Emotional responding and distress tolerance in women at high vs. low risk for eating disorders in response to physical and cognitive stress

Background: Disordered eating has been theorised to function as a maladaptive way of coping with negative affect. The current study aimed to comprehensively assess emotional responding and distress tolerance to a cognitive and a physical distress tolerance task using physiological (heart rate), self-report and behavioural measures (latency to quit task).Methods: 56 women at high vs. 58 at low eating disorder risk completed the "Paced Auditory Serial Addition Task-Computerised" (PASAT-C) and the "Breath-holding Task" (BHT) and provided their affective ratings upon completion of the tasks. Heart rate was recorded during both tasks. Distress tolerance was assessed via a self-report measure, while latency to quit each task was used as a behavioural index of distress tolerance.Results: Participants at high risk for eating disorders had higher heart rate during both tasks and reported significantly more unpleasantness and less control after the PASAT-C compared to the lowrisk group. Shorter latency to quit the PASAT-C was evidenced in the high vs. low-risk group suggesting lower tolerance for cognitive distress. Breath-holding duration did not differ between the two groups.Conclusions: Greater physiological and subjective arousal to distressing situations in high-risk individuals indicates a potential hypersensitivity to negative affect, possibly increasing eating disorder vulnerability. Potential implications for eating disorder prevention and management are discussed.