A machine learning investigation into the temporal dynamics of physical activity‐mediated emotional regulation in adolescents with anorexia nervosa and healthy controls.

Objective: Anorexia nervosa (AN) is commonly experienced alongside difficulties of emotion regulation (ER). Previous works identified physical activity (PA) as a mechanism for AN sufferers to achieve desired affective states, with evidence towards mitigation of negative affect. However, temporal associations of PA with specific emotional state outcomes are unknown. Method: Using lag‐ensemble machine learning and feature importance analyses, 888 affect‐based ecological momentary assessments across N = 75 adolescents with AN (N = 44) and healthy controls (N = 31) were analysed to explore significance of past PA, measured through passively collected wrist‐worn actigraphy, with subsequent self‐report momentary affect change across 9 affect constructs. Results: Among AN adolescents, later lags (≥2.5 h) were important in predicting change across negative emotions (hostility, sadness, fear, guilt). AN‐specific model performance on held‐out test data revealed the holistic "negative affect" construct as significantly predictable. Only joviality and self‐assurance, both positively‐valenced constructs, were significantly predictable among healthy‐control‐specific models. Discussion: Results recapitulated previous findings regarding the importance of PA in negative ER for AN individuals. Moreover, PA was found to play a uniquely prominent role in predicting negative affect 4.5–6 h later among AN adolescents. Future research into the PA‐ER dynamic will benefit from targeting specific negative emotions across greater temporal scales. Key Points: Physical activity (PA) plays an important role in the regulation of negative emotion for those with anorexia nervosa (AN).Compared with healthy controls (HC), negative affect among adolescents with AN is uniquely predicted by PA 4.5–6 h prior.Further exploration of delayed associations between PA and specific negative affect states may help to better understand the dynamics of emotion regulation (ER) in those with AN. [ABSTRACT FROM AUTHOR]