Date on Senior Honors Thesis


Document Type

Senior Honors Thesis

Degree Name



Psychological and Brain Sciences

Author's Keywords

eating disorder; negative affect; depression; anxiety; worry; ecological momentary assessment


Background: Eating disorders (EDs) are becoming increasingly commonplace and are associated with a broad array of dangerous medical complications. Further, EDs frequently present alongside comorbid psychiatric disorders (e.g., depressive and anxiety-related disorders), which are known to both predict ED severity and reduce treatment efficacy. While diagnostic categorization persists, Fairburn et al.’s (1993) transdiagnostic model suggests EDs may be more closely related and maintained through core, shared symptoms. To assess ED maintenance, momentary triggers such as negative affect (NA) are becoming increasingly centralized. The present study examines the roles of depressive symptoms and worry in predicting and moderating the relationships among NA (i.e., guilt/anxiety) and ED behaviors (i.e., binge eating, dietary restriction, and driven exercise) to provide a clearer description of ED psychopathology. Method: Participants (N = 130) completed diagnostic screenings and baseline questionnaires at onset, and ecological momentary assessment (EMA) surveys sent to their mobile phones four times per day for 25 days. The relationships among NA and ED behaviors were tested using mixed effects models in R. Results: State and trait NA were differentially implicated in the associations among ED behaviors and depression/worry. Depressive symptoms and worry were each moderators of the relationship between driven exercise and state NA. Discussion: The present study broadens current understanding of NA’s contribution to ED psychopathology and emphasizes the significance of psychiatric comorbidities in maintaining ED behaviors. Future research should assess the treatment of depressive cognitions in reducing binge eating behaviors and the efficacy of emotional regulation strategies in reducing dietary restriction and driven exercise.

Lay Summary

Eating disorders (EDs) are becoming increasingly commonplace and are closely associated with a variety of dangerous health consequences, both mental and physical. Having another psychiatric disorder (e.g., comorbid depression or anxiety) alongside an ED diagnosis is known to increase the severity of each disorder’s symptoms, as well as reduce the effectiveness of their treatment. In the field of ED research, there is currently a growing interest on assessing moment-to-moment changes in various triggers which may serve to maintain ED behaviors. One such momentary trigger—negative affect (NA), generally characterized by unpleasant emotions—has been especially linked to ED maintenance, and its analysis is useful in more descriptively assessing the interactions among EDs and their comorbidities.

The present study aimed to clarify the contributions of worry and depression to the associations among NA (i.e., guilt/anxiety) and ED behaviors (i.e., binge eating, dietary restriction, and driven exercise). We found that depressive symptoms were generally more involved in the interactions among NA and both dietary restriction and binge eating behaviors. For the relationship between NA and driven exercise, worry and depressive symptoms played similar roles, and further served to predict the strength of the relationship between momentary NA and driven exercise. The authors suggest that, for individuals who experience frequent states of NA, the treatment of depressive cognitions be assessed in reducing binge eating behaviors, and that emotional regulation strategies be assessed for their efficacy in reducing dietary restriction and driven exercise. These findings stress the significance of comorbid psychiatric disorders in maintaining ED behaviors and provide a clearer description of the role NA plays in their interactions.