Self-report and startle-based measures of emotional reactions to body image cues as predictors of Drive for Thinness and Body Dissatisfaction in female college students

Visualizing Emotional Arousal within the Context of Body Size Evaluation: A Pilot Study of Steady-State Visual Evoked Potentials in Women with Anorexia Nervosa and Healthy Controls

Maladaptive body size evaluation processes and body dissatisfaction are known as central risk factors for the development and maintenance of anorexia nervosa (AN). This study aimed to experimentally test potential key facets, such as (psycho)physiological, cognitive-verbal and behavioral mechanisms, within the context of these evaluation processes. Twenty-two females with AN (AN-G) and 22 healthy controls (HC-G) looked at pictures of their body gradually increasing in weight using a morphing technique. Implicit emotional arousal was assessed using steady-state visual evoked potentials (SSVEP) in electroencephalography. Additionally, in a forced-choice body size evaluation task, participants were asked to classify pictures of their own body as not big or big while reaction times were captured. A significantly earlier increase in SSVEPs emerged in AN-G compared to HC-G (p <.05), with AN-G evaluating their bodies in the morphing process as big at a significantly thinner body size (p <.05). The AN-G showed faster reaction times in the categorical evaluation of body stimuli (p <.05). Findings from this multimodal paradigm underline the importance of body size evaluation mechanisms and underlying emotional arousal for AN. A differentiated understanding of these processes is essential, since the effectiveness of therapeutic interventions for AN is limited and relapses are frequent.

Physiological, emotional and neural responses to visual stimuli in eating disorders: a review

BACKGROUND

Overconcern with food and shape/weight stimuli are central to eating disorder maintenance with attentional biases seen towards these images not present in healthy controls. These stimuli trigger changes in the physiological, emotional, and neural responses in people with eating disorders, and are regularly used in research and clinical practice. However, selection of stimuli for these treatments is frequently based on self-reported emotional ratings alone, and whether self-reports reflect objective responses is unknown.

MAIN BODY

This review assessed the associations across emotional self-report, physiological, and neural responses to both food and body-shape/weight stimuli in people with anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). For food stimuli, either an aversive or lack of physiological effect was generated in people with AN, together with a negative emotional response on neuroimaging, and high subjective anxiety ratings. People with BN showed a positive self-rating, an aversive physiological reaction, and a motivational neural response. In BED, an aversive physiological reaction was found in contrast to motivational/appetitive neural responses, with food images rated as pleasant. The results for shape/weight stimuli showed aversive responses in some physiological modalities, which was reflected in both the emotional and neural responses, but this aversive response was not consistent across physiological studies.

CONCLUSIONS

Shape/weight stimuli are more reliable for use in therapy or research than food stimuli as the impact of these images is more consistent across subjective and objective responses. Care should be taken when using food stimuli due to the disconnect reported in this review.

The influence of mood and attitudes towards eating on cognitive and autobiographical memory flexibility in female university students

Cognitive flexibility, as measured through set-shifting ability, appears to be impaired in patients with eating disorders (EDs). Thus, it is important to determine if the switching deficit seen in clinical eating disorders generalizes to participants with a subclinical disordered eating. Another deficit manifested by clinical and subclinical disordered eating is the ability to retrieve specific autobiographical memories. It is possible that deficits in autobiographical memory retrieval extends to the ability to shift between retrieving specific versus general autobiographical memory information, a function important for problem -solving and emotion regulation. Therefore, the aims of the present study were to determine whether deficits in set-shifting are evident in a non-clinical sample of female university students with eating concerns, and whether inflexibility is also manifested in autobiographical memory retrieval. Sixty-nine female undergraduate students completed a measure of autobiographical memory flexibility, a set-shifting task (Brixton Spatial Anticipation Test) and measures of mood, ruminative thinking, and eating habits. After controlling for mood and rumination, bulimic traits predicted set-shifting ability and flexibility in autobiographical memory retrieval. Thus, flexibility deficits appear to manifest at the subclinical level, are evident in different domains, and appear to be related to bulimic traits, such as binge eating.

The influence of eating psychopathology on autobiographical memory specificity and social problem-solving

The primary aim was to examine the influence of subclinical disordered eating on autobiographical memory specificity (AMS) and social problem solving (SPS). A further aim was to establish if AMS mediated the relationship between eating psychopathology and SPS. A non-clinical sample of 52 females completed the autobiographical memory test (AMT), where they were asked to retrieve specific memories of events from their past in response to cue words, and the means-end problem-solving task (MEPS), where they were asked to generate means of solving a series of social problems. Participants also completed the Eating Disorders Inventory (EDI) and Hospital Anxiety and Depression Scale. After controlling for mood, high scores on the EDI subscales, particularly Drive-for-Thinness, were associated with the retrieval of fewer specific and a greater proportion of categorical memories on the AMT and with the generation of fewer and less effective means on the MEPS. Memory specificity fully mediated the relationship between eating psychopathology and SPS. These findings have implications for individuals exhibiting high levels of disordered eating, as poor AMS and SPS are likely to impact negatively on their psychological wellbeing and everyday social functioning and could represent a risk factor for the development of clinically significant eating disorders.

Application of the Research Domain Criteria (RDoC) framework to eating disorders: emerging concepts and research

The Research Domain Criteria (RDoC) project was initiated by the National Institute of Mental Health as a heuristic for addressing the limitations of categorical, symptom-based psychiatric diagnoses. RDoC is conceptualized as a matrix, with the rows representing dimensional constructs or domains implicated in the expression of psychiatric symptoms and the columns representing units of analysis that can be used to assess dimensional constructs (i.e., genes, molecules, cells, circuits, physiology, behavior, and self-reports). Few studies in eating disorders have adopted an RDoC framework, but accumulating data provide support for the relevance of RDoC dimensions to eating disorder symptoms. Herein, we review findings from RDoC-informed studies across the five domains of functioning included in the RDoC matrix-negative valence systems, positive valence systems, cognitive systems, systems for social processes, and arousal and regulatory systems-and describe directions for future research utilizing RDoC to enhance study design and treatment development in eating disorders.

Body dissatisfaction and self-esteem in female students aged 9-15: the effects of age, family income, body mass index levels and dance practice

This study aimed to analyze the effects of age, family income, body mass index and dance practice on levels of body dissatisfaction and self-esteem in female students. The sample consisted of 283 female subjects attending a public school with a mean age of 11.51±1.60 years and a mean body mass index of 18.72 kg/m2 (SD=3.32). The instruments used were the Body Dissatisfaction Scale for Adolescents and the Rosenberg Self-Esteem Scale, both of which showed good internal consistency (0.77 and 0.81, respectively). The tests were applied (two-factor ANOVA) to compare the students practicing and those not practicing dance; the differences in the levels of body dissatisfaction (p=0.104) and self-esteem (p=0.09) were considered significant. The results demonstrated that age negatively correlated with body dissatisfaction (r=-0.19; p<0.01) and that higher body mass index levels were associated with greater body dissatisfaction (r=0.15, p=0.016) and lower levels of self-esteem (r=-0.17, p<0.01) only in non-practitioners. The practice of dance had a significant effect on levels of body dissatisfaction (F=4.79; p=0.030; η(2)=0.02), but there was no significant difference in self-esteem (F=1.88; p=0.172; η(2)=0.02). It can be concluded that female children and adolescents practicing dance have higher self-esteem, and are more satisfied with their body weight and their appearance. Moreover, results showed that self-esteem and body dissatisfaction were influenced by the body mass index levels only in the non-practitioners group.

Feeling bad posing as a model: an objective manner of study upward own-body comparisons in body-dissatisfied women

Emotional effects of upward body comparisons are suggested to occur automatically. A startle reflex paradigm was used to objectively examine the emotions elicited by viewing a picture of one's own body adopting a model pose or a neutral pose, in 30 women with high body dissatisfaction (HBD) and 33 women with low body dissatisfaction (LBD). In-task emotional responses in perceived valence, arousal and control were assessed. Additionally, post-task positive/negative and body-related beauty feelings were recorded. The results revealed that HBD women, compared with LBD women, showed (i) less pleasure, higher activation and less control whilst viewing their own bodies and (ii) less pleasure, more negative/ugliness feelings and an increased startle response when viewing themselves posing as models. The data showed that their own bodies provoked an immediate negative emotional state in HBD women. However, greater aversive psychophysiological mechanisms were automatically activated only when these women posed as models, suggesting that they made upward own-body comparisons.

"That camera adds ten pounds!:" women's reactions to visual weight-related feedback and the role of trait body checking

In Study 1 women were randomly assigned to viewing: (1) no photo of themselves, (2) an accurate, full-body photo, (3) a photo modified to make them appear thinner than usual, or (4) a photo modified to make them appear heavier than usual. Measures of mood, state self-esteem, and body dissatisfaction were completed. There were no main effects of photo condition; participants were generally poor at perceiving weight change. The heavier that participants thought they looked in their photo as compared to usual, the worse their appearance self-esteem and body dissatisfaction. Study 2 replicated these results and found that participants with higher levels of trait body checking were more likely to report that they looked heavier than usual in the photo. Study 3 replicated these results and found that the correlation between body parts checking and how participants thought they looked in the photo held true even after controlling for appearance investment.

Risk for eating disorders modulates startle-responses to body words

Body image disturbances are core symptoms of eating disorders (EDs). Recent evidence suggests that changes in body image may occur prior to ED onset and are not restricted to in-vivo exposure (e.g. mirror image), but also evident during presentation of abstract cues such as body shape and weight-related words. In the present study startle modulation, heart rate and subjective evaluations were examined during reading of body words and neutral words in 41 student female volunteers screened for risk of EDs. The aim was to determine if responses to body words are attributable to a general negativity bias regardless of ED risk or if activated, ED relevant negative body schemas facilitate priming of defensive responses. Heart rate and word ratings differed between body words and neutral words in the whole female sample, supporting a general processing bias for body weight and shape-related concepts in young women regardless of ED risk. Startle modulation was specifically related to eating disorder symptoms, as was indicated by significant positive correlations with self-reported body dissatisfaction. These results emphasize the relevance of examining body schema representations as a function of ED risk across different levels of responding. Peripheral-physiological measures such as the startle reflex could possibly be used as predictors of females' risk for developing EDs in the future.