Emotion avoidance in anorexia nervosa

A sudden spate of new research on emotions in anorexia nervosa has definitely caught my interest, as emotions are not something that come easy for me. It's not just a feel your feelings sort of thing, but also a "I know I'm pissed and anxious, so now what" kind of thing. I feel emotions and I feel them hard and deep. I can usually identify them, but regulating them and living with them isn't one of my strong points.

A new study, titled "Emotion avoidance in patients with anorexia nervosa," found a strong relationship between levels of emotional avoidance, anxiety, and ED psychopathology in people with AN.

"Patients with AN endorsed levels of emotion avoidance that were comparable to or higher than other psychiatric populations and exceeded community controls...[These] findings confirm that emotion avoidance is present in patients with AN and provide initial support for the idea that anorexic symptoms function, in part, to help individuals avoid aversive emotional states."

Which makes a lot of sense. Anxiety is quite possibly one of the biggest triggers I have, and not eating makes me feel less anxious. And the strong relationship between anxiety and eating disorders hasn't gone unnoticed. Walt Kaye's group out at UCSD found this to be true experimentally.

Another study, titled "Emotional processing in women with anorexia nervosa and in healthy volunteers," found that

"Compared to the [healthy volunteers], patients with AN had lower levels of self reported emotional awareness and expression. They also responded more slowly to, correctly identified fewer emotions and misclassified more emotions in a facial recognition task, and responded more slowly to, and recalled fewer, self-referent emotion words."

Previous research has suggested that adolescents with anorexia had impaired emotional processing compared to non-anorexic adolescents.

A study from earlier this year, "Emotional perception in eating disorders," found that

"Patients with AN-R showed increased fear when confronted with stimuli containing anger, whereas patients with BN showed a tendency towards decreased fear...The finding of increased fear when exposed to the emotion of anger might be attributed to introversion and conflict avoidance of anorectic patients."

Which I have again found to be true in my personal experiences. Anger, whether mine or anyone else's, tends to terrify me. I typically avoid conflict, but my mom has also described me as "scrappy" at times, so it's not a 100% thing. I'll charge in if no other alternative is open, or if I'm feeling quite peeved, but usually, I just stay in the background. Some of this hanging back is conflict avoidance, and some of it is my innate introversion.

Other, more qualitative, studies have also looked at emotion perception in anorexia nervosa and the use of emotion-focused therapy to treat AN. I don't find either of these two studies as promising as the first three, largely because the results don't seem to be as concrete or reproducible.

Regardless, issues with emotion processing and recognition are neither purely genetic or purely environmental but arise from an interaction between the two.

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Anonymous said...

I have read studies that show a correlation between Anorexia Nervosa and various disorders on the autism spectrum. A similar study of facial recognition tests was condusted with children suffering from Asperger's, an autism spectrum disorder. I really wish the bridge between the two disorders was more clear as I suffer from a mild form of autism as well as Anorexia Nervosa.

Has anyone else seen research in this field?

Kim said...

I was just thinking about this today. Great post.

Anonymous said...

you are so smart. i love your research. can i ask, what do you do as your "day job"? Whatever you do, I want to support it in whatever way i can!

Carrie Arnold said...


I've blogged on the autism/anorexia connection before- here are some of the relevent ones.

Emotions in anorexia
Autism and anorexia
More on the biological basis of EDs

Although I personally don't have autism or an ASD, there are certainly personality traits common in these conditions that really resonate with me. As well, my cousin has autism and I've done some research on the subject for my aunt.

Carrie Arnold said...


My comment crossed with yours! I'm a science writer. I'm currently on disability due to a relapse of the ED, but my job is to translate research articles (on any science related subject, so I can work on physics in the morning and cell biology in the afternoon) into plain English both for other scientists and for journalists. Basically, I google a lot. It's fun because I'm always learning, even if the actual writing can get a little banal.

Eli said...

You read my mind, Invisible Monster (and thanks for posting the links in your comment, Carrie). I have Asperger’s Syndrome and have been in recovery from “atypical” anorexia for five years (I never really had body image issues – it was more about sensory problems and harmful ingrained routines).

People on the autistic spectrum who do not have anorexia or another eating disorder often have “odd” attitudes about food nevertheless. Imagine my team’s surprise when my parents told them I had only eaten eight plain foods that were not allowed to touch or mix for years before becoming sick with anorexia! We also tend to have high levels of anxiety and depression, and “perseverate” on odd topics and interests (much like how people with eating disorders obsess over food). Anyways, I’m interested to see what the research on this topic will continue to reveal.

ghost girl said...

This goes right along with what my T has said in our sessions. When she kept referring to my AVOIDANT personality traits, I was thinking, "I am not avoiding, i am focusing on 1. hunger and 2. pain." But it was only bc i didn't know how to deal with anything else .... especially anger. Once again, thank you for a great post.

Eating With Others said...

I was so afraid of any kind of change at all I was in a state of paralysis for years. Didn't change my foods the time or places I ate. I avoided going anywere cause then there would be change. Change terrified me. I tend to avoid everything that I can. Or at least I did. I'm starting to let go a little now. Like with this but it's very hard.

Thanks for the post. Great the word verification - bingue how great is that.

Carrie Arnold said...

Yes, my cousin has autism and is very resistant to eating anything "new" or "different." He likes the same things, day in and day out. It's a habit I can easily fall into as well.

It's interesting because I have a texture thing with my food, too. I really like creamy things, and I don't (for example) like nuts on my sundaes not because I don't like nuts--I do--but because it wrecks the texture.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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