1
|
Datta N, Foukal M, Erwin S, Hopkins H, Tchanturia K, Zucker N. A mixed-methods approach to conceptualizing friendships in anorexia nervosa. PLoS One 2021; 16:e0254110. [PMID: 34525111 PMCID: PMC8443043 DOI: 10.1371/journal.pone.0254110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/20/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Individuals with anorexia nervosa have reported feelings of loneliness, social anhedonia, and interpersonal difficulties. This study sought to clarify the nature of interpersonal relationships in adults with anorexia, which may help improve existing interventions while also facilitating the attainment of something that might compete with the drive for thinness: friendships. METHODS The present study used a mixed-methods approach to investigate friendship experiences in three groups: anorexia (n = 27), participants with a history of anorexia who are weight restored (n = 20), and healthy controls (n = 24). Thematic analysis was used to isolate the most prevalent themes that emerged from an open-ended interview of experiencing friendships in a subset of participants. Three self-report questionnaires investigating friendship valuation and attachment styles were also administered. RESULTS 11 unique themes emerged in the data: social comparison, reciprocity, trust, fear of negative evaluation, perceived skills deficit, logistical barriers, reliability, identity issue, low interest, similarity, and conflict avoidance. Only 17% of those with anorexia reported experiencing friendships as positive, relative to 82% of healthy controls and 52% of weight restored participants. Lastly, on self-report measures, participants with anorexia reported greater reliance on themselves versus others, greater use of care-seeking behaviors, and more fear/anger at the thought of losing an attachment figure (p < .05 in all cases). CONCLUSION Results suggest that individuals with anorexia have particular challenges which interfere with the formation and maintenance of friendships, such as viewing friendships negatively and struggling with social comparisons in friendships. Assessing and addressing barriers to intimacy may motivate those with anorexia to relinquish dangerous symptoms that maintain the illness.
Collapse
Affiliation(s)
- Nandini Datta
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States of America
- * E-mail:
| | - Molly Foukal
- Duke University Department of Psychology and Neuroscience, Durham, NC, United States of America
| | - Savannah Erwin
- Duke University Department of Psychology and Neuroscience, Durham, NC, United States of America
| | - Hannah Hopkins
- Duke University Department of Psychology and Neuroscience, Durham, NC, United States of America
| | - Kate Tchanturia
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Trust, National Eating Disorders Service, Psychological Medicine Clinical Academic Group, London, United Kingdom
- Department of Psychology, Ilia State University, Tbilisi, Georgia
| | - Nancy Zucker
- Duke University Department of Psychology and Neuroscience, Durham, NC, United States of America
- Duke University School of Medicine Department of Psychiatry & Behavioral Sciences, Durham, NC, United States of America
| |
Collapse
|
2
|
Harrison A. Experimental Investigation of Non-Verbal Communication in Eating Disorders. Psychiatry Res 2021; 297:113732. [PMID: 33535088 DOI: 10.1016/j.psychres.2021.113732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 01/14/2021] [Indexed: 10/22/2022]
Abstract
This study aimed to be the first to measure non-verbal communication in 25 eating disorder (ED) and 25 non-ED control participants during a naturalistic social interaction incorporating positive, negative and neutrally-valenced topics. The first hypothesis, that ED participants would show significantly reduced facial emotional expression than controls, was not supported. Supporting the second hypothesis of between-group differences in non-verbal behaviour, ED participants were less likely to lean in towards their interlocutor (d=.81) discussing negatively-valanced topics and were more likely to be positioned upright when discussing positively-valenced topics (d=.1.09) than controls. Irrespective of emotional valence, ED participants positioned their gaze on their interlocutor significantly less (d=.29) and spent more time looking down (d=.54), or away than controls (d=.63). ED participants moved their hands along with speech significantly less (d=.63) and gestured fewer real/hypothetical/imagined images/actions/objects) than controls (d=.57), irrespective of emotional valence. Instead, ED participants indicated discomfort in the social interaction, touching their nose (d=.89) or playing with their nails (d=.95) more often than controls. ED participants, regardless of emotional valence, showed significantly lowered electro-dermal activity (d=.60) than controls, supporting the exploratory hypothesis. People with EDs appear to make less efficient use of non-verbal communication than controls.
Collapse
Affiliation(s)
- A Harrison
- Associate Professor in Psychology, University College London, Institute of Education, Department of Psychology and Human Development.
| |
Collapse
|
3
|
Laghi F, Pompili S, Bianchi D, Lonigro A, Baiocco R. Drunkorexia: An Examination of the Role of Theory of Mind and Emotional Awareness among Adolescents. Dev Neuropsychol 2020; 46:70-81. [PMID: 33372552 DOI: 10.1080/87565641.2020.1869743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to investigate Theory of Mind (ToM) and emotional awareness in drunkorexia, an emerging behavior characterized by calorie restriction when drinking alcohol is planned. A sample of 246 adolescents (148 females, 98 males; range 17-20) completed self-reported measures assessing drunkorexia, ToM and lack of emotional awareness. Drunkorexia was negatively correlated with ToM abilities, with reading neutral emotions, and positively with lack of emotional awareness. ToM and lack of emotional awareness were also found to predict drunkorexia. Findings highlighted that adolescents who engage in drunkorexia may have difficulties in reading others' mental states and being aware of their emotions.
Collapse
Affiliation(s)
- Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| | - Antonia Lonigro
- Department of Human Sciences, European University of Rome , Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome , Rome, Italy
| |
Collapse
|
4
|
Kerr-Gaffney J, Harrison A, Tchanturia K. Autism spectrum disorder traits are associated with empathic abilities in adults with anorexia nervosa. J Affect Disord 2020; 266:273-281. [PMID: 32056888 DOI: 10.1016/j.jad.2020.01.169] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/10/2019] [Accepted: 01/28/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Social and emotional difficulties have been identified as key factors in the development and maintenance of anorexia nervosa (AN). However, few studies have investigated the influence of comorbid psychopathology on social cognition. The aim of the current study was to examine perception of nonverbal communication and empathy in AN using ecologically valid, performance-based measures, and to explore associations with comorbid psychopathology (anxiety, depression, autism spectrum disorder (ASD) traits, alexithymia, and social anxiety). METHODS In this cross-sectional study, the Multifaceted Empathy Test (MET) and the Mini Profile of Nonverbal Sensitivity (MiniPONS) were administered to 51 adults with AN, 51 recovered AN (REC), and 51 healthy controls (HCs). Comorbid psychopathological traits were assessed using self-report questionnaires and the Autism Diagnostic Observation Schedule - 2nd edition (ADOS-2). RESULTS Individuals with AN showed reduced affective empathy to positive stimuli compared to HCs, and a trend towards lower vocal prosody recognition scores relative to REC. Around a quarter of AN and REC scored above the clinical cut-off for ASD on the ADOS-2, and high ASD symptoms predicted lower cognitive and affective empathy scores. LIMITATIONS The study is cross-sectional, future research would benefit from examining social-cognition performance and comorbid psychopathology longitudinally. CONCLUSIONS The findings highlight the importance of ASD symptoms in empathy dysfunction in those with a lifetime history of AN. Future research should explore whether treatment adaptations to accommodate for differences in social-cognitive abilities may be helpful in the treatment of AN.
Collapse
Affiliation(s)
- Jess Kerr-Gaffney
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom.
| | - Amy Harrison
- University College London, Department of Psychology and Human Development, London, United Kingdom; South London and Maudsley NHS Trust, National Eating Disorders Service, Psychological Medicine Clinical Academic Group, London, United Kingdom
| | - Kate Tchanturia
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, London, United Kingdom; South London and Maudsley NHS Trust, National Eating Disorders Service, Psychological Medicine Clinical Academic Group, London, United Kingdom; Department of Psychology, Ilia State University, Tbilisi, Georgia
| |
Collapse
|
5
|
Isernia S, Sokolov AN, Fallgatter AJ, Pavlova MA. Untangling the Ties Between Social Cognition and Body Motion: Gender Impact. Front Psychol 2020; 11:128. [PMID: 32116932 PMCID: PMC7016199 DOI: 10.3389/fpsyg.2020.00128] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 01/16/2020] [Indexed: 01/25/2023] Open
Abstract
We proved the viability of the general hypothesis that biological motion (BM) processing serves as a hallmark of social cognition. We assumed that BM processing and inferring emotions through BM (body language reading) are firmly linked and examined whether this tie is gender-specific. Healthy females and males completed two tasks with the same set of point-light BM displays portraying angry and neutral locomotion of female and male actors. For one task, perceivers had to indicate actor gender, while for the other, they had to infer the emotional content of locomotion. Thus, with identical visual input, we directed task demands either to BM processing or inferring of emotion. This design allows straight comparison between sensitivity to BM and recognition of emotions conveyed by the same BM. In addition, perceivers were administered a set of photographs from the Reading the Mind in the Eyes Test (RMET), with which they identified either emotional state or actor gender. Although there were no gender differences in performance on BM tasks, a tight link occurred between recognition accuracy of emotions and gender through BM in males. In females only, body language reading (both accuracy and response time) was associated with performance on the RMET. The outcome underscores gender-specific modes in visual social cognition and triggers investigation of body language reading in a wide range of neuropsychiatric disorders.
Collapse
Affiliation(s)
- Sara Isernia
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- CADITeR, IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Alexander N. Sokolov
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Andreas J. Fallgatter
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Marina A. Pavlova
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany
| |
Collapse
|
6
|
Cascino G, Castellini G, Stanghellini G, Ricca V, Cassioli E, Ruzzi V, Monteleone P, Monteleone AM. The Role of the Embodiment Disturbance in the Anorexia Nervosa Psychopathology: A Network Analysis Study. Brain Sci 2019; 9:brainsci9100276. [PMID: 31619011 PMCID: PMC6826416 DOI: 10.3390/brainsci9100276] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/04/2019] [Accepted: 10/12/2019] [Indexed: 12/15/2022] Open
Abstract
Anorexia Nervosa (AN) is characterized by body image distortion. From a phenomenological perspective, body image disturbance has been associated with a more profound disturbance encompassing disorders of the way persons experience their own body. The aim of this study was to disentangle the complex dynamics that connect the experience of one’s own body and self-identity to the psychopathological features of AN by applying a network analysis. Fifty-seven patients with AN restrictive subtype and 27 with AN binge–purging subtype participated in the study. Eating Disorders Inventory-2 and Identity and Eating Disorders subscores, measuring the embodiment dimensions, were included in the network. Two of the main dimensions of embodiment—feeling extraneous from one’s own body and feeling oneself through objective measures—were the nodes with the highest strength together with interoceptive awareness (IA). IA was a node included in several pathways connecting embodiment dimensions with most of the AN psychopathological dimensions. The centrality of the embodiment disorder suggests the importance of considering the body image disturbance in people with AN as resulting from their difficulty in experiencing inner states and as a tool to build its own self. This assumption may orient therapeutic interventions.
Collapse
Affiliation(s)
- Giammarco Cascino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, 84081 Salerno, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Giovanni Stanghellini
- Department of Psychological, Humanistic and Territorial Sciences, 'G. d'Annunzio' University, 66100 Chieti, Italy
- 'D. Portales' University, 8320000 Santiago, Chile
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Valeria Ruzzi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, 84081 Salerno, Italy
| | | |
Collapse
|
7
|
Dinkler L, Rydberg Dobrescu S, Råstam M, Gillberg IC, Gillberg C, Wentz E, Hadjikhani N. Visual scanning during emotion recognition in long-term recovered anorexia nervosa: An eye-tracking study. Int J Eat Disord 2019; 52:691-700. [PMID: 30828832 DOI: 10.1002/eat.23066] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 02/15/2019] [Accepted: 02/17/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine Facial Emotion Recognition (FER) and visual scanning behavior (eye-tracking) during FER in women long-term recovered from teenage-onset anorexia nervosa (recAN) with and without autism spectrum disorder (±ASD) and age-matched comparison women (COMP), using a sensitive design with facial emotion expressions at varying intensities in order to approximate real social contexts. METHOD Fifty-seven 38-47-year-old women (26 recAN of whom six with ASD, 31 COMP) participated in the study. They completed a non-verbal FER task, consisting of matching basic emotions at different levels of expression intensity with full emotional expressions. Accuracy, response time and visual scanning behavior were measured. RESULTS There were no differences between recAN-ASD and COMP in FER accuracy and visual scanning behavior during FER, including eye viewing and hyperscanning. In an exploratory analysis, recAN+ASD were more accurate than recAN-ASD in identifying expressions at low intensity, but not at medium or high expression intensity. Accuracy was not associated with the extent of attention to the eye region. DISCUSSION Our data indicate that women long-term recovered from adolescent-onset AN do not have deficits in basic FER ability and visual scanning behavior during FER. However, the presence of comorbid ASD might affect face processing in recovered AN. Future studies investigating basic FER in acute and recovered AN and other conditions need to ensure that the stimuli used are sensitive enough to detect potential deficits.
Collapse
Affiliation(s)
- Lisa Dinkler
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Sandra Rydberg Dobrescu
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Maria Råstam
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - I Carina Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Elisabet Wentz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Nouchine Hadjikhani
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| |
Collapse
|
8
|
Implicit Mental Motor Imagery Task Demonstrates a Distortion of the Body Schema in Patients With Eating Disorders. J Int Neuropsychol Soc 2018; 24:715-723. [PMID: 29909800 DOI: 10.1017/s1355617718000371] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES A rich body of literature has established the role of body image distortion and dissatisfaction in the development and maintenance of eating disorders. However, many of the currently used techniques require explicit comparison of the person's body to an external stimulus. As the body schema is a largely unconscious construct, explicit comparison tasks may reflect a proxy, rather than the body schema itself. METHODS Here we use an implicit mental motor imagery (MMI) task to interrogate the body schema in healthy control participants (N=40) and participants at a residential eating disorder treatment center (N=42). By comparing the time it takes to imagine making a movement along a part of the body to the time it takes to actually make the same movement, we were able to assess participants' mental image of their body (i.e., body schema). RESULTS We found that participants with eating disorders, but not healthy controls, exhibited distortions of the body schema such that they believed their abdomen, buttocks, and thighs to be larger than they really are. Additionally, the MMI task used here provided information above and beyond traditional self-report measures (i.e., Body Shape Questionnaire). Together the MMI task and traditional measures provide the most information. CONCLUSIONS Findings using the novel MMI task are in line with the literature; participants with eating disorders consider themselves to be larger than they truly are. Taken together, results of this study suggest that MMI tasks provide complementary information to traditional self-report measures. (JINS, 2018, 24, 715-723).
Collapse
|
9
|
Oldershaw A, Lavender T, Schmidt U. Are socio-emotional and neurocognitive functioning predictors of therapeutic outcomes for adults with anorexia nervosa? EUROPEAN EATING DISORDERS REVIEW 2018; 26:346-359. [PMID: 29744972 DOI: 10.1002/erv.2602] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/08/2018] [Accepted: 04/10/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Emotional, social, and neurocognitive factors are theorised to maintain anorexia nervosa (AN). Yet whether they predict outcomes or relate to clinical change remains unclear. METHODS Seventy-one consecutive adult outpatient eating disorder service referrals presenting with AN, who participated in a randomised controlled trial comparing 2 psychotherapies, were assessed for emotional processing, social cognition, and neurocognition pretherapy and posttherapy. Intention-to-treat analysis employed maximum-likelihood methods to model missing data. Baseline self-reported emotional processing, social cognitive, or neurocognitive task performance was entered into forward stepwise regression models with posttreatment clinical outcomes (weight, eating disorder psychopathology, psychosocial functioning) as dependent variables. Correlation analyses examined relationships between clinical and self-report/task score change. RESULTS Self-reported emotional avoidance (behavioural/cognitive avoidance, low acceptance) and submissive behaviour predicted clinical outcomes. Social cognitive (emotion recognition, emotional theory of mind) and neurocognitive performance (set-shifting, detail focus) had limited predictive ability. CONCLUSIONS Emotional avoidance and submissiveness may represent maintenance factors for AN.
Collapse
Affiliation(s)
- Anna Oldershaw
- Salomons Centre for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, UK.,Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tony Lavender
- Salomons Centre for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, UK
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
10
|
Okruszek Ł. It Is Not Just in Faces! Processing of Emotion and Intention from Biological Motion in Psychiatric Disorders. Front Hum Neurosci 2018; 12:48. [PMID: 29472852 PMCID: PMC5809469 DOI: 10.3389/fnhum.2018.00048] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 01/26/2018] [Indexed: 01/29/2023] Open
Abstract
Social neuroscience offers a wide range of techniques that may be applied to study the social cognitive deficits that may underlie reduced social functioning—a common feature across many psychiatric disorders. At the same time, a significant proportion of research in this area has been conducted using paradigms that utilize static displays of faces or eyes. The use of point-light displays (PLDs) offers a viable alternative for studying recognition of emotion or intention inference while minimizing the amount of information presented to participants. This mini-review aims to summarize studies that have used PLD to study emotion and intention processing in schizophrenia (SCZ), affective disorders, anxiety and personality disorders, eating disorders and neurodegenerative disorders. Two main conclusions can be drawn from the reviewed studies: first, the social cognitive problems found in most of the psychiatric samples using PLD were of smaller magnitude than those found in studies presenting social information using faces or voices. Second, even though the information presented in PLDs is extremely limited, presentation of these types of stimuli is sufficient to elicit the disorder-specific, social cognitive biases (e.g., mood-congruent bias in depression, increased threat perception in anxious individuals, aberrant body size perception in eating disorders) documented using other methodologies. Taken together, these findings suggest that point-light stimuli may be a useful method of studying social information processing in psychiatry. At the same time, some limitations of using this methodology are also outlined.
Collapse
Affiliation(s)
- Łukasz Okruszek
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| |
Collapse
|
11
|
Dapelo MM, Surguladze S, Morris R, Tchanturia K. Emotion Recognition in Face and Body Motion in Bulimia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2017; 25:595-600. [DOI: 10.1002/erv.2554] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 08/13/2017] [Accepted: 08/21/2017] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Robin Morris
- Department of Psychology, IoPPN; King's College London (KCL); UK
| | - Kate Tchanturia
- Psychological Medicine, IoPPN; King's College London (KCL); UK
- Ilia State University Tbilisi; Georgia
| |
Collapse
|
12
|
Ambrosecchia M, Ardizzi M, Russo E, Ditaranto F, Speciale M, Vinai P, Todisco P, Maestro S, Gallese V. Interoception and Autonomic Correlates during Social Interactions. Implications for Anorexia. Front Hum Neurosci 2017; 11:219. [PMID: 28567008 PMCID: PMC5434670 DOI: 10.3389/fnhum.2017.00219] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 04/18/2017] [Indexed: 01/01/2023] Open
Abstract
The aim of this study is to investigate the bodily-self in Restrictive Anorexia, focusing on two basic aspects related to the bodily self: autonomic strategies in social behavior, in which others' social desirability features, and social cues (e.g., gaze) are modulated, and interoception (i.e., the sensitivity to stimuli originating inside the body). Furthermore, since previous studies carried out on healthy individuals found that interoception seems to contribute to the autonomic regulation of social behavior, as measured by Respiratory Sinus Arrhythmia (RSA), we aimed to explore this link in anorexia patients, whose ability to perceive their bodily signal seems to be impaired. To this purpose, we compared a group of anorexia patients (ANg; restrictive type) with a group of Healthy Controls (HCg) for RSA responses during both a resting state and a social proxemics task, for their explicit judgments of comfort in social distances during a behavioral proxemics task, and for their Interoceptive Accuracy (IA). The results showed that ANg displayed significantly lower social disposition and a flattened autonomic reactivity during the proxemics task, irrespective of the presence of others' socially desirable features or social cues. Moreover, unlike HCg, the autonomic arousal of ANg did not guide behavioral judgments of social distances. Finally, IA was strictly related to social disposition in both groups, but with opposite trends in ANg. We conclude that autonomic imbalance and its altered relationship with interoception might have a crucial role in anorexia disturbances.
Collapse
Affiliation(s)
- Marianna Ambrosecchia
- Department of Medicine and Surgery, Unit of Neuroscience, University of ParmaParma, Italy
| | - Martina Ardizzi
- Department of Medicine and Surgery, Unit of Neuroscience, University of ParmaParma, Italy
| | - Elisa Russo
- Casa di Cura, Villa MargheritaVicenza, Italy
| | - Francesca Ditaranto
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione Stella MarisPisa, Italy
| | | | | | | | - Sandra Maestro
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione Stella MarisPisa, Italy
| | - Vittorio Gallese
- Department of Medicine and Surgery, Unit of Neuroscience, University of ParmaParma, Italy
- Institute of Philosophy, School of Advanced Study, University of LondonLondon, UK
| |
Collapse
|
13
|
Laghi F, Pompili S, Zanna V, Castiglioni MC, Criscuolo M, Chianello I, Baumgartner E, Baiocco R. Are adolescents with anorexia nervosa better at reading minds? Cogn Neuropsychiatry 2016; 20:489-501. [PMID: 26465706 DOI: 10.1080/13546805.2015.1091766] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The present study aimed to investigate mindreading abilities in female adolescent patients with AN compared to healthy controls (HCs), analysing differences for emotional valence of facial stimuli. METHODS The Eating Disorder Inventory) for evaluating psychological traits associated with eating disorders and the Children's version of the Reading the Mind in the Eyes Test for evaluating mindreading abilities were administered to 40 Italian female patients (mean age = 14.93; SD = 1.48) with restrictive diagnosis of anorexia nervosa (AN) and 40 healthy females (mean age = 14.88; SD = 0.56). RESULTS No significant differences between the AN group and HCs for the Eyes Total score were found. Even when analysing emotional valence of the items, the two groups were equally successful in the facial recognition of positive, negative and neutral emotions. A significant difference was revealed for the percentage of correct responses of item 10 and item 15, where the AN group was less able to correctly identify the target descriptor (Not believing) over the foils than HCs. A significant difference was revealed in discriminating for affective emotions versus cognitive states; only for affective but not for cognitive states, patients with AN were found to perform better than controls on the mindreading task. CONCLUSIONS Our study highlighted the importance of analysing and discriminating for different valences of facial stimuli when assessing mindreading abilities in adolescents with AN, so that more precise and specific treatment approaches could be developed for female adolescents with AN.
Collapse
Affiliation(s)
- Fiorenzo Laghi
- a Faculty of Medicine and Psychology , Sapienza, University of Rome , Rome , Italy
| | - Sara Pompili
- a Faculty of Medicine and Psychology , Sapienza, University of Rome , Rome , Italy
| | - Valeria Zanna
- b Child Neuropsychiatry Unit, Department of Neuroscience-I.R.C.C.S ., Children Hospital Bambino Gesù , Rome , Italy
| | - Maria Chiara Castiglioni
- b Child Neuropsychiatry Unit, Department of Neuroscience-I.R.C.C.S ., Children Hospital Bambino Gesù , Rome , Italy
| | - Michela Criscuolo
- b Child Neuropsychiatry Unit, Department of Neuroscience-I.R.C.C.S ., Children Hospital Bambino Gesù , Rome , Italy
| | - Ilenia Chianello
- b Child Neuropsychiatry Unit, Department of Neuroscience-I.R.C.C.S ., Children Hospital Bambino Gesù , Rome , Italy
| | - Emma Baumgartner
- a Faculty of Medicine and Psychology , Sapienza, University of Rome , Rome , Italy
| | - Roberto Baiocco
- a Faculty of Medicine and Psychology , Sapienza, University of Rome , Rome , Italy
| |
Collapse
|
14
|
Phillipou A, Rossell SL, Gurvich C, Castle DJ, Troje NF, Abel LA. Body Image in Anorexia Nervosa: Body Size Estimation Utilising a Biological Motion Task and Eyetracking. EUROPEAN EATING DISORDERS REVIEW 2015; 24:131-8. [DOI: 10.1002/erv.2423] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 10/08/2015] [Accepted: 11/06/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Andrea Phillipou
- Department of Optometry & Vision Sciences; The University of Melbourne; Melbourne Australia
- Department of Psychiatry; The University of Melbourne; Melbourne Australia
- Department of Mental Health; The Austin Hospital; Melbourne Australia
| | - Susan Lee Rossell
- Brain and Psychological Sciences Research Centre; Swinburne University of Technology; Melbourne Australia
- Monash Alfred Psychiatry Research Centre; Melbourne Australia
- Department of Psychiatry; St Vincent's Hospital; Melbourne Australia
| | | | - David Jonathan Castle
- Department of Psychiatry; The University of Melbourne; Melbourne Australia
- Department of Psychiatry; St Vincent's Hospital; Melbourne Australia
- Faculty of Health Sciences; Australian Catholic University; Melbourne Australia
| | | | - Larry Allen Abel
- Department of Optometry & Vision Sciences; The University of Melbourne; Melbourne Australia
| |
Collapse
|
15
|
Lang K, Dapelo MM, Khondoker M, Morris R, Surguladze S, Treasure J, Tchanturia K. Exploring Emotion Recognition in Adults and Adolescents with Anorexia Nervosa Using a Body Motion Paradigm. EUROPEAN EATING DISORDERS REVIEW 2015; 23:262-8. [DOI: 10.1002/erv.2358] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 02/14/2015] [Accepted: 02/24/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Katie Lang
- King's College London (KCL); Psychological Medicine, IoPPN; UK
| | | | | | - Robin Morris
- King's College London (KCL); Department of Psychology, IoPPN; UK
| | | | - Janet Treasure
- King's College London (KCL); Psychological Medicine, IoPPN; UK
| | - Kate Tchanturia
- King's College London (KCL); Psychological Medicine, IoPPN; UK
- Ilia State University Tbilisi; Georgia
| |
Collapse
|
16
|
Treasure J, Schmidt U. The cognitive-interpersonal maintenance model of anorexia nervosa revisited: a summary of the evidence for cognitive, socio-emotional and interpersonal predisposing and perpetuating factors. J Eat Disord 2013; 1:13. [PMID: 24999394 PMCID: PMC4081714 DOI: 10.1186/2050-2974-1-13] [Citation(s) in RCA: 364] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 02/03/2013] [Indexed: 12/12/2022] Open
Abstract
AIM To describe the evidence base relating to the Cognitive-Interpersonal Maintenance Model for anorexia nervosa (AN). BACKGROUND A Cognitive-Interpersonal Maintenance Model maintenance model for anorexia nervosa was described in 2006. This model proposed that cognitive, socio-emotional and interpersonal elements acted together to both cause and maintain eating disorders. METHOD A review of the empirical literature relating to the key constructs of the model (cognitive, socio-emotional, interpersonal) risk and maintaining factors for anorexia nervosa was conducted. RESULTS Set shifting and weak central coherence (associated with obsessive compulsive traits) have been widely studied. There is some evidence to suggest that a strong eye for detail and weak set shifting are inherited vulnerabilities to AN. Set shifting and global integration are impaired in the ill state and contribute to weak central coherence. In addition, there are wide-ranging impairments in socio-emotional processing including: an automatic bias in attention towards critical and domineering faces and away from compassionate faces; impaired signalling of, interpretation and regulation of emotions. Difficulties in social cognition may in part be a consequence of starvation but inherited vulnerabilities may also contribute to these traits. The shared familial traits may accentuate family members' tendency to react to the frustrating and frightening symptoms of AN with high expressed emotion (criticism, hostility, overprotection), and inadvertently perpetuate the problem. CONCLUSION The cognitive interpersonal model is supported by accumulating evidence. The model is complex in that cognitive and socio-emotional factors both predispose to the illness and are exaggerated in the ill state. Furthermore, some of the traits are inherited vulnerabilities and are present in family members. The clinical formulations from the model are described as are new possibilities for targeted treatment.
Collapse
Affiliation(s)
- Janet Treasure
- Department of Psychological Medicine, King’s College London, Institute of Psychiatry, The Basement, P059, 103 Denmark Hill, London, SE5 8AF, UK
| | - Ulrike Schmidt
- Department of Psychological Medicine, King’s College London, Institute of Psychiatry, The Basement, P059, 103 Denmark Hill, London, SE5 8AF, UK
| |
Collapse
|