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Emotion regulation difficulties in anorexia nervosa before and after inpatient weight restoration


  • Supported by the National Institute of Mental Health of the National Institutes of Health under Award Number F31MH097450, Robert Wood Johnson Foundation Health and Society Scholar at Harvard University (C.A.R.).



This study examined: (1) changes in emotion regulation difficulties in underweight inpatients with anorexia nervosa (AN) following weight restoration, (2) differences in emotion regulation between AN subtypes at acute and weight-restored stages of illness.


Repeated measure analyses of variance examined changes in scores on the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, J Psychopathol Behav Assess, 26, 41–54, 2004) and other clinical variables in a group of inpatients with AN from hospital admission (N = 65) to weight restoration (N = 51). Correlations between BMI and DERS scores at both time points were examined. Emotion regulation difficulties were compared between individuals with AN, restricting type (AN-R) and AN, binge/purge type (AN-BP) at both time points using multivariate analysis of covariance.


All clinical variables, except for the DERS, significantly improved with weight restoration (p < .001). There were no associations between BMI and DERS prior to or after weight restoration and AN subtypes did not significantly differ in emotion regulation difficulties.


Unlike other clinical variables, emotion regulation difficulties in AN did not improve with weight restoration. In addition, both subtypes of AN appear to have similar difficulties with emotion regulation. The treatment of AN might be enhanced by focusing on improving emotion regulation abilities. © 2014 Wiley Periodicals, Inc. Int J Eat Disord 2014; 47:888–891