Korean Clinical Psychology Association
[ Original Article ]
Korean Journal of Clinical Psychology - Vol. 38, No. 4, pp.349-356
ISSN: 1229-0335 (Print) 2466-197X (Online)
Print publication date 30 Nov 2019
Received 18 Jul 2019 Revised 23 Sep 2019 Accepted 21 Oct 2019
DOI: https://doi.org/10.15842/kjcp.2019.38.4.001

The Effect of Binge Eaters’ Anger Regulation Training on Attentional Bias and Caloric Intake

Eun-Ji Lee ; Eun-Hae Shin ; Jang-Han Lee
Department of Psychology, Chung-Ang University, Seoul

Correspondence to: Jang-Han Lee, Department of Psychology, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, Korea; E-mail: clipsy@cau.ac.kr

© 2019 Korean Clinical Psychology Association


Binge eating, defined as the consumption of large quantities of food in a short period of time, is a behavior that manifests when a binge eater, who cannot regulate negative emotion-provoking situations and has increased attentional bias to high-caloric food. This study aimed to investigate the influence of anger regulation training (reappraisal and suppression) on attentional bias to food images and caloric intake. Forty-seven binge eaters and 44 healthy control subjects were randomly assigned to one of the two anger regulation training conditions (reappraisal, suppression) and given anger mood induction and instructions. Consequently, the binge eater group spent significantly less time dwelling on food images, and caloric intake was significantly lower under the suppression condition, than the reappraisal condition. The results of the present study suggest that when trained through reappraisal, binge eaters decrease the time they spending dwelling on food images and caloric intake.


binge eating, attentional bias, anger regulation, suppression, reappraisal


This work was supported by the National Research Foundation of Korea Grant funded by the Korean Government (NRF-2017S1A5B4055761). This research was supported by Graduate Fellowship Scholarship in 2018.


  • Brumbaugh, C. C., Kothuri, R., Marci, C., Siefert, C., & Pfaff, D. D. (2013). Physiological correlates of the Big 5: Autonomic responses to video presentations. Applied Psychophysiology and Biofeedback, 38, 293-301. [https://doi.org/10.1007/s10484-013-9234-5]
  • Brytek-Matera, A. (2008). Mood and emotional symptoms in eating disordered patients. Archives of Psychiatry & Psychotherapy, 10, 65-71.
  • Dick, D. M., Smith, G., Olausson, P., Mitchell, S. H., Leeman, R. F., O'Malley, S. S., & Sher, K. (2010). Understanding the construct of impulsivity and its relationship to alcohol use disorders. Addiction Biology, 15, 217-226. [https://doi.org/10.1111/j.1369-1600.2009.00190.x]
  • Evers, C., Marijn Stok, F., & de Ridder, D. T. (2010). Feeding your feelings: Emotional regulation strategies and emotional eating. Personality and Social Psychology Bulletin, 36, 792-804. [https://doi.org/10.1177/0146167210371383]
  • Field, M., & Cox, W. M. (2008). Attentional bias in addictive behaviors: A review of its development, causes, and consequences. Drug and Alcohol Dependence, 97, 1-20. [https://doi.org/10.1016/j.drugalcdep.2008.03.030]
  • Fox, J. R., & Power, M. J. (2009). Eating disorders and multi‐level models of emotion: An integrated model. Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 16, 240-267. [https://doi.org/10.1002/cpp.626]
  • Gormally, J., Black, S., Daston, S., & Rardin, D. (1982). The assessment of binge eating severity among obese persons. Addictive Behaviors, 7, 47-55. [https://doi.org/10.1016/0306-4603(82)90024-7]
  • Gross, J. J. (2001). Emotion regulation in adulthood: Timing is everything. Current Directions in Psychological Science, 10, 214-219. [https://doi.org/10.1111/1467-8721.00152]
  • Gross, J. J. (2013). Emotion regulation: Taking stock and moving forward. Emotion, 13, 359. [https://doi.org/10.1037/a0032135]
  • Hilbert, A., Tuschen-Caffier, B., Karwautz, A., Niederhofer, H., & Munsch, S. (2007). Eating disorder examination-questionnaire. Diagnostica, 53, 144-154. [https://doi.org/10.1026/0012-1924.53.3.144]
  • Jansen, A., Nederkoorn, C., & Mulkens, S. (2005). Selective visual attention for ugly and beautiful body parts in eating disorders. Behaviour Research and Therapy, 43, 183-196. [https://doi.org/10.1016/j.brat.2004.01.003]
  • John, O. P., & Gross, J. J. (2004). Healthy and unhealthy emotion regulation: Personality processes, individual differences, and life span development. Journal of Personality, 72, 1301-1334. [https://doi.org/10.1111/j.1467-6494.2004.00298.x]
  • Lang, P. J., Bradley, M. M., & Cuthbert, B. N. (1997). International affective picture system (IAPS): Technical manual and affective ratings. NIMH Center for the Study of Emotion and Attention, 1, 39-58.
  • Lee, S. H. & Hyun, M. H. (2001). The effects of body image satisfaction, binge eating on depression in obese middle school girls. The Korean Journal of Health Psychology, 6, 195-207.
  • Marcus, M. D., Wing, R. R., & Hopkins, J. (1988). Obese binge eaters: Affect, cognitions, and response to behavioural weight control. Journal of Consulting and Clinical Psychology, 56, 433-439. [https://doi.org/10.1037/0022-006X.56.3.433]
  • Masheb, R. M., & Grilo, C. M. (2006). Emotional overeating and its associations with eating disorder psychopathology among overweight patients with binge eating disorder. International Journal of Eating Disorders, 39, 141-146. [https://doi.org/10.1002/eat.20221]
  • Muraven, M., Tice, D. M., & Baumeister, R. F. (1998). Self-control as a limited resource: Regulatory depletion patterns. Journal of Personality and Social Psychology, 74, 774-789. [https://doi.org/10.1037/0022-3514.74.3.774]
  • Robinson, T. E., & Berridge, K. C. (2008). The incentive sensitization theory of addiction: Some current issues. Philosophical Transactions of the Royal Society B: Biological Sciences, 363, 3137-3146. [https://doi.org/10.1098/rstb.2008.0093]
  • Sayette, M. A. (2016). The role of craving in substance use disorders: Theoretical and methodological issues. Annual Review of Clinical Psychology, 12, 407-433. [https://doi.org/10.1146/annurev-clinpsy-021815-093351]
  • Stein, M. B., Simmons, A. N., Feinstein, J. S., & Paulus, M. P. (2007). Increased amygdala and insula activation during emotion processing in anxiety-prone subjects. American Journal of Psychiatry, 164, 318-327. [https://doi.org/10.1176/ajp.2007.164.2.318]
  • Stice, E. (2001). A prospective test of the dual-pathway model of binge eating pathology: Mediating effects of dieting and negative affect. Journal of Abnormal Psychology, 110, 124-135. [https://doi.org/10.1037/0021-843X.110.1.124]
  • Svaldi, J., Griepenstroh, J., Tuschen-Caffier, B., & Ehring, T. (2012). Emotional regulation deficits in eating disorders: A marker of eating pathology or general psychopathology? Psychiatry Research, 197, 103-111. [https://doi.org/10.1016/j.psychres.2011.11.009]
  • Svaldi, J., Schmitz, F., Trentowska, M., Tuschen-Caffier, B., Berking, M., & Naumann, E. (2014). Cognitive interference and a food-related memory bias in binge eating disorder. Appetite, 72, 28-36. [https://doi.org/10.1016/j.appet.2013.09.014]
  • Svaldi, J., Tuschen-Caffier, B., Peyk, P., & Blechert, J. (2010). Information processing of food pictures in binge eating disorder. Appetite, 55, 685-694. [https://doi.org/10.1016/j.appet.2010.10.002]
  • Tomiyama, A. J., Dallman, M. F., & Epel, E. S. (2011). Comfort food is comforting to those most stressed: Evidence of the chronic stress response network in high stress women. Psychoneuroendocrinology, 36, 1513-1519. [https://doi.org/10.1016/j.psyneuen.2011.04.005]
  • Waller, D., Loomis, J. M., & Haun, D. B. (2004). Body-based senses enhance knowledge of directions in large-scale environments. Psychonomic Bulletin & Review, 11, 157-163. [https://doi.org/10.3758/BF03206476]
  • Whiteside, U., Chen, E., Neighbors, C., Hunter, D., Lo, T., & Larimer, M. (2007). Difficulties regulating emotions: Do binge eaters have fewer strategies to modulate and tolerate negative affect?. Eating Behaviors, 8, 162-169. [https://doi.org/10.1016/j.eatbeh.2006.04.001]
  • Wiers, R. W., Gladwin, T. E., Hofmann, W., Salemink, E., & Ridderinkhof, K. R. (2013). Cognitive bias modification and cognitive control training in addiction and related psychopathology: Mechanisms, clinical perspectives, and ways forward. Clinical Psychological Science, 1, 192-212. [https://doi.org/10.1177/2167702612466547]
  • Zeeck, A., Stelzer, N., Linster, H. W., Joos, A., & Hartmann, A. (2011). Emotion and eating in binge eating disorder and obesity. European Eating Disorders Review, 19, 426-437. . [https://doi.org/10.1002/erv.1066]