Emptiness and negative affect changes related to binge eating and borderline personality traits

Borderline personality disorder (BPD) is characterized by unstable self-image, conflictual interpersonal relationships, emotional dysregulation, and marked impulsivity. One form of impulsivity commonly seen in BPD is binge eating; however, little is known about this maladaptive behavior in the context of BPD. In the eating disorder (ED) literature, multiple theories suggest binge eating occurs as a result of heightened levels of negative affect. Given that BPD and EDs share emotional dysregulation and impulsivity as maintaining mechanisms of each respective disorder, these theories of binge eating may provide a model for binge eating in BPD. Existing literature suggests feelings of emotional emptiness may precede binge episodes in those with EDs. The current study sought to explore feelings of emptiness as antecedents to binge eating behaviors in those with BPD traits. Using ecological momentary assessment, binge episodes, affect, and feelings of emptiness were tracked throughout the day for 14 days in undergraduate students with BPD traits (n = 55). The current study found momentary feelings of emptiness at the time of the binge eating episode significantly predicted increased odds of a binge episode occurring. Additionally, momentary feelings of emptiness, as well as other negative affects, increase following a binge episode. Results suggest treatment of binge eating within BPD should include elements of acceptance of negative affects including emptiness, such as in dialectical behavior therapy distress tolerance skills training. (PsycInfo Database Record (c) 2024 APA, all rights reserved).