What is the role of emotional regulation in children and young people with a diagnosed eating disorder and self-harming behaviours? A systematic review

Abstract

Background: Eating disorders and self-harm are commonly presenting conditions with children and young people and both conditions have similar traits. With 30%-40% of young people with a diagnosed eating disorder presenting with self-harming behaviours, it is important to understand the role that emotional regulation plays within the two conditions as this can inform practice, contribute to a thorough assessment and treatment plan and inform future policy and guidelines. This review will be focusing on the role of emotional regulation within children and young people with diagnosed eating disorders and will also link it to Non-Suicidal Self-Injury (NSSI).

Methods: A quantitative systematic review was undertaken. A literature search was conducted on databases, CINAHL, PsycInfo, and Web of Science using the search strategy developed using the Population Exposure Outcome (PEO) framework. The inclusion criteria was groups of children and young people (25 years and younger) with a diagnosed eating disorder, where the young person is also presenting with some form of self-harm. JBI’s Critical Appraisal Tool Checklist was
used to appraise the quality of the included studies. All studies involved the use of the Difficulties Emotional Regulation Scale (DERS) questionnaire within their research.

Results: Six studies were eligible to be included within the review. The overall quality of the studies ranged from weak to good. The studies identified three potential outcomes (prevalence of eating disorders overlapping with NSSI, different types of NSSI and the role of emotional regulation within eating disorders and NSSI). The review clearly demonstrates that NSSI can be used to regulate emotional feelings however the emotional feelings need to first be present. It further demonstrates that individuals with the co-occurrence of eating disorders and NSSI have an intensified emotional state, relying on several forms of emotional regulation. This suggests there is emotional under regulation within his group and possible difficulties in accessing the domains of emotional regulation. The review also demonstrates that the relationship between eating disorders and NSSI can be reinforced by emotional regulation.

Conclusion: The findings from this review suggest that emotional regulation plays a role in self-harming behaviours in children and young people with diagnosed eating disorder. It also highlights that more research is needed into eating disorders from an individual perspective, in addition to the individual self-harming behaviours.