Emotional Response Inhibition: A Shared Neurocognitive Deficit in Eating Disorder Symptoms and Nonsuicidal Self-Injury

Abstract

Eating disorder (ED) symptoms often co-occur with non-suicidal self-injury (NSSI). This comorbidity is consistent with evidence that trait negative urgency increases risk for both of these phenomena. We previously found that impaired late-stage negative emotional response inhibition (i.e., negative emotional action termination or NEAT) might represent a neurocognitive mechanism for heightened negative urgency among people with NSSI history. The current study evaluated whether relations between negative urgency and ED symptoms similarly reflect deficits in this neurocognitive process. A total of 105 community adults completed an assessment of ED symptoms, negative urgency, and an emotional response inhibition task. Results indicated that, contrary to predictions, negative urgency and NEAT contributed independent variance to the prediction of ED symptoms, while controlling for demographic covariates and NSSI history. Worse NEAT was also uniquely associated with restrictive eating, after accounting for negative urgency. Our findings suggest that difficulty inhibiting ongoing motor responses triggered by negative emotional reactions (i.e., NEAT) may be a shared neurocognitive characteristic of ED symptoms and NSSI. However, negative urgency and NEAT dysfunction capture separate variance in the prediction of ED-related cognitions and behaviors, distinct from the pattern of results we previously observed in NSSI.

Keywords: binge eating; body image; cognitive control; compulsive behavior; eating disorders; emotional regulation; impulsive behavior; non-suicidal self-injury; self-injurious behavior; urgency.

Figure 1

Multiple linear regression results for EDE-Q global scale scores with predictors entered hierarchically in three steps: (a) Sex, gender/sexual orientation, race, NSSI history, ESST accuracy (Step 1); (b) negative urgency (Step 2); and (c) NEAT (Step 3). Both negative urgency and NEAT uniquely contributed significant variance to the prediction of ED symptoms, after controlling for demographic variables, NSSI history, and ESST performance (see Table 3 for additional information). AIC = Akaike’s Information Criterion; BIC = Bayesian Information Criterion.