FEEL - fostering emotion regulation skills in eating disorders: affective, behavioral and psychophysiological correlates of emotion, acceptance and compassion-based interventions

Programa doutoral em Psychology (ramo do conhecimento em Psychotherapy and Psychopathology)
The relationship between difficulties in emotion regulation and eating psychopathology is well established in the literature. Notwithstanding, the question regarding which specific protective and risk factors underly this relationship is still an avenue for both cross-sectional and prospective research. This dissertation includes six studies. In the first study, the psychometric properties of the Portuguese version of the Committed Action Questionnaire-8 – an instrument designed to assess the adaptive process variable committed action – were analyzed in a clinical ED sample. In the second study, conducted in a transdiagnostic ED clinical sample, a path analysis tested the combined role of self-criticism, experiential avoidance, and negative urgency as mediators of the relationship between ED-related symptoms and specific dimensions of difficulties in emotion regulation. In the third study, the clinical profile presentation of participants derived from two merged samples – a transdiagnostic ED clinical sample and a college sample – was explored through a two-step cluster analysis, across a continuum of eating psychopathology levels, in terms of psychological processes empirically recognized as relevant to foster/hinder emotion regulation skills – self-compassion, self-criticism, and experiential avoidance. In the fourth study, a network analysis was performed to preliminarily explore the strength centrality of a pool of adaptive and maladaptive variables of interest to the study of eating psychopathology and emotion regulation (e.g., interoceptive awareness; self-compassion, mindfulness self-criticism, and experiential avoidance) in a college sample. In the fifth study, a sample of treatment-seeking participants who completed a CBTbased treatment for EDs, was characterized in terms of sociodemographic and clinical variables, EDrelated symptomatology, difficulties in emotion regulation, overall psychopathology, and temperament and character dispositions. Also, patients were compared across three treatment outcome groups (full remission, partial remission, and poor treatment outcome) in terms of pre-post changes in their clinical profile, including difficulties in emotion regulation scores. Finally, in the sixth study, the prospective impact of a brief mindfulness- and compassion-based practice component was tested among college students. Affective, neurocognitive and psychophysiological correlates of difficulties in emotion regulation, attention bias, and interoceptive awareness were explored. The current results hold translational research potential and contribute to current knowledge with regard to the processes underlying the relationship between difficulties in emotion regulation and eating psychopathology.
This thesis was supported by a PhD studentship (SFRH/BD/143601/2019) granted by the Portuguese
Foundation for Science and Technology (FCT), funded with allocations from the State Budget of the
Ministry for Science, Technology and Higher Education, and the European Social Fund (ESF), available
through the North Regional Operational Program (NORTE 2020).