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. 2023 Jul 31;11(1):125.
doi: 10.1186/s40337-023-00848-2.

Inhibitory control towards angry stimuli in patients with binge eating disorder: a pilot study

Kathrin Schag  1   2 , Lea Sandler  3 , Stephan Zipfel  3   4   5 , Birgit Derntl  5   6 , Katrin Elisabeth Giel  3   4   5
Affiliations

Inhibitory control towards angry stimuli in patients with binge eating disorder: a pilot study

Kathrin Schag et al. J Eat Disord. .

Abstract

Background: Emotion regulation theories and the negative urgency concept assume that negative mood increases binge eating. Negative emotions are considered as a trigger for binge eating, while binge eating itself is regarded as an impulsive behavior and should thus be increased within the negative urgency concept. Anger might be a specific negative emotion triggering binge eating in patients with binge eating disorder (BED). We investigated how inhibitory control as one main factor of impulsivity is influenced by anger stimuli in patients with BED and two control groups.

Methods: We compared patients with BED (N = 20) with normal-weight healthy control participants (NW-CG, N = 20) and BMI-matched overweight and obese control participants (BMI-CG, N = 18). We used the emotional Stop Signal task (eSST) to investigate inhibitory control, where we presented angry facial expressions in comparison with neutral facial expressions as emotional stimuli.

Results: All participants showed decreased inhibitory control in the angry versus neutral condition, i.e., a faster Stop Signal Reaction Time and a lower percentage of correct reactions. However, no significant group differences emerged in terms of performance. Performance in the eSST did not correlate with negative urgency, disorder- or emotion-related characteristics.

Conclusions: The current pilot study does not deliver evidence for decreased inhibitory control towards angry stimuli in patients with BED, as we detected a general and not disorder-related effect in all participants that might represent the conjunction of inhibitory control and anger. A direct mood induction technique might have led to different results. Further research in healthy and clinical groups is needed.

Keywords: Anger; Binge eating disorder; Eating disorder; Emotion; Impulsivity; Inhibitory control; Mood; Stop signal task.

Plain language summary

Several theories suggest that binge eating episodes are often appearing in negative mood and anger is one specific emotion that might commonly trigger binge eating. The aim of this study was to investigate inhibitory control under anger in patients with binge eating disorder (BED). Inhibitory control is a specific component of impulsivity and further studies suggest that inhibitory control deficits are related to binge eating. We compared patients with BED with normal-weight participants and overweight or obese participants as control groups in a specific inhibitory control task, where faces with angry or neutral expressions were presented and participants should stop, i.e. inhibit their reactions. All participants had more inhibitory control deficits when they viewed angry faces in comparison with neutral expressions, and patients with BED did not differ from the participants of the two control groups. Thus, all participants react on anger with increased impulsivity indicating that patients with BED seem to have no specific deficit in this regard. As this was a pilot study, further studies should investigate the interplay of several emotions and impulsivity in healthy and clinical groups.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Exemplary trials of the emotional Stop Signal Task (eSST). Legend One go trial on the left side and one stop trial on the right side of the emotional Stop Signal Task with an angry stimulus according to the Brain Behavior Laboratory of the University of Pennsylvania [31]
Fig. 2
Fig. 2
Performance in the eSST (emotional Stop Signal Task). Legend. Panel A: SSRT (Stop Signal Reaction Time) and Panel B: Correct reactions (%) of the for angry versus neutral stimuli, pooled over the groups BED, BMI-CG and NW-CG. Significant differences are indicated with*
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