Characterizing Emotional Inertia and Its Relation to Eating Disorder Behaviors in Patients Seeking Treatment for...

Emotional inertia, the tendency for emotions to persist over time, has received little attention in relation to eating disorders (ED). However, emotional inertia may reflect poor emotion regulation and unresponsiveness to environmental cues, and individuals may use ED behaviors to distract from or escape persistent emotions. We aimed to characterize emotional inertia and its relationship with ED behavior frequency among adults with EDs.

Adults (N = 94) with bulimia nervosa (BN) or binge eating disorder (BED) spectrum EDs completed 7-14 days of ecological momentary assessment, reporting negative affect (NA), positive affect (PA), and ED behaviors. Inertia was computed using within-person autoregressive estimates in a multilevel model. We compared NA and PA inertia between diagnostic groups, and as predictors of ED behavior frequency.

Average NA and PA inertia did not differ by diagnostic group. Higher NA inertia was cross-sectionally associated with greater overall frequency of compensatory behaviors in participants with BN-spectrum EDs. NA inertia was not cross-sectionally associated with binge eating but was positively associated with overall frequency of dietary restriction. The cross-sectional association of NA inertia with binge eating and dietary restriction was not moderated by diagnostic group. PA inertia was not cross-sectionally associated with frequency of any ED behaviors.

Emotional inertia may be important for understanding the development and maintenance of ED behaviors, particularly dietary restriction. Future research should explore temporal relationships. Interventions promoting flexible emotional responding may help to reduce emotional inertia and its effect on ED behaviors.