Attention bias for chocolate increases chocolate consumption--an attention bias modification study

A Cognitive Profile of Obesity and Its Translation into New Interventions

Change your lifestyle: decrease your energy intake and increase your energy expenditure, is what obesity experts tell people who need to lose weight. Though the advice might be correct, it appears to be extremely difficult to change one’s lifestyle. Unhealthy habits usually are ingrained and hard to change, especially for people with an “obese cognitive profile.” Knowledge of the cognitive mechanisms that maintain unhealthy eating habits is necessary for the development of interventions that can change behavior effectively. This paper discusses some cognitive processes that might maintain unhealthy eating habits and make healthier eating difficult, like increased food cue reactivity, weak executive skills and attention bias. An effort is also done to translate these basic scientific findings into new interventions which aim to tackle the sabotaging cognitive processes. Preliminary studies into the effectiveness of these interventions, if available, are presented.

Inhibitory control training for appetitive behaviour change: A meta-analytic investigation of mechanisms of action and moderators of effectiveness

Inhibitory control training (ICT) is a novel intervention in which participants learn to associate appetitive cues with inhibition of behaviour. We present a meta-analytic investigation of laboratory studies of ICT for appetitive behaviour change in which we investigate candidate mechanisms of action, individual differences that may moderate its effectiveness, and compare it to other psychological interventions. We conducted random-effects generic inverse variance meta-analysis on data from 14 articles (18 effect sizes in total). Participants who received ICT chose or consumed significantly less food or alcohol compared to control groups (SMD = 0.36, 95% CIs [0.24, 0.47]; Z = 6.18, p < .001; I(2) = 71%). Effect sizes were larger for motor (Go/No-Go and Stop Signal) compared to oculomotor (Antisaccade) ICT. The effects of ICT on behaviour were comparable to those produced by other psychological interventions, and effects of ICT on food intake were greater in participants who were attempting to restrict their food intake. The magnitude of the effect of ICT on behaviour was predicted by the proportion of successful inhibitions but was unrelated to the absolute number of trials in which appetitive cues were paired with the requirement to inhibit, or the contingency between appetitive cues and the requirement to inhibit. The effect of ICT on cue devaluation (primarily assessed with implicit association tests) was not statistically significant. Our analysis confirms the efficacy of ICT for short-term behaviour change in the laboratory, and we have demonstrated that its effectiveness may depend on pairings between appetitive cues and successful inhibition. We highlight the need for further research to translate these findings outside of the laboratory.

Behavioral Bias for Food Reflected in Hand Movements: A Preliminary Study with Healthy Subjects

Palatable food induces general approach tendencies when compared to nonfood stimuli. For eating disorders, the modification of an attention bias toward food was proposed as a treatment option. Similar approaches have been efficient for other psychiatric conditions and, recently, successfully incorporated approach motivation. The direct impact of attentional biases on spontaneous natural behavior has hardly been investigated so far, although actions may serve as an intervention target, especially seeing the recent advances in the field of embodied cognition. In this study, we addressed the interplay of motor action execution and cognition when interacting with food objects. In a Virtual Reality (VR) setting, healthy participants repeatedly grasped or warded high-calorie food or hand-affordant ball objects using their own dominant hand. This novel experimental paradigm revealed an attention-like bias in hand-based actions: 3D objects of food were collected faster than ball objects, and this difference correlated positively with both individual body mass index and diet-related attitudes. The behavioral bias for food in hand movements complements several recent experimental and neurophysiological findings. Implications for the use of VR in the treatment of eating-related health problems are discussed.

Reduced Inhibition of Return to Food Images in Obese Individuals

Previous research has shown that obese individuals may be biased towards attending to food over non-food information, and this bias may contribute to the development and/or maintenance of obesity. The present study sought to extend our understanding of maladaptive attentional processing in this population by investigating whether obese individuals have difficulty in disengaging attention from food compared with non-food images, relative to normal-weight controls. To address this question, we measured inhibition of return (IOR) in an attentional cueing task. The participants were 29 obese and 35 normal-weight satiated females without eating disorders. The obese group displayed less IOR to food images than the normal-weight group, while there was no difference in IOR between the groups for non-food images. This suggests that obese females have greater difficulty disengaging attention from food than normal-weight females. Our findings provide a new focus for studies investigating maintenance factors in obesity and are discussed in relation to a theory of incentive-sensitisation.

Longitudinal relations among exuberance, externalizing behaviors, and attentional bias to reward: the mediating role of effortful control

The present study examined the associations between temperamental exuberance during toddlerhood (20 months), attention bias towards reward at the end of kindergarten (76 months), and externalizing behaviors across the kindergarten year. Moreover, we examined the role of effortful control at 48 months on the relation between early exuberance and attention bias. Attention bias towards reward was positively predicted by exuberance, negatively predicted by effortful control, and positively related to externalizing problems. Finally, the longitudinal path between exuberance and attention bias to reward was mediated by effortful control - such that higher toddler exuberance led to increased attention bias towards reward by way of lower effortful control. These results extend the attention bias and socioemotional functioning literature and have implications for the identification of children at risk for behavioral problems.

The processing of food stimuli in abnormal eating: a systematic review of electrophysiology

To update the knowledge about attentional processing of food stimuli, a systematic review of electrophysiological studies was conducted using PubMed, PsychInfo and Web of Knowledge (2000-2014). Twenty-one studies were included into a qualitative synthesis. Presentation of food and control pictures was used to analyze event-related potentials related to sensory processing and motivated attention. Results show consistent attentional bias towards food pictures compared with neutral pictures for patient and control groups. Group comparisons between individuals with abnormal-eating and healthy-eating participants were more inconsistent. Results suggest that temporal differences in the millisecond range are essential for the understanding of visual food processing. In obesity, early attention engagement to food is followed by relatice disengagement. Loss of control eating, as well as external and emotional eating, are associated with a sustained maintenance of attention towards high-caloric food. There is a lack of studies in anorexia nervosa, bulimia nervosa and binge eating disorder.

External eating mediates the relationship between impulsivity and unhealthy food intake

Recent evidence from the eating domain shows a link between impulsivity and unhealthy food intake. However, the mechanism underlying this relationship remains unclear. One possibility is an external eating style, which has been linked to both impulsivity and food intake. The current study investigated the potential mediating role of external eating in the relationship between impulsivity and food intake. Participants were 146 undergraduate women who completed measures of impulsivity and external eating, and took part in a laboratory taste test as a behavioural index of unhealthy snack food intake. It was found that attentional and motor impulsivity interacted in predicting sweet food intake, but only motor impulsivity predicted both external eating and sweet food intake. Furthermore, the relationship between motor impulsivity and food intake was mediated by external eating. These findings support the development of interventions aimed at targeting specific aspects of impulsivity in order to reduce unhealthy eating behaviour.

UnAdulterated - children and adults' visual attention to healthy and unhealthy food

OBJECTIVE

Visually attending to unhealthy food creates a desire to consume the food. To resist the temptation people have to employ self-regulation strategies, such as visual avoidance. Past research has shown that self-regulatory skills develop throughout childhood and adolescence, suggesting adults' superior self-regulation skills compared to children.

METHODS

This study employed a novel method to investigate self-regulatory skills. Children and adults' initial (bottom-up) and maintained (top-down) visual attention to simultaneously presented healthy and unhealthy food were examined in an eye-tracking paradigm.

RESULTS

Results showed that both children and adults initially attended most to the unhealthy food. Subsequently, adults self-regulated their visual attention away from the unhealthy food. Despite the children's high self-reported attempts to eat healthily and importance of eating healthily, children did not self-regulate visual attention away from unhealthy food. Children remained influenced by the attention-driven desire to consume the unhealthy food whereas adults visually attended more strongly to the healthy food thereby avoiding the desire to consume the unhealthy option.

CONCLUSIONS

The findings emphasize the necessity of improving children's self-regulatory skills to support their desire to remain healthy and to protect children from the influences of the obesogenic environment.

Worry or craving? A selective review of evidence for food-related attention biases in obese individuals, eating-disorder patients, restrained eaters and healthy samples

Living in an ‘obesogenic’ environment poses a serious challenge for weight maintenance. However, many people are able to maintain a healthy weight indicating that not everybody is equally susceptible to the temptations of this food environment. The way in which someone perceives and reacts to food cues, that is, cognitive processes, could underlie differences in susceptibility. An attention bias for food could be such a cognitive factor that contributes to overeating. However, an attention bias for food has also been implicated with restrained eating and eating-disorder symptomatology. The primary aim of the present review was to determine whether an attention bias for food is specifically related to obesity while also reviewing evidence for attention biases in eating-disorder patients, restrained eaters and healthy-weight individuals. Another aim was to systematically examine how selective attention for food relates (causally) to eating behaviour. Current empirical evidence on attention bias for food within obese samples, eating-disorder patients, and, even though to a lesser extent, in restrained eaters is contradictory. However, present experimental studies provide relatively consistent evidence that an attention bias for food contributes to subsequent food intake. This review highlights the need to distinguish not only between different (temporal) attention bias components, but also to take different motivations (craving v. worry) and their impact on attentional processing into account. Overall, the current state of research suggests that biased attention could be one important cognitive mechanism by which the food environment tempts us into overeating.

Food-pics: an image database for experimental research on eating and appetite

Our current environment is characterized by the omnipresence of food cues. The sight and smell of real foods, but also graphically depictions of appetizing foods, can guide our eating behavior, for example, by eliciting food craving and influencing food choice. The relevance of visual food cues on human information processing has been demonstrated by a growing body of studies employing food images across the disciplines of psychology, medicine, and neuroscience. However, currently used food image sets vary considerably across laboratories and image characteristics (contrast, brightness, etc.) and food composition (calories, macronutrients, etc.) are often unspecified. These factors might have contributed to some of the inconsistencies of this research. To remedy this, we developed food-pics, a picture database comprising 568 food images and 315 non-food images along with detailed meta-data. A total of N = 1988 individuals with large variance in age and weight from German speaking countries and North America provided normative ratings of valence, arousal, palatability, desire to eat, recognizability and visual complexity. Furthermore, data on macronutrients (g), energy density (kcal), and physical image characteristics (color composition, contrast, brightness, size, complexity) are provided. The food-pics image database is freely available under the creative commons license with the hope that the set will facilitate standardization and comparability across studies and advance experimental research on the determinants of eating behavior.

Looking at food in sad mood: do attention biases lead emotional eaters into overeating after a negative mood induction?

BACKGROUND

Emotional eating is associated with overeating and the development of obesity. Yet, empirical evidence for individual (trait) differences in emotional eating and cognitive mechanisms that contribute to eating during sad mood remain equivocal.

AIM

The aim of this study was to test if attention bias for food moderates the effect of self-reported emotional eating during sad mood (vs neutral mood) on actual food intake. It was expected that emotional eating is predictive of elevated attention for food and higher food intake after an experimentally induced sad mood and that attentional maintenance on food predicts food intake during a sad versus a neutral mood.

METHOD

Participants (N = 85) were randomly assigned to one of the two experimental mood induction conditions (sad/neutral). Attentional biases for high caloric foods were measured by eye tracking during a visual probe task with pictorial food and neutral stimuli. Self-reported emotional eating was assessed with the Dutch Eating Behavior Questionnaire (DEBQ) and ad libitum food intake was tested by a disguised food offer.

RESULTS

Hierarchical multivariate regression modeling showed that self-reported emotional eating did not account for changes in attention allocation for food or food intake in either condition. Yet, attention maintenance on food cues was significantly related to increased intake specifically in the neutral condition, but not in the sad mood condition.

DISCUSSION

The current findings show that self-reported emotional eating (based on the DEBQ) might not validly predict who overeats when sad, at least not in a laboratory setting with healthy women. Results further suggest that attention maintenance on food relates to eating motivation when in a neutral affective state, and might therefore be a cognitive mechanism contributing to increased food intake in general, but maybe not during sad mood.