Alexithymia, dissociation and emotional regulation in eating disorders: Evidence of improvement through specialized inpatient treatment

The research into emotional regulation in eating disorders (EDs) has shown specificimpairments and maladaptive coping strategies in patients, and there is an increasinginterest in the role of the emotional domain in the treatment outcome. This studyaims to evaluate the effect of a specialized inpatient treatment characterized by bothan intensive and comprehensive standardized multidisciplinary programme based oncognitive–behavioural therapy and a flexible and personalized componentimplemented by third-wave interventions. A cohort of 67 female ED patients(anorexia nervosa = 28, bulimia nervosa = 28 and binge eating disorder = 11)underwent an evaluation of emotional regulation difficulties, alexithymia and dissociative symptomatology at admission to a specialized ED ward. The psychological modifications were subsequently re-evaluated upon discharge, after an inpatients treatment of 60 days, examining specific changes in the specific psychopathology. A significant improvement after specialized ED treatment was shown in alexithymia, emotional regulation difficulties and dissociation symptoms,with higher effect sizes in patients with higher alexithymia scores. As regards the specific effect of the psychological improvement, changes into alexithymia score shave shown specific correlations with ED psychopathology (p < 0.010) and with difficulties in emotional regulation (p < 0.010) in patients with higher alexithymia levels at admission. Emotional regulation and dissociation should therefore be evaluated in ED patients and may be improved with specific therapeutic approaches,while alexithymia remains a clinical trait, even with a significant reduction.