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Rossi AA, Pietrabissa G, Castelnuovo G, Mannarini S. Cognitive restraint, uncontrolled eating, and emotional eating. The Italian version of the Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18): a three-step validation study. Eat Weight Disord 2024; 29:16. [PMID: 38402372 PMCID: PMC10894126 DOI: 10.1007/s40519-024-01642-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/29/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used questionnaire to measure three transdiagnostic features of eating behavior: cognitive restraint, uncontrolled eating, and emotional eating. OBJECTIVE This research aims to investigate the psychometric properties of the Italian version of the TFEQ-R-18 in three large community samples. METHOD Cross-sectional research designs were employed. In Study 1 (N = 537), an exploratory graph analysis (EGA) was used to examine item clustering within the TFEQ-R-18. In Study 2 (N = 645), a confirmatory factor analysis (CFA) was conducted to test its structural validity. In Study 3 (N = 346), a MANOVA was employed assessing mean differences across eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder). RESULTS In Study 1, the EGA accurately identified the three original dimensions of the TFEQ-R-18. Study 2 showed that the Italian TFEQ-R-18 has good fit indexes (CFI = 0.989, RMSEA = 0.064; 90% CI [0.058, 0.070], SRMR = 0.062), and possesses robust psychometric properties. Study 3 reveals distinct, statistically significant differences among eating disorders. CONCLUSION The TFEQ-R-18 proves to be a concise and precise tool for measuring transdiagnostic eating behaviors. Its applicability in the Italian context, supported by robust psychometric properties, suggests its utility for both research and clinical purposes. The findings affirm its potential to inform interventions aimed at enhancing psychological health. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- Alessandro Alberto Rossi
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padua, Italy.
- Center for Intervention and Research on Family studies - CIRF, Department FISPPA, University of Padova, Padua, Italy.
| | - Giada Pietrabissa
- Clinical Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Dipartimento di Psicologia, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Gianluca Castelnuovo
- Clinical Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Dipartimento di Psicologia, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padua, Italy
- Center for Intervention and Research on Family studies - CIRF, Department FISPPA, University of Padova, Padua, Italy
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Horndasch S, Sharon E, Eichler A, Graap H, Moll GH, Kratz O. Heart Rate as a Correlate for the Emotional Processing of Body Stimuli in Anorexia Nervosa. Behav Sci (Basel) 2023; 13:bs13030215. [PMID: 36975240 PMCID: PMC10045133 DOI: 10.3390/bs13030215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
In anorexia nervosa, aberrant emotional reactions toward body stimuli have been discussed. We investigated heart rate as a physiological marker when viewing body stimuli and hypothesized altered HR reactions toward those highly significant and emotional stimuli in anorexia nervosa. In total, 37 anorexia nervosa patients and 43 control participants viewed pictures of women of five different weight categories, while their cardiac activity was recorded. R-R intervals following picture onset were determined, and means were calculated for three distinct time periods. The overall change in HR relative to baseline across all picture categories was greater in the patient group than in the control group (significant effect of “group”, p = 0.002, partial η2 = 0.120). A significant decrease in HR 2 to 8 s after picture presentation was found for pictures of women of extreme weight in both participant groups (significant “category ∗ time segment interaction”, p = 0.01, partial η2 = 0.037) and correlated with scores of sociocultural attitudes toward the appearance for the extremely underweight category (r = −0.33, p = 0.005). Therefore, differential HR reactions for anorexia nervosa patients and control participants were found for body stimuli in general. The highest HR decelerations in response to pictures of strongly underweight and overweight women may reflect emotional processes such as anxiety due to social comparison.
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Affiliation(s)
- Stefanie Horndasch
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
- Correspondence: ; Tel.: +49-9131-8539123
| | - Elisabeth Sharon
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Holmer Graap
- Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Gunther H. Moll
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany
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Bokoch R, Hass-Cohen N, Fowler G, Liu L. Obesity prevention: a pilot study on community workshops delivered by art therapists. INTERNATIONAL JOURNAL OF ART THERAPY 2022. [DOI: 10.1080/17454832.2022.2123010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Rebecca Bokoch
- California School of Professional Psychology, Alliant International University, Alhambra, CA, USA
| | - Noah Hass-Cohen
- California School of Professional Psychology, Alliant International University, Alhambra, CA, USA
| | - Grace Fowler
- California School of Professional Psychology, Alliant International University, Alhambra, CA, USA
| | - Lisa Liu
- California School of Professional Psychology, Alliant International University, Alhambra, CA, USA
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Mahr F, Bunce SC, Meyer RE, Halmi KA. Affect Modulated Startle Response in Anorexia Nervosa, Restricting Type: Implications for Theory and Practice. Cureus 2022; 14:e27304. [PMID: 36039238 PMCID: PMC9403399 DOI: 10.7759/cureus.27304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2022] [Indexed: 11/29/2022] Open
Abstract
Objective: Individuals with anorexia nervosa (AN), restricting type demonstrate unique emotional responses to hedonically positive stimuli beyond eating disorder (ED)-related stimuli. The goal of this study was to evaluate differences in responses to five types of emotionally positive stimuli among acutely ill anorexia nervosa (IAN), restricting type patients, weight-recovered anorexia patients (WRAN), and healthy controls (HCs) using affect modulated startle response (AMSR) as an objective measure. Method: A total of 28 participants were recruited (n=28). Fourteen participants were recruited as IAN using the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) criteria, seven were WRAN, and seven were HC females. All participants were female and aged between 8 and 18 years. The participants viewed images depicting negative, neutral, standardized, and non-eating disorder (ED)-related positive stimuli. Additionally, four categories of ED-related stimuli (high-calorie food, body image, success, and parent-child relationships) were presented to all participants during a standard AMSR paradigm. Results: No significant between-group differences were found for any of the four ED stimulus categories; all groups showed an inhibited startle response to the four ED-related categories. In contrast, IAN and WRAN showed reduced hedonic responses to standardized positive stimuli relative to HC-replicating previous results. Reduced hedonic response to the standardized (non-ED) positive stimuli was highly correlated with self-reported social anxiety, low self-esteem, body dissatisfaction, asceticism, interpersonal problems, and ineffectiveness. Conclusion: AN patients had a reduced hedonic response to some non-ED-related positive stimuli, which correlated with several anxiety-related traits. In contrast, their early automatic responses to high-calorie food, normal weight models, images of success, and positive parent-child relationships did not differ from HC, suggesting these stimuli are either being evaluated as highly interesting or hedonically positive.
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Wilson S, Benning SD, Racine SE. Examining relationships among thin-ideal internalization, eating pathology, and motivational reactions to high- and low-calorie food. Appetite 2022; 178:106258. [DOI: 10.1016/j.appet.2022.106258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/18/2022] [Accepted: 07/24/2022] [Indexed: 11/02/2022]
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Ackermans MA, Jonker NC, Bennik EC, de Jong PJ. Hunger increases negative and decreases positive emotions in women with a healthy weight. Appetite 2021; 168:105746. [PMID: 34637770 DOI: 10.1016/j.appet.2021.105746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 01/06/2023]
Abstract
The term 'hangry' is colloquially used to describe being "bad tempered or irritable as a result of hunger," but remarkably few studies have examined the effect of hunger on emotions. Yet, women attempting to restrict their food intake may be at risk of becoming entangled in a vicious cycle of hunger and negative emotions. That is, hunger may lead to negative emotions, which can lead to overeating and overeating can, in turn, provoke subsequent restriction leading to more hunger. Therefore the aim of this study was to examine the effect of hunger on positive and negative emotions in women with a healthy BMI, and the role of subclinical eating disorder symptoms in this effect. We randomly assigned women to a hunger condition (fasting for 14 h, n = 53) or satiated condition (eat breakfast before the study, n = 55), and they completed the Eating Disorder Examination Questionnaire and the Profile of Mood States in the lab. Hungry women reported overall higher negative emotions (higher tension, anger, fatigue, and confusion) and lower positive emotions (lower vigour and marginally lower esteem-related affect) than satiated women. Moreover, for satiated but not for hungry women, higher eating disorder symptoms were associated with lower esteem-related affect. These findings show that food restriction leads to negative emotions, and practitioners and individuals should be aware of these implications of food restriction on mental health. Second, clinicians and individuals should be wary of relatively low esteem-related affect when satiated in individuals with eating disorder symptoms, as it could serve as a maintaining factor in eating pathology.
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Affiliation(s)
- M A Ackermans
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands
| | - N C Jonker
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands.
| | - E C Bennik
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands
| | - P J de Jong
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, the Netherlands
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Hernández-Rivero I, Blechert J, Miccoli L, Eichin KN, Fernández-Santaella MC, Delgado-Rodríguez R. Emotional reactivity to binge food and erotic cues in women with bulimia nervosa symptoms. J Eat Disord 2021; 9:120. [PMID: 34583783 PMCID: PMC8479974 DOI: 10.1186/s40337-021-00475-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/10/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Studies on food cue reactivity have documented that altered responses to high-calorie food are associated with bulimic symptomatology, however, alterations in sexual motivations and behaviors are also associated clinical features in this population, which justify their inclusion as a research target. Here, we study responses to erotic cues-alongside food, neutral and aversive cues-to gain an understanding of specificity to food versus a generalized sensitivity to primary reinforcers. METHODS We recorded peripheral psychophysiological indices -the startle reflex, zygomaticus, and corrugator responses-and self-reported emotional responses (valence, arousal, and dominance) in 75 women completing the Bulimia Test-Revised (BULIT-R). Multiple regression analysis tested whether BULIT-R symptoms were predicted by self-reported and psychophysiological responses to food versus neutral and erotic versus neutral images. RESULTS The results showed that individuals with higher bulimic symptoms were characterized by potentiated eye blink startle response during binge food (vs. neutral images) and more positive valence ratings during erotic (vs. neutral) cues. CONCLUSIONS The results highlight the negative emotional reactivity of individuals with elevated bulimic symptoms toward food cues, which could be related to the risk of progression to full bulimia nervosa and thereby addressed in prevention efforts. Results also point to the potential role of reactivity to erotic content, at least on a subjective level. Theoretical models of eating disorders should widen their conceptual scope to consider reactivity to a broader spectrum of primary reinforcers, which would have implications for cue exposure-based treatments. We examined appetitive and aversive cue responses in college women to investigate how bulimic symptoms relate to primary reinforcers such as food and erotic images. We recorded peripheral psychophysiological indices (the startle reflex, zygomaticus, and corrugator responses) and self-reported emotional responses (valence, arousal, and dominance) in 75 college women that were presented with the Spanish version of the Bulimia Test-Revised. The results showed that bulimic symptoms increase both psychophysiological defensiveness toward food cues and subjective pleasure toward erotic cues. The findings suggest a generalized sensitivity to primary reinforcers in the presence of bulimic symptoms, and emphasize the relevance of adopting a wider framework in research and treatment on bulimia nervosa.
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Affiliation(s)
- Isabel Hernández-Rivero
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Campus de Cartuja s/n, 18071, Granada, España
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunnerstraße 34, 5020, Salzburg, Austria
| | - Laura Miccoli
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Campus de Cartuja s/n, 18071, Granada, España
| | - Katharina Naomi Eichin
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunnerstraße 34, 5020, Salzburg, Austria
| | - M Carmen Fernández-Santaella
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Campus de Cartuja s/n, 18071, Granada, España
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Sierra I, Senín-Calderón C, Roncero M, Perpiñá C. The Role of Negative Affect in Emotional Processing of Food-Related Images in Eating Disorders and Obesity. Front Psychol 2021; 12:723732. [PMID: 34497567 PMCID: PMC8419244 DOI: 10.3389/fpsyg.2021.723732] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/29/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to analyze differences in the emotional processing (valence, arousal, and dominance) of food-related information in patients with eating disorders (ED), patients with obesity, and healthy women. Moreover, the mediator role of negative affect and the moderating role of the diagnostic group (ED vs. non-ED) were analyzed. METHOD The sample consisted of 94 women (39 with eating disorders, 19 with obesity, and 36 healthy participants). MEASURES International Affective Picture System (IAPS) food picture exposure task; Self-Assessment Manikin Analog-Visual Scale (SAM) appraising Arousal, Valence, and Dominance; Eating Attitudes Test (EAT-26); Positive and Negative Affect Schedule (PANAS). RESULTS Patients with purging symptomatology rated food images as more unpleasant than healthy women. Patients with purging and restrictive eating symptomatology showed higher levels of arousal and less dominance over the emotions experienced, compared to patients with obesity and healthy women. The mediation analysis showed that negative affect mediated the relationship between eating symptomatology (EAT-26) and the Valence of food images, as well as the control over the emotions experienced when viewing food images (Dominance). For the moderation analysis participants were regrouped into two groups (ED patients vs. non-ED patients). The direct relationship between eating symptomatology and food image valence was moderated by the diagnostic group. However, the group did not moderate the direct relationship between the EAT-26 and dominance over experienced emotions, or the indirect effect on eating symptomatology through negative affect. These results show the relevance of negative affect in the emotional processing of food-related information, and they support an eating disorder-disordered eating dimensional perspective.
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Affiliation(s)
- Irene Sierra
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
| | | | - María Roncero
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
| | - Conxa Perpiñá
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
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Schnepper R, Richard A, Georgii C, Arend AK, Naab S, Voderholzer U, Wilhelm FH, Blechert J. Bad mood food? Increased versus decreased food cue reactivity in anorexia nervosa and bulimia nervosa during negative emotions. EUROPEAN EATING DISORDERS REVIEW 2021; 29:756-769. [PMID: 34176193 DOI: 10.1002/erv.2849] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 04/02/2021] [Accepted: 05/31/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Emotion regulation difficulties in anorexia nervosa (AN) and bulimia nervosa (BN) might underlie bingeing and purging in BN, extreme fasting in AN, or combinations of these symptoms in binge-purge type AN. In this study, we tested for decreased food cue reactivity in response to negative emotions in AN, and the opposite pattern for BN. Furthermore, we explored subgroup differences (restrictive vs. binge-purging AN; history of AN in BN). METHOD Patients with AN (n = 41), BN (n = 39), and matched controls (n = 70) completed an emotional eating questionnaire. In a laboratory experiment, we induced negative emotions and measured food cue reactivity (pleasantness, desire to eat (DTE), and corrugator muscle activity). RESULTS AN reported emotional undereating, while BN reported emotional overeating. In the laboratory task, BN showed increased DTE and an appetitive corrugator response during negative emotions, selectively towards high-calorie foods. AN showed generalized reduced cue reactivity to high-calorie food regardless of emotional state. This pattern appears to be characteristic of restrictive AN, while cue reactivity of both BN subgroups pointed towards emotional overeating. CONCLUSIONS The emotional over- versus undereating framework might help to explain bingeing and restricting along the anorectic-bulimic disorder spectrum, which calls for novel transdiagnostic theories and subgroup-specific treatments.
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Affiliation(s)
- Rebekka Schnepper
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Anna Richard
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Claudio Georgii
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Ann-Kathrin Arend
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Silke Naab
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Ulrich Voderholzer
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg, Germany
| | - Frank H Wilhelm
- Department of Psychology, Division of Clinical Psychology and Psychopathology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Jens Blechert
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
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Physiological, emotional and neural responses to visual stimuli in eating disorders: a review. J Eat Disord 2021; 9:23. [PMID: 33597022 PMCID: PMC7890903 DOI: 10.1186/s40337-021-00372-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 01/26/2021] [Indexed: 11/25/2022] Open
Abstract
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.
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Racine SE, Suissa-Rocheleau L, Martin SJ, Benning SD. Implicit and explicit motivational responses to high- and low-calorie food in women with disordered eating. Int J Psychophysiol 2020; 159:37-46. [PMID: 33245920 DOI: 10.1016/j.ijpsycho.2020.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 10/21/2020] [Accepted: 11/20/2020] [Indexed: 11/29/2022]
Abstract
Eating disorders and their symptoms are thought to be associated with altered motivational responding to food. Binge eating may relate to increased reward reactivity, restrictive eating may be associated with increased threat and/or decreased reward reactivity, and the combination of these symptoms within an individual may be linked to motivational conflict to food. Using both implicit (i.e., physiological) and explicit (i.e., self-reported) measures, we tested these hypotheses in 88 women with binge eating only, restrictive eating only, both binge eating and restrictive eating, or no eating pathology. Participants viewed and rated high-calorie food, low-calorie food, and emotional images while startle eye blink and postauricular reflexes were measured. Arousal and craving, but not valence, ratings were significantly greater for high- than low-calorie food. Startle blink reflexes during all food images were significantly lower than during neutral images, whereas only high-calorie foods related to greater postauricular reactivity than neutral images. Eating pathology group did not predict implicit and explicit motivational reactions to food. Exploratory dimensional analyses revealed that rating low-calorie foods as lower on craving predicted endorsement of restrictive eating, while rating low-calorie foods as lower on valence and arousal, and experiencing lower postauricular reactivity to high-calorie foods minus neutral images, predicted greater frequency of restrictive eating episodes. Decreased implicit and explicit appetitive motivation to high- and low-calorie food may relate to the presence and frequency of restrictive eating. Future longitudinal research should investigate whether decreased appetitive responding to food is a risk factor for, versus consequence of, restrictive eating.
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Affiliation(s)
- Sarah E Racine
- Department of Psychology, McGill University, 2001 Avenue McGill College, Montréal, QC H3A 1G1, Canada.
| | - Léah Suissa-Rocheleau
- Department of Psychology, McGill University, 2001 Avenue McGill College, Montréal, QC H3A 1G1, Canada
| | - Shelby J Martin
- Department of Psychology, Ohio University, Porter Hall, Athens, OH 45701, United States
| | - Stephen D Benning
- Department of Psychology, University of Nevada Las Vegas, 4505 S. Maryland Pkwy, Las Vegas, NV 89154-5030, United States
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Key AP, Zengin-Bolatkale H, Dimitropoulos A, Doernberg E. Eye tracking as an objective measure of hyperphagia in children with Prader-Willi syndrome. Am J Med Genet A 2020; 182:1655-1663. [PMID: 32343043 PMCID: PMC7408294 DOI: 10.1002/ajmg.a.61606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/27/2020] [Accepted: 04/08/2020] [Indexed: 11/06/2022]
Abstract
This study examined sensitivity of eye tracking measures to hyperphagia severity in Prader-Willi syndrome (PWS). Gaze data were collected in 57 children with PWS, age 3-11 years, and 47 typically developing peers at two study sites during free visual exploration of complex stimulus arrays that included images of food, animals, and household objects. Analysis of the number and duration of fixations as well as gaze perseverations revealed that food items are not exceptionally salient for children with PWS. Instead, increased attention to food in the context of other high-interest items (e.g., animals) was associated with caregiver reports of more severe hyperphagia and more advanced nutritional phase. The study also provided preliminary evidence of possible genetic subtype and sex differences as well as demonstrated that multiple investigators in a wide range of settings can effectively implement the eye tracking protocol. The results indicate that gaze characteristics derived from eye tracking may be a promising objective marker of hyperphagia in PWS for use in research and clinical trials.
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Affiliation(s)
| | - Hatun Zengin-Bolatkale
- Vanderbilt University Medical Center, Nashville, Tennessee
- Istanbul Medipol University, Istanbul, Turkey
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Psychological characteristics and eating attitudes in adolescents with drunkorexia behavior: an exploratory study. Eat Weight Disord 2020; 25:709-718. [PMID: 30888609 DOI: 10.1007/s40519-019-00675-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/13/2019] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Drunkorexia represents an emerging phenomenon that is still understudied especially among adolescents. The present study aimed to investigate the relation between drunkorexia and psychological characteristics relevant and commonly associated with existing forms of eating disorders. METHODS The sample was composed of 849 adolescents (513 boys, 334 girls, 2 unknown; range 14-22) who completed a survey composed of Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale and Psychological scales of the Eating Disorders Inventory-3. RESULTS Our findings highlighted that drunkorexia was associated with low self-esteem, personal alienation, interoceptive deficits, emotional dysregulation, and asceticism. Hierarchical multiple regression analysis indicated that difficulties with emotion regulation and ascetic tendencies were significant predictors of drunkorexia among adolescents. CONCLUSIONS Our findings suggest the importance for programs preventing drunkorexia to be focused on training adolescents in using more adaptive strategies to manage emotions and accepting both emotional and physical signals without feeling guilty or threatened. LEVEL OF EVIDENCE Level V, descriptive study.
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Abstract
OBJECTIVE Event-related brain potential (ERP) studies have shown that bulimia nervosa (BN) is associated with facilitated processing of disorder-specific stimuli, visible in altered early components during presentation of food cues and bodies varying in size. Less is known about BN and late ERPs, typically less influenced by perceptual features and regarded as more reliable indices of motivational relevance. The purpose of this study was to use the late positive potential (LPP) to investigate the motivational significance of BN-relevant stimuli. METHODS Highly salient stimuli, such as pictures of personal binge foods and images that are pleasant, neutral, and unpleasant (e.g., human attacks) were presented to 24 women with bulimia and 24 healthy women (19.7 ± 2.1 and 20.5 ± 2.6 years, respectively). Pictures of erotic couples, previously shown to prompt the greatest appetitive reactions in healthy women, were used as pleasant cues. Based on BN aversion to body cues, we hypothesized that the motivational significance of erotic cues could be increased in bulimic women. RESULTS Consistent with the literature, the LPP was modulated by the salience of the pictures (F(2.8,130.7) = 24.6, p < .001). An additional interaction with diagnostic group (F(2.8,130.7) = 2.8, p = .047) indicated that bulimic women showed a larger LPP than healthy controls during pictures displaying binge foods (p = .037) and erotic couples (p = .031). CONCLUSIONS The findings provide objective evidence that BN is characterized by dysregulated emotional processing that is not limited to food cues. The implications are discussed within a transdiagnostic perspective on food-related disorders.
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Ralph-Nearman C, Achee M, Lapidus R, Stewart JL, Filik R. A systematic and methodological review of attentional biases in eating disorders: Food, body, and perfectionism. Brain Behav 2019; 9:e01458. [PMID: 31696674 PMCID: PMC6908865 DOI: 10.1002/brb3.1458] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 10/05/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The current systematic and methodological review aimed to critically review existing literature utilizing implicit processing, or automatic approach- and/or avoidance-related attentional biases between eating disorder (ED) and nonclinical samples, which (a) highlights how psychophysiological methods advance knowledge of ED implicit bias; (b) explains how findings fit into transdiagnostic versus disorder-specific ED frameworks; and (c) suggests how research can address perfectionism-related ED biases. METHOD Three databases were systematically searched to identify studies: PubMed, Scopus, and PsychInfo electronic databases. Peer-reviewed studies of 18- to 39-year-olds with both clinical ED and healthy samples assessing visual attentional biases using pictorial and/or linguistic stimuli related to food, body, and/or perfectionism were included. RESULTS Forty-six studies were included. While behavioral results were often similar across ED diagnoses, studies incorporating psychophysiological measures often revealed disease-specific attentional biases. Specifically, women with bulimia nervosa (BN) tend to approach food and other body types, whereas women with anorexia nervosa (AN) tend to avoid food as well as overweight bodies. CONCLUSIONS Further integration of psychophysiological and behavioral methods may identify subtle processing variations in ED, which may guide prevention strategies and interventions, and provide important clinical implications. Few implicit bias studies include male participants, investigate binge-eating disorder, or evaluate perfectionism-relevant stimuli, despite the fact that perfectionism is implicated in models of ED.
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Affiliation(s)
- Christina Ralph-Nearman
- Laureate Institute for Brain Research, Tulsa, OK, USA.,School of Psychology, University of Nottingham, Nottingham, UK
| | - Margaret Achee
- Department of Psychology, University of Tulsa, Tulsa, OK, USA
| | | | - Jennifer L Stewart
- Laureate Institute for Brain Research, Tulsa, OK, USA.,Department of Community Medicine, University of Tulsa, Tulsa, OK, USA
| | - Ruth Filik
- School of Psychology, University of Nottingham, Nottingham, UK
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16
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MacLeod JS, MacLeod C, Dondzilo L, Bell J. The Role of Fear of Fatness and Avoidance of Fatness in Predicting Eating Restraint. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10052-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Suissa-Rocheleau L, Benning SD, Racine SE. Associations between self-report and physiological measures of emotional reactions to food among women with disordered eating. Int J Psychophysiol 2019; 144:40-46. [DOI: 10.1016/j.ijpsycho.2019.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/12/2019] [Accepted: 08/11/2019] [Indexed: 11/29/2022]
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18
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Buodo G, Rumiati R, Lotto L, Sarlo M. Does food-drink pairings affect appetitive processing of food cues with different rewarding properties? Evidence from subjective, behavioral, and neural measures. Food Qual Prefer 2019. [DOI: 10.1016/j.foodqual.2019.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Boecker L, Pauli P. Affective startle modulation and psychopathology: Implications for appetitive and defensive brain systems. Neurosci Biobehav Rev 2019; 103:230-266. [PMID: 31129237 DOI: 10.1016/j.neubiorev.2019.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 05/12/2019] [Accepted: 05/18/2019] [Indexed: 02/06/2023]
Abstract
Startle reflex potentiation versus startle attenuation to unpleasant versus pleasant stimuli likely reflect priming of the defensive versus appetitive motivational systems, respectively. This review summarizes and systemizes the literature on affective startle modulation related to psychopathologies with the aim to reveal underlying mechanisms across psychopathologies. We found evidence for psychopathologies characterized by increased startle potentiation to unpleasant stimuli (anxiety disorders), decreased startle potentiation to unpleasant stimuli (psychopathy), decreased startle attenuation to pleasant stimuli (ADHD), as well as a general hyporeactivity to affective stimuli (depression). Increased versus decreased startle responses to disorder-specific stimuli characterize specific phobia and drug dependence. No psychopathology is characterized by increased startle attenuation to standard pleasant stimuli or a general hyperreactivity to affective stimuli. This review indicates that the defensive and the appetitive systems operate independently mostly in accordance with the motivational priming hypothesis and that affective startle modulation is a highly valuable paradigm to unraveling dysfunctions of the defensive and appetitive systems in psychopathologies as requested by the Research Domain Criteria initiative.
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Affiliation(s)
- Lea Boecker
- Department of Economic Psychology, Social Psychology & Experimental Methods, Leuphana University of Lüneburg, Universitätsallee 1, 21335 Lüneburg, Germany.
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Marcusstraße 9-11, 97070 Germany; Center of Mental Health, Medical Faculty, University of Würzburg, Germany
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Motoki K, Saito T, Nouchi R, Kawashima R, Sugiura M. Tastiness but not healthfulness captures automatic visual attention: Preliminary evidence from an eye-tracking study. Food Qual Prefer 2018. [DOI: 10.1016/j.foodqual.2017.09.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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21
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Leppanen J, Ng KW, Kim YR, Tchanturia K, Treasure J. Meta-analytic review of the effects of a single dose of intranasal oxytocin on threat processing in humans. J Affect Disord 2018; 225:167-179. [PMID: 28837950 DOI: 10.1016/j.jad.2017.08.041] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/23/2017] [Accepted: 08/14/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Heightened threat sensitivity is a transdiagnostic feature in several psychiatric disorders. The neuropeptide oxytocin has been shown to reduce fear related behaviours and facilitated fear extinction in animals. These findings have led to increasing interest to explore the effects of intranasal oxytocin on threat processing in humans. METHODS The review included 26 studies (N = 1173), nine of which included clinical populations (N = 234). The clinical groups included were people with borderline personality disorder (BPD), anorexia nervosa, bulimia nervosa, depression, anxiety, and alcohol dependence disorder. We examined the effects of a single dose of intranasal oxytocin on startle response, attentional responses, and behavioural responses to threat. RESULTS A single dose of intranasal oxytocin significantly increased the physiological startle response to threat in healthy people with a small effect size. However, oxytocin did not have significant effects on attentional bias towards social or disorder-specific threat, fixation towards threatening stimuli among healthy or clinical populations, or on threat related behavioural approach or avoidance responses. LIMITATIONS No studies investigated the effects of oxytocin on the startle response to threat among clinical populations. Additionally, only one of the reviewed studies had sufficient power to detect at least a moderate effect of oxytocin according to our criterion. DISCUSSION The synthesis of literature suggest that oxytocin may influence the salience of threatening stimuli among healthy individuals, increasing the startle response to threat. It would be of interest to investigate the effects of oxytocin on the startle response to threat among clinical populations.
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Affiliation(s)
- Jenni Leppanen
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, Department of Psychological Medicine, London, United Kingdom.
| | - Kah Wee Ng
- Singapore General Hospital, 20 College Road, Academia, 169865 Singapore, Singapore
| | - Youl-Ri Kim
- Department of Psychiatry, Seoul Paik Hospital, Inje University, Seoul, South Korea
| | - Kate Tchanturia
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, Department of Psychological Medicine, London, United Kingdom; Department of Psychology, Illia State University, Tbilisi, Georgia
| | - Janet Treasure
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience, Department of Psychological Medicine, London, United Kingdom
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22
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Racine SE, Hebert KR, Benning SD. Emotional Reactivity and Appraisal of Food in Relation to Eating Disorder Cognitions and Behaviours: Evidence to Support the Motivational Conflict Hypothesis. EUROPEAN EATING DISORDERS REVIEW 2017; 26:3-10. [DOI: 10.1002/erv.2567] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 08/25/2017] [Accepted: 10/11/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Sarah E. Racine
- Department of Psychology; Ohio University; OH USA
- Department of Psychology; McGill University; QC Canada
| | - Karen R. Hebert
- Department of Occupational Therapy; Seton Hall University; NJ USA
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Abstract
Understanding factors that contribute to eating disorders, which affect 13% of females, is critical to developing effective prevention and treatment programs. In this paper, we summarize results from prospective studies that identified factors predicting onset and persistence of eating disorders and core symptom dimensions. Next, implications for intervention targets for prevention, and treatment interventions from the risk- and maintenance-factor findings are discussed. Third, given that evidence suggests eating disorders are highly heritable, implying biological risk and maintenance factors for eating disorders, we offer working hypotheses about biological factors that might contribute to eating disorders, based on extant risk factor findings, theory, and cross-sectional studies. Finally, potentially fruitful directions for future research are presented. We suggest that it would be useful for experimental therapeutics trials to evaluate the effects of reducing the risk factors on future onset of eating pathology and on reducing maintenance factors on the risk for persistence of eating pathology, and encourage researchers to utilize prospective high-risk studies so that knowledge regarding potential intervention targets for prevention and treatment interventions for eating disorders can be advanced. Using the most rigorous research designs should help improve the efficacy of prevention and treatment interventions for eating disorders.
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Affiliation(s)
- Eric Stice
- Heather Shaw Oregon Research Institute, Eugene, USA
| | - Heather Shaw
- Heather Shaw Oregon Research Institute, Eugene, USA
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24
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Kekic M, McClelland J, Bartholdy S, Boysen E, Musiat P, Dalton B, Tiza M, David AS, Campbell IC, Schmidt U. Single-Session Transcranial Direct Current Stimulation Temporarily Improves Symptoms, Mood, and Self-Regulatory Control in Bulimia Nervosa: A Randomised Controlled Trial. PLoS One 2017; 12:e0167606. [PMID: 28121991 PMCID: PMC5266208 DOI: 10.1371/journal.pone.0167606] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 11/16/2016] [Indexed: 02/05/2023] Open
Abstract
Background Evidence suggests that pathological eating behaviours in bulimia nervosa (BN) are underpinned by alterations in reward processing and self-regulatory control, and by functional changes in neurocircuitry encompassing the dorsolateral prefrontal cortex (DLPFC). Manipulation of this region with transcranial direct current stimulation (tDCS) may therefore alleviate symptoms of the disorder. Objective This double-blind sham-controlled proof-of-principle trial investigated the effects of bilateral tDCS over the DLPFC in adults with BN. Methods Thirty-nine participants (two males) received three sessions of tDCS in a randomised and counterbalanced order: anode right/cathode left (AR/CL), anode left/cathode right (AL/CR), and sham. A battery of psychological/neurocognitive measures was completed before and after each session and the frequency of bulimic behaviours during the following 24-hours was recorded. Results AR/CL tDCS reduced eating disorder cognitions (indexed by the Mizes Eating Disorder Cognitions Questionnaire-Revised) when compared to AL/CR and sham tDCS. Both active conditions suppressed the self-reported urge to binge-eat and increased self-regulatory control during a temporal discounting task. Compared to sham stimulation, mood (assessed with the Profile of Mood States) improved after AR/CL but not AL/CR tDCS. Lastly, the three tDCS sessions had comparable effects on the wanting/liking of food and on bulimic behaviours during the 24 hours post-stimulation. Conclusions These data suggest that single-session tDCS transiently improves symptoms of BN. They also help to elucidate possible mechanisms of action and highlight the importance of selecting the optimal electrode montage. Multi-session trials are needed to determine whether tDCS has potential for development as a treatment for adult BN.
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Affiliation(s)
- Maria Kekic
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- * E-mail:
| | - Jessica McClelland
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Savani Bartholdy
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Elena Boysen
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Peter Musiat
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Bethan Dalton
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Meyzi Tiza
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Anthony S. David
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Iain C. Campbell
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
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25
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Deluchi M, Costa FS, Friedman R, Gonçalves R, Bizarro L. Attentional bias to unhealthy food in individuals with severe obesity and binge eating. Appetite 2017; 108:471-476. [DOI: 10.1016/j.appet.2016.11.012] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 11/02/2016] [Accepted: 11/03/2016] [Indexed: 11/16/2022]
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26
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Brockmeyer T, Schmidt U, Friederich HC. The ABBA study - approach bias modification in bulimia nervosa and binge eating disorder: study protocol for a randomised controlled trial. Trials 2016; 17:466. [PMID: 27670138 PMCID: PMC5037622 DOI: 10.1186/s13063-016-1596-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 08/30/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The core symptoms of bulimia nervosa (BN) and binge eating disorder (BED) are recurrent episodes of binge eating. Despite negative psychological and physical consequences, BN/BED patients show uncontrollable approach tendencies towards food. This cognitive bias occurs at an early stage of information processing. Cognitive bias modification (CBM) directly targets such biases and has been shown to be effective in treating several mental disorders. In alcohol addiction, automatic action tendencies towards alcohol cues and relapse rates were successfully reduced by a specific form of CBM, termed approach bias modification. Based on these findings and data from a proof-of-concept study in people with high levels of food craving, CBM is considered a promising new treatment approach for BN/BED. Given the similarities between BN/BED and addictive disorders, the rationale for using approach bias modification appears to be particularly strong. The aim of the present study is to examine whether, compared to a sham training, computerised approach bias modification (10 sessions) can reduce binge-eating episodes in BN/BED patients from pre-treatment to follow-up. Additionally, we will investigate whether this CBM programme also reduces global eating disorder psychopathology, trait and cue-elicited food craving, food intake as well as approach and attentional bias towards visual food cues. Treatment acceptance will be determined by attrition rates and responses on a feedback form. METHODS This is a double-blind, randomised, placebo-controlled, parallel-group superiority trial with two parallel arms. A total of 54 BN/BED patients will be recruited. Approach bias towards food will be retrained by a computer task adopting an implicit learning paradigm. Patients in the control condition (sham) will conduct a similar task but will not be trained to avoid food cues. Methods against bias include public registration, randomisation by a central study office, standardisation of the treatments and blinding of assessors. Furthermore, the session number and duration will be equivalent in the two conditions. DISCUSSION This is the first registered randomised controlled trial of approach bias modification in a clinical BN/BED sample. Results from this study will provide an indication of the efficacy of approach bias modification training for BN/BED and the potential mechanisms of action underlying this treatment. TRIAL REGISTRATION DRKS00010231 (retrospectively registered on 24 March 2016; first version).
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Affiliation(s)
- Timo Brockmeyer
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
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Enhanced Early Neuronal Processing of Food Pictures in Anorexia Nervosa: A Magnetoencephalography Study. PSYCHIATRY JOURNAL 2016; 2016:1795901. [PMID: 27525258 PMCID: PMC4976260 DOI: 10.1155/2016/1795901] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/15/2016] [Accepted: 06/19/2016] [Indexed: 11/30/2022]
Abstract
Neuroimaging studies in Anorexia Nervosa (AN) have shown increased activation in reward and cognitive control regions in response to food, and a behavioral attentional bias (AB) towards food stimuli is reported. This study aimed to further investigate the neural processing of food using magnetoencephalography (MEG). Participants were 13 females with restricting-type AN, 14 females recovered from restricting-type AN, and 15 female healthy controls. MEG data was acquired whilst participants viewed high- and low-calorie food pictures. Attention was assessed with a reaction time task and eye tracking. Time-series analysis suggested increased neural activity in response to both calorie conditions in the AN groups, consistent with an early AB. Increased activity was observed at 150 ms in the current AN group. Neuronal activity at this latency was at normal level in the recovered group; however, this group exhibited enhanced activity at 320 ms after stimulus. Consistent with previous studies, analysis in source space and behavioral data suggested enhanced attention and cognitive control processes in response to food stimuli in AN. This may enable avoidance of salient food stimuli and maintenance of dietary restraint in AN. A later latency of increased activity in the recovered group may reflect a reversal of this avoidance, with source space and behavioral data indicating increased visual and cognitive processing of food stimuli.
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28
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Racine SE, Forbush KT, Wildes JE, Hagan KE, Pollack LO, May C. Voluntary emotion regulation in anorexia nervosa: A preliminary emotion-modulated startle investigation. J Psychiatr Res 2016; 77:1-7. [PMID: 26945729 PMCID: PMC4826846 DOI: 10.1016/j.jpsychires.2016.02.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 01/25/2016] [Accepted: 02/19/2016] [Indexed: 11/17/2022]
Abstract
Emotion regulation difficulties are implicated in the development and maintenance of anorexia nervosa (AN). However, research has been limited by an almost exclusive reliance on self-report. This study is the first to use the emotion-modulated startle paradigm (EMSP) to investigate emotional reactivity and voluntary emotion regulation in individuals with AN. Twenty women with AN viewed negative, positive, neutral, and food images and were asked to enhance, suppress, or maintain their emotional responses mid-way through picture presentation. Startle eyeblink magnitudes in response to startle probes administered prior, and subsequent, to regulation instructions indexed emotional reactivity and regulation, respectively. On emotional reactivity trials, startle magnitudes were greater for negative, positive, and food images, compared to neutral images. Participants had difficulty suppressing startle responses to negative and food images, as indicated by non-significant suppress-maintain comparisons. In contrast, startle responses to enhance and suppress cues during presentation of pleasant images were comparable and significantly lower than maintain cues. Findings converge with self-report data to suggest that patients with AN have difficulties with voluntary emotion regulation. The EMSP may be a promising trans-diagnostic method for examining emotion regulation difficulties that underlie risk for eating disorders and other psychiatric conditions.
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Affiliation(s)
| | | | - Jennifer E. Wildes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kelsey E. Hagan
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Lauren O. Pollack
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Casey May
- Department of Psychology, University of North Carolina-Greensboro, Greensboro, NC, USA
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29
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Peschel SK, Feeling NR, Vögele C, Kaess M, Thayer JF, Koenig J. A systematic review on heart rate variability in Bulimia Nervosa. Neurosci Biobehav Rev 2016; 63:78-97. [DOI: 10.1016/j.neubiorev.2016.01.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 01/20/2016] [Accepted: 01/26/2016] [Indexed: 11/15/2022]
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Brockmeyer T, Hahn C, Reetz C, Schmidt U, Friederich HC. Approach bias and cue reactivity towards food in people with high versus low levels of food craving. Appetite 2015; 95:197-202. [DOI: 10.1016/j.appet.2015.07.013] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/30/2015] [Accepted: 07/12/2015] [Indexed: 11/25/2022]
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31
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Brockmeyer T, Hahn C, Reetz C, Schmidt U, Friederich HC. Approach Bias Modification in Food Craving-A Proof-of-Concept Study. EUROPEAN EATING DISORDERS REVIEW 2015; 23:352-60. [DOI: 10.1002/erv.2382] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/11/2015] [Accepted: 06/08/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Timo Brockmeyer
- Department of General Internal Medicine and Psychosomatics; University Hospital Heidelberg; Heidelberg Germany
| | - Carolyn Hahn
- Department of General Internal Medicine and Psychosomatics; University Hospital Heidelberg; Heidelberg Germany
| | - Christina Reetz
- Department of General Internal Medicine and Psychosomatics; University Hospital Heidelberg; Heidelberg Germany
| | - Ulrike Schmidt
- King's College London; Institute of Psychiatry, Psychology and Neuroscience, Section of Eating Disorders; London UK
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics; University Hospital Heidelberg; Heidelberg Germany
- Department of Psychosomatic Medicine and Psychotherapy; LVR Klinik, University of Duisburg-Essen; Essen Germany
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32
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Miccoli L, Delgado R, Rodríguez-Ruiz S, Guerra P, García-Mármol E, Fernández-Santaella MC. Meet OLAF, a good friend of the IAPS! The Open Library of Affective Foods: a tool to investigate the emotional impact of food in adolescents. PLoS One 2014; 9:e114515. [PMID: 25490404 PMCID: PMC4260831 DOI: 10.1371/journal.pone.0114515] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 11/10/2014] [Indexed: 11/18/2022] Open
Abstract
In the last decades, food pictures have been repeatedly employed to investigate the emotional impact of food on healthy participants as well as individuals who suffer from eating disorders and obesity. However, despite their widespread use, food pictures are typically selected according to each researcher's personal criteria, which make it difficult to reliably select food images and to compare results across different studies and laboratories. Therefore, to study affective reactions to food, it becomes pivotal to identify the emotional impact of specific food images based on wider samples of individuals. In the present paper we introduce the Open Library of Affective Foods (OLAF), which is a set of original food pictures created to reliably select food pictures based on the emotions they prompt, as indicated by affective ratings of valence, arousal, and dominance and by an additional food craving scale. OLAF images were designed to allow simultaneous use with affective images from the International Affective Picture System (IAPS), which is a well-known instrument to investigate emotional reactions in the laboratory. The ultimate goal of the OLAF is to contribute to understanding how food is emotionally processed in healthy individuals and in patients who suffer from eating and weight-related disorders. The present normative data, which was based on a large sample of an adolescent population, indicate that when viewing affective non-food IAPS images, valence, arousal, and dominance ratings were in line with expected patterns based on previous emotion research. Moreover, when viewing food pictures, affective and food craving ratings were consistent with research on food cue processing. As a whole, the data supported the methodological and theoretical reliability of the OLAF ratings, therefore providing researchers with a standardized tool to reliably investigate the emotional and motivational significance of food. The OLAF database is publicly available at zenodo.org.
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Affiliation(s)
- Laura Miccoli
- Department of Personality, University of Granada, Granada, Spain
| | - Rafael Delgado
- Department of Personality, University of Granada, Granada, Spain
| | | | - Pedro Guerra
- Department of Personality, University of Granada, Granada, Spain
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Cortisol, but not intranasal insulin, affects the central processing of visual food cues. Psychoneuroendocrinology 2014; 50:311-20. [PMID: 25265284 DOI: 10.1016/j.psyneuen.2014.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 09/02/2014] [Accepted: 09/06/2014] [Indexed: 11/22/2022]
Abstract
Stress glucocorticoids and insulin are important endocrine regulators of energy homeostasis, but little is known about their central interaction on the reward-related processing of food cues. According to a balanced group design, healthy food deprived men received either 40IU intranasal insulin (n=13), 30mg oral cortisol (n=12), both (n=15), or placebo (n=14). Acoustic startle responsiveness was assessed during presentation of food and non-food pictures. Cortisol enhanced startle responsiveness during visual presentation of "high glycemic" food pictures, but not during presentation of neutral and pleasant non-food pictures. Insulin had no effect. Based on the "frustrative nonreward" model these results suggest that the reward value of high glycemic food items is specifically increased by cortisol.
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Schulz A, Ferreira de Sá DS, Dierolf AM, Lutz A, van Dyck Z, Vögele C, Schächinger H. Short-term food deprivation increases amplitudes of heartbeat-evoked potentials. Psychophysiology 2014; 52:695-703. [DOI: 10.1111/psyp.12388] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 10/29/2014] [Indexed: 12/19/2022]
Affiliation(s)
- André Schulz
- Institute for Health and Behaviour; Research Unit INSIDE; University of Luxembourg; Luxembourg
- Institute of Psychobiology; Division of Clinical Psychophysiology; University of Trier; Trier Germany
| | - Diana S. Ferreira de Sá
- Institute of Psychobiology; Division of Clinical Psychophysiology; University of Trier; Trier Germany
| | - Angelika M. Dierolf
- Psychophysiological Laboratory; Department of Psychology; University of Trier; Trier Germany
| | - Annika Lutz
- Institute for Health and Behaviour; Research Unit INSIDE; University of Luxembourg; Luxembourg
| | - Zoé van Dyck
- Institute for Health and Behaviour; Research Unit INSIDE; University of Luxembourg; Luxembourg
| | - Claus Vögele
- Institute for Health and Behaviour; Research Unit INSIDE; University of Luxembourg; Luxembourg
| | - Hartmut Schächinger
- Institute of Psychobiology; Division of Clinical Psychophysiology; University of Trier; Trier Germany
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Herbert C, Platte P, Wiemer J, Macht M, Blumenthal TD. Supertaster, super reactive: Oral sensitivity for bitter taste modulates emotional approach and avoidance behavior in the affective startle paradigm. Physiol Behav 2014; 135:198-207. [DOI: 10.1016/j.physbeh.2014.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 03/24/2014] [Accepted: 06/01/2014] [Indexed: 11/30/2022]
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Reichel VA, Schneider N, Grünewald B, Kienast T, Pfeiffer E, Lehmkuhl U, Korte A. "Glass fairies" and "bone children": adolescents and young adults with anorexia nervosa show positive reactions towards extremely emaciated body pictures measured by the startle reflex paradigm. Psychophysiology 2014; 51:168-77. [PMID: 24423135 DOI: 10.1111/psyp.12160] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 09/06/2013] [Indexed: 11/28/2022]
Abstract
In this study, we investigated the emotional processing of extremely emaciated body cues in adolescents and young adults with (n = 36) and without (n = 36) anorexia nervosa (AN), introducing a new picture type, which was taken from websites that promote extreme thinness and is targeted specifically at adolescents interested in extreme thinness. A startle reflex paradigm was used for implicit reactions, while a self-assessment instrument was used for subjective responses. We found a significant group difference with a startle inhibition (appetitive response) among the patients and a startle potentiation (aversive response) among the controls, whereas no such difference for subjective measures was found. The results are in contrast to previous studies, which proposed a general failure to activate the appetitive motivational system in AN, but in keeping with findings from other addictions, where the same response pattern has been found. Implications for prevention and therapy are discussed.
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Affiliation(s)
- Valeska A Reichel
- Department of Child and Adolescent Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany; Department of Psychiatry and Psychotherapy, Universitätsklinikum Halle (Saale), Halle, Germany
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Blechert J, Naumann E, Schmitz J, Herbert BM, Tuschen-Caffier B. Startling sweet temptations: hedonic chocolate deprivation modulates experience, eating behavior, and eyeblink startle. PLoS One 2014; 9:e85679. [PMID: 24416437 PMCID: PMC3887070 DOI: 10.1371/journal.pone.0085679] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 12/05/2013] [Indexed: 12/31/2022] Open
Abstract
Many individuals restrict their food intake to prevent weight gain. This restriction has both homeostatic and hedonic effects but their relative contribution is currently unclear. To isolate hedonic effects of food restriction, we exposed regular chocolate eaters to one week of chocolate deprivation but otherwise regular eating. Before and after this hedonic deprivation, participants viewed images of chocolate and images of high-calorie but non-chocolate containing foods, while experiential, behavioral and eyeblink startle responses were measured. Compared to satiety, hedonic deprivation triggered increased chocolate wanting, liking, and chocolate consumption but also feelings of frustration and startle potentiation during the intertrial intervals. Deprivation was further characterized by startle inhibition during both chocolate and food images relative to the intertrial intervals. Individuals who responded with frustration to the manipulation and those who scored high on a questionnaire of impulsivity showed more relative startle inhibition. The results reveal the profound effects of hedonic deprivation on experiential, behavioral and attentional/appetitive response systems and underscore the role of individual differences and state variables for startle modulation. Implications for dieting research and practice as well as for eating and weight disorders are discussed.
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Affiliation(s)
- Jens Blechert
- Department for Clinical Psychology, Psychotherapy, and Heath Psychology, University of Salzburg, Salzburg, Austria
| | - Eva Naumann
- Department for Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg im Breisgau, Germany
| | - Julian Schmitz
- Department for Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg im Breisgau, Germany
| | - Beate M. Herbert
- Department of Health Psychology, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Brunna Tuschen-Caffier
- Department for Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg im Breisgau, Germany
- * E-mail:
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de Sá DSF, Plein DE, Schulz A, Oitzl MS, Blumenthal TD, Schächinger H. Acoustic startle reactivity while processing reward-related food cues during food deprivation: Evidence from women in different menstrual cycle phases and men. Psychophysiology 2013; 51:159-67. [DOI: 10.1111/psyp.12166] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 09/27/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Diana S. Ferreira de Sá
- Institute of Psychobiology; Division of Clinical Psychophysiology; University of Trier; Trier Germany
| | - Debora E. Plein
- Institute of Psychobiology; Division of Clinical Psychophysiology; University of Trier; Trier Germany
| | - André Schulz
- Research Unit INSIDE; Division of Clinical and Health Psychology; University of Luxembourg; Walferdange Luxembourg
| | - Melly S. Oitzl
- Division of Medical Pharmacology; Leiden/Amsterdam Center for Drug Research; University of Leiden; Leiden The Netherlands
- Swammerdam Institute for Life Sciences; Center for Neuroscience; University of Amsterdam; Amsterdam The Netherlands
| | - Terry D. Blumenthal
- Department of Psychology; Wake Forest University; Winston-Salem North Carolina USA
| | - Hartmut Schächinger
- Institute of Psychobiology; Division of Clinical Psychophysiology; University of Trier; Trier Germany
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Herbert BM, Blechert J, Hautzinger M, Matthias E, Herbert C. Intuitive eating is associated with interoceptive sensitivity. Effects on body mass index. Appetite 2013; 70:22-30. [DOI: 10.1016/j.appet.2013.06.082] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 05/29/2013] [Accepted: 06/14/2013] [Indexed: 10/26/2022]
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Herbert C, Kübler A, Vögele C. Risk for eating disorders modulates startle-responses to body words. PLoS One 2013; 8:e53667. [PMID: 23341969 PMCID: PMC3547051 DOI: 10.1371/journal.pone.0053667] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Accepted: 12/03/2012] [Indexed: 12/17/2022] Open
Abstract
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.
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Affiliation(s)
- Cornelia Herbert
- Department of Psychology I, University of Würzburg, Würzburg, Germany.
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Muehlenkamp JJ, Peat CM, Claes L, Smits D. Self-injury and disordered eating: expressing emotion dysregulation through the body. Suicide Life Threat Behav 2012; 42:416-25. [PMID: 22646483 DOI: 10.1111/j.1943-278x.2012.00100.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Previous research has suggested that emotion dysregulation, body-related concerns, and depressive symptoms are associated with nonsuicidal self-injury (NSSI) and disordered eating (DE) separately and in combination. However, it has been difficult to ascertain to what extent these constructs contribute to NSSI and DE given the relatively small number of studies examining their co-occurrence, particularly among nonclinical samples. Based on responses to self-report questionnaires, college-aged women who completed the study were divided into three groups: NSSI only; DE only; and NSSI + DE based on clinical cutoff criteria. Results support hypotheses that emotion dysregulation is a shared vulnerability and that body-related concerns and depression exhibit unique patterns of association across the three groups. It appears that NSSI is best understood as a response to negative affective states relative to DE, which is best understood as a set of behaviors motivated by body image concerns. The presence of both NSSI and DE is primarily influenced by emotion dysregulation and the dominant difficulties linked to each behavior; depression and body dissatisfaction. These findings suggest that treatment and prevention efforts should emphasize emotion regulation skills and differentially target body concerns or depressive symptoms according to the primary behavioral dysfunction that is present.
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Topolinski S, Türk Pereira P. Mapping the tip of the tongue--deprivation, sensory sensitisation, and oral haptics. Perception 2012; 41:71-92. [PMID: 22611665 DOI: 10.1068/p6903] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We investigated the impact of food deprivation on oral and manual haptic size perception of food and non-food objects. From relevant theories (need-proportional perception, motivated perception, frustrative nonreward, perceptual defence, and sensory sensitisation) at least four completely different competing predictions can be derived. Testing these predictions, we found across four experiments that participants estimated the length of both non-food and food objects to be larger when hungry than when satiated, which was true only for oral haptic perception, while manual haptic perception was not influenced by hunger state. Subjectively reported hunger correlated positively with estimated object size in oral, but not in manual, haptic perception. The impact of food deprivation on oral perception vanished after oral stimulations even for hungry individuals. These results favour a sensory sensitisation account maintaining that hunger itself does not alter oral perception but the accompanying lack of sensory stimulation of the oral mucosa. Both oral and manual haptic perception tended to underestimate actual object size. Finally, an enhancing effect of domain-target matching was found, ie food objects were perceived larger by oral than by manual haptics, while non-food objects were perceived larger by manual than by oral haptics.
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Affiliation(s)
- Sascha Topolinski
- Department of Psychology II, Social Psychology, University of Wcrzburg, Roentgenring 10, 97070 Würzburg, Germany.
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Moreno-Domínguez S, Rodríguez-Ruiz S, Fernández-Santaella MC, Ortega-Roldán B, Cepeda-Benito A. Impact of Fasting on Food Craving, Mood and Consumption in Bulimia Nervosa and Healthy Women Participants. EUROPEAN EATING DISORDERS REVIEW 2012; 20:461-7. [DOI: 10.1002/erv.2187] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Barnow S, Limberg A, Stopsack M, Spitzer C, Grabe HJ, Freyberger HJ, Hamm A. Dissociation and emotion regulation in borderline personality disorder. Psychol Med 2012; 42:783-794. [PMID: 22067328 DOI: 10.1017/s0033291711001917] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although some evidence suggests that borderline personality disorder (BPD) is primarily a disorder of the emotion regulation system, findings remain inconsistent. One potential explanation for this is the moderating role of dissociation. METHOD In this study, 33 female subjects with BPD and 26 healthy controls (HC; matched by education level and nicotine intake) were presented idiographic aversive, standard unpleasant and neutral scripts. Modulation of startle reflex and electrodermal responses (skin conductance level; SCL) were measured during imagery of emotional and neutral scripts. Additionally, self-reports of emotional experience (valence and arousal) and present-state dissociation were assessed. RESULTS Patients with BPD showed elevated levels of dissociative experiences during testing. Present-state dissociation mediated group differences in SCL and startle response between the HC and BPD groups. CONCLUSIONS These results suggest that careful attention must be paid to the moderating effect of dissociative symptoms on the psychophysiological responses of BPD patients. Furthermore, the findings have important implications for the assessment and treatment of BPD, including the need to carefully assess BPD patients for dissociative symptoms and to incorporate the treatment of dissociation.
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Affiliation(s)
- S Barnow
- Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany.
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Spresser CD, Keune KM, Filion DL, Lundgren JD. 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. Body Image 2012; 9:298-301. [PMID: 22305111 DOI: 10.1016/j.bodyim.2011.12.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 12/23/2011] [Accepted: 12/24/2011] [Indexed: 10/14/2022]
Abstract
The purpose was to compare self-report and psychophysiological assessment techniques in the measurement of emotional response to body image cues. Female college students (n=53; % Caucasian=53.6; M body mass index=26.1 kg/m²) completed the Eating Disorder Inventory (EDI-3) and viewed photos of themselves both unaltered and morphed to simulate weight gain. Response to the photos was assessed by self-report and the affect modulated startle paradigm. EDI-3 Drive for Thinness (DT) and Body Dissatisfaction (BD) scale scores were correlated with startled amplitude for the largest simulated weight gain photo. Startle eye blink amplitude predicted more variance in DT and BD subscales than self-reported response to the image. The affect modulated startle paradigm may provide unique information in the assessment of eating disorder symptomatology that cannot be captured via self-report techniques, and has potential to inform evaluation of treatment outcomes of eating and body image disorders.
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Affiliation(s)
- Carrie D Spresser
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO 64110, USA.
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Rodríguez-Ruiz S, Guerra PM, Moreno S, Fernández MC, Vila J. Heart Rate Variability Modulates Eye-Blink Startle in Women With Bulimic Symptoms. J PSYCHOPHYSIOL 2012. [DOI: 10.1027/0269-8803/a000064] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of the present study was to examine the modulatory influence of heart rate variability (HRV), an index of autonomic regulation, on eye-blink startle in women with bulimic symptoms. Twenty-four women with bulimic symptoms and 24 control women underwent a psychophysiological test to assess their HRVs during a rest period. They then underwent 20 trials designed to measure their startle motor reflexes while viewing pictures of food and pleasant, neutral, and unpleasant pictures. Women with bulimic symptoms and low HRV had larger startle magnitudes while viewing the pictures than women with both bulimic symptoms and high HRV and control women. A negative relationship between HRV and startle magnitude while viewing food pictures was also found in this group. These findings suggest that poor autonomic regulation, indicated by low HRV, plays a modulatory influence in women with bulimic symptoms.
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Affiliation(s)
| | | | | | | | - Jaime Vila
- Faculty of Psychology, University of Granada, Spain
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47
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Bohon C, Stice E. Reward abnormalities among women with full and subthreshold bulimia nervosa: a functional magnetic resonance imaging study. Int J Eat Disord 2011; 44:585-95. [PMID: 21997421 PMCID: PMC3111910 DOI: 10.1002/eat.20869] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2010] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To test the hypothesis that women with full and subthreshold bulimia nervosa show abnormal neural activation in response to food intake and anticipated food intake relative to healthy control women. METHOD Females with and without full/subthreshold bulimia nervosa recruited from the community (N = 26) underwent functional magnetic resonance imaging (fMRI) during receipt and anticipated receipt of chocolate milkshake and a tasteless control solution. RESULTS Women with bulimia nervosa showed trends for less activation than healthy controls in the right anterior insula in response to anticipated receipt of chocolate milkshake (vs. tasteless solution) and in the left middle frontal gyrus, right posterior insula, right precentral gyrus, and right mid dorsal insula in response to consumptions of milkshake (vs. tasteless solution). DISCUSSION Bulimia nervosa may be related to potential hypofunctioning of the brain reward system, which may lead these individuals to binge eat to compensate for this reward deficit, though the hypo-responsivity might be a result of a history of binge eating highly palatable foods.
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Affiliation(s)
- Cara Bohon
- Department of Psychology, University of Oregon, Eugene, Oregon, USA.
| | - Eric Stice
- Oregon Research Institute, Eugene, Oregon
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Ferriter C, Ray LA. Binge eating and binge drinking: an integrative review. Eat Behav 2011; 12:99-107. [PMID: 21385638 DOI: 10.1016/j.eatbeh.2011.01.001] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Revised: 12/11/2010] [Accepted: 01/17/2011] [Indexed: 11/29/2022]
Abstract
The primary goal of this review is to provide a framework for understanding two highly overlapping behaviors: binge eating and binge drinking. Research is presented that suggests binge eating and drinking behaviors may share several important features, including personality correlates such as neuroticism and urgency, as well as affective characteristics, such as elevated levels of negative affect. Additionally, the review describes common explanatory models, which are helpful in terms of their potential to link these common features to the functions of, or reasons why individuals engage in, binge eating and drinking behaviors. Implications for understanding potentially common etiological pathways and development of interventions designed to target multiple behaviors are discussed.
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Affiliation(s)
- Caitlin Ferriter
- Department of Psychology, University of California, Los Angeles, CA 90095-1563, United States.
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Burger KS, Stice E. Relation of dietary restraint scores to activation of reward-related brain regions in response to food intake, anticipated intake, and food pictures. Neuroimage 2011; 55:233-9. [PMID: 21147234 PMCID: PMC3032532 DOI: 10.1016/j.neuroimage.2010.12.009] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 11/18/2010] [Accepted: 12/03/2010] [Indexed: 11/30/2022] Open
Abstract
Prospective studies indicate that individuals with elevated dietary restraint scores are at increased risk for future bulimic symptom onset, suggesting that these individuals may show hyper-responsivity of reward regions to food and food cues. Thus, we used functional magnetic resonance imaging (fMRI) to examine the relation of dietary restraint scores to activation of reward-related brain regions in response to receipt and anticipated receipt of chocolate milkshake and exposure to pictures of appetizing foods in 39 female adolescents (mean age=15.5 ± 0.94). Dietary restraint scores were positively correlated with activation in the right orbitofrontal cortex (OFC) and bilateral dorsolateral prefrontal cortex (DLPFC) in response to milkshake receipt. However, dietary restraint scores did not correlate with activation in response to anticipated milkshake receipt or exposure to food pictures. Results indicate that individuals who report high dietary restraint have a hyper-responsivity in reward-related brain regions when food intake is occurring, which may increase risk for overeating and binge eating.
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50
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Giel KE, Teufel M, Friederich HC, Hautzinger M, Enck P, Zipfel S. Processing of pictorial food stimuli in patients with eating disorders--a systematic review. Int J Eat Disord 2011; 44:105-17. [PMID: 20127931 DOI: 10.1002/eat.20785] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The processing of food cues in eating-disordered patients has recently been increasingly investigated. Outlined is current evidence from pictorial food stimuli studies. METHOD PubMed and PsychINFO were searched for quantitative pictorial food stimuli studies investigating healthy controls and expert-diagnosed eating-disordered patients. RESULTS Patients with eating disorders (ED) demonstrated cue reactivity to food stimuli. Results from functional imaging suggest sensory disengagement and higher emotional involvement while self-reported data and facial EMG revealed that food pictures were perceived as less pleasurable. Different experimental paradigms have demonstrated an attentional bias for food cues in ED. Currently, psychophysiological data is widely inconclusive. DISCUSSION Evidence suggests cue reactivity to food pictures in eating-disordered patients. However, the overall picture is inconclusive because methodological problems and the integration of findings from different experimental approaches pose a challenge to the research field.
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Affiliation(s)
- Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen 72076, Germany.
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