Emotion Dysregulation, Impulsivity, Mindfulness, and Attachment Orientation in People with Symptoms of Bulimia Nervosa and Binge Eating Disorder

Abstract

Emotion dysregulation has been implicated in over half the DSM-IV Axis I diagnoses and all the Axis II disorders, and greater dysregulation has been associated with more severe psychopathology in clinical populations (Bradley, 2003; Fischer, Smith, Spillane, & Cyders, 2005; Gross, 1998; Hayes, Wilson, Strosahl, Gifford, & Follett, 1996). Despite this, there is still much research to do in order to understand the causes of emotion dysregulation and to consider its association with other theories that incorporate perspectives on emotional recognition and regulation, such as mindfulness. In some theories emotion dysregulation is believed to stem from poor quality early attachment relationships (Bowlby, 1962/69, 1973, 1980) which are believed to affect both inter- and intra-personal functioning. For example, individuals receiving mental health treatment tend to have higher proportions of individuals with attachment insecurity than community populations. Moreover, individuals with greater attachment insecurity have been found to resort to binge eating and purging which are sometimes referred to as secondary attachment strategies (Evans & Wertheim, 2005; Flores, 2004; Mikulincer, Shaver, & Pereg, 2003; Orzolek-Kronner, 2002; Polivy & Herman, 2002; Schore, 2003; Zvolensky & Forsyth, 2002). Binge eating and purging have also been associated with impulsivity in general, but may actually be more closely aligned with ‘urgency’, a facet of impulsivity (Fischer, Smith, Spillane, & Cyders, 2005).