Purpose: Ecological momentary assessment (EMA) studies preliminarily support the transactional model of emotion regulation in eating disorders, such that heightened stress appraisal (i.e., the cognitive evaluation of an event's demands) results in increased negative affect (NA) and subsequent binge eating (BE). However, the temporal relationships between these variables and the magnitude of stress appraisal that is clinically significant require clarification. The current study aimed to extend previous research by (1) examining the temporal relationship between stress appraisal, changes in NA, and BE using three timepoints, (2) exploring what magnitude of momentary stress appraisal results in clinically significant increases in NA and BE, and (3) characterizing what stressors are associated with clinically significant stress appraisal.
Methods: 37 adult females completed an EMA protocol assessing momentary stressors, stress appraisal, NA, and BE over 2 week duration. Multilevel mediation models were used to test the study aims.
Results: Momentary increases in stress appraisal significantly predicted binge eating through increases in NA. Stress appraisal ratings of 0.50 SD higher relative to one's average stress appraisal began to significantly predict the likelihood of BE through increases in NA, and the likelihood of BE occurrence increased with every 0.25 increments in momentary stress appraisal. Work/school stressors and interpersonal stressors were the most commonly endorsed stressors of clinically significant stress appraisal.
Conclusion: The current study supported the transactional model of emotion dysregulation in a binge eating sample and supports the use of momentary interventions at times of clinically significant stress appraisal to reduce BE risk.
Level of evidence: Level II, controlled trial without randomization.
Keywords: Binge eating; Ecological momentary assessment; Negative affect; Stress appraisal; Stressors.
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