailable via self-report.

Examining Patterns of Change in the Acquired Capability for Suicide Among Eating Disorder Patients

OBJECTIVE Several models of suicidal behavior posit that, to transition from suicidal ideation to attempting suicide, individuals must have an acquired capability for suicide (ACS), comprised of fearlessness about death (FAD) and pain tolerance. ACS is hypothesized to increase monotonically through exposure to painful and provocative experiences. However, recent research suggests that ACS can decrease, bringing into question the hypothesis of monotonic increase. This study examined the nature of change in ACS over time within a sample of patients with eating disorder (ED). We predicted that there would be two classes of change in ACS: one high and increasing and one moderate and stable. METHOD One hundred female patients with ED reported on ACS at admission and weekly during treatment. RESULTS Growth mixture modeling to test models of FAD and pain tolerance identified that, for both factors, a one-class intercept-only model was the best-fitting model, suggesting that patients entered treatment with midlevel ACS and experienced no significant linear change over the course of treatment. CONCLUSIONS Acquired capability for suicide demonstrated stability in this study; results highlight the need for additional research examining ACS across different timescales and in varied populations.

Implicit attitudes toward eating stimuli differentiate eating disorder and non-eating disorder groups and predict eating disorder behaviors

OBJECTIVE The current study tested whether people with and without eating disorders (EDs) varied in their implicit attitudes toward ED-relevant stimuli. Additionally, the study tested whether implicit evaluations of ED-relevant stimuli predicted ED symptoms and behaviors over a 4-week interval. METHOD Participants were people without EDs (N = 85) and people seeking treatment for EDs (N = 92). All participants completed self-report questionnaires and a version of the affect misattribution procedure (AMP) at baseline. The AMP indexed implicit evaluations of average body stimuli, eating stimuli, and ED-symptom stimuli. Participants with EDs completed weekly follow-up measures of ED symptoms and behaviors for 4 weeks. RESULTS Contrary to predictions, the anorexia nervosa (AN) group did not differ from the no ED group on implicit attitudes toward ED-symptom stimuli, and the bulimia nervosa (BN) group had less positive implicit attitudes toward ED-symptom stimuli relative to the no ED group. In line with predictions, people with AN and BN had more negative implicit attitudes toward average body and eating stimuli relative to the no ED group. In addition, among the ED group more negative implicit attitudes toward eating stimuli predicted ED symptoms and behaviors 4 weeks later, over and above baseline ED symptoms and behaviors. DISCUSSION Taken together, implicit evaluations of eating stimuli differentiated people with AN and BN from people without EDs and longitudinally predicted ED symptoms and behaviors. Interventions that increase implicit liking of eating-related stimuli may reduce ED behaviors.

Which Comes First? An Examination of Associations and Shared Risk Factors for Eating Disorders and Suicidality

Purpose of ReviewThis narrative review evaluates recent literature on the associations between eating disorders and suicidality and discusses potential shared mechanisms that may account for these relationships. Additionally, the review highlights shortcomings with the literature to date and suggests avenues for future research.Recent FindingsIndividuals with anorexia nervosa, bulimia nervosa, and binge eating disorder experience elevated rates of suicidality compared to the general population. Suicide risk is higher when eating disorders occur with other psychological conditions. Additionally, genetic factors, emotion dysregulation, trauma, stressful life events, and lack of body regard may have roles in the development of both eating disorders and suicidality.SummaryMuch of the risk for suicidality in eating disorders appears to be driven by comorbid psychopathology and genetic factors. However, the lack of longitudinal research makes it difficult to draw conclusions about the directionality or temporality of these relations; thus, novel methods are needed.

Identity, Relationship Satisfaction, and Disclosure Predicting Suicide Risk Among Sexual Minority Women

We tested the usefulness of combining the Interpersonal–Psychological Theory of Suicide and minority stress models in studying suicidality among sexual minority women. According to the Interpersonal–Psychological Theory of Suicide, perceptions of being a burden on others and feelings of failed belongingness predict suicidal ideation. In a sample of sexual minority women (n = 51), we tested first, if the interaction of perceived burdensomeness and failed belongingness predicted lifetime suicidal behavior; second, if identity affirmation was negatively related to perceived burdensomeness and if this relation was moderated by disclosure; and third, if relationship satisfaction was negatively related to failed belongingness and if this relation was moderated by acceptance concerns. The proposed interaction of perceived burdensomeness and failed belongingness predicted lifetime suicide attempts. Moreover, among sexual minority women with greater disclosure of their sexual minority identities, low identity affirmation was related to higher perceived burdensomeness. For sexual minority women with high acceptance concerns, relationship satisfaction did not relate to lower feelings of failed belongingness. These findings suggest that sexual minority related stressors moderate risk factors for suicidality—in particular, perceptions of burdensomeness and failed belongingness. We suggest clinicians and others encourage sexual minority individuals to engage in activities that promote effectiveness and interpersonal closeness. Online slides for instructors who want to use this article for teaching are available to PWQ subscribers on PWQs website at http://pwq.sagepub.com/supplemental