The Role of Emotion and its Regulation in Gluten-Free Diet Adherence Among Adults with Coeliac Disease
Alice Owen*, Amy Baraniak and Paul Staples
ABSTRACT
Objectives: Coeliac disease (CD) is an autoimmune condition affecting 1-2% of the population, requiring a lifelong gluten-free diet (GFD) to manage adverse health outcomes, though compliance varies [1,2]. Research links negative emotional states (ES) to poorer GFD adherence [3]. Few studies find negative ES mediating emotional CD perceptions and adherence, and one Australian study suggests emotion regulation as a moderator [4,5]. This study explores the interrelationships and predictive utility of emotional factors on GFD adherence in CD internationally.
Design: Quantitative, cross-sectional questionnaire.
Method: Participants (N=82) were adults with CD recruited via social-media. Measures included illness perceptions, emotion regulation, negative ES, emotional eating and GFD adherence [6-10]. Linear regression analyses assessed the predictive strength of emotional variables on GFD adherence. Mediation and moderation analyses examined the roles of negative ES, emotional eating, and emotion regulation on adherence.
Results: Depression significantly predicted GFD adherence, while anxiety and stress did not. Negative ES mediated negative illness perceptions, but emotional eating did not. Emotion regulation strategies did not individually moderate these relationships, but their combined effect was significant.
Conclusions: Depression predicts GFD adherence in CD, influenced by negative illness perceptions. These findings could inform psychological interventions targeting depression and emotional CD perceptions to enhance GFD adherence in CD populations. Future research should explore specific mechanisms that moderate this relationship.
