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Chen Q, Peng S, Luo C, Zhuang X, Ma G. Measuring early-stage attentional bias towards food images using saccade trajectory deviations. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04051-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Paslakis G, Scholz-Hehn AD, Sommer LM, Kühn S. Implicit bias to food and body cues in eating disorders: a systematic review. Eat Weight Disord 2021; 26:1303-1321. [PMID: 32770476 PMCID: PMC8128803 DOI: 10.1007/s40519-020-00974-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Rigid, restrictive eating patterns, fear of gaining weight, body image concerns, but also binge eating episodes with loss of control leading to overweight, at times followed by compensatory measures to control weight, are typical symptoms in eating disorders (EDs). The regulation of food intake in EDs may underlie explicit processes that require cognitive insight and conscious control or be steered by implicit mechanisms that are mostly automatic, rapid, and associated with affective-rather than cognitive-processing. While introspection is not capable of assessing implicit responses, so-called indirect experimental tasks can assess implicit responses underlying a specific behavior by-passing the participant's consciousness. Here, we aimed to present the current evidence regarding studies on implicit biases to food and body cues in patients with EDs. METHODS We performed a systematic review (PRISMA guidelines). We included controlled studies performed in clinical ED cohorts (vs. healthy control subjects or another control condition, e.g., restrictive vs. binge/purge AN) and using at least one indirect assessment method of interest. RESULTS Out of 115 screened publications, we identified 29 studies fulfilling the eligibility criteria, and present a synthesis of the essential findings and future directions. CONCLUSION In this emerging field of research, the present work provides cornerstones of evidence highlighting aspects of implicit regulation in eating disorders. Applying both direct (e.g., self-reports) and indirect measures for the assessment of both explicit and implicit responses is necessary for a comprehensive investigation of the interplay between these different regulatory mechanisms and eating behavior. Targeted training of implicit reactions is already in use and represents a useful future tool as an add-on to standard psychotherapeutic treatments in the battle against eating disorders. EVIDENCE LEVEL 1 (systematic review).
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Affiliation(s)
- Georgios Paslakis
- Toronto General Hospital, University Health Network, Toronto, ON, M5G 2C4, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada. .,Department of Psychosomatic Medicine and Psychotherapy, Christian-Albrechts-University, Niemannsweg 147, 24105, Kiel, Germany.
| | - Anne Deborah Scholz-Hehn
- University Medical Center, Hamburg-Eppendorf, Clinic and Policlinic for Psychiatry and Psychotherapy, Martinistraße 52, 20246, Hamburg, Germany
| | - Laura Marie Sommer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Simone Kühn
- University Medical Center, Hamburg-Eppendorf, Clinic and Policlinic for Psychiatry and Psychotherapy, Martinistraße 52, 20246, Hamburg, Germany
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Gallucci A, Del Mauro L, Pisoni A, Lauro LJR, Mattavelli G. A Systematic Review Of Implicit Attitudes And Their Neural Correlates In Eating Behaviour. Soc Cogn Affect Neurosci 2020; 18:nsaa156. [PMID: 33219691 PMCID: PMC10074774 DOI: 10.1093/scan/nsaa156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 09/17/2020] [Accepted: 11/20/2020] [Indexed: 12/15/2022] Open
Abstract
An increasing number of studies suggests that implicit attitudes toward food and body shape predict eating behaviour and characterize patients with eating disorders (EDs). However, literature has not been previously analysed, thus differences between patients with EDs and healthy controls and the level of automaticity of the processes involved in implicit attitudes are still matters of debate. The present systematic review aimed to synthetize current evidence from papers investigating implicit attitudes towards food and body in healthy and EDs populations. PubMed, EMBASE (Ovid), PsycINFO, Web of Science and Scopus were systematically screened and 183 studies using different indirect paradigms were included in the qualitative analysis. The majority of studies reported negative attitudes towards overweight/obese body images in healthy and EDs samples and weight bias as a diffuse stereotypical evaluation. Implicit food attitudes are consistently reported as valid predictors of eating behaviour. Few studies on the neurobiological correlates showed neurostimulation effects on implicit attitudes, but the automaticity at brain level of implicit evaluations remains an open area of research. In conclusion, implicit attitudes are relevant measures of eating behaviour in healthy and clinical settings, although evidence about their neural correlates is limited.
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Affiliation(s)
- Alessia Gallucci
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48--20900, Monza, Italy
- NeuroMi (Neuroscience Center), University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1--20126, Milan, Italy
| | - Lilia Del Mauro
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1--20126, Milan, Italy
| | - Alberto Pisoni
- NeuroMi (Neuroscience Center), University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1--20126, Milan, Italy
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1--20126, Milan, Italy
| | - Leonor J Romero Lauro
- NeuroMi (Neuroscience Center), University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1--20126, Milan, Italy
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1--20126, Milan, Italy
| | - Giulia Mattavelli
- NETS, School of Advanced Studies, IUSS, Piazza della Vittoria n.15, 27100, Pavia, Italy
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Korn J, Dietel FA, Hartmann AS. Testing the specificity of interpretation biases in women with eating disorder symptoms: An online experimental assessment. Int J Eat Disord 2020; 53:372-382. [PMID: 31750564 DOI: 10.1002/eat.23201] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 11/05/2019] [Accepted: 11/05/2019] [Indexed: 11/11/2022]
Abstract
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.
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Affiliation(s)
- Julia Korn
- Department of Psychiatry, University of Lübeck, Lübeck, Germany
| | - Fanny A Dietel
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Münster, Münster, Germany
| | - Andrea S Hartmann
- Institute of Psychology, Department of Human Sciences, Osnabrück University, Osnabrück, Germany
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Korn J, Dietel FA, Hartmann AS. An experimental Study on the Induction of an Eating Disorder-Specific Interpretation Bias in Healthy Individuals: Testing the Interpretation Modification Paradigm for Eating Disorders (IMP-ED). COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10026-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cassidy AR, Bernstein JH, Bellinger DC, Newburger JW, DeMaso DR. Visual-spatial processing style is associated with psychopathology in adolescents with critical congenital heart disease. Clin Neuropsychol 2018; 33:760-778. [PMID: 30585527 DOI: 10.1080/13854046.2018.1503333] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To determine whether visual-spatial processing style is associated with psychopathology in a large sample of adolescents with critical congenital heart disease (CHD). Local (part-oriented) style was hypothesized to increase risk for internalizing (but not externalizing) forms of psychopathology. METHOD Participants included 278 adolescents with critical CHD (dextro-transposition of the great arteries = 134, tetralogy of Fallot = 58, single-ventricle cardiac anatomy requiring the Fontan procedure = 86). Visual-spatial processing style was indexed using Copy Style Ratings from the Rey-Osterrieth Complex Figure-Developmental Scoring System. The Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present & Lifetime Version was used to determine presence/absence of diagnosable DSM-IV psychiatric disorder(s). Processing style and psychopathology were assessed concurrently. RESULTS Thirty-three percent of the sample had a part-oriented processing style. In multivariable binary logistic regression models, part-orientation was associated with more than twice the odds of having an anxiety disorder (lifetime: OR = 2.2, p = .02, 95% CI = 1.1-4.1; current: OR = 2.7, p = .03, 95% CI = 1.1-6.5) but was not associated with an increased risk for ADHD, disruptive behavior, or mood disorders (ps > .05). CONCLUSIONS Adolescents with critical CHD who approach complex visual-spatial materials in a local, part-oriented fashion are more likely to meet criteria for an anxiety disorder than those who approach complexity more holistically. Part-orientation may make it more difficult for individuals to judge the relative importance of isolated details and engage in more adaptive perspective-taking.
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Affiliation(s)
- Adam R Cassidy
- a Department of Psychiatry , Boston Children's Hospital, Harvard Medical School , Boston , MA , USA
| | - Jane Holmes Bernstein
- a Department of Psychiatry , Boston Children's Hospital, Harvard Medical School , Boston , MA , USA
| | - David C Bellinger
- a Department of Psychiatry , Boston Children's Hospital, Harvard Medical School , Boston , MA , USA.,b Department of Neurology , Boston Children's Hospital, Harvard Medical School , Boston , MA , USA
| | - Jane W Newburger
- c Department of Cardiology , Boston Children's Hospital, Harvard Medical School , Boston , MA , USA
| | - David R DeMaso
- a Department of Psychiatry , Boston Children's Hospital, Harvard Medical School , Boston , MA , USA
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