The momentary associations of negative affect, anxiety and stress with symptoms in individuals with anorexia nervosa: a scoping review.
5 affiliations
- 1Mind-Body Research Group, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Herestraat 49, Leuven, 3000, Belgium. [email protected].
- 2Mind-Body Research Group, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Herestraat 49, Leuven, 3000, Belgium.
- 3Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, Hanover, NH, USA.
- 4Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, NH, USA.
- 5Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Hanover, NH, USA.
Abstract
Introduction
Negative affect, anxiety, and stress are common in individuals with anorexia nervosa (AN), but their momentary link to symptoms remains unclear. This review aims to (1) examine how negative affect, anxiety, and stress are associated with eating-disorder-related symptoms in the moment in individuals with AN and (2) explore how these concepts are conceptualised and measured across studies in this field.Method
A systematic search following PRISMA-ScR guidelines was conducted across 11 databases. Eligible studies included individuals with a diagnosis of (atypical) AN, examined negative affect, anxiety, or stress, and reported outcomes related to AN symptoms.Results
We identified 95 eligible studies, which we categorised into retrospective self-report, qualitative, experimental, and daily life studies. Across experimental paradigms, negative affect was primarily examined in relation to disorder-specific cognitions. In daily life studies, negative affect was associated with binge eating and purging, while associations with restriction and physical activity were mixed. Mealtime anxiety was related to caloric intake. Stress investigated using general stress paradigms yielded mixed findings for eating-disorder behaviours, with notable divergences between subjective and physiological stress responses. Few studies directly compared negative affect, anxiety, and stress within the same design, limiting conclusions regarding their relative importance.Conclusion
Negative affect, anxiety and stress are associated with disorder-specific cognitions and urges, though the translation into observable behaviour varies by context and subtype. Future research must address current gaps by adopting multi-modal assessments. Strengthening methodological consistency will be important for advancing the understanding of the interplay between affective states and symptoms in AN.
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BibTeX
@article{quagebeur2026momentary,
title = {{The momentary associations of negative affect, anxiety and stress with symptoms in individuals with anorexia nervosa: a scoping review.}},
author = {Robin Quagebeur and Emma De Schuyteneer and Elfi Vergaelen and Emily K Presseller and Elske Vrieze},
journal = {Journal of eating disorders},
year = {2026},
month = sep,
doi = {10.1186/s40337-026-01744-1},
url = {https://europepmc.org/article/MED/42963783},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - The momentary associations of negative affect, anxiety and stress with symptoms in individuals with anorexia nervosa: a scoping review.
AU - Robin Quagebeur
AU - Emma De Schuyteneer
AU - Elfi Vergaelen
AU - Emily K Presseller
AU - Elske Vrieze
PY - 2026
DA - 2026/09/23
JO - Journal of eating disorders
DO - 10.1186/s40337-026-01744-1
UR - https://europepmc.org/article/MED/42963783
AB - Introduction Negative affect, anxiety, and stress are common in individuals with anorexia nervosa (AN), but their momentary link to symptoms remains unclear. This review aims to (1) examine how negative affect, anxiety, and stress are associated with eating-disorder-related symptoms in the moment in individuals with AN and (2) explore how these concepts are conceptualised and measured across studies in this field.Method A systematic search following PRISMA-ScR guidelines was conducted across 11 databases. Eligible studies included individuals with a diagnosis of (atypical) AN, examined negative affect, anxiety, or stress, and reported outcomes related to AN symptoms.Results We identified 95 eligible studies, which we categorised into retrospective self-report, qualitative, experimental, and daily life studies. Across experimental paradigms, negative affect was primarily examined in relation to disorder-specific cognitions. In daily life studies, negative affect was associated with binge eating and purging, while associations with restriction and physical activity were mixed. Mealtime anxiety was related to caloric intake. Stress investigated using general stress paradigms yielded mixed findings for eating-disorder behaviours, with notable divergences between subjective and physiological stress responses. Few studies directly compared negative affect, anxiety, and stress within the same design, limiting conclusions regarding their relative importance.Conclusion Negative affect, anxiety and stress are associated with disorder-specific cognitions and urges, though the translation into observable behaviour varies by context and subtype. Future research must address current gaps by adopting multi-modal assessments. Strengthening methodological consistency will be important for advancing the understanding of the interplay between affective states and symptoms in AN.
SN - 2050-2974
ER -