The role of cognitive emotion regulation in disordered eating among chronically ill adolescents

Introduction: The association of chronic diseases with eating disorders requires increased attention due to the potential for serious complications and increased risk of mortality. Eating disorders and sub-clinical eating disorders are associated with maladaptive emotion regulation, which may be both triggers and maintaining factors of the disease. To our knowledge, the role of cognitive emotion regulation in eating disorders in adolescents with inflammatory bowel disease and type 1 diabetes mellitus has not been investigated to date.Objective: We analysed the relationship between cognitive emotion regulation and symptoms of eating disorder in adolescents aged 14 to 18 years, focusing on young people with type 1 diabetes mellitus and inflammatory bowel disease. Our research aimed to identify the role of specific cognitive emotion regulation strategies in eating disorders in patient populations with chronic disease.Method: In our study, 300 adolescents completed the Cognitive Emotion Regulation Questionnaire and the Self Administrated Psychiatric Scales for Children and Adolescents after informed consent. The four study groups consisted of 157 physically healthy adolescents, 51 adolescents diagnosed with IBD, 61 adolescents diagnosed with type 1 diabetes mellitus and 31 adolescents diagnosed with anorexia nervosa.Results: The results of our study showed that rumination and positive reframing were significantly associated with symptoms of eating disorders in adolescents with inflammatory bowel disease, and self-blame and rumination were significantly associated with symptoms of eating disorders in adolescents with type 1 diabetes mellitus diagnosis, through an indirect pathway.Discussion: Our results suggest that cognitive emotion regulation strategies are indirectly related to symptoms of eating disorders among adolescents with the chronic illness studied. More frequent use of negative emotion regulation strategies of self-blame and rumination increases the incidence of eating disorder symptoms, and less frequent use is associated with fewer eating disorder symptoms. Greater use of positive reappraisal is associated with fewer eating disorder symptoms.Conclusion: We recommend the incorporation of cognitive emotion regulation strategies in the complex care of chronically ill adolescents, both in screening and in interventions.