Distress, emotional clarity, and disordered eating in young people with complex emotional and behavioural difficulties

Background: Disordered eating frequently co-occurs in young people seeking treatment for mental health and substance use difficulties. High levels of psychological distress and a lack of emotional clarity (LEC) are two constructs that have received recent attention as important constructs underlying this harmful behaviour; however how they interact to precipitate and maintain disordered eating still remains unclear. This study sought to address this gap by examining whether psychological distress moderates the relationship between LEC and disordered eating in a sample of young people with complex emotional and behavioural difficulties. Methods: Participants were young people (N = 306, M = 20.8 years) accessing youth specific alcohol and other drugs and/or primary mental health services in Australia who completed an online questionnaire which examined their level of emotional clarity, degree of distress, and engagement in disordered eating behaviours. Results: Moderation analysis was employed to examine if psychological distress (i.e., anxiety and depression) significantly moderates the relationship between LEC and disordered eating. A small, significant interactive effect of high levels of depressive symptoms on the relationship between LEC and disordered eating was found. Whereas, anxious affect did not significantly interact with LEC to predict disordered eating. Conclusions: Young people who struggle to identify and articulate their emotions are more likely to engage in disordered eating in the presence of high distress relating to depressive symptomatology. Addressing LEC through increasing emotional literacy, while treating depressive symptomatology, are key intervention strategies that may assist young people with complex emotional and behavioural difficulties manage disordered eating.