Affect trajectories surrounding binge eating episodes and heavy drinking episodes in adults with binge-spectrum eating disorders

ObjectiveThe comorbidity of binge eating and heavy drinking (BE + HD) is concerning due to high prevalence and associated consequences. Affective pathways may maintain BE + HD, yet more micro-level research is needed. This study used ecological momentary assessment (EMA) to examine between-person and day-level relationships between positive and negative affect and binge eating or heavy drinking episodes in BE + HD.MethodsParticipants (N = 53) were adults with binge-spectrum eating disorders who completed between 7 and 14 days of EMA prior to a treatment for binge eating.ResultsAnxiety was highest on days with both binge eating and heavy drinking, while excitement and confidence were highest on days with only heavy drinking episodes for BE + HD. Global negative affect was relatively stable surrounding binge eating episodes. Guilt significantly increased prior to binge eating, and sadness significantly decreased following binge eating. Global positive affect significantly decreased prior to and stopped decreasing following heavy drinking episodes.DiscussionResults support binge eating being negatively reinforced by specific aspects of negative affect, while heavy drinking may be positively reinforced by global positive affect for individuals with BE + HD. Clinicians should incorporate interventions that focus on specific negative affect dimensions and that promote alternative rewarding activities besides heavy drinking. In individuals with binge eating and heavy drinking, guilt worsens before binge eating episodes, while sadness decreases afterwards. Individuals with co-morbid binge eating and heavy drinking may experience less anhedonia than commonly seen in binge eating samples. However, trajectories of positive affect suggest that heavy drinking may be positively reinforced in individuals with binge eating and heavy drinking.