Korean Clinical Psychology Association

Korean Journal of Clinical Psychology - Vol. 37 , No. 4

[ Original Article ]
Korean Journal of Clinical Psychology - Vol. 37 , No. 4 , pp.491-502
ISSN: 2733-4538 (Online)
publication date 30 Nov 2018
Received 26 Apr 2018 Revised 03 Sep 2018 Accepted 08 Sep 2018
DOI: https://doi.org/10.15842/kjcp.2018.37.4.003

분노표현양식이 폭식행동에 미치는 영향: 부정정서 조급성의 매개효과
임지수 ; 박경
서울여자대학교 특수치료전문대학원 심리치료학과

Impact of Anger Expression and Negative Urgency on Binge Eating Behavior
Ji Su Lim ; Kyung Park
Department of Psychotherapy, Graduate School of Professional Therapeutic Technology, Seoul Women’s University, Seoul, Korea
Correspondence to : Kyung Park, Department of Psychotherapy, Seoul Women’s University Graduate School of Professional Therapeutic Technology, 621 Hwarang-ro, Nowon-gu, Seoul, Korea; E-mail: kyungpark@swu.ac.kr

© 2018 Korean Clinical Psychology Association
Funding Information ▼


본 연구에서는 분노표현양식이 폭식행동에 미치는 영향과 그 관계에 있어 부정정서 조급성의 효과를 검증하고자 하였다. 폭식행동이 우울, 분노를 포함하는 부정적 정서로 인해 촉발된다는 선행연구들이 있었지만 정서조절의 측면을 가지는 분노표현양식이 폭식행동에 미치는 영향에 관한 국내 연구는 부족한 실정이다. 또한 분노는 성격 특성인 충동성과 밀접한 관련을 가진다는 것이 알려져 있는 바 분노표현양식 중 분노-표출과 분노-억제가 폭식행동에 미치는 영향에 있어 충동성의 하위요인인 부정정서 조급성이 매개 효과를 가질 것이라는 가설을 검증하였다. 본 연구에서는 섭식장애 발생 연령의 범위가 넓어지고 있는 점을 고려하여 20대 여성 314명을 대상으로 설문을 진행하였으며, 그 가운데 302부를 자료 분석에 사용하였다. 각 변인들의 상관관계는 모두 유의하였다. 분석 결과, 부적응적인 분노표현양식으로 분류되는 분노-억제가 폭식행동에 미치는 영향에 있어 부정정서 조급성의 완전 매개 효과가 유의하였으며, 분노-표출과 분노-통제의 경우 그 효과가 유의하지 않았다. 이러한 연구 결과는 분노를 억제하는 것이 부정정서 조급성의 증가로 이어지며, 이는 폭식행동에 영향을 미칠 수 있음을 시사한다. 이러한 결과를 바탕으로 본 연구문제 및 임상적 의의, 한계점 등을 논의하였다.


This study aimed to examine the mediation effects of negative urgency on the relationship of anger-in and anger-out, which are subtypes of anger expression, with binge eating behavior. Participants were 302 early adults aged 18 to 29 years. They were asked to complete on-line questionnaires, including the Korean version of State-Trait Anger Expression Inventory–IV (STAXI-K), Revised Bulimia Test (BULIT-R), and UPPS Impulsive Behavior Scale. Data analysis was conducted using correlation analysis and structural equation modeling. Analyses revealed a significant correlation between anger expression and binge eating behavior. Additionally, there was a significant positive correlation among anger-in, binge eating behavior, and negative urgency. The complete mediation effect of negative urgency on the relationship between anger-in and binge eating behavior was significant, and the direct effect of anger expression on binge eating behavior was non-significant. Finally, implication ns and limitations of this study and suggestions for future research were discussed.

Keywords: anger expression, binge eating behavior, negative urgency
키워드: 분노표현양식, 폭식행동, 분노-억제, 부정정서 조급성


This work was supported by a research grant from Seoul Women’s University (2018).

This work is based on a master’s thesis of the first author submitted to Graduate School, The Seoul Women’s University.

1. Abraham, S. F., & Beumont, P. J. V. (1982). How patients describe bulimia or binge eating. Psychological Medicine, 12, 625-635.
2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
3. Anestis, M. D., Selby, E. A., Fink, E. L., & Joiner, T. E. (2007). The multifaceted role of distress tolerance in dysregulated eating behaviors. International Journal of Eating Disorders, 40, 718-726.
4. Anestis, M. D., Smith, A. R., Fink, E. L., & Joiner, T. E. (2009). Dysregulated eating and distress: Examining the specific role of negative urgency in a clinical sample. Cognitive Therapy and Research, 33, 390-397.
5. Baumeister, R. F., Bratslavsky, E., Muraven, M., & Tice, D. M. (1998). Ego depletion: Is the active self a limited resource? Journal of Personality and Social Psychology, 74, 1252.
6. Baumeister, R. F., Vohs, K. D., & Tice, D. M. (2007). The strength model of self-control. Current Directions in Psychological Science, 16, 351-355.
7. Bollen, K. A., & Stine, R. A. (1993). Bootstrapping goodness-of-fit measures in structural equation models. Sage Focus Editions, 154, 111.
8. Boon, B., Stroebe, W., Schut, H., & Ijntema, R. (2002). Ironic processes in the eating behaviour of restrained eaters. British journal of health psychology, 7(1), 1-10.
9. Bruce, B., & Agras, W. S. (1992). Binge eating in females: A population‐based investigation. International Journal of Eating Disorders, 12, 365-373.
10. Brytek-Matera, A. (2008). Dimensions of locus of control and the role of anger expression & anger control in women diagnosed with eating disorders: A pilot study. Archives of Psychiatry & Psychotherapy, 10, 49-53.
11. Burton, E. M., Stice, E., Bearman, S. K., & Rohde, P. (2007). An experimental test of the affect-regulation model of bulimic symptoms and substance use: An affective intervention. International Journal of Eating Disorders, 40, 27-36.
12. Choi, M. S. (2002). A study on eating disorder, depression and body dissatisfaction of middle aged women. Korean Journal of Women Health Nursing, 8, 570-582.
13. Chon, K. K. (1991). The relationship between anger expression and physical illness. The Korean Psychological Association, 1, 9-15.
14. Chon, K. K., Han, D. W., Lee, C. H., & Spielberger, C. D. (1997). Korea adaptation of the State-Trait Anger Expression Inventory: Anger and blood pressure. Korean Journal of Health Psychology, 2, 60-78.
15. Chon, K. K., Kim, D. Y., & Lee, J. S. (2010). Development of the STAXI-K: IV. Art Therapy Study, 7, 33-50.
16. Chon, K. K., Kim, K. H., & Ryu, J. B. (2000). Experience and expression of anger in Korean and American. The Korean Journal of Rehabilitation Psychology, 7, 61-75.
17. Chon, S. M., Lee, Y. S., & Lee, H. Y. (2000). The effect of cognitive-behavioral group therapy on neurotic juvenile delinquents’ anger control. Korean Journal of Counseling and Psychotherapy, 12, 53-82.
18. Chong, H. J. (2015). Relationship of social anxiety, anger suppression, depression and binge eating behavior among women university student (Master’s thesis). Ewha Women’s University, Seoul, Korea.
19. Cyders, M. A., & Coskunpinar, A. (2010). Is urgency emotionality? Separating urgent behaviors from effects of emotional experiences. Personality and Individual Differences, 48, 839-844.
20. Cyders, M. A., Smith, G. T., Spillane, N. S., Fischer, S., Annus, A. M., & Peterson, C. (2007). Integration of impulsivity and positive mood to predict risky behavior: Development and validation of a measure of positive urgency. Psychological assessment, 19, 107-118.
21. Davis-Becker, K., Peterson, C. M., & Fischer, S. (2014). The relationship of trait negative urgency and negative affect to disordered eating in men and women. Personality and Individual Differences, 56, 9-14.
22. DePaulo, B. M., Blank, A. L., Swaim, G. W., & Hairfield, J. G. (1992). Expressiveness and expressive control. Personality and Social Psychology Bulletin, 18, 276-285.
23. 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.
24. Dimitrov, D. M. (2006). Comparing groups on latent variables: A structural equation modeling approach. Work, 26, 429-436.
25. Fairburn, C. G., & Bohn, K. (2005). Eating disorder NOS (EDNOS): An example of the troublesome “not otherwise specified”(NOS) category in DSM-IV. Behaviour research and therapy, 43, 691-701.
26. Fassino, S., Daga, G. A., Pierò, A., Leombruni, P., & Rovera, G. G. (2001). Anger and personality in eating disorders. Journal of Psychosomatic Research, 51, 757-764.
27. Hae, J. (2017). The effect of perfectionistic self-presentation on bulimia nervosa of female adolescents: Moderating effect of anger expression (Master’s thesis). Dongduk Women’s University, Seoul, Korea.
28. Heatherton, T. F., & Baumeister, R. F. (1991). Binge eating as escape from self-awareness. Psychological Bulletin, 110, 86-108.
29. Heatherton, T. F., Herman, C. P., & Polivy, J. (1991). Effects of physical threat and ego threat on eating behavior. Journal of Personality and Social Psychology, 60, 138-143.
30. Hirst, R. B., Beard, C. L., Colby, K. A., Quittner, Z., Mills, B., & Lavender, J. M. (2017). Anorexia nervosa and bulimia nervosa: A meta-analysis of executive functioning. Neuroscience & Biobehavioral Reviews, 83, 678-690.
31. Hofmann, W., Gschwendner, T., Friese, M., Wiers, R. W., & Schmitt, M. (2008). Working memory capacity and self-regulatory behavior: Toward an individual differences perspective on behavior determination by automatic versus controlled processes. Journal of Personality and Social Psychology, 95, 962-977.
32. Hong, S. H. (2000). The criteria for selecting appropriate fit indices in structural equation modeling and their rationales. Korean Journal of Clinical Psychology, 19, 161-177.
33. Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1-55.
34. Jeon, J. R. (2011). The relation between negative urgency and binge eating (Master’s thesis). Seoul National University, Seoul, Korea.
35. Karyadi, K. A., & King, K. M. (2011). Urgency and negative emotions: Evidence for moderation on negative alcohol consequences. Personality and Individual Differences, 51, 635-640.
36. Kim, J. Y., & Ha, E. H. (2013). The mediating effects of anger expression type on the relationships between female high school students’ perfectionism and binge eating behavior. Adolescent Counseling Studies, 21, 99-119.
37. Kim, K. S. (2010). Analysis of structural equation modeling. Seoul, Korea: Academy Hannarae.
38. Kim, M. R., & Kim, H. J. (2008). A study on diet behaviors and related factors in dieting college students. The East Asian Society of Dietary Life, 18, 135-148.
39. Kim, S. H. (2010). Anger and art therapy: Benefits of the art therapy intervention in dealing with anger. Korean Journal of Psychotherapy, 2, 97-105.
40. Kim, Y. J., Moon, J. A., & Wang, S. K. (2010). A study on diet and eating habits of university students. Institute of Basic Science Taejon University.
41. Krug, I., Bulik, C. M., Vall-Llovera, O. N., Granero, R., Agüera, Z., Villarejo, C., . . . Fernández-Aranda, F. (2008). Anger expression in eating disorders: Clinical, psychopathological and personality correlates. Psychiatry Research, 161, 195-205.
42. Lavender, J. M., Green, D., Anestis, M. D., Tull, M. T., & Gratz, K. L. (2015). Negative affect, negative urgency, thought suppression, and bulimic symptoms: A moderated mediation analysis in a sample at‐risk for bulimic symptoms. European Eating Disorders Review, 23, 246-250.
43. Lee, J. Y. (2010). The effects of emotion regulation strategies on emotion dysregulation. Korean Journal of Counseling And Psychotherapy, 22, 821-841.
44. Lee, J. Y., & Kwon, S. M. (2009). Development of the Emotion Regulation Strategy Questionnaire. Korean Journal of Clinical Psychology, 26, 963-976.
45. Lee, M. H., & Chae, K. M. (2009). The relationship between negative affect and binge eating behavior-focusing on the mediating effect of difficulties with emotional regulation. Cognitive Behavior Therapy, 12, 129-144.
46. Lee, S. J., & Jang, H. I. (2017). The influence of maladaptive perfectionism, negative affect, and negative urgency on bulimic symptoms among female college students. Korean Journal of Clinical Psychology, 36, 192-205.
47. Lee, S. J., & Kim, M. R. H. (2015). The effects of mindfulness meditation on binge eating, body dissatisfaction, depression and anger in patients with eating disorders: A preliminary study. Mental Health & Social Work, 43, 58-81.
48. Lee, S. S. (2007). The evaluation of dual-pathway model on bulimia: Measurement of negative emotion experience and need of distinguishing negative emotion regulation from negative emotion. Korean Journal of Clinical Psychology, 26, 883-902.
49. Lim, S. Y. (2014). The effects of negative urgency, negative affect and emotional dysregulation on binge eating and self harm behavior: In terms of the UPPS-P model (Doctoral dissertation). The Catholic University of Korea, Bucheon, Korea.
50. Lim, S. Y., & Lee, Y. H. (2014). A Korean validation of the UPPS-P Impulsive Behavior Scale in college students. Korean Journal of Clinical Psychology, 33, 51-71.
51. MacCallum, R. C., Browne, M. W., & Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological methods, 1, 130-149.
52. Martin, R., Wan, C. K., David, J. P., Wegner, E. L., Olson, B. D., & Watson, D. (1999). Style of anger expression: Relation to expressivity, personality, and health. Personality and Social Psychology Bulletin, 25, 1196-1207.
53. Masicampo, E. J., & Baumeister, R. F. (2007). Relating mindfulness and self-regulatory processes. Psychological Inquiry, 18, 255-258.
54. McManus, F., & Waller, G. (1995). A functional analysis of binge-eating. Clinical Psychology Review, 15, 845-863.
55. Meyer, C., Leung, N., Waller, G., Perkins, S., Paice, N., & Mitchell, J. (2005). Anger and bulimic psychopathology: Gender differences in a nonclinical group. International Journal of Eating Disorders, 37, 69-71.
56. Milligan, R. J., & Waller, G. (2000). Anger and bulimic psychopathology among nonclinical women. International Journal of Eating Disorders, 28, 446-450.
57. Milligan, R. J., & Waller, G. (2001). Anger and impulsivity in non-clinical women. Personality and Individual Differences, 30, 1073-1078.
58. 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.
59. Ooh, Y. R. (2017). The mediating effects of anger expression type on the relationship between internalized shame and binge eating behavior of high school girls (Master’s thesis). Sookmyung Women’s University, Seoul, Korea.
60. Park, H. S., & Hong, C. H. (2008). The effect of emotion-expression technique and cognitive-relaxation technique by anger expression. Journal of Korean Psychodrama Association, 11, 53-69.
61. Park, W. R., & Kwon, S. M. (2017). The influence of negative urgency on the loss of control eating. Korean Journal of Clinical Psychology, 36, 89-103.
62. Peñas‐Lledó, E., Fernández, J. D. D., & Waller, G. (2004). Association of anger with bulimic and other impulsive behaviours among non‐clinical women and men. European Eating Disorders Review, 12, 392-397.
63. Polivy, J. (1998). The effects of behavioral inhibition: Integrating internal cues, cognition, behavior, and affect. Psychological Inquiry, 9, 181-204.
64. Polivy, J., & Herman, C. P. (1985). Dieting and binging: A causal analysis. American psychologist, 40, 193-201.
65. Pyeon, J. E., & Lee, J. Y. (2016). The effects of positive and negative affect on binge eating behavior of high school students: Moderating effects of impulsivity based on UPPS-P model. Korean Journal of Clinical Psychology, 35, 784-796.
66. Quadflieg, N., & Fichter, M. M. (2003). The course and outcome of bulimia nervosa. European Child & Adolescent Psychiatry, 12, 99-109.
67. Schmeichel, B. J., Volokhov, R. N., & Demaree, H. A. (2008). Working memory capacity and the self-regulation of emotional expression and experience. Journal of Personality and Social Psychology, 95, 1526-1540.
68. Smink, F. R., Van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports, 14, 406-414.
69. Smith, M. C., & Thelen, M. H. (1984). Development and validation of a test for bulimia. Journal of Consulting and Clinical Psychology, 52, 863-872.
70. Spielberger, C. D., Krasner, S. S., & Solomon, E. P. (1988). The experience, expression, and control of anger. In M. P. Janisse (Ed.), Health psychology: Individual differences and stress (pp. 89-108). New York, NY: Springer-Verlag.
71. Spielberger, C. D., Reheiser, E. C., & Sydeman, S. J. (1995). Measuring the experience, expression, and control of anger. Issues in comprehensive pediatric nursing, 18, 207-232.
72. Tchanturia, K., Anderluh, M. B., Morris, R. G., Rabe-Hesketh, S., Collier, D. A., Sanchez, P., & Treasure, J. L. (2004). Cognitive flexibility in anorexia nervosa and bulimia nervosa. Journal of the International Neuropsychological Society, 10, 513-520.
73. Thelen, M. H., Farmer, J., Wonderlich, S., & Smith, M. (1991). A revision of the Bulimia Test: The BULIT-R. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3, 119-124.
74. Tice, D. M., & Bratslavsky, E. (2000). Giving in to feel good: The place of emotion regulation in the context of general self-control. Psychological inquiry, 11, 149-159.
75. Tice, D. M., Bratslavsky, E., & Baumeister, R. F. (2001). Emotional distress regulation takes precedence over impulse control: If you feel bad, do it! Journal of Personality and Social Psychology, 80, 53.
76. Westen, D. (1994). Toward an integrative model of affect regulation: Applications to social‐psychological research. Journal of Personality, 62, 641-667.
77. Whiteside, S. P., & Lynam, D. R. (2001). The five factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669-689.
78. Yoon, H. Y. (1996). Relationship among binge eating behavior, depression, and attributional style of female university students (Master’s thesis). The Catholic University of Korea, Bucheon, Korea.