Repetitive negative thinking predicts eating disorder behaviors: A pilot ecological momentary assessment study in a treatment seeking eating disorder sample

Abstract

Background: Repetitive negative thinking is a transdiagnostic process that occurs across several psychological disorders, including eating disorders. Individuals with eating disorders have higher levels of repetitive negative thinking than controls, and repetitive negative thinking is associated with eating disorder behaviors. However, no study has measured how momentary repetitive negative thinking may subsequently impact daily eating disorder behaviors and vice-versa.

Method: In the current study (N = 66, recently treated individuals recruited from an eating disorder treatment center), we examined the relationship between repetitive negative thinking and subsequent eating disorder behaviors and vice-versa using ecological momentary assessment.

Results: We found that higher momentary repetitive negative thinking predicted higher subsequent weighing and body checking. We also found that higher momentary meal-specific repetitive negative thinking predicted higher subsequent weighing and lower subsequent compensatory behavior. We also found that higher repetitive negative thinking predicted higher eating disorder symptoms at one-month follow-up.

Conclusion: There are short-term and long-term negative effects of repetitive negative thinking in the eating disorders. Targeting repetitive negative thinking may be important for decreasing eating disorder behaviors.

Keywords: EMA; Eating disorder; Repetitive negative thinking; Transdiagnostic.