Eating Disorders, Emotion Regulation, and Mentalization : Addressing the gap between Theory and Practice

Abstract

Clarifying terminology in psychological science is crucial to develop suitable practices and improve treatment effectiveness. Objectives: To provide theoretical framework which integrates the scientific literature regarding the transdiagnostic dimensions in the eating disorders (ED) spectrum: self-agency, mentalization, self-control and self-regulation. In addition to introducing a newly developed eating and control style axis, (ECOSA), it focuses on better conceptualizing the complex interaction between eating style, control conditions, and the impact of the “emotional brain” versus the “thinking brain.” Methods: Electronic searches of MEDLINE, EMBASE, and PsycINFO, were performed on April–May 2020 using the keywords Self agency or mentalization or reflective functioning or self-regulation or emotion regulation or self-control or self-agency and eating disorders. Results: There are numerous scientific literatures related to eating disorders. However, only two were related to all the dimensions discussed in this manuscript. Most reviews have focused on a single diagnostic category or two dimensions. Only, one study reported the results of mentalization-based treatment (MBT). ECOSA provides an example of a tool that may be used to promote self-agency in the management of eating disorders. Conclusion: To enhance perception of ownership over an effector (self-agency), clinicians need an instrument that assists in exploring the agent’s inner intentions. ECOSA may be used by all those who seek further clarity regarding the association between pathological eating behaviors, self-regulation and under- or over-c