Body-related film clip triggers desire to binge in women with binge eating disorder

Momentary physiological indices related to eating disorders: A systematic and methodological review

Eating disorders (ED) are serious psychiatric illnesses, with no everyday support to intervene on the high rates of relapse. Understanding physiological indices that can be measured by wearable sensor technologies may provide new momentary interventions for individuals with ED. This systematic review, searching large databases, synthesises studies investigating peripheral physiological (PP) indices commonly included in wearable wristbands (heart rate [HR], heart rate variability [HRV], electrodermal activity [EDA], peripheral skin temperature [PST], and acceleration) in ED. Inclusion criteria included: (a) full peer-reviewed empirical articles in English; (b) human participants with active ED; and (c) containing one of five wearable physiological measures. Kmet risk of bias was assessed. Ninety-four studies were included (Anorexia nervosa [AN; N = 4418], bulimia nervosa [BN; N = 916], binge eating disorder [BED; N = 1604], other specified feeding and eating disorders [OSFED; N = 424], and transdiagnostic [N = 47]). Participants with AN displayed lower HR and EDA and higher HRV compared to healthy individuals. Those with BN showed higher HRV, and lower EDA and PST compared to healthy individuals. Other ED and Transdiagnostic samples showed mixed results. PP differences are indicated through various assessments in ED, which may suggest diagnostic associations, although more studies are needed to validate observed patterns. Results suggest important therapeutic potential for PP in ED, and larger studies including diverse participants and diagnostic groups are needed to fully uncover their role in ED.

Emotion and Psychophysiological Responses During Emotion-Eliciting Film Clips in an Eating Disorders Sample

Background: Greater vulnerability to negative emotions appears associated with the development and maintenance of eating disorders (EDs). A systematic review of psychophysiological studies using emotion-eliciting film clips reveals that there are no studies examining the effect of standardized validated film clips on psychophysiological response across a range of EDs.

Methods: Using standardized validated film clips without ED-specific content, the present study examined self-reported emotions and psychophysiological responses of women with Binge-Eating Disorder (BED; n = 57), Anorexia Nervosa (AN; n = 16), Bulimia Nervosa (BN; n = 34), and Healthy Controls (HCs; n = 26) at Baseline, during Neutral, Sad, Happy, and Fear-inducing film clips, and at Recovery.

Results: Throughout the protocol, the ED groups reported significantly greater sadness and anxiety than HCs. Additionally, the AN group reported more fear, the BED group more frustration, and the BED and BN groups more tension than HCs. Compared to HCs, the BED group reported stronger urges to binge throughout the protocol, whereas BN group reported stronger urges to binge relative to the HC group only at Baseline and Recovery. The BN and BED groups experienced decreased urges to binge during all film clips compared to Baseline. Respiratory Sinus Arrhythmia levels were significantly lower in the BED group compared to HCs and the BN group throughout the protocol.

Discussion: Standardized validated film clips can be used to elicit expected self-reported emotion and skin conductance responses in ED groups, although individuals with EDs compared HCs report greater negative emotions. Interestingly, film clips appeared to reduce urges to binge in binge-eating groups.

The effect of cognitive symptoms in binge eating disorder on depression and self-esteem: a cross-sectional study

PURPOSE

To compare individuals with class II and III obesity with and without binge eating disorder (BED) in terms of sociodemographic characteristics, depressive symptoms, self-esteem, eating behaviors, and cognitive variables thought to be involved in the pathophysiology of the disease.

METHODS

The participants were selected from volunteer patients with body mass index ≥ 35 applying to the Ondokuz Mayıs University Medical Faculty, Turkey, for bariatric surgery between 01.07.2016 and 31.05.2019. The Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSES), and Eating Disorder Examination Questionnaire (EDE-Q) were administered to all participants.

RESULTS

Binge eating disorder (BED) was determined in 95 (34%) of the 278 individuals applying for bariatric surgery. The frequency of previous psychiatric diseases was higher in the BED group than in the non-BED group. BDI, RSES, total EDE-Q, weight concern, shape concern, and eating concern EDE-Q subscale scores were also higher in the BED group. Correlation analysis revealed positive low correlation between depression scores and total EDE-Q scores and all subscales scores, with the exception of restraint. Positive low correlation was determined between decreased self-esteem and body weight and shape concern. At multivariate regression analysis, cognitive variables explained 28.6% of variance in depressive symptoms in the BED group, and 21.5% of variance in self-esteem.

CONCLUSION

The study results showed elevation in cognitive factors in patients with BED compared to the controls. Among these variables, eating and weight concern were shown to be associated with depressive symptoms, while eating concern was linked to self-esteem.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

Emotion regulation of others' positive and negative emotions is related to distinct patterns of heart rate variability and situational empathy

Although emotion regulation has been proposed to be crucial for empathy, investigations on emotion regulation have been primarily limited to intrapersonal processes, leaving the interpersonal processes of self-regulation rather unexplored. Moreover, studies showed that emotion regulation and empathy are related with increased autonomic activation. How emotion regulation and empathy are related at the autonomic level, and more specifically during differently valenced social situations remains an open question. Healthy adults viewed a series of short videos illustrating a target who was expressing positive, negative, or no emotions during a social situation (Positive, Negative, or Neutral Social Scenes). Prior to each video, participants were instructed to reappraise their own emotions (Up-regulation, Down-regulation, or No-regulation). To assess autonomic activation, RR intervals (RRI), high frequency (HF) components of heart rate variability (HRV), and electrodermal activity phasic responses (EDRs) were calculated. Situational empathy was measured through a visual analogue scale. Participants rated how empathic they felt for a specific target. Up- and Down-regulation were related to an increase and a decrease in situational empathy and an increase in RRI and HF, respectively, compared to the control condition (No-regulation). This suggests increased activity of the parasympathetic branch during emotion regulation of situational empathic responses. Positive compared to Negative Social Scenes were associated with decreased situational empathy, in addition to a slightly but non-significantly increased HF. Altogether, this study demonstrates that emotion regulation may be associated with changes in situational empathy and autonomic responses, preferentially dominated by the parasympathetic branch and possibly reflecting an increase of regulatory processes. Furthermore, the current study provides evidence that empathy for different emotional valences is associated with distinct changes in situational empathy and autonomic responses.

An investigation of the affective experience of females at high risk for eating disorders in general and pathology-specific contexts

OBJECTIVE

Difficulties with emotional experiences have long been implicated in the development or maintenance of eating disorders (EDs). However, the vast majority of this work is theoretical or self-report, with few studies examining the somatic-affective experience of individuals with EDs under experimental conditions. The aim of the current study was to: i) examine physiological reactivity and subjective report of emotional experiences in response to ED pathology-specific and general affective film clips, and ii) examine the impact of film on body size estimation in females at risk for EDs.

METHOD

Females aged 14-24 years old of either high (N = 42) or low (N = 43) risk for EDs viewed pathology-specific and general affective film clips and provided their affective ratings and body-size estimations post film clips. Heart Rate and Skin Conductance Levels were recorded during each clip.

RESULTS

High risk participants evidenced greater physiological arousal across conditions and in both general and pathology-specific affective contexts. Negative affect induced via the ED-pathology specific film clip had a greater impact on the high risk group's body-size estimations.

CONCLUSIONS

Individuals at risk for EDs seem to experience greater physiological arousal and this may influence the experience of their bodies, or direct attention to their body as a way to attenuate unwanted emotion or due to somatic feedback.

Inducing negative affect using film clips with general and eating disorder-related content

The aim of the present study was to select appropriate film clips with a general vs. eating disorder (ED)-related content to induce negative affect. More specifically, the study examined the subjective emotional experience (valence, arousal, anxiety, induction of somatic symptoms, and ability to control reactions during film clips) of Greek-Cypriot university students (N = 79) in response to three types of film clips: general unpleasant, ED-specific unpleasant, and emotionally neutral. In addition, the study aimed to compare the emotional reactions to the aforementioned clips between two groups of participants differing on their risk for ED (high vs. low). Preliminary results indicate the clips with general content ("The Champ") and with ED-specific content ("Binge eating") that are most effective in inducing negative affect and differentiating between risk groups. These clips provide an effective method for emotion induction that can be used for assessing the emotional experience of individuals with ED symptoms, since their emotional experience is significantly implicated in the development and maintenance of their symptoms (Merwin, Clin Psychol Sci Pract 18(3):208-214, 2011).Level of evidence No level of evidence, Experimental Study.

Different Facets of Body Image Disturbance in Binge Eating Disorder: A Review

The goal of the present review is to give an overview of the current findings on various facets of body image disturbance in Binge Eating Disorder such as body dissatisfaction, overconcern with weight and shape, body-related checking and avoidance behavior, misperception of body size, and body-related cognitive bias. In addition, treatments for a disturbed body image in BED and evidence of body image disturbance in youth with binge eating are reviewed. The results show that a disturbed body image in BED is present in the form of overconcern with weight and shape. Furthermore, there are hints that body dissatisfaction, as well as body-related checking and avoidance behavior, are also impaired. Research concerning misperception of body size in BED has been neglected so far, but first findings show that individuals with BED rate their own body shape rather accurately. Furthermore, there are first hints that body-related cognitive biases are present in individuals with BED. Moreover, in children and adolescents, there are first hints that body dissatisfaction, as well as shape and weight concerns, seem to be associated with loss of control and binge eating. Treatments aimed directly at the convertibility of a disturbed body image in BED have revealed encouraging outcomes. In conclusion, body image disturbance seems to occur in BED, and first studies show that it can be treated effectively.

Emotion Regulation in Binge Eating Disorder: A Review

The purpose of the present review is to provide a summary of the research findings on emotion regulation in Binge Eating Disorder (BED). Negative emotions and maladaptive emotion regulation strategies play a role in the onset and maintenance of binge eating in BED. Anger and sadness, along with negative emotions related to interpersonal experiences (i.e., disappointment, being hurt or loneliness), seem to be particularly relevant. Individuals with BED have a tendency to suppress and ruminate on their unwanted emotions, which leads to increased psychopathological thoughts and symptoms. Compared to healthy controls, they use adaptive strategies, such as reappraisal, less frequently. Evidence concerning the causal relation between negative affect and binge eating is inconclusive and still very limited. While experimental studies in a laboratory setting lack ecological validity, ecological momentary assessment studies offer more promise at unraveling the causal relationship between emotions and binge eating. Increases in negative affect are found to be antecedents of binge eating in BED. However, there seems to be less support for the possibility that binge eating serves as a means to alleviate negative affect. Finally, BED seems to be related to other forms of maladaptive emotion regulation strategies, such as substance abuse and self-harm.

The importance of body image concerns in overweight and normal weight individuals with binge eating disorder

Body image concerns in binge eating disorder (BED) have been examined almost exclusively in overweight individuals with BED. The current study extends past research by including overweight and normal weight BED and non-BED groups to assess the multifactorial construct of body image using subscales of the Eating Disorder Examination 16.0 (EDE-16.0) and a Body Comparison Task. Independent of weight status and when controlling for age and race, women with BED are distinguished from those without BED by significantly greater overvaluation of shape and weight on the EDE-16.0 and significantly reduced weight satisfaction after a Body Comparison Task. Both BED diagnosis and weight status were independently associated with Weight Concern and Shape Concern subscales on the EDE-16.0. Taken together, these data provide further support for the consideration of body image concerns in the diagnostic criteria for BED.

Exploring the mind's eye: Contents and characteristics of mental images in overweight individuals with binge eating behaviour

Mental images play a role in various mental disorders and are strongly associated with emotions. Negative emotions and their regulation are important in eating disorders. However, research on mental imagery in eating disorders is still scarce. We investigated mental images and their relation to distress and eating disorder psychopathology in individuals with binge eating behaviour. Content and characteristics of mental images and their relation to psychopathology of 21 individuals with binge eating behaviour, 19 mixed patient controls and 21 healthy controls have been assessed with a semi-structured interview. Occurrence and vividness of food-related images did not differ between groups. However they were experienced as more distressing and distracting and more difficult to control by eating disordered patients. Body-related mental images were less associated with desire to eat than expected. Mental images of social rejection were experienced as more vivid by both clinical groups and caused desire to eat in individuals with binge eating behaviour. Mental images are relevant in binge eating behaviour, but with different patterns regarding concomitant distress and eating disorder psychopathology. As transdiagnostic mental images of social rejection are relevant for individuals with binge eating behaviour, research on imagery based techniques in eating disorders seems promising.

Does habituation really happen? Investigation of psycho-biological responses to body exposure in bulimia nervosa

BACKGROUND

Body exposure is a common and effective treatment for body image disturbance in bulimia nervosa (BN). However, little is known about treatment mechanisms. Based on models of emotional processing and neurovisceral integration, we expected to observe a) initial activation and b) habituation of cognitive-affective and autonomic responding within one and between two standardized body exposure sessions.

METHODS

A group of 13 women with BN and 13 healthy controls (HC) were repeatedly exposed to their bodies. Prior to and after treatment with three individualized mirror exposure sessions participants received a session of standardized exposure to videographic recordings of their body. Subjective ratings of body-related emotions and thoughts were assessed repeatedly throughout the standardized exposure sessions and autonomic responses were recorded continuously.

RESULTS

Subjective and sympathetic responses were activated initially in both groups. Cognitive-affective responses habituated within the standardized sessions in both groups, whereas between the standardized sessions habituation was only found in women with BN. Increasing sympathetic responses were found within the sessions in both groups.

CONCLUSIONS

The results support cognitive-affective habituation during body exposure in BN and to a lesser extent in HC. Autonomic responses however did not show a corresponding pattern and did not distinguish between groups. Implications for body exposure research and practice are discussed.

Behavioral evidence of emotion dysregulation in binge eaters

Binge eating is the most common disordered eating symptom and can lead to the development of obesity. Previous self-report research has supported the hypothesis that individuals who binge eat report greater levels of general emotion dysregulation, which may facilitate binge-eating behavior. However, to date, no study has experimentally tested the relation between binge eating history and in-vivo emotion dysregulation. To do this, a sample of female college students who either endorsed binge eating (n = 40) or denied the presence of any eating pathology (n = 47) completed the Difficulties with Emotion Regulation Scale (DERS) and a behavioral distress tolerance task (the Paced Auditory Serial Addition Task-Computer: PASAT-C) known to induce negative affect and distress. The binge eating group was 2.96 times more likely to quit the PASAT-C early (χ² = 5.04, p = 0.025) and reported greater irritability (F(1,84) = 7.09 p = 0.009) and frustration (F(1,84) = 5.00, p = 0.028) after completing the PASAT-C than controls, controlling for initial levels of these emotions. Furthermore, across the entire sample, quitting early was associated with greater emotion dysregulation on the DERS (r_pb = 0.342, p < 0.01). This study is the first to demonstrate that individuals who binge eat show in-vivo emotional dysregulation on a laboratory task. Future studies should examine the PASAT-C to determine its potential clinical utility for individuals with or at risk of developing binge eating.

Diagnosing binge eating disorder in a primary care setting

Binge eating disorder (BED), now recognized as a distinct eating disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is the most prevalent eating disorder. Although nearly half of individuals with BED are obese, BED also occurs in nonobese individuals. Despite the relatively high percentage of weight loss treatment-seeking individuals meeting BED criteria, primary care physicians may not be familiar with or have ever diagnosed BED. Many providers may also have difficulty distinguishing BED as a contributory factor in obesity. This review differentiates BED from other causes of obesity by describing how obese individuals with BED differ from obese individuals without BED and from nonobese individuals with BED in areas including psychopathology, behavior, genetics, physiology, quality of life and productivity. The ways in which health-care providers can identify individuals who may have BED are also highlighted so the proper course of treatment is pursued. Overall, obese individuals with BED demonstrate a number of key characteristics that differentiate them from obese individuals without eating disorders, including increased impulsivity in response to food stimuli with loss of control over eating, resulting in the consumption of more calories. They also experience significant guilt and other negative emotions following a meal. In addition, individuals with BED patients have more psychiatric comorbidity, display more psychopathology, exhibit longer binge durations, consume more meals as snacks during the day and have less dietary restraint compared with individuals with BED who are not obese. However, the differences between individuals with BED who are obese versus not obese are not as prominent. Taken together, the evidence appears to support the conclusion that BED is a unique and treatable neurobehavioral disorder associated with distinct behavioral and psychological profiles and distinct medical and functional outcomes, and that it is not merely a subtype of obesity.

Comorbidity of mood and substance use disorders in patients with binge-eating disorder: Associations with personality disorder and eating disorder pathology

OBJECTIVE

Binge-eating disorder (BED) is associated with elevated rates of mood and substance use disorders, but the significance of such comorbidity is ambiguous. We compared personality disorder and eating disorder psychopathology in four subgroups of BED patients: those with mood disorders, those with substance use disorders, those with both, and those with neither.

METHOD

Subjects were 347 patients who met DSM-IV research criteria for BED. Semistructured interviews evaluated lifetime DSM-IV axis I disorders, DSM-IV personality disorder features, and eating disorder psychopathology.

RESULTS

Among these patients, 129 had co-occurring mood disorder, 34 had substance use disorder, 60 had both, and 124 had neither. Groups differed on personality disorder features, with those having mood disorder and both mood and substance use disorders showing the highest frequencies. Although groups did not differ in body mass index or binge eating frequency, they did differ on eating disorder psychopathology-with the groups having mood disorder and both comorbidities demonstrating higher eating, weight, and shape concerns. No differences were observed between groups with respect to ages of onset for specific eating behaviors, but some differences were observed for ages of disorder onset.

CONCLUSION

Mood and substance use disorders co-occur frequently among patients with BED. Compared with a previous work, the additional comparison group (those with both mood and substance use disorders) and the control group (those with neither) afforded better discrimination regarding the significance of these comorbidities. Our findings suggest approaches to subtyping BED based on psychiatric comorbidity, and may also have implications for treatment.

Examining the role of distress tolerance and negative urgency in binge eating behavior among women

The current study examined whether distress tolerance and negative urgency moderate the link between depressive symptoms and binge eating frequency, and between disordered eating attitudes and binge eating frequency. Young adult women (N=186) completed questionnaires assessing depressive symptoms, cognitive restraint, eating, shape and weight concerns, distress tolerance, impulsivity (including negative urgency), and binge eating. After controlling for body mass index, race/ethnicity, and other domains of impulsivity, negative urgency was significantly associated with binge eating above and beyond the influence of disordered eating attitudes and depressive symptoms. Distress tolerance, in contrast, was not associated with binge eating. In addition, neither negative urgency nor distress tolerance moderated the associations between disordered eating attitudes and binge eating frequency, or between depressive symptoms and binge eating. Results support the additive role of difficulties responding adaptively to distress in binge eating frequency, above and beyond the influence of emotional distress. Findings highlight the potential value of focusing on negative urgency in targeted treatments for binge eating among women. Importantly, results from the current study differ from those of previous research; these discrepancies could be the result of variations in sample characteristics and approaches to the assessment of binge eating behavior. Additional research, including longitudinal studies and research using "real-time" assessment strategies, such as ecological momentary assessment, is necessary to elucidate further the role of various emotion regulation strategies in maintaining binge eating behavior in adult women.

General and food-specific inhibitory deficits in binge eating disorder

OBJECTIVE

To investigate behavioral inhibition in individuals with binge eating disorder (BED) compared with overweight and obese individuals without BED (No-BED).

METHOD

Participants with BED (n = 31) and the weight-matched No-BED group (n = 29) completed an inhibitory control task (stop-signal task, SST) with food and neutral stimuli.

RESULTS

The BED group needed more time to stop an ongoing response, as indicated by increased stop signal reaction time (SSRT) relative to the No-BED group. Additionally, compared with the No-BED group, the BED group displayed more difficulty inhibiting responses elicited by food stimuli. The deficits in behavioral response inhibition were also found to be related to the severity of reported symptoms.

DISCUSSION

There is a general deficit in late stage behavioral inhibition in BED, and this may be particularly pronounced in the context of food stimuli.

Pilotstudie zur Effektivität eines Emotionsregulationstrainings bei Frauen mit Binge-Eating-Störung

Negative Emotionen sind ein häufiger Auslöser von Essanfällen bei Personen mit Binge-Eating-Störung (BES). Erste Untersuchungen haben gezeigt, dass Defizite in der Emotionsregulation (ER) den Zusammenhang von negativen Emotionen und Essanfällen mediieren. Vor diesem Hintergrund erhielten im Rahmen einer Pilotstudie 14 Frauen mit BES ein ER-Training in der Gruppe. Indikatoren für die Effektivität des Trainings waren Anzahl der Episoden und Tage mit objektiven Essanfällen, Körperunzufriedenheit, sowie Depressivität vor Studienbeginn (T0), nach 8 Wochen Wartezeit (T1) und nach dem 8-wöchigen ER-Training (T2). Während es keine Veränderungen von T0 zu T1 gab, zeigte sich eine signifikante Reduktion der Symptomatik in allen erhobenen Variablen von T1 zu T2. Die Ergebnisse der Pilotstudie unterstützen die Relevanz der ER bezüglich der Reduktion von Essanfällen und damit die Notwendigkeit gut implementierter Therapiestudien, die die Effektivität von ER-Trainings in der Veränderung der Psychopathologie der BES untersuchen. Zudem sind weitere Studien, die die Rolle der ER bei der Aufrechterhaltung der BES klären, notwendig.

Binge eating in binge eating disorder: a breakdown of emotion regulatory process?

Current explanatory models for binge eating in binge eating disorder (BED) mostly rely on models for bulimia nervosa (BN), although research indicates different antecedents for binge eating in BED. This study investigates antecedents and maintaining factors in terms of positive mood, negative mood and tension in a sample of 22 women with BED using ecological momentary assessment over a 1-week. Values for negative mood were higher and those for positive mood lower during binge days compared with non-binge days. During binge days, negative mood and tension both strongly and significantly increased and positive mood strongly and significantly decreased at the first binge episode, followed by a slight though significant, and longer lasting decrease (negative mood, tension) or increase (positive mood) during a 4-h observation period following binge eating. Binge eating in BED seems to be triggered by an immediate breakdown of emotion regulation. There are no indications of an accumulation of negative mood triggering binge eating followed by immediate reinforcing mechanisms in terms of substantial and stable improvement of mood as observed in BN. These differences implicate a further specification of etiological models and could serve as a basis for developing new treatment approaches for BED.

Clarifying boundaries of binge eating disorder and psychiatric comorbidity: a latent structure analysis

Binge eating disorder (BED) presents with substantial psychiatric comorbidity. This latent structure analysis sought to delineate boundaries of BED given its comorbidity with affective and anxiety disorders. A population-based sample of 151 women with BED, 102 women with affective or anxiety disorders, and 259 women without psychiatric disorders was assessed with clinical interviews and self-report-questionnaires. Taxometric analyses were conducted using DSM-IV criteria of BED and of affective and anxiety disorders. The results showed a taxonic structure of BED and of affective and anxiety disorders. Both taxa co-occurred at an above-chance level, but also presented independently with twice-as-large probabilities. Within the BED taxon, diagnostic co-occurrence indicated greater general psychopathology, lower social adaptation, and greater premorbid exposure to parental mood and substance disorder, but not greater eating disorder psychopathology. Eating disorder psychopathology discriminated individuals in the BED taxon from individuals in the affective and anxiety disorders taxon. Diagnostic criteria of BED were more indicative of the BED taxon than were criteria of affective and anxiety disorders. The results show that at the latent level, BED was co-occurring with, yet distinct from, affective and anxiety disorders and was not characterized by an underlying affective or anxiety disorder.

Effectiveness for interpersonal problem-solving is reduced in women with binge eating disorder

OBJECTIVE

Therapeutic programs for binge eating disorder (BED) often include the mediation of problem-solving skills to deal with the desire to binge. In women with BED, problem-solving abilities have not been studied yet. Knowing that reasons for binge episodes are often linked to interpersonal topics, we expected women with BED to have poorer problem-solving abilities than healthy controls (HC).

METHODS

Twenty-five women with BED and 30 overweight HC were given a shortened version of the Means-Ends Problem-Solving Procedure (MEPS). Dependent variables were the number of relevant means, the effectiveness and the specificity of the generated solution.

RESULTS

Generated solutions in the group of women with BED were significantly less effective and less specific compared to HC. Moreover, reduced effectiveness of interpersonal problem-solving was related to increased binge frequency.

CONCLUSIONS

The results support the importance of teaching problem-solving ability in individuals with BED to promote behaviour change.

Erfassung dysfunktionaler Kognitionen zum Body Checking

Zusammenfassung. Theoretischer Hintergrund: Empirische Befunde zeigen, dass körperbezogenes Kontrollverhalten und die zugrunde liegenden Kognitionen eine zentrale Rolle in der Aufrechterhaltung von Essstörungspsychopathologie spielen. Fragestellung: Eine deutschsprachige Version der Body Checking Cognitions Scale (BCCS) soll teststatistisch überprüft werden. Methode: Frauen mit Anorexia Nervosa (n = 19), Bulimia Nervosa (n = 22) und Binge-Eating Störung (n = 28) sowie eine weibliche nicht-klinische Vergleichsgruppe (n = 195) füllten die BCCS sowie weitere Fragebögen zur Essstörungspsychopathologie aus. Ergebnisse: Das 4-Faktorenmodell der englischsprachigen Originalversion zeigte in Faktorenanalysen die beste Passung. Die deutschsprachige BCCS erwies sich als intern konsistent und zeigte eine zufriedenstellende konvergente und diskriminante Validität. Schlussfolgerungen: Die deutschsprachige BCCS ist ein reliabler und valider Selbstbeurteilungsfragebogen. Sie stellt ein vielversprechendes Instrument zum Einsatz in der Essstörungstherapie und -forschung dar.

Explicit memory bias for positively valenced body-related cues in women with binge eating disorder

Overweight women with and without binge eating disorder (BED) are characterized by a marked body dissatisfaction, which may in part be due to the negative comments about their weight. Weight-related teasing and discrimination is reported both by healthy overweight women and women with BED, whereas body dissatisfaction is markedly increased among women with BED. Therefore, a memory bias for negatively valenced body-related cues is suspected to occur as a mediating factor in women with BED. In an experimental study, 18 women with BED were compared to 18 overweight healthy female controls (HC) on a free recall task containing four word categories: positively valenced with and without body-related content and negatively valenced with and without body-related content. While both groups showed a bias towards negatively valenced shape-/weight-related words, women with BED retrieved positively valenced shape-/weight-related words significantly less often compared to overweight HC. Findings suggest that it may be the reduced ability to attend to positively valenced shape-/weight-related information, rather than the activation of negative body schemata that differentiates overweight women with BED from overweight women without BED. Results are discussed in the context of cognitive biases in the maintenance of body dissatisfaction.

Decision-making impairments in women with binge eating disorder

Even though eating is frequently driven by overindulgence and reward rather than by energy balance, few studies so far have analyzed decision-making processes and disturbances in feedback processing in women with binge eating disorder (BED). In an experimental study, 17 women with BED (DSM-IV) and 18 overweight healthy controls (HC) were compared in the game of dice task (GDT). This task assesses decision-making under risk with explicit rules for gains and losses. Additionally, differences in dispositional activation of the behavior inhibition and behavior approach system as well as cognitive flexibility were measured. Main results revealed that women with BED make risky decisions significantly more often than HC. Moreover, they show impaired capacities to advantageously utilize feedback processing. Even though these deficits were not related to disease-specific variables, they may be important for the daily decision-making behavior of women with BED, thus being relevant as a maintenance factor for the disorder.