Exploring Prospective Relationships of Emotion Regulation Difficulties With Eating Disorder Psychopathology and Eating-Related Psychosocial Impairment Among Older Adults in China

Objective: Emotion regulation (ER) difficulties are a robust risk factor for eating disorder (ED) psychopathology. As symptoms are often overlooked or misattributed to ageing, these associations are unclear in older adults. This study investigated the longitudinal relationships between ER difficulties, ED psychopathology (e.g., thinness-oriented ED psychopathology and avoidant/restrictive food intake disorder [ARFID] symptoms), and eating-related psychosocial impairment among Chinese older adults. Method: An online sample of 551 Chinese adults aged 56–78 provided data at baseline (T1), and 202 older adults were retained 12 months later (T2). Cross-lagged models explored reciprocal associations between ER difficulties, both global ER difficulties and six unique dimensions, and eating-related variables. Results: Global ER difficulties at T1 were related to higher ED psychopathology and eating-related psychosocial impairment at T2. For ER difficulties as six dimensions, lack of ability to manage one's impulse during negative emotions at T1 was uniquely related to higher ARFID symptoms and eating-related psychosocial impairment at T2. However, eating-related variables at T1 were not associated with global or any dimension of ER difficulties at T2. Conclusions: Results suggest unidirectional, prospective associations between ER difficulties and eating-related variables, underscoring the potential importance of ER-focused prevention and intervention strategies to improve eating behaviours and reduce psychosocial impairment in older adults.