Daily Patterns of Anxiety in Anorexia Nervosa: Associations With Eating Disorder Behaviors in the Natural Environment

被引:92
作者
Lavender, Jason M. [1 ]
De Young, Kyle P. [2 ]
Wonderlich, Stephen A. [1 ,3 ]
Crosby, Ross D. [1 ,3 ]
Engel, Scott G. [1 ,3 ]
Mitchell, James E. [1 ,3 ]
Crow, Scott J. [4 ]
Peterson, Carol B. [4 ]
Le Grange, Daniel [5 ]
机构
[1] Neuropsychiat Res Inst, Fargo, ND 58103 USA
[2] Univ N Dakota, Dept Psychol, Grand Forks, ND 58201 USA
[3] Univ N Dakota, Dept Psychol, Neuropsychiat Res Inst, Grand Forks, ND 58201 USA
[4] Univ Minnesota, Minneapolis, MN 55455 USA
[5] Univ Chicago, Chicago, IL 60637 USA
关键词
eating disorder; anxiety; ecological momentary assessment; latent growth mixture modeling; personality; MOMENTARY ASSESSMENT; PERSONALITY-DISORDERS; MODEL; COMORBIDITY; PREVALENCE; MOOD; MAINTENANCE; AVOIDANCE; MORTALITY; THERAPY;
D O I
10.1037/a0031823
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
The role of anxiety has been emphasized in etiological/maintenance models of anorexia nervosa. This study identified daily patterns of anxiety in anorexia nervosa and examined the likelihood of the occurrence of eating disorder behaviors in each trajectory, the daily temporal distribution of eating disorder behaviors in each trajectory, and the extent to which the tendency to exhibit particular anxiety trajectories was associated with baseline diagnostic and trait-level personality variables. Women with full or subthreshold anorexia nervosa (N = 118) completed a 2-week ecological momentary assessment (EMA) protocol during which they reported on a variety of behavioral and affective variables, including anxiety and eating disorder behaviors. Using latent growth mixture modeling to classify EMA days (N = 1,526) based on anxiety ratings, we identified 7 distinct daily anxiety trajectories. Overall differences between trajectories were found for rates of binge eating, self-induced vomiting, body checking, skipping meals, and dietary restriction. Furthermore, distinct daily temporal distributions of eating disorder behaviors were found across the trajectories, with peaks in the probability of behaviors frequently coinciding with high levels of anxiety. Finally, traits of personality pathology (affective lability, self-harm, social avoidance, and oppositionality) and the presence of a co-occurring mood disorder were found to be associated with the tendency to experience particular daily anxiety trajectories (e.g., stable high anxiety). Findings support the presence of within-person variability in daily anxiety patterns in anorexia nervosa and also provide evidence for an association between these anxiety patterns and eating disorder behaviors.
引用
收藏
页码:672 / 683
页数:12
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