Distress tolerance across self-report, behavioral and psychophysiological domains in women with eating disorders and healthy controls

Background and objectives The tendency to engage in impulsive behaviors when distressed is linked to engagement in disordered eating. The current study comprehensively examines emotional responses to a distress tolerance task by utilizing self-report, psychophysiological measures (respiratory sinus arrhythmia [RSA], skin conductance responses [SCRs] and tonic skin conductance levels [SCLs]), and behavioral measures (i.e., termination of task, latency to quit task). Methods 26 healthy controls (HCs) and a sample of treatment-seeking women with Bulimia Nervosa (BN), Binge Eating Disorder (BED) and Anorexia Nervosa (AN) ( N =106) completed the Paced Auditory Serial Addition Task-Computerized (PASAT-C). Psychophysiological measurements were collected during baseline, PASAT-C, and recovery, then averaged for each time-period. Self-reported emotions were collected at baseline, post-PASAT-C and post-recovery. Results Overall, we found an effect of Time, with all participants reporting greater negative emotions, less happiness, lower RSA, more SCRs and higher tonic SCLs after completion of the PASAT-C relative to baseline. There were no differences in PASAT-C performance between groups. There was an effect of Group for negative emotions, with women with BN, BED and AN reporting overall higher levels of negative emotions relative to HCs. Furthermore, we found an effect of Group for greater urges to binge eat and lower RSA values among BED, relative to individuals with BN, AN and HCs. Limitations This study is cross-sectional and lacked an overweight healthy control group. Conclusion During the PASAT-C, individuals with EDs compared to HCs report higher levels of negative emotions, despite similar physiological and behavioral manifestations of distress.