Experiential Avoidance During Mealtimes Among Individuals With Eating Disorders.

• Mealtime anxiety predicted increased emotional avoidance at the next meal. • When considering concurrent guilt, anxiety did not predict emotional avoidance. • Mealtime guilt and physical discomfort predicted emotional avoidance. • These affective processes may differentially relate to eating disorder symptoms. • Guilt should be considered in conceptualizing the anxiety–avoidance cycle. The relationship between negative emotions and avoidance is widely theorized as a bidirectional cycle implicated in a range of psychopathology. Historically, research on this cycle has examined one type of negative emotion: anxiety. Yet, a broader range of internal experiences may be implicated in the maintenance of unhealthy avoidance cycles in psychopathology. This study examines prospective relationships among anxiety, guilt, physical discomfort, and experiential avoidance during mealtimes for individuals with eating disorders (EDs). Participants (N = 108) completed ecological momentary assessments four times a day for 25 days. We computed multilevel models to examine between- and within-person effects of negative emotions and physical discomfort on experiential avoidance. When including guilt and anxiety in one model, guilt, but not anxiety, explained the significant variance in experiential avoidance at the next meal. Mealtime physical discomfort and experiential avoidance evidenced reciprocal prospective relationships. Future research should test whether interventions targeting experiential avoidance and physical discomfort at mealtimes disrupt guilt. [ABSTRACT FROM AUTHOR]