Attentional and interpretative biases in appearance concern: An investigation of biases in appearance-related information processing

Negative comments and social media: How cognitive biases relate to body image concerns

Body image concern (BIC) is a prevalent issue thought to be exacerbated by social media. In addition to sociocultural factors, cognitive biases may also contribute to BIC. We explore whether cognitive biases in memory for body image-related words, presented in a mock social-media context, are associated with BIC in young adult women. A sample of 150 University students was presented with a series of body image-related comments aimed at either themselves, a close friend, or a celebrity in a recognisable social media context. Afterwards, a surprise memory task was completed that assessed the participant's memory for body image-related words (item memory), their insight (metamemory), and to whom a specific word was directed (source memory). Self-referential biases were identified for both item memory and source memory. Individuals with greater BIC displayed a greater self-referential bias for correctly and incorrectly sourcing negative words to themselves compared with both friend and celebrity. A greater self-referential effect in metacognitive sensitivity was also associated with higher BIC. We provide novel evidence for a cognitive bias in sourcing negative body image-related information to the self in individuals with higher BIC. The results should inform cognitive remediation programmes aimed at treating individuals with body and eating-related disorders.

Higher general executive functions predicts lower body mass index by mitigating avoidance behaviors

BACKGROUND

The present study examines the relationship between obesity, executive functions, and body image in a nonclinical population from southern Italy.

METHODS

General executive functioning (Frontal Assessment Battery-15), and body image disturbances (Body Uneasiness Test) were assessed in a sample including 255 participants (138 females, M age = 43.51 years, SD = 17.94, range = 18-86 years; M body mass index (BMI) = 26.21, SD = 4.32, range = 18.03-38.79).

FINDINGS

Multiple Linear Regression Analysis indicated that age, years of education, FAB15 score, body image concerns, and avoidance predicted the variance of BMI. A subsequent mediation analysis highlighted that the indirect effect of FAB15 on BMI through avoidance was statistically significant.

INTERPRETATION

Our results suggest that more performing executive functioning predicts a decrease in BMI that is partially due to the mitigation of avoidance behaviors.

Body surveillance as a prospective risk factor for depressive symptoms in low-income adolescent girls from the United States

Adolescent girls who engage in frequent self-objectification often report a greater number of depressive symptoms. Although concurrent associations between self-objectification and depression are well-documented, it is less clear if objectification contributes to the course of symptoms. The current study examined: (a) whether body surveillance is prospectively related to depressive symptoms over a 1-month period in a sample of 150 low-income adolescent girls in the United States, and; (b) whether receiving certain types of weight-relevant information (i.e., learning one's weight is much higher than estimated) moderates this association. Heightened body surveillance at baseline predicted greater symptom severity one month later, but the strength of this relationship depended on what type of weight information girls received. Among girls high in body surveillance, those who found out their actual weight was much higher than they estimated subsequently reported more severe depressive symptoms; those who learned their actual weight was consistent or lower than they estimated reported fewer depressive symptoms. For girls low in body surveillance, weight-relevant information was not significantly related to the subsequent severity of depressive symptoms. Findings highlight the potential utility of assessing and addressing heightened body surveillance in depression interventions for adolescent girls.

Interpretation Bias Across Body Dysmorphic, Social Anxiety and Generalized Anxiety Disorder—A Multilevel, Diffusion Model Account

Background

Interpretation biases are suggested to be transdiagnostic phenomena, but have rarely been compared across different disorders and current concerns.

Methods

We investigated explicit, decision-based, and more implicit, reaction time-based interpretation bias in individuals with body dysmorphic disorder (BDD; N = 29), social anxiety disorder (SAD; N = 36), generalized anxiety disorder (GAD; N = 22), and non-clinical controls (NC; N = 32), using an adapted Word Sentence Association Paradigm (WSAP).

Results

Results indicated that interpretation bias occurred transdiagnostically, while content-specific bias patterns varied meaningfully across groups. BDD and SAD shared explicit and, more inconsistently, implicit interpretation biases for appearance-related and social situations. The GAD group exhibited an explicit and implicit negative interpretation bias for general situations, and an additional implicit lack of positive bias. Mechanistic Wiener diffusion model analyses revealed that interpretation bias patterns were mainly driven by speeded information uptake, potentially mirroring disorder-specific associative memory organization.

Conclusions

These findings have important implications for understanding interpretation biases as both etiological and treatment factors.

Examination of momentary maintenance factors and eating disorder behaviors and cognitions using ecological momentary assessment

The integrative cognitive-affective therapy (ICAT) momentary maintenance model proposes a number of situational factors that precipitate eating disorder (ED) behaviors and cognitions. The current study examines momentary situational triggers in relation to a broad range of ED symptoms in a diagnostically heterogeneous sample of individuals with ED psychopathology. In the current study, 30 women with binge eating pathology completed a 14-day ecological momentary assessment (EMA) protocol during which they responded to five random signals throughout the day. During signaled assessments, participants completed measures of self-criticism, interpersonal problems, self-regulation of binge eating, appearance concerns, and cognitive and behavioral ED symptoms. Multilevel models were used to examine prospective associations between hypothesized ICAT maintenance factors and ED symptoms. Within-subjects self-criticism prospectively predicted vomiting, restriction, preoccupation with thoughts of food, and urges to eat. Within-subjects interpersonal problems prospectively predicted vomiting, and within-subjects appearance concerns prospectively predicted preoccupation with thoughts of food. There were no significant predictors of binge eating. These results provide some support for hypothesized momentary situational triggers of ED symptoms in the momentary maintenance model of ICAT using naturalistic, momentary assessment. Specifically, it may be particularly useful for interventions such as ICAT to address momentary self-criticism when targeting a range of ED symptoms.

Body image in and out of the lab: Correspondence between lab-based attentional bias data and body shape dissatisfaction experiences in daily life

Accumulating lab-based studies have identified attentional biases in processing of negative appearance-related information among individuals with elevated trait body shape and weight dissatisfaction (BD). How these biases translate into experiences of BD in daily life remains unclear and, hence, was the focus of the present study. Thirty-eight women aged between 18-40 years completed a baseline survey and modified dot-probe task with both fat and thin appearance-related stimuli in a laboratory setting. Participants also downloaded a smartphone app that prompted them 10 times per day for 7 days to rate current body dissatisfaction. Results revealed that heightened BD in daily life tended to be transitory, and followed by a substantially lower rating of BD by the next survey (∼1-2 h later). For individuals with elevated trait BD and facilitated attention towards thin body images, this reduction in state BD was more gradual. Surprisingly, delayed disengagement towards thin body images was associated with greater reduction in state BD. Consistent with the hypothesis, moderating effects were not observed when initial state BD level was low. Susceptibility for immediate, short-term attentional biases towards appearance-related information may be a vulnerability factor for the prolonged persistence of negative body image experiences in daily life.

Testing the specificity of interpretation biases in women with eating disorder symptoms: An online experimental assessment

OBJECTIVE

Cognitive biases, such as memory, attention, and interpretation bias, are thought to play a central role in the development and maintenance of eating disorders (EDs). The aim of the present study was to investigate whether the interpretation bias is ED-specific or can be generalized to comorbid disorder-related threats in women with high levels of ED symptoms.

METHOD

In an online study, we measured interpretation bias using the modified Sentence Word Association Paradigm (SWAP), comparing women with (n = 39) and without (sub)threshold eating disorders (n = 56). We assessed endorsement and rejection rates as well as reaction times in response to a positive/neutral or a negative ED-specific, social anxiety-specific (SAD), or generalized anxiety-specific (GAD) interpretive word following an ambiguous sentence.

RESULTS

In ambiguous situations, women with high ED symptoms selected more negative (p < .001) and fewer positive/neutral ED-related interpretations (p < .001). Negative interpretations were endorsed significantly faster (p < .001), while positive interpretations were rejected faster in this group (p < .001). These women also manifested negative SAD-specific interpretation bias patterns in reaction time measures. Nevertheless, ED severity was best predicted by the endorsement of negative ED-specific stimuli, whereas ED and SAD reaction time measures seemed to have a negligible effect.

DISCUSSION

The results indicate that the interpretation bias might be ED-specific. The SWAP can be a useful tool for the further investigation of the etiological relevance of the interpretation bias as well as for the development of modification training interventions.

Body Dissatisfaction Enhances Awareness and Facilitates the Consolidation of Body-Related Words During Rapid Serial Visual Presentation

Attentional biases have received considerable focus in research on cognitive biases and body dissatisfaction (BD). However, most work has focused on spatial allocation of attention. The current two experiments employed a rapid serial visual presentation (RSVP) task to investigate attention bias to body-related words in the temporal domain among young females with high and low BD. During this task, there were two targets presented in the same stimulus stream. The first target was defined as target one (T1) and the second was defined as target 2 (T2). Participants were asked to identify T2 while ignoring T1 in single task mode or identify both targets in the dual task mode. In the current study, Experiment 1 assessed the stimulus-driven attention of body-related stimuli. Participants were required to identify a target of neutral word (T2) as quickly and accurately as possible while ignoring the preceding target (T1) of neutral, fat-, or thin-related words. As expected, we observed spontaneous attentional blink (AB) effects elicited by both fat- and thin-related T1s among participants with high BD, suggesting enhanced awareness of body-related stimuli even when this information does not have to be identified. Such effects did not emerge among participants without BD. Experimental 2 investigated the goal-directed attention of body-related stimuli, during which participants needed to identify both the T1 and neutral T2. Participants with BD showed reduced AB effects after both fat- and thin-related T1, suggesting facilitated consolidation of body-related information in goal-directed attention among participants with BD. These findings have important clinical implications that it provided insight for creating more accurate attention bias modification (ABM) task aiming at reducing and preventing BD among young females.

Effects of an Appearance-Focused Interpretation Training Intervention on Eating Disorder Symptoms

Background: Previous research suggests that computerized interpretation bias modification (IBM) techniques may be useful for modifying thoughts and behaviours relevant to eating pathology; however, little is known about the utility of IBM for decreasing specific eating disorder (ED) symptoms (e.g. bulimia, drive for thinness). Aims: The current study sought to further examine the utility of IBM for ED symptoms via secondary analyses of an examination of IBM for individuals with elevated body dysmorphic disorder (BDD) symptoms (see Summers and Cougle, 2016), as these disorders are both characterized by threat interpretation biases of ambiguous appearance-related information. Method: We recruited 41 participants for a randomized trial comparing four sessions of IBM aimed at modifying problematic social and appearance-related threat interpretation biases with a placebo control training (PC). Results: At 1-week post-treatment, and relative to the PC, the IBM group reported greater reductions in negative/threat interpretations of ambiguous information in favour of positive/benign biases. Furthermore, among individuals with high pre-treatment bulimia symptoms, IBM yielded greater reductions in bulimia symptoms compared with PC at post-treatment. No treatment effects were observed on drive for thinness symptoms. Conclusions: The current study suggests that cognitive interventions for individuals with primary BDD symptoms may improve co-occurring ED symptoms such as bulimia.

The effects of priming in a cued dot-probe task on appearance-related attentional biases in women

The dot-probe task (DPT) is a reaction time measure of attentional bias. Research using this task has found inconsistent patterns of appearance-related attentional biases in women. This study examined the effects of a novel priming variation of the DPT, which incorporated additional cues into each trial of the task, on measurement of such biases. The study also examined associations between these biases and body image, a component of eating disorder symptomatology. A convenience sample of women from the general community (N = 103) completed body image measures online and attended a laboratory session to complete one of four DPTs: (1) an appearance-cued DPT containing images of thin-ideal models between each trial; (2) neutral-cued DPT containing images of forests; (3) time-delayed DPT controlling for time in place of an image; or (4) typical DPT containing only word stimuli. Women who completed the appearance-cued DPT demonstrated a stronger attentional bias for positive, but not negative, appearance words than women who completed the other DPT versions. Furthermore, for the appearance-cued and time-delayed DPTs, this bias correlated with poorer body image across several indicators (appearance evaluation, body dissatisfaction, self-evaluative salience of appearance, and state body satisfaction). Although it was unexpected that no attentional bias for negative-appearance words was found, the attentional bias for positive-appearance words may suggest that effects were driven by the ego-threat of positive-appearance words. Further research is warranted to determine whether such biases contribute to and maintain body image disturbance and disordered eating.

Risk for eating disorders modulates interpretation bias in a semantic priming task

The current study used a semantic priming paradigm to investigate the presence of implicit interpretation biases for food and body shape words among 118 undergraduate females. Reaction times (RTs) were recorded while participants made lexical decisions (i.e., word vs. non-word judgments) to lexical targets that were preceded by negatively valenced eating disorder related (e.g., fat-PIZZA), eating disorder unrelated (e.g., party-PIZZA), or semantically unrelated (e.g., umbrella-PIZZA) prime words. Self-reported eating disorder traits were assessed using the Body Shape Questionnaire (BSQ-34), the Eating Attitudes Test (EAT-26), and the Eating Disorder Examination (EDE-Q 6.0). Results suggested that biased RT priming effects for eating disorder related word pairs were strongly associated with measures of body dissatisfaction and ED symptomology. Specifically, scales targeting eating disordered cognitions (the BSQ-34 and the Shape/Weight Concern subscales of the EDE-Q 6.0) demonstrated the strongest association with implicit interpretation biases as assessed by performance on the semantic priming task.

Body image and adolescence: A behavioral impairment model

Adolescence is a period marked by important physical and social changes that can lead to a negative body image. The purpose of this study was to find a model enabling the appearance of behavioral impairment related to body image (restrictions, avoidance, and checking) to be predicted by body image attitudes (concern or Appearance Orientation, and dissatisfaction or Appearance Evaluation), Gender, emotional symptomatology, self-consciousness, ideas of reference (IR) and age. A total of 661 participants (67.47% girls) with an average age of 17.14 years (SD=2.34) filled in the GHQ-28, SCS on self-consciousness, REF referential thinking scale, MBSRQ (AO and AE), and BIAQ. A partial mediation model was found for IR, age and depressive symptomatology between dissatisfaction and concern about body image and Gender, to behavioral impairment related to body image. The results found suggest that age, depressive symptomatology, and IR may be mediator variables in the relationship between dissatisfaction and concern about body image, on body image behavioral impairment. This relationship implies a severity to be considered in intervention and monitoring of body image behavioral impairments in adolescents.

Análise fatorial da versão portuguesa da Escala de Avaliação da Aparência de Derriford (DAS-24)

Objetivo

As preocupações com a aparência têm vindo a ter um crescente interesse ao nível da investigação. Pretende-se avaliar a validade fatorial e a fiabilidade da Escala de Avaliação da Aparência de Derriford (DAS-24) na população portuguesa.

Método

Quinhentos e oito sujeitos, participaram neste estudo, utilizando uma amostra por conveniência. Os participantes responderam a questões sociodemográficas, questões relacionadas com o investimento esquemático da aparência e a autoconsciência da aparência.

Resultados

A DAS-24 apresentou um bom índice de consistência interna (α = 0,91). Através dos resultados obtidos na análise fatorial confirmatória (AFC), apresenta um ajustamento aceitável (χ²/df = 2,5; GFI = 0,912; CFI = 0,925; TLI = 0,909; RMSEA = 0,054; p [rmsea ≤ 0,05] = 0,130).

Conclusão

A DAS-24, na população portuguesa, apresenta-se psicometricamente robusta na avaliação da autoconsciência da aparência, tornando-se uma escala aplicável e aceitável da versão original.

A longitudinal study of 340 young people with or without a visible difference: The impact of teasing on self-perceptions of appearance and depressive symptoms

Previous research in both the general population and in those with a visible facial difference has identified potential associations between teasing, dissatisfaction with appearance and emotional distress. However, most studies are based on cross-sectional and retrospective methodology, restricting the interpretation of findings. The present study explored the longitudinal impact of perceived teasing on satisfaction with appearance and depressive symptoms in young people with and without a visible congenital condition. Routine psychological assessments were conducted at ages 10 and 16 years (N=340). Experiences of teasing after the age of 10 significantly impacted on appearance evaluations and depressive symptoms in adolescent females. The impact of teasing on adolescent males was possibly counteracted by reports of more positive social experiences. Early identification of perceived teasing in all children to prevent the development of emotional problems and dissatisfaction with appearance is of vital importance.

Identification of the underlying factor structure of the Derriford Appearance Scale 24

Background. The Derriford Appearance Scale24 (DAS24) is a widely used measure of distress and dysfunction in relation to self-consciousness of appearance. It has been used in clinical and research settings, and translated into numerous European and Asian languages. Hitherto, no study has conducted an analysis to determine the underlying factor structure of the scale.

Methods. A large (n = 1,265) sample of community and hospital patients with a visible difference were recruited face to face or by post, and completed the DAS24.

Results. A two factor solution was generated. An evaluation of the congruence of the factor solutions on each of the the hospital and the community samples using Tucker’s Coefficient of Congruence (r_c = .979) and confirmatory factor analysis, which demonstrated a consistent factor structure. A main factor, general self consciousness (GSC), was represented by 18 items. Six items comprised a second factor, sexual and body self-consciousness (SBSC). The SBSC scale demonstrated greater sensitivity and specificity in identifying distress for sexually significant areas of the body.

Discussion. The factor structure of the DAS24 facilitates a more nuanced interpretation of scores using this scale. Two conceptually and statistically coherent sub-scales were identified. The SBSC sub-scale offers a means of identifying distress and dysfunction around sexually significant areas of the body not previously possible with this scale.

Validation of an interpretation bias assessment for body dissatisfaction

Currently, research on interpretation bias and body dissatisfaction is limited. The few experimental paradigms that have been used to explore this phenomenon utilized a method that may not accurately capture the nature of interpretation bias as explained by cognitive theory. The present study investigated the reliability and validity of a novel computerized assessment of interpretation bias (WSAP) for body dissatisfaction, which may more accurately reflect the cognitive processing involved in such bias by implementing the Word Sentence Association Paradigm (WSAP), a previously established method of measuring interpretation bias in other clinical populations. Undergraduate females (n=214) completed the WSAP and other measures. Results indicate initial support for the WSAP as a valid, reliable measure of interpretation bias for body dissatisfaction. Although preliminary, this study contributes to the minimal research in this area and serves as the first psychometric investigation of the WSAP to measure such interpretation bias for body dissatisfaction.

Cultures of trust: effects of avatar faces and reputation scores on German and Arab players in an online trust-game

Reputation systems as well as seller depictions (photos; avatars) have been shown to reduce buyer uncertainty and to foster trust in online trading. With the emergence of globalized e-markets, it remains an urgent question whether these mechanisms, found to be effective for Western cultures, also apply to other cultures. Hypothesizing that members of collectivistic cultures in contrast to those of individualistic cultures would rely more on visual social cues (seller faces) than on factual information (reputation scores), we compared buying decisions of Arab and German participants in an experimental trust game. Photo-realistic avatars were used instead of photos to control facial features and expressions. The results revealed significant main effects for both reputation scores and avatar faces. Moreover, both variables significantly affected the purchase behavior of Arab as well as German buyers, suggesting cross-cultural universals in the processing of trust cues. The results have implications for future cross-cultural studies in e-commerce as well as the design of online markets and shared virtual environments.

A systematic review of self-help for disfigurement: effectiveness, usability, and acceptability

Self-help has been found to be efficacious in treating mood disorders, however, little is known about its use, effectiveness, or user satisfaction, in reducing distress associated with disfigurement. This review describes the content and focus of self-help interventions available in this area. A systematic search and appraisal protocol facilitated identification of studies, extraction of data, and appraisal of quality. Clinical trials were included if the primary method of intervention delivery was via self-help. Other types of study were included if they investigated user perspectives of a self-help intervention. Eleven studies covering a range of populations met the inclusion criteria. There is tentative support for the use of self-help to manage anxiety associated with disfigurement but little is known about the management of other psychosocial difficulties. Further research and intervention development is required to examine the effectiveness, acceptability, and utility of self-help in managing the appearance related distress associated with disfigurement.

Breaking the circle: challenging Western sociocultural norms for appearance influences young women's attention to appearance-related media

Paying attention to thin media models may negatively affect women's self-evaluation. This study aimed to reduce the amount of attention that young women give to appearance-related information by challenging the sociocultural norms for appearance, and studied the moderating role of self-esteem. Seventy-one college women either received norm-confirming, norm-challenging, or no information regarding the sociocultural norms for appearance. Subsequently, participants' visual attention to appearance-related and neutral advertisements was measured using an eye-tracker. The results demonstrate that when no information or norm-confirming information was received, women with lower self-esteem paid more attention to the appearance-related advertisements than women with higher self-esteem. Importantly however, when norm-challenging information was received, women with lower self-esteem paid significantly less attention to the appearance-related ads than women with lower self-esteem who did not receive this manipulation. These findings indicate that challenging the sociocultural norms for appearance can attenuate the amount of attention women give to appearance-related media.

Body dissatisfaction levels and gender differences in attentional biases toward idealized bodies

Attentional bias toward idealized bodies (men: muscular; women: thin) may cause upward comparisons and increase body dissatisfaction (BD). We investigated attentional biases of 39 men and 41 women with high and low BD toward muscular male bodies and thin female bodies. An eye-tracker measured gaze durations and fixation frequencies while exposing participants to images of thin, normal, muscular, and fat bodies of the same gender. Results revealed longer and more frequent attention toward muscular bodies in high BD men, and toward thin bodies in high BD women. High BD men and women also rated muscular and thin bodies as more attractive than those with low BD. Although men attended to muscular and women attended to thin bodies, both showed an attentional bias toward body types they rated as more attractive. These findings could provide indirect evidence in explaining the relationship between BD and the social comparison theory with attentional bias.

Body image concern and selective attention to disgusting and non-self appearance-related stimuli

Although selective attention to one's own appearance has been widely documented in studies of body dysmorphic disorder (BDD), little is known about attentional bias toward non-self appearance-related stimuli in BDD. Furthermore, despite reports of heightened experience of disgust in BDD, it is unknown whether these individuals differentially attend to disgusting stimuli and whether disgust is important in processing of unattractive stimuli. We used a dot probe procedure to investigate the relationship between dysmorphic concern, a defining feature of BDD, and selective attention to faces, attractive, unattractive and disgusting images in a female heterosexual student population (N=92). At the long stimulus presentation (1000 ms), dysmorphic concern was positively associated with attention to faces in general and attractive appearance-related images. In contrast, at the short stimulus presentation (200 ms), there was a positive association between dysmorphic concern and disgusting images. Implications for theoretical models of BDD are discussed.

Self-body recognition depends on implicit and explicit self-esteem

The present contribution bridges research on body image, self-esteem, and body recognition. Recent work in neuroscience indicates a superiority in the processing of self relative to others' body parts. The present contribution shows that this ability is not universal but it is qualified by individual differences in implicit and explicit self-esteem. In fact, two studies (n₁ = 41 and n₂ = 35) using two different paradigms in body recognition and direct and indirect measures of self-esteem reveal that this advantage in recognizing one's own body parts is associated with one's level of self-esteem. Moreover, it appears that measures of implicit and explicit self-esteem provide different contributions to self-body recognition abilities and that these contributions depend on how self-body recognition is assessed. Implications of these results are discussed notably in the perspective of research on body image.