The role of negative affect in eating disorders and substance use disorders

Affect regulation is one mechanism that has been implicated in the development and maintenance of both eating disorders and substance use disorders. Specifically, the affective processing model of negative reinforcement posits that negative affect, as a symptom of withdrawal, is the main impetus in substance use disorder development and maintenance. Similarly, a recent transactional model of emotion dysregulation posits that individuals with eating disorders display heightened emotional sensitivity and reactivity, which in turn predisposes these individuals to eating disorder behaviors (e.g., binge eating, purging, etc.) as a means of attempting to modulate heightened negative affect. While affect regulation is similar in eating disorders and substance use disorders, differences in precursors of negative affect, cognitions, and withdrawal symptoms are present in these two forms of psychopathology. Despite these differences, affect regulation models in both eating and substance use disorders have begun to influence treatment. Thus, understanding the role of negative affect may be a key component of treating substance use disorders and eating disorders independently, as well as the co-occurrence of these disorders.