An examination of state and trait urgency in individuals with binge-eating disorder

ObjectiveNegative urgency (i.e., acting rashly when experiencing negative affect; NU), is a theorised maintenance factor in binge-eating type eating disorders. This study examined the association between trait NU and eating disorder severity, momentary changes in state NU surrounding episodes of binge eating, and the momentary mechanistic link between affect, rash action, and binge-eating risk.MethodsParticipants were 112 individuals with binge-eating disorder (BED). Baseline measures included the UPPS-P Impulsive Behaviour Scale to assess trait NU and the Eating Disorders Examination to assess binge-eating frequency and global eating disorder severity. Ecological momentary assessment captured real-time data on binge eating, negative affect, and state NU.ResultsMultiple regression analysis revealed a strong association between trait NU and eating disorder severity. Generalised estimating equations showed that state NU increased before and decreased after binge-eating episodes, and that this pattern was not moderated by trait-level NU. Finally, a multilevel structural equation model indicated that increases in rash action mediated the momentary relationship between states of high negative affect and episodes of binge eating.ConclusionThese findings underscore the importance of both trait and state NU in binge-eating type eating disorders, and suggest NU as a potential key target for intervention. Trait negative urgency (tNU) appears to be a marker of disorder severity, potentially above and beyond binge frequency State urgency significantly increased prior to binge eating and decreased following binge eating, regardless of tNU Moments of high negative affect predict increases in subsequent rash action, and that this impulsivity is predictive of a greater likelihood of a binge-eating episode