Emotion regulation and drunkorexia behaviors among Lebanese adults: the indirect effects of positive and negative metacognition

Vanessa Azzi; Dora Bianchi; Sara Pompili; Fiorenzo Laghi; Sarah Gerges; Marwan Akel; Diana Malaeb; Sahar Obeid; Souheil Hallit

doi:10.1186/s12888-022-04030-x

Emotion regulation and drunkorexia behaviors among Lebanese adults: the indirect effects of positive and negative metacognition

BMC Psychiatry. 2022 Jun 10;22(1):391. doi: 10.1186/s12888-022-04030-x.

Authors

Vanessa Azzi^#¹, Dora Bianchi^#², Sara Pompili², Fiorenzo Laghi², Sarah Gerges¹, Marwan Akel³, Diana Malaeb^{3

4}, Sahar Obeid^#⁵, Souheil Hallit^#^{6

7

8}

Affiliations

¹ School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon.
² Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy.
³ School of Pharmacy, Lebanese International University, Beirut, Lebanon.
⁴ School of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates.
⁵ Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
⁶ School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon. souheilhallit@hotmail.com.
⁷ Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia. souheilhallit@hotmail.com.
⁸ Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon. souheilhallit@hotmail.com.

^# Contributed equally.

Abstract

Background: Although metacognition processes are a core feature of restrictive eating and alcohol cravings and entail an individual to control both of his/her emotions and thoughts, yet, to our knowledge, a scarcity of research has examined their potential role in drunkorexia as cognitive and emotional predictors. The following study investigates the different associations between two emotion regulation strategies (i.e. emotional suppression and cognitive reappraisal) and drunkorexia behaviors in a sample of Lebanese adults, exploring the possible indirect effects of positive and negative alcohol-related metacognitions.

Methods: This was a cross-sectional study that enrolled 335 participants (March-July 2021).

Results: Higher problematic alcohol use (beta = 5.56), higher physical activity index (beta = 0.08), higher expressive suppression (beta = 0.23), higher negative metacognitive beliefs about cognitive harm due to drinking (beta = 0.75) and higher cognitive reappraisal (beta = 0.20) were significantly associated with more drunkorexic behaviors. The positive metacognitive beliefs about cognitive self-regulation significantly mediated the association between cognitive reappraisal and drunkorexia behaviors. Both the positive metacognitive beliefs about cognitive self-regulation and the negative metacognitive beliefs about the uncontrollability of drinking significantly mediated the association between expressive suppression and drunkorexia behaviors.

Conclusion: This study demonstrated that emotional and metacognitive processes are associated with drunkorexia, addressing as well the mediating effect between deficient emotional regulation and risky behavioral patterns. Overall, our results would speculate that the lack of emotional and cognitive assets might enhance internal distress perceived out of control, leading individuals to indulge in maladaptive behavioral patterns for managing the underlying impairment.

Keywords: Alcohol use disorder; Drunkrexia behaviors; Emotion regulation; Lebanese adults; Metacognition.

MeSH terms

Adult
Alcoholism* / psychology
Cross-Sectional Studies
Emotional Regulation*
Emotions / physiology
Female
Humans
Male
Metacognition* / physiology