Abstract
Objective
People with bulimia nervosa (BN) self-report difficulties processing and regulating emotions. However, self-reports have been shown to be biased, particularly with people with BN who have difficulties describing their emotions. Self-reports also cannot easily disentangle between early processing and later regulatory stages, so it is not clear whether people with BN really do process their emotions more intensely or whether this is due to the aftermath of regulatory difficulties. This study aimed to use an objective way to measure (1) whether people with BN process their emotions with higher intensity compared to healthy controls (HC) and (2) whether they can successfully implement an emotion regulation strategy called cognitive reappraisal.
Methods
We developed a neuroimaging task using electroencephalography to answer these questions, using the Late Positive Potential (LPP) as an objective measure of emotional arousal at the processing and regulatory stages. We tested the task in females with BN (N = 32) and matched HC (N = 35).
Results
We found that our BN group showed higher LPP compared to our HC group when viewing emotional pictures, demonstrating increased emotional intensity at the processing stage. We also found that our BN group had difficulties successfully implementing cognitive reappraisal to reduce emotional arousal.
Discussion
This suggests that people with BN process their emotions with higher intensity and struggle to implement subsequent cognitive reappraisal strategies. This has direct implications for clinicians who should be aware that when evoking affect in treatment, people with BN may need greater support in understanding and managing their emotions.