Cognitive restraint versus restriction: An investigation of daily eating patterns among women with eating disorders...

Research has found only small-to-moderate correlations between cognitive restraint (efforts to reduce food intake) and dietary restriction (actual reduction in food intake) in laboratory settings. It is unknown whether retrospective measures of cognitive restraint and restriction relate to momentary endorsements of restrictive eating in daily life among women with eating disorders characterized by restrictive eating. In the current study, the Eating Pathology Symptoms Inventory Cognitive Restraint (EPSI-CR) and Restriction (EPSI-R) subscale scores were: 1) compared across women with AN (n = 58), BN (n = 56), ARFID (n = 31), and non-eating disorder controls (NED; n = 53), and 2) correlated with frequency of daily restrictive eating reported via two-weeks of ecological momentary assessment. We found that individuals with AN scored significantly higher on the EPSI-CR than all other groups, while individuals with BN scored significantly higher than ARFID and NED groups, whose scores did not differ. Individuals with AN and ARFID did not significantly differ on EPSI-R scores, while both groups scored higher than individuals with BN, who scored higher than NEDs. EPSI-CR scores were not significantly correlated with frequency of restrictive eating in daily life in any diagnostic group, suggesting that past-month cognitive restraint was not associated with dietary restriction in daily life. EPSI-R scores were strongly correlated with frequency of dietary restriction in women with BN and ARFID, but not women with AN, demonstrating a discrepancy between EMA and retrospective responses. Results highlight the importance of differentiating cognitive restraint and restriction when assessing and treating eating disorders.