Background & Aims: Eating disorders are a group of common psychosomatic disorders that are mainly observed in early adolescence and young adulthood and are accompanied by abnormal feedback to eating and significant abnormalities in thoughts and perceptions about food, self, and body weight. These disorders can lead to problems such as damage to mental, physical, psychosocial functioning, and changes in food consumption or absorption. Binge eating disorder is one of the most common types of eating disorders and is identified as a separate eating disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, with an estimated prevalence of about 3% in the general population. People with binge eating disorder eat a large amount of food in a given period of time (for example, within two hours), which is very different and more than the amount of food that most people eat in the same period of time and under similar circumstances. Also, people with this disorder have different psychological characteristics than other people and may feel deeply ashamed and embarrassed about overeating or binge eating and make a promise to themselves to give up this habit, but they feel so compelled that they cannot cope with it and continue to do so, causing them to feel stressed and restless. Therefore, it is understandable that people with binge eating use food as a strategy to control emotions and improve their emotions. In fact, behaviors related to binge eating are frequently associated with negative emotional states, including depression, anxiety, and anger, and it is assumed that a deficit in the general ability to regulate emotions, such as perceiving, understanding, moderating, and accepting negative emotions, increases negative emotions, reduces positive emotions, lowers self-efficacy related to emotions, and therefore provokes dysfunctional behavior as a means of avoiding negative emotions. Therefore, the present study was conducted by developing a treatment based on emotional factors of binge eating disorder in adolescent girls with this disorder.
Methods: The research is an exploratory research of qualitative nature that includes two parts: identifying emotional factors affecting binge eating disorder and developing an emotion-based treatment protocol based on the data-based method. In the first part, the sampling method was purposeful, and finally, based on theoretical saturation, 12 adolescents with binge eating disorder participated as a sample in the first part of the qualitative part of the present study. In the second part of the qualitative analysis, the statistical population included experts and psychology specialists who had executive backgrounds in the field of emotion-based psychological treatments and were active in the period 1401-1402. The measurement tools included the binge eating questionnaires of Gormali et al. (1982), an in-depth interview to investigate the causes of binge eating disorder, and a researcher-made questionnaire to investigate the opinions of experts about the sessions.
Results: After developing and validating the emotional components of binge eating in adolescent girls with this disorder, tasks at different levels were considered for the identified components to develop a treatment package, and finally, a 10-session emotion regulation-based treatment protocol was designed. First, the concepts of causal conditions, underlying conditions, intervening conditions, consequences, and strategies for reducing binge eating in adolescent girls with this disorder were obtained from the statements of the interviews. The findings showed that the causal conditions of binge eating in adolescent girls with this disorder included individual causes, cognitive-emotional causes, and interpersonal causes; the underlying conditions of binge eating in adolescent girls with this disorder included socio-cultural infrastructure and educational infrastructure; The conditions that interfere with binge eating in adolescent girls with this disorder include social causes, future-related causes, and cultural causes; the consequences of reducing binge eating in adolescent girls with this disorder include individual and interpersonal consequences; and the strategies that affect binge eating in adolescent girls with this disorder include educational strategies, empowerment, relationship improvement strategies, and sociocultural strategies. Finally, according to the results of the Fuzzy Delphi, the experts reached a consensus on all concepts of the pattern of causes of binge eating in adolescent girls, and the identified components were confirmed for the paradigm model of the pattern of causes of binge eating in adolescent girls. After developing and validating the emotional components of binge eating in adolescent girls with this disorder, tasks at different levels were considered for the identified components to develop a treatment package. Therefore, an emotion regulation-based treatment protocol was designed in 10 sessions. This protocol, which is presented in Table 1, is a combination of different techniques for training mental and physical awareness and emotion regulation skills for binge eating disorder.
Conclusion: Therefore, binge eating disorder occurs through emotional arousal in order to reduce the level of arousal and shows the importance of paying attention to the emotional dimension of this disorder and using emotion-based therapies to treat the symptoms of people with binge eating disorder. Emotion-based therapy is designed to help adolescents reveal and change their emotional experiences and engage with a set of perceptions, emotions, cognitions, physical experiences, and behavioral forms of personal reactions. In fact, one of the goals of emotion-based therapy was to work on the underlying processes and thoughts associated with unpleasant emotions by becoming aware of and correctly expressing the internal experiences of emotions, in order to regulate emotions and activate healthy emotions. This treatment method also strengthens positive emotion regulation so that adolescents can respond to environmental situations in adaptive and healthy ways.