(PS2-11) Examining the Relationship between Emotion Regulation Strategies and Eating Disorder Pathology Among Adults with Type 2 Diabetes

Abstract Text:

Introduction: Intrapersonal and interpersonal emotion regulation difficulties have been associated with eating disorders (Denning et al., 2023) and type 2 diabetes (Embaye et al., 2023). Type 2 diabetes is an extremely common medical condition affecting approximately 1 in 10 U.S. adults (CDC, 2024). Individuals with type 2 diabetes may be particularly susceptible to the development of eating disorders (Coleman & Caswell, 2020) due to 1) dysregulated behaviors around food preceding the development of the disorder and 2) the implementation of demanding disease self-management practices (e.g., dietary restrictions) following the development of the disorder (Bottari et al., 2024). The proposed study aims to 1) examine the frequency of eating disorder pathology among adults with type 2 diabetes and 2) investigate the relationship of difficulties in intrapersonal and interpersonal emotion regulation with disordered eating symptoms among adults with type 2 diabetes.

Methods: Data was collected from adults with type 2 diabetes (N = 393) who completed an online study. Participants were primarily female (64.5%), White (79.3%), and a mean age of approximately 59 years (range: 20 to 87 years). Participants completed self-report questionnaires to measure intrapersonal (DERS-16; Bjureberg et al., 2016) and interpersonal (DIRE; Dixon-Gordon et al., 2018) difficulties with emotion regulation. Linear regression models examined the relationship between subscales of the DERS-16 and DIRE emotion regulation and the Eating Disorder Questionnaire (EDE-Q) global score.

Results: Nearly half (44.9%) of the sample met clinical cut-off for an eating disorder (EDE-Q global score > 2.8; Fairburn & Beglin, 1994). Regression analysis revealed that there was a significant positive relationship between various aspects of emotion dysregulation and eating disorder pathology after controlling for sex. Greater difficulties with intrapersonal emotion regulation domains of non-acceptance of emotional responses (B = .09, SE = .03, p = .008) and lack of emotional clarity (B = .10, SE = .05, p = .027) were associated with greater eating disorder pathology. Difficulties engaging in goal-directed behavior, impulse control difficulties, and limited access to emotion regulation strategies were all nonsignificant predictors (ps > .306). Of the interpersonal emotion regulation subscales, increased venting (B = .05, SE = .01, p < .001) but not reassurance seeking (B = -.02, SE = .01, p = .237) was related to greater eating disorder pathology.

Conclusions: Findings suggest a link between greater difficulties in emotion regulation and increased eating disorder pathology among adults with type 2 diabetes. Clinicians may target intrapersonal and interpersonal emotion regulation, specifically control over one’s own emotional awareness and expression of emotions to others, to reduce risk of developing and maintaining disordered eating behaviors in adults with type 2 diabetes.