1 - (SYM 126) Exploring Functional Relationships Between Uncertainty, Repetitive Negative Thinking, and Eating Disorder Risk Using Ecological Momentary Assessment

Objective: Despite theoretical and qualitative data suggesting that eating disorder (ED) behaviors may function to decrease negative reactions to state uncertainty, no studies have explored real-time, functional associations between states of uncertainty and later engagement in ED behaviors. Further, while research has suggested that intolerance of uncertainty may prompt momentary engagement in repetitive negative thinking (RNT), which could promote engagement in ED behaviors, no work to date has explored these theoretical relationships. Accordingly, the current study tested whether state uncertainty predicted later loss of control eating, dietary restriction, body dissatisfaction, and exercise in a sample of undergraduates at elevated risk for EDs, and whether state RNT mediated the association between state uncertainty and ED behaviors.

Methods: Participants (N=41; M_age=19.20; SD=1.79; 83.3% cisgender female; 62.1% white) completed a 15-day, 5-prompt/day ecological momentary assessment (EMA) protocol that probed state uncertainty, RNT, and ED behaviors. We used multi-level mediation models to explore direct and indirect effects within and between subjects, lagging effects within individual and day. 

Results:  Across models, greater uncertainty predicted increased RNT both within-, b=1.17, se=.07, p< .001, and between-subjects, b=2.52, se=.36, p< .001. Mediation models indicated direct, between-subject effects for uncertainty on dietary restriction, b=.22 se=.07, p=.002, and loss of control eating, b=.09, se=.04, p=.032, but not exercise, b=.01, se=.01, p=.269. A within-subjects indirect effect showed RNT mediated the relationship between state uncertainty and later body dissatisfaction, b=.09, se=.04, p=.032. RNT did not mediate the relationship between uncertainty and other ED symptoms (within- or between-subjects).

 


Discussion:  Our data suggest that state and trait uncertainty predict RNT, and individuals with higher state uncertainty show greater engagement in dietary restriction and loss of control eating. Further, the relationship between state uncertainty and later body dissatisfaction was partly explained by increased RNT among individuals at risk for EDs, highlighting the promise of this construct for understanding the onset and maintenance of ED symptoms. Future research should replicate these findings in clinical samples and consider whether targeting reactions to uncertainty results in a decrease in ED symptom engagement.