Cognitive Therapy and Research

, Volume 33, Issue 4, pp 390–397 | Cite as

Dysregulated Eating and Distress: Examining the Specific Role of Negative Urgency in a Clinical Sample

  • Michael D. Anestis
  • April R. Smith
  • Erin L. Fink
  • Thomas E. Joiner
Original Article


Many theories exist regarding dysregulated eating behaviors such as bingeing and purging. Recent research has provided consistent and compelling evidence supportive of theories that favor an emotion regulatory model (Smyth et al. J Consult Clin Psychol 75:629–638, 2007). Specifically, these theories posit that individuals engage in dysregulated eating behaviors in a maladaptive attempt to alleviate negative affect. Along these lines, several studies have reported that negative urgency, the tendency to act rashly in an attempt to immediately reduce feelings of negative affect (Whiteside and Lynam Pers Individ Dif 30:669–689, 2001), is a particularly important variable in this process (Anestis et al. Behav Res Ther 45:3018–3029, 2007; Fischer et al. Int J Eat Disord 33:406–411, 2003). In this study, we sought to expand upon prior research by testing the relationship between negative urgency and EDI-Bulimia in a clinical sample (N = 130) when controlling for an extensive list of relevant covariates, including additional components of impulsivity. Results supported our hypotheses. These findings indicate that the previously reported relationship between negative urgency and dysregulated eating behaviors remains significant in a clinical setting, even when controlling a more extensive list of impulsivity related variables than has been utilized in prior research. As such, this study has potentially important clinical implications.


Negative urgency Bulimia nervosa Emotion regulation 


  1. Anestis, M. D., Holm-Denoma, J. M., Gordon, K. H., Schmidt, N. B., & Joiner, T. E. (2008). The role of anxiety sensitivity in eating pathology. Cognitive Therapy and Research, 32, 370–385. doi:10.1007/s10608-006-9085-y.CrossRefGoogle Scholar
  2. Anestis, M. D., Selby, E. A., & Joiner, T. E. (2007). The role of urgency in maladaptive behaviors. Behaviour Research and Therapy, 45, 3018–3029. doi:10.1016/j.brat.2007.08.012.PubMedCrossRefGoogle Scholar
  3. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.-Text revision). Washington, DC: Author.CrossRefGoogle Scholar
  4. Arnow, B., Kenardy, J., & Agras, W. S. (1995). The emotional eating scale: The development of a measure to assess coping with negative affect by eating. The International Journal of Eating Disorders, 18, 79–90. doi:10.1002/1098-108X(199507)18:1<79::AID-EAT2260180109>3.0.CO;2-V.PubMedCrossRefGoogle Scholar
  5. Beck, A. T., & Steer, R. A. (1993). Manual for the Beck anxiety inventory. San Antonio, TX: Psychological Corporation.Google Scholar
  6. Beck, A. T., Steer, R. A., & Garbin, M. G. (1998a). Psychometric properties of the Beck depression inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100. doi:10.1016/0272-7358(88)90050-5.CrossRefGoogle Scholar
  7. Beck, A. T., Steer, R. A., & Ranieri, W. F. (1988b). Scale for suicide ideation: psychometric properties of a self-report version. Journal of Clinical Psychology, 44, 499–505. doi:10.1002/1097-4679(198807)44:4<499::AID-JCLP2270440404>3.0.CO;2-6.PubMedCrossRefGoogle Scholar
  8. Claes, L., Vandereycken, W., & Vertommen, H. (2005). Impulsivity-related traits in eating disorder patients. Personality and Individual Differences, 39, 739–749. doi:10.1016/j.paid.2005.02.022.CrossRefGoogle Scholar
  9. Cyders, M. A., Smith, G. T., Spillane, N. S., Fischer, S., Annus, A. M., & Peterson, C. (2007). Integration of impulsivity and positive mood to predict risky behavior: Development and validation of a measure of positive urgency. Psychological Assessment, 19, 107–118. doi:10.1037/1040-3590.19.1.107.PubMedCrossRefGoogle Scholar
  10. Cyders, M. A., & Smith, G. T. (2007). Mood-based rash action and its components: Positive and negative urgency and their relations with other impulsivity-like constructs. Personality and Individual Differences, 43, 839–850. doi:10.1016/j.paid.2007.02.008.CrossRefGoogle Scholar
  11. Fahy, T., & Eisler, I. (1993). Impulsivity and eating disorders. The British Journal of Psychiatry, 162, 193–197.PubMedCrossRefGoogle Scholar
  12. First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (1995). Structured clinical interview for the DSM-IV axis I disorders—Patient edition (SCID-I/P—version 2). New York State Psychiatric Insititute, Biometrics Research Department.Google Scholar
  13. First, M. B., Spitzer, R. L., Gibbon, M., Williams, J. B. W., & Benjamin, L. (1997). Structured clinical interview for DSM-IV personality disorders (SCID-II). Washington, DC7: American Psychiatric Publishing.Google Scholar
  14. Fischer, S., Smith, G. T., & Anderson, K. G. (2003). Clarifying the role of impulsivity in Bulimia nervosa. The International Journal of Eating Disorders, 33, 406–411. doi:10.1002/eat.10165.PubMedCrossRefGoogle Scholar
  15. Fischer, S., Anderson, K. G., & Smith, G. T. (2004). Coping with distress by eating or drinking: Role of trait urgency and expectancies. Psychology of Addictive Behaviors, 18, 269–274. doi:10.1037/0893-164X.18.3.269.PubMedCrossRefGoogle Scholar
  16. Friis, S., Melle, I., Opjordsmoen, S., & Retterstol, N. (1993). Global Assessment Scale and Health Rating Scale: Problems in comparing the global functioning scores across investigations. Psychotherapy Research, 3, 105–144.Google Scholar
  17. Garner, D. M., Olmstead, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and Bulimia. The International Journal of Eating Disorders, 2, 15–19. doi:10.1002/1098-108X(198321)2:2<15::AID-EAT2260020203>3.0.CO;2-6.CrossRefGoogle Scholar
  18. Heatherton, T. F., & Baumeister, R. F. (1991). Binge eating as escape from self-awareness. Psychological Bulletin, 110, 86–108. doi:10.1037/0033-2909.110.1.86.PubMedCrossRefGoogle Scholar
  19. Keesey, R. E. (1986). A set-point theory of obesity. In K. D. Brownell & J. P. Foreyt (Eds.), Handbook of eating disorders: Physiology, psychology, and treatment of obesity, anorexia, and Bulimia (pp. 63–87). New York: Basic Books.Google Scholar
  20. Lynam, D. R., & Miller, J. D. (2004). Personality pathways to impulsive behavior and their relations to deviance: Results from three samples. Journal of Quantitative Criminology, 20, 319–341. doi:10.1007/s10940-004-5867-0.CrossRefGoogle Scholar
  21. Moos, R. F., McCoy, L., & Moos, B. S. (2000). Global assessment of functioning (GAF) ratings: Determinants and use as predictors of one-year treatment outcomes. Journal of Clinical Psychology, 56, 449–461.PubMedCrossRefGoogle Scholar
  22. Peterson, R. A., & Plehn, K. (1999). Measuring anxiety sensitivity. In S. Taylor (Ed.), Anxiety sensitivity: Theory, research, and treatment of the fear of anxiety. The LEA series in personality and clinical psychology (pp. 61–81). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
  23. Reardon, M. L., Cukrowicz, K. C., Reeves, M. D., & Joiner, T. E. (2002). Duration and regularity of therapy attendance as predictors of treatment outcome in an adult outpatient population. Psychotherapy Research, 12, 273–285.CrossRefGoogle Scholar
  24. Reiss, S., Peterson, R., Gursky, D., & McNally, R. (1986). Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8. doi:10.1016/0005-7967(86)90143-9.PubMedCrossRefGoogle Scholar
  25. Rosotto, E., Yager, J., & Rorty, M. (1998). The impulsive behavior scale: In. J. Vanderlinden & W. Vandereycken (Eds.). Trauma, dissociation, and impulsive dyscontrol in eating disorders. Brunner/Mazel.Google Scholar
  26. Smyth, J. M., Wonderlich, S. A., Heron, K. E., Sliwinski, M. J., Crosby, R. D., Mitchell, J. E., et al. (2007). Daily and momentary mood and stress are associated with binge eating and vomiting in Bulimia nervosa patients in the natural environment. Journal of Consulting and Clinical Psychology, 75, 629–638. doi:10.1037/0022-006X.75.4.629.PubMedCrossRefGoogle Scholar
  27. Sullivan, P. F., Bulik, C. M., & Kendler, K. S. (1998). The genetic epidemiology of binging and vomiting. The British Journal of Psychiatry, 173, 75–79.PubMedCrossRefGoogle Scholar
  28. Wallis, D. J., & Hetherington, M. M. (2004). Stress and eating: the effects of ego-threat and cognitive demand on food intake in restrained and emotional eaters. Appetite, 43, 39–46. doi:10.1016/j.appet.2004.02.001.PubMedCrossRefGoogle Scholar
  29. Watson, D., Clark, L. A., & Tellegen, A. (1998). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. doi:10.1037/0022-3514.54.6.1063.CrossRefGoogle Scholar
  30. Wegner, K. E., Smyth, J. M., Crosby, R. D., Wittrock, D., Wonderlich, S. A., & Mitchell, J. E. (2002). An evaluation of the relationship between mood and binge eating in the natural environment using ecological momentary assessment. The International Journal of Eating Disorders, 32, 352–361. doi:10.1002/eat.10086.PubMedCrossRefGoogle Scholar
  31. Whiteside, S. P., & Lynam, D. R. (2001). The five factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669–689. doi:10.1016/S0191-8869(00)00064-7.CrossRefGoogle Scholar
  32. Wurtman, R. J., & Wurtman, J. J. (1984). Nutrients, neurotransmitter synthesis, and the control of food intake. In A. J. Stunkard & E. Stellar (Eds.), Eating and its disorders (pp. 77–86). New York: Raven Press.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Michael D. Anestis
    • 1
  • April R. Smith
    • 1
  • Erin L. Fink
    • 1
  • Thomas E. Joiner
    • 1
  1. 1.Florida State UniversityTallahasseeUSA

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