Selective Visual Attention Towards Oneself and Associated State Body Satisfaction: an Eye-Tracking Study in Adolescents with Different Types of Eating Disorders

The influence of gender and body satisfaction on attentional bias among young adults in Hong Kong: An eye-tracking study

The present study examined gender differences in attentional bias of body images. Using an experimental design, 58 young adults aged 18-29 years (Mage = 20.53) completed self-report measures of body satisfaction, eating pathology and trait appearance comparison before viewing whole body images of thin/muscular and large men/women through an eye tracker. After viewing the images, participants completed self-report measures of body satisfaction and state appearance comparison, BMI was also recorded. Results revealed that higher BMI was associated with reduced body satisfaction. Problematic eating attitudes were associated with greater engagement in appearance comparison, which was linked to lower levels of body satisfaction. Exposure to idealised body images negatively impacted individuals with lower body satisfaction leading to lower levels of body satisfaction post-experiment. Findings provide support for the positive association between body dissatisfaction and attentional bias to idealised bodies in both women and men in a Chinese context.

Autistic traits and perspective taking in youths with anorexia nervosa: an exploratory clinical and eye tracking study

BACKGROUND

Despite their apparent dissimilarity, Anorexia Nervosa (AN) and Autism Spectrum Disorder (ASD) share many features, especially in terms of social and emotional difficulties. In recent years, empathic abilities in AN have been frequently assessed using self-report measures. Otherwise, the director task (DT) has been used to investigate the ability to take the visual perspective of another individual in a communicative context, using eye-tracking technology. The aim of the current study was to test the presence of autism-relevant features in AN, through: (i) comparing self-reported autistic traits and empathic abilities in a group of young inpatients with AN and age/gender matched healthy controls (HC); (ii) comparing performance on the director paradigm.

METHODS

The participants were females in the age-range between 11 and 18 years: 24 with AN and 23 HC. Autistic traits, empathic abilities, and severity of the eating disorder were respectively measured using: the Autism Quotient (AQ), the Interpersonal Reactivity Index (IRI), and the Eating Disorder Inventory-3 (EDI-3). Both groups performed a computerized task in which a director instructed them to move objects placed on a set of shelves using a mouse, while their eye gaze was tracked. A total of 36 shelf configurations, divided into three categories (with dimensional distractor - with spatial distractor - control), were created.

RESULTS

Subjects with AN showed higher autistic traits than HC. Eye-tracking data revealed that subjects with AN took longer to decide which object to select and where to move it, both in distractor-trials and in control-trials. In the AN group, we found a significant negative correlation between the total score of the AQ and the number of fixations to the irrelevant object in the dimensional control condition -in which the subjects were asked to focus on dimensional aspects of the object (large-small)-.

CONCLUSIONS

Autistic traits were over-represented in a group of young inpatients with AN. Through the use of eye-tracking technology, this exploratory study documented some differences between AN inpatients and HC in their online processes during the perspective taking tasks, which could be considered a target of tailored intervention. A larger sample of patients is needed to confirm these preliminary findings.

Comprehensive elucidation of resting-state functional connectivity in anorexia nervosa by a multicenter cross-sectional study

BACKGROUND

Previous research on the changes in resting-state functional connectivity (rsFC) in anorexia nervosa (AN) has been limited by an insufficient sample size, which reduced the reliability of the results and made it difficult to set the whole brain as regions of interest (ROIs).

METHODS

We analyzed functional magnetic resonance imaging data from 114 female AN patients and 135 healthy controls (HC) and obtained self-reported psychological scales, including eating disorder examination questionnaire 6.0. One hundred sixty-four cortical, subcortical, cerebellar, and network parcellation regions were considered as ROIs. We calculated the ROI-to-ROI rsFCs and performed group comparisons.

RESULTS

Compared to HC, AN patients showed 12 stronger rsFCs mainly in regions containing dorsolateral prefrontal cortex (DLPFC), and 33 weaker rsFCs primarily in regions containing cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between anterior cingulate cortex (ACC) and thalamus (p < 0.01, false discovery rate [FDR] correction). Comparisons between AN subtypes showed that there were stronger rsFCs between right lingual gyrus and right supracalcarine cortex and between left temporal occipital fusiform cortex and medial part of visual network in the restricting type compared to the binge/purging type (p < 0.01, FDR correction).

CONCLUSION

Stronger rsFCs in regions containing mainly DLPFC, and weaker rsFCs in regions containing primarily cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between ACC and thalamus, may represent categorical diagnostic markers discriminating AN patients from HC.

How evaluative pairings improve body dissatisfaction in adult women: evidence from a randomized-controlled online study

BACKGROUND

Many young women are dissatisfied with their bodies. This study investigated the effect on current body dissatisfaction levels of a newly developed evaluative conditioning procedure that paired self-similar and self-dissimilar images of bodies with positive and neutral affective images, respectively. We hypothesized that learning the contingency that self-similar bodies predict positive affectivity is one process that could aid in explaining how these procedures function.

METHODS

Adult women without disordered eating pathology participated in an online experiment with random assignment to an intervention or a control condition. All participants initially rated body images in self-similarity and were subsequently asked to categorize positive and neutral images by valence as quickly and accurately as possible. In the intervention condition, self-similar bodies systematically preceded positive images, and self-dissimilar images preceded neutral images, creating a similar body → positive contingency. Pairings in the control condition were unsystematic such that no contingency was present. We measured categorization latencies and accuracies to infer contingency learning as well as current body dissatisfaction immediately before and after exposure to the pairings. All participants further completed measures of trait body image concerns and disordered eating psychopathology at baseline, which we examined as moderators of an expected relation between condition assignment, contingency learning, and body dissatisfaction improvements.

RESULTS

We analyzed data from N = 173 women fulfilling the inclusion criteria. Moderated mediation analyses showed that assignment to the intervention (vs. control) condition predicted increased similar body → positive contingency learning, which in turn predicted improved body dissatisfaction post-intervention, but only among women with higher pre-existing trait body image concerns or disordered eating levels.

CONCLUSIONS

The findings point toward the relevancy of further exploring the utility of pairing procedures. Similar body → positive contingency learning predicted improved body dissatisfaction in individuals with normatively high body image concerns, which suggests pairing procedures could help inform future research on reducing body dissatisfaction.

Mirror Exposure Training for Adolescents With Anorexia Nervosa (MIRADAN): Cognitive Mechanisms of Body Disturbance - A Study Protocol

Background

Anorexia Nervosa (AN) is a severe mental illness, which typically develops in adolescence and, if left untreated, often becomes chronic. Body dissatisfaction is a core characteristic of AN. Mirror exposure (ME) is an effective therapeutic technique to tackle body dissatisfaction in adult patients with eating disorders, but there is limited evidence for the effects of ME in adolescence. One potential mechanism underlying effects of ME on body dissatisfaction is change in body-related attention bias. However, this mechanism remains to be empirically tested. Accordingly, the aim of the current study is twofold: primarily, we aim to test if ME can reduce body dissatisfaction and associated symptoms in adolescent patients with AN. Additionally, we aim to investigate whether change in biased body-related attention due to ME is a possible mechanism of action.

Method

Adolescent patients with AN are randomized to either 12 sessions of ME (3 ME-sessions/week) or wait-list within four weeks. Main outcomes include body dissatisfaction and associated symptoms of AN. Moreover, body-related attention bias is assessed at baseline and post-treatment by means of eye-tracking with two paradigms. Further, process variables are collected weekly. In addition, 12 weeks after end of the study, the acceptability of the ME is assessed.

Discussion

The main aim of the study is to evaluate high-frequency and high-intense ME for treating body dissatisfaction in adolescents with AN. In addition, we would like to clarify whether change in attentional bias for body stimuli is a mechanism underlying change in body dissatisfaction due to ME.

Attentional Bias Modification Training Based on Virtual Reality and Eye Tracking in Anorexia Nervosa Patients

Anorexia nervosa (AN) patients exhibit attentional bias (AB) related to the body, which is the tendency to pay greater attention to weight-related body areas compared to non-weight-related ones. This phenomenon has been linked to elevated levels of body dissatisfaction (BD) and may potentially reduce the effectiveness of body exposure therapy. The purpose of this pilot study is to assess the efficacy of a single session of a new body-related AB modification task (ABMT) that combines virtual reality with eye tracking in patients with AN. The goals of the ABMT are to reduce body-related AB by balancing attention between weight and non-weight-related body areas and to reduce BD levels. Twenty-three adolescent patients with AN were embodied in a virtual avatar and immersed in a virtual environment where they completed the ABMT. Body-related AB measures and BD levels were assessed before and after the training. A paired samples t-test showed statistically significant differences between pre-assessment and post-assessment; the complete fixation time on weight-related body parts was reduced and BD levels decreased. The initial evidence of the efficacy of this ABMT has important clinical implications, since AB and BD are considered risk factors for developing and maintaining eating disorder symptomatology among patients with AN.

Body Dissatisfaction and Body-Related Attentional Bias: Is There a Causal Relationship?

Previous research has shown an association between body dissatisfaction and attentional biases toward the body, but the nature of this relationship is not clear. It is possible that dissatisfaction causes attentional bias or that dissatisfaction is a result of such bias. To clarify the causal relationship between these two variables, this study manipulated dissatisfaction in a sample of healthy women by exposing them to images of "ideal" bodies and observed whether this manipulation increased attentional biases toward different body parts. Fifty-seven women took part in a pre-post experimental design in which they observed an avatar representing themselves in a virtual mirror before and after being exposed to "thin ideal" photographs. Eye-tracking technology was employed to quantify the frequency and duration of fixations on weight-related and weight-unrelated body parts. The outcomes revealed a successful induction of body dissatisfaction, leading participants to display a heightened number of fixations and prolonged fixation durations on unrelated-weight body parts. These findings remained significant after controlling for the effects of trait body dissatisfaction and body mass index. The results imply that heightened body dissatisfaction fosters the aversion of attention from weight-related body parts, which may function as a protective mechanism for preserving self-esteem and promoting psychological well-being.

Modification of Body-Related Attentional Bias through Virtual Reality and Eye-Tracking in Healthy Participants: Implications for Anorexia Nervosa Treatments

Cognitive biases have a significant impact on the etiology and treatment of eating disorders (EDs). These biases, including selective attentional bias (AB) to disliked body parts, may reinforce concerns about body shape, fear of gaining weight and body image disturbances and may contribute to dietary restriction and restraint. Decreasing AB could reduce core symptoms in anorexia nervosa (AN). This study represents a preliminary exploration aiming to assess whether AB towards weight-related (WR) and non-weight-related (NW) body parts could be reduced through an AB modification task in a virtual reality (VR) environment in healthy participants. A total of 54 female participants, aged 22.98 ± 1.89, were recruited. The task consisted of directing the participants' attention towards all body parts equally in a VR setting. Eye-tracking (ET) measurements (complete fixation time [CFT] and number of fixations [NF]) were made before and after the task. The results showed a significant reduction of the AB in the two groups with an initial AB towards WR body parts or towards NW body parts. Participants showed a tendency to more balanced (non-biased) attention after the intervention. This study provides evidence of the usefulness of AB modification tasks in a non-clinical sample.

An Attentional Bias Modification Task, through Virtual Reality and Eye-Tracking Technologies, to Enhance the Treatment of Anorexia Nervosa

Mirror exposure therapies (METs) have been shown to be effective in reducing body image disturbances through the habituation process. Virtual reality (VR) combined with eye-tracking techniques can provide innovative solutions to some of METs’ limitations reported with patients with anorexia nervosa (AN), especially the negative influence of body-related attentional bias (AB). This pilot study aimed to assess the preliminary efficacy of a new VR-based AB modification task (ABMT) among healthy women and the procedure’s user experience. AB levels towards weight- and non-weight-related body parts, using complete fixation time (CFT) and number of fixations (NF), were assessed throughout the ABMT procedure (300 trials). The user experience was evaluated at the end of the procedure. The results showed that VR-based ABMT was effective in reducing AB significantly after 150 trials for both CFT- and NF-based measures, although 225 trials were necessary to get the same result for women with an NF initially more oriented towards weight-related body parts. Overall, the software received a “C-rating” on a scale from “A” (most usable) to “F” (least usable). These results provide evidence of the opportunity to use a VR-based ABMT procedure to reduce AB and improve existing treatments for AN.

(Eye-)tracking the escape from the self: guilt proneness moderates the effect of failure on self-avoidance

Failure increases the motivation to escape self-awareness. To date, however, the role of self-conscious emotions (shame and guilt) in triggering escape responses after failure has not been sufficiently addressed. In this pre-registered study (N = 156 undergraduates), we adapted a classic paradigm (avoidance of one's image in a mirror) to a modern eye-tracking technology to test the hypothesis that shame proneness moderates the effect of failure on self-awareness avoidance. Individual differences in guilt and shame proneness were assessed before priming thoughts of failure or success. Then, an eye-tracking paradigm was used to monitor gaze avoidance of one's screen-reflected face during a neutral, unrelated task. Unexpectedly, results showed that guilt but not shame proneness exacerbated self-avoidance after failure. The present findings challenge the dominant view that shame fosters avoidance more so than guilt.

Perception of the non-dominant hand as larger after non-judgmental focus on its details

We investigated whether brief non-judgmental focus on the details of one's non-dominant hand might lead to changes in perception of its size, and if such a change would be related to central coherence, body dissatisfaction, or how much participants liked their hand. After two pilot experiments (N = 28 and N = 30 respectively: Appendix 1), a within-subject experiment (N = 82) was conducted. Subjects were mainly university students. They were asked to rate the size of their non-dominant hand and how much they liked it, and the size of an external object (a X-box controller) on a visual-analog scale before and after focusing on their details for 5 min, as well as the size of another object (a calculator) before and after a 5 min long distraction task. After completing the tasks, they were asked to respond to a brief questionnaire on body dissatisfaction. A s significant interaction between time and factors (non-dominant hand, X-box controller and calculator) emerged (F(2, 78) = 6.41, p = .003). Participants rated their hand as larger after focusing on its details compared to baseline, and this change was significantly larger than those reported for the X-box controller. No significant change in how they liked their hand was observed, and contrary to the pilot experiments, the perceived change in size of the hand was not related to body dissatisfaction. The significant change in reporting of the size of the hand after focusing on its details seems to be an interesting finding, worth further replications.

Sensor Technology and Intelligent Systems in Anorexia Nervosa: Providing Smarter Healthcare Delivery Systems

Ubiquitous technology, big data, more efficient electronic health records, and predictive analytics are now at the core of smart healthcare systems supported by artificial intelligence. In the present narrative review, we focus on sensing technologies for the healthcare of Anorexia Nervosa (AN). We employed a framework inspired by the Interpersonal Neurobiology Theory (IPNB), which posits that human experience is characterized by a flow of energy and information both within us (within our whole body), and between us (in the connections we have with others and with nature). In line with this framework, we focused on sensors designed to evaluate bodily processes (body sensors such as implantable sensors, epidermal sensors, and wearable and portable sensors), human social interaction (sociometric sensors), and the physical environment (indoor and outdoor ambient sensors). There is a myriad of man-made sensors as well as nature-based sensors such as plants that can be used to design and deploy intelligent systems for human monitoring and healthcare. In conclusion, sensing technologies and intelligent systems can be employed for smarter healthcare of AN and help to relieve the burden of health professionals. However, there are technical, ethical, and environmental sustainability issues that must be considered prior to implementing these systems. A joint collaboration of professionals and other members of the society involved in the healthcare of individuals with AN can help in the development of these systems. The evolution of cyberphysical systems should also be considered in these collaborations.

Die Spiegelkonfrontationstherapie zur Behandlung von Körperbildstörungen bei Essstörungen – Evidenz, Wirkmechanismen und Vorgehensweise

Zusammenfassung. Körperbildprobleme sind ein Kernmerkmal von Essstörungen. Daher gilt eine Verbesserung des Körperbildes bei der Behandlung von Essstörungen als zentrales Therapieziel. Verschiedene empirische Befunde weisen auf die Spiegelkonfrontation als wirksame Methode zur Reduktion von Körperbildstörungen hin. Ziel dieses Übersichtsartikels ist es, den aktuellen Stand der wissenschaftlichen Literatur zum Thema Spiegelkonfrontationstherapie bei Essstörungen darzulegen. Insbesondere sollen die Wirksamkeitsstudien getrennt für nicht-klinische, körperunzufriedene Gruppen mit und ohne Übergewicht sowie die verschiedenen Essstörungsgruppen systematisiert und unterschiedliche Vorgehensweisen beschrieben werden. Der Übersichtsartikel liefert Hinweise dafür, dass die Spiegelkonfrontationstherapie bei Hochrisikogruppen mit erhöhter Körperunzufriedenheit sowie bei Essstörungen zu positiven Veränderungen hinsichtlich der kognitiv-affektiven und behavioralen Komponente des Körperbildes führt. Jedoch mangelt es insgesamt an randomisiert-kontrollierten Studien, die die Wirksamkeit der Spiegelkonfrontationstherapie mit ausreichend großen Stichproben gezielt untersuchen – vor allem bei der Anorexia nervosa. Der Übersichtsartikel schließt mit einer Diskussion über mögliche Wirkmechanismen, (Kontra–)‌Indikationen und einem Ausblick für zukünftige Forschung ab.

Giving a Body a Different Face—How Men and Women Evaluate Their Own Body vs. That of Others

Eating disorders affect women more than men. Women reportedly dislike their body shape more and appreciate it less than do men. One factor influencing body image might be the application of different standards for oneself than for other people when evaluating bodies. To investigate this possibility, we determined whether the application of double standards is different between men and women. We presented 57 women and 54 men (aged 18–30 and of average weight) with pictures of their own bodies and pictures of average weight, overweight, and “ideal” bodies attached to the participants’ own face and to another person’s face. Participants were instructed to evaluate their emotional reaction to the pictures and then rate the various pictures on aspects of attractiveness, body fat, and muscle mass. The degree of the double standard was defined as the difference between ratings of what appeared to be one’s own body and what appeared to be someone else’s according to the presented face. The analyses revealed, firstly, that both genders applied self-deprecating double standards when viewing overweight and average-weight bodies. Women, but not men, also showed self-deprecating double standards when viewing the ideal body and their own body. By contrast, men applied fewer double standards when viewing the ideal body and self-enhancing double standards when viewing their own body. The study suggests that young, average-weight men are more or less satisfied with their own bodies, whereas young, average-weight women tend to apply a stricter standard for themselves than for others, thus devaluing their own bodies. This vulnerability to body image is hypothesized as contributing to the prevalence of eating disorders in women.

Gender differences in state body satisfaction, affect, and body-related attention patterns towards one’s own and a peer’s body: an Eye-Tracking Study with Women and Men

Background

Body-related attentional biases are assumed to contribute to the development and maintenance of body-related concerns or specific mental disorders such as eating disorders. However, while studies have indicated gender-specific differences in body-related concerns, less is known about gender-specific differences in body-related attention allocation.

Methods

An eye-tracking paradigm was used to assess women’s (n = 41) and men’s (n = 42) attention patterns towards their own and a peer’s body. Additionally, state body satisfaction and affect were examined.

Results

While both women and men showed higher state positive and negative affect after viewing one’s own body than after viewing a peer’s body, only women displayed worse state body satisfaction after viewing one’s own body than after viewing a peer’s body. Conversely, both genders showed a similar deficit-oriented attention pattern, irrespective of the presented body type.

Conclusions

The findings provide evidence of gender-specific differences in state body satisfaction after viewing one’s own and a peer’s body. However, these differences do not seem to be reflected by gender differences in body-related attention allocation. As both women and men showed a deficit-oriented attentional bias, they might benefit from interventions which aim to establish a functional or self-serving way of looking at one’s own body.

I Look at my whole body and i feel better: attentional bias, emotional and psychophysiological response by pure exposure treatment in women with obesity

Obesity is one of the most important health problems nowadays. In addition to the direct physical consequences, it is also a risk factor in the development of psychological (Eating disorders, body dissatisfaction, depression, anxiety, etc.) and social problems. Among there, body dissatisfaction is key for development and maintenance of such problems.

OBJECTIVE

to deepen the effectiveness of the body exposure treatment, both in its pure form and guided modality in subjective, psychological and attentional levels in people with body dissatisfaction and obesity.

METHODS

Evaluations were carried out in a total of 16 women with obesity and body dissatisfaction at the beginning and end of 6 treatment sessions of pure exposure in front of the mirror. The changes experienced at the subjective level (questionnaires and subjective discomfort during the sessions) and psychophysiological (eye-tracking and heart rate) were analyzed.

RESULTS

Pure exposure treatment reduces negative thoughts and emotions towards the body itself, as well as the experienced discomfort towards the most conflictive parts. Selective attention to those parts of the body classified as uglier by the participants (especially the rear view of the body) show a decrease in physiological reactivity.

CONCLUSIONS

Pure exposure treatment seems to be effective in reducing subjective and psychological symptoms associated with body dissatisfaction in people with obesity, this technique could be considered a good choice for the treatment of body dissatisfaction. This step is essential to guarantee the long-term therapeutic success of any other treatment (nutritional or/and physical activity) in the future.

Affective touch topography and body image

Recent evidence suggests that altered responses to affective touch—a pleasant interoceptive stimulus associated with activation of the C-Tactile (CT) system—may contribute to the aetiology and maintenance of mental conditions characterised by body image disturbances (e.g., Anorexia Nervosa). Here, we investigated whether tactile pleasantness and intensity differ across body sites, and if individual differences in dysmorphic appearance concerns and body and emotional awareness might be associated with touch perceptions across body sites. To this end, we measured perceived pleasantness and intensity of gentle, dynamic stroking touches applied to the palm, forearm, face, abdomen and back of 30 female participants (mean age: 25.87±1.17yrs) using CT-optimal (3 cm/s) and non-CT optimal (0.3 and 30 cm/s) stroking touch. As expected, participants rated CT-targeted touch as more pleasant compared to the two non-CT optimal stroking touch at all body sites. Regardless of stroking velocity, touch applied to the abdomen elicited the lowest pleasantness ratings. Lower levels of emotional awareness, greater levels of interoceptive sensibility and of dysmorphic concerns were associated with lower preference for CT-optimal stroking touch applied to the forearm and the back. These findings begin to elucidate the link between CT sensitivity, dysmorphic appearance concerns and body and emotional awareness, which may have implications for future research looking to inform early interventions. Addressing impaired processing of affective interoceptive stimuli, such as CT-targeted touch, may be the key to current treatment approaches available for those populations at risk of disorders characterised by body image disturbance.

[Psychometric Evaluation of the German-Language Version of the Feedback on Physical Appearance Scale on Female Adolescents With Eating Disorders Plus Adolescents and Women Without Eating Disorders]

Negative body-related feedback is associated with increased body dissatisfaction. The English-language version of the Feedback on Physical Appearance Scale (FOPAS) is an instrument to assess verbal and non-verbal body-related feedback, but a German-language version has not been validated yet. The aim of this study was to evaluate the psychometric properties of its German-language version in a sample of adolescents with eating disorders (n=88) and in a sample of adolescents (n=123) and women (n=228) without eating disorders. Confirmatory factor analyses showed a moderate model fit from the English-language original study. All samples showed acceptable internal consistencies. The retest reliability was also mostly acceptable. Significant positive correlations with questionnaires on eating disorder symptoms (criterion validity), teasing (convergent validity) as well as the expected negative correlation with self-esteem indicated good validity. In addition, the FOPAS was able to differentiate between adolescents with and without eating disorders. To sum up, the German-language FOPAS appears to be suitable to assess verbal and non-verbal body-related feedback in research and practice.

Body exposure, its forms of delivery and potentially associated working mechanisms: How to move the field forward

Background

Body image disturbance (BID) is a hallmark feature of eating disorders (EDs) and has proven to be involved in their etiology and maintenance. Therefore, the targeting of BID in treatment is crucial, and has been incorporated in various treatment manuals. One of the most common techniques in the treatment of BID is body exposure (BE), the confrontation with one’s own body. BE has been found to be effective in individuals with EDs or high body dissatisfaction. However, BE is applied in a multitude of ways, most of which are based on one or a combination of the hypothesized underlying working mechanisms, with no differential effectiveness known so far.

Method

The aim of this paper is to selectively review the main hypothesized working mechanisms of BE and their translation into therapeutic approaches.

Results and Conclusion

Specifically, we underline that studies are needed to pinpoint the proposed mechanisms and to develop an empirically informed theoretical model of BE. We provide a framework for future studies in order to identify working mechanisms and increase effectiveness of BE.

Effects of full-body mirror exposure on eating pathology, body image and emotional states: Comparison between positive and negative verbalization

Mirror exposure (ME) is an effective technique to improve body image. However, evidence on the underlying mechanisms and the optimal verbalization instruction during ME is lacking. Therefore, this experimental study analyzed mechanisms of ME and therapeutic outcomes by comparing positive (PV) and negative (NV) full-body verbalization. N = 73 healthy females were randomized to a PV or an NV condition. PV participants verbalized positively while NV participants verbalized negatively about their whole body. Each participant underwent three standardized ME sessions. Before and after each ME session, positive affect, negative affect and body satisfaction were assessed. Before the first and after the third ME, participants completed questionnaires on cognitive-affective and behavioral aspects of body image, eating pathology and self-esteem. Regarding within-ME changes, the results indicate that positive affect and body satisfaction decreased while negative affect increased in the NV group but not in the PV group. In contrast, regarding between-ME changes, decreased negative affect as well as positive affect and increased body satisfaction were observed in both groups. However, eating pathology remained stable, whereas body-checking behavior increased and the PV condition was followed by higher levels of self-esteem compared to the NV condition. These findings suggest that both PV and NV improve negative affect and body satisfaction between-ME, and thus seem to be effective ME instructions. Given that NV led to increased negative affect within-ME and did not influence self-esteem, PV might represent the favorable instruction during ME for body-satisfied women.

What Do Children Think of Their Perceived and Ideal Bodies? Understandings of Body Image at Early Ages: A Mixed Study

Research into children’s body perceptions and ideals is scarce despite evidence of body dissatisfaction in childhood. This study aimed to understand preschoolers’ body image by employing a mixed design. Using a novel figural scale (Preschoolers’ Body Scale) that comprises four child figures ranging in BMI, 395 children ages 4–6 (54% boys) selected their perceived and ideal body and explained why they picked these bodies. Children tended to underestimate their body size and many of them desired slimmer bodies, especially girls and older participants, although body-size perception improved with age. Most children showed body satisfaction, especially boys and younger children. Ideal body choices were not always explained by beauty ideals but by physical abilities, desire to grow up, mothers’ comments, and nutrition. Many responses reflected limited body awareness, suggesting body image may not yet be fully formed in preschoolers due to their incipient cognitive development.

An Analysis of Eating Disorders in Adolescent Idiopathic Scoliosis: A Prospective Cross-sectional Study in a Female Population

STUDY DESIGN

Prospective cross-sectional study.

OBJECTIVE

We designed this study to investigate whether adolescent girls with idiopathic scoliosis show a predisposition for eating disorders (EDs) and alterations of the quality of life and body image self-perception, compared to same-age healthy females.

SUMMARY OF BACKGROUND DATA

Idiopathic scoliosis is the most common spinal deformity of adolescence. Recent findings about the impairment of the self-body image in adolescents with idiopathic scoliosis provide a common trait of scoliosis and EDs and could lead to the suspicion of an association between these two pathological conditions. Despite this, current literature shows the lack of evident results about the impact of adolescent idiopathic scoliosis (AIS) on the possibility to develop of EDs.

METHODS

One hundred forty-four females with diagnosis of AIS (aged 10-18 years) formed the scoliosis group. One hundred forty-six same-age healthy girls were enrolled in the control group. For all subjects, we considered sport practice. Only for Scoliosis Group, we also considered the severity of scoliosis, the use of brace and the practice of physiotherapy scoliosis-specific exercises. The participants were asked to answer to the Scoliosis Research Society-22 revised Patient Questionnaire (SRS-22r) and the Eating Disorders Inventory (EDI).

RESULTS

In the scoliosis group, significantly lower scores on the SRS-22r total and in the self-image domain were detected. The two groups showed differences in the total EDI score and in the body dissatisfaction EDI's domain. Severity of scoliosis was correlated with worse SRS-22r total score and SRS-22r self-image domain score. There were no differences in the scores of the SRS-22r and EDI between braced and nonbraced subjects. Lower scores in SRS-22r total and self-image domain were found in girls who practiced physiotherapy exercises. Subjects who practiced a sport showed higher SRS-22r total scores.

CONCLUSION

The AIS cohort in our study demonstrated lower levels of eating psychopathology than healthy controls. Surprisingly, eating behavior does not seem to be affected by orthotic management. However, quality of life and self-body image could be impaired in scoliotic girls, especially when they practice physiotherapy exercises, whereas those who practice sport seem to be preserved in this regard.Level of Evidence: 4.

AN-VR-BE. A Randomized Controlled Trial for Reducing Fear of Gaining Weight and Other Eating Disorder Symptoms in Anorexia Nervosa through Virtual Reality-Based Body Exposure

In vivo body exposure therapy is considered an effective and suitable intervention to help patients with anorexia nervosa (AN) reduce their body image disturbances (BIDs). However, these interventions have notable limitations and cannot effectively reproduce certain fears usually found in AN, such as the fear of gaining weight (FGW). The latest developments in virtual reality (VR) technology and embodiment-based procedures could overcome these limitations and allow AN patients to confront their FGW and BIDs. This study aimed to provide further evidence of the efficacy of an enhanced (by means of embodiment) VR-based body exposure therapy for the treatment of AN. Thirty-five AN patients (16 in the experimental group, 19 in the control group) participated in the study. FGW, BIDs, and other body-related and ED measures were assessed before and after the intervention and three months later. The experimental group received treatment as usual (TAU) and five additional sessions of VR-based body exposure therapy, while the control group received only TAU. After the intervention, ED symptoms were clearly reduced in both groups, with most of the changes being more noticeable in the experimental group. Specifically, after the intervention and at follow-up, significant group differences were found in the FGW and BIDs, with the experimental group showing significantly lower values than the control group. The current study provides new insights and encouraging findings in the field of exposure-based therapies in AN. VR technology might improve research and clinical practice in AN by providing new tools to help patients confront their core fears (i.e., food- or weight-related cues) and improve their emotional, cognitive, and behavioral responses to their body image.

Psychometric properties of the Eating Disorder Examination-Questionnaire and psychopathology in Japanese patients with eating disorders

OBJECTIVE

The Eating Disorder Examination-Questionnaire (EDE-Q) is one of the most widely used tools to assess the core psychopathology of eating disorders (ED). However, recent empirical findings did not support the original four-factor structure. The aims of the present study were to investigate the factor structure of the EDE-Q in Japanese ED patients, to test the reliability and convergent validity of the EDE-Q, to examine group differences between various ED groups and healthy participants, and to explore the main behavioral features of Japanese ED patients using the newly developed Japanese version of EDE-Q.

METHOD

A total of 148 ED patients and 469 healthy participants completed the EDE-Q, Eating Attitudes Test-26 (EAT-26), and Eating Disorder Inventory-2 (EDI-2). The factor structure, reliability, and validity of the EDE-Q were assessed in ED patients. Group differences were assessed using the new Japanese version of the EDE-Q (EDE-Q-J).

RESULTS

The EDE-Q-J had three factors. Cronbach's alphas ranged from 0.83 to 0.93. Total score and subscale scores of "Dieting" and "Bulimia and Food Preoccupation" of EAT-26 and of "Drive for Thinness," "Body Dissatisfaction," and "Bulimia" of EDI-2 correlated with the global score and three subscale scores of the EDE-Q-J.

DISCUSSION

For Japanese female ED patients, the EDE-Q-J had three subscales that were not consistent with the original subscales, but were interpretable. It demonstrated sufficient reliability and validity. Japanese female patients with restricting-type anorexia nervosa (AN-R) displayed less dissatisfaction with shape and weight than healthy participants. AN-R patients in Japan might present with a non-fat-phobic symptom profile.

Computer Based Body Exposure in Adolescents With Anorexia Nervosa: A Study Protocol

Body dissatisfaction is a core feature of eating disorders (EDs) and plays an essential role in the development and maintenance of anorexia nervosa (AN). In the current study, a computer based body exposure intervention is conducted and evaluated regarding short-term effects on body dissatisfaction, psychopathology, viewing patterns, and stress reactivity. Within a randomized controlled trial (RCT) female adolescents and young women with AN are either receiving the intervention or treatment as usual (TAU). Furthermore, in a transdiagnostic approach, a highly body-dissatisfied group of clinical control participants obtaining the intervention will be surveyed to identify AN-specific processes. The standardized four-session body exposure intervention using photographs of the own body is adapted from a manualized body image treatment program for computer use. Psychopathology (body dissatisfaction, body image avoidance, body checking, depression, anxiety) is assessed via standardized questionnaires before and after the intervention. During each session, attentional biases regarding one's own body are measured via eye tracking, stress levels are measured via subjective ratings, heart rate variability, as well as salivary cortisol and alpha amylase. Between- and within-subject effects will be assessed. The pilot study aims to identify short-term effects of the intervention on body dissatisfaction and attentional bias, as well as to investigate the potential underlying mechanism of physiological habituation.

Revisiting the Postulates of Etiological Models of Eating Disorders: Questioning Body Checking as a Longer-Term Maintaining Factor

Body checking (BC) is not only inherent to the maintenance of eating disorders but is also widespread among healthy females. According to etiological models, while BC serves as an affect-regulating behavior in the short term, in the longer term it is assumed to be disorder-maintaining and also produces more negative affect. The present study therefore aimed to empirically examine the proposed longer-term consequences of increased BC. In an online study, N = 167 women tracked their daily amount of BC over a total of 7 days: Following a 1-day baseline assessment of typical BC, participants were asked to check their bodies in an typical manner for 3 days and with a 3-fold increased frequency for 3-days. Before and after each BC episode, the impact of BC on affect, eating disorder symptoms, general pathology and endorsement of different functions of BC was assessed. Participants showed longer-term consequences of increased BC in terms of increased negative affect and general pathology, while eating disorder symptoms remained unaffected. In the case of typical BC, participants showed decreased general pathology and anxiety. Furthermore, the endorsement of a higher number of BC functions led to increased negative affect and an increased amount of typical BC. The findings support the theoretically assumed role of maladaptive BC in maintaining negative emotion in the longer term. However, though requiring replication, our finding of positive effects of typical BC calls into question the overall dysfunctionality of BC among non-clinical women who are not at risk of developing an eating disorder.

Faced with one's fear: Attentional bias in anorexia nervosa and healthy individuals upon confrontation with an obese body stimulus in an eye-tracking paradigm

OBJECTIVES

Cognitive biases, particularly attentional biases, have been shown to be central to anorexia nervosa (AN). This study looked at attention deployment when consecutively viewing an obese and own body stimulus that both might represent feared stimuli in AN.

METHODS

Individuals with AN (n = 26) and mentally healthy controls (MHCs; n = 16) viewed a picture of themselves and a standardized computer-generated obese body in random order for 4,000 ms each and then rated the attractiveness of the body parts of both stimuli. We compared dwell times on subjectively unattractive versus attractive body parts, and body parts that show weight status and gain most strongly (stomach, hips, thighs) versus least strongly.

RESULTS

For both stimuli, participants focused longer on the subjectively unattractive body parts (p < .01 and .001), with an even stronger attentional bias in individuals with AN regarding the obese stimulus (p < .05). Both groups also gazed longer at body parts indicative of weight status or gain (both stimuli p < .001), with no group differences.

CONCLUSIONS

The attentional bias to one's own subjectively unattractive body parts might represent a mechanism maintaining body image disturbance in women in general. This attentional bias is even stronger when women with AN are confronted with an obese stimulus, highlighting a potential mental preoccupation with being fat or weight gain and a behavior distinct for the disorder.

Validity of Virtual Reality Body Exposure to Elicit Fear of Gaining Weight, Body Anxiety and Body-Related Attentional Bias in Patients with Anorexia Nervosa

Fear of gaining weight (FGW), body image disturbances, associated anxiety and body-related attentional bias are the core symptoms of anorexia nervosa (AN) and play critical roles in its development and maintenance. The aim of the current study is to evaluate the usefulness of virtual reality-based body exposure software for the assessment of important body-related cognitive and emotional responses in AN. Thirty female patients with AN, one of them subclinical, and 43 healthy college women, 25 with low body dissatisfaction (BD) and 18 with high BD, owned a virtual body that had their silhouette and body mass index. Full-body illusion (FBI) over the virtual body was induced using both visuo-motor and visuo-tactile stimulation. Once the FBI was induced, the FBI itself, FGW, body anxiety and body-related attentional bias toward weight-related and non-weight-related body areas were assessed. One-way analyses of covariance (ANCOVA), controlling for age, showed that AN patients reported higher FGW, body anxiety and body-related attentional bias than healthy controls. Unexpectedly, patients with AN reported significantly lower FBI levels than healthy participants. Finally, Pearson correlations showed significant relationships between visual analog scales and body-related attentional bias measures, compared to other eating disorder measures. These results provide evidence about the usefulness of virtual reality-based body exposure to elicit FGW and other body-related disturbances in AN patients. Thus, it may be a suitable intervention for reducing these emotional responses and for easing weight recovery.

Are Individuals Perceived as More Attractive within a Group? A Confirmative Study of Group Attractiveness Effect and the Cheerleader Effect in China

The stereotype "what is beautiful is good" suggests that having an attractive physical appearance is very important to people's lives. Physical attractiveness, as an important personal trait, plays vital roles for shaping one's first impression, and for influencing one's subsequent evaluation and selection, based on obvious visual features. However, the contextual difference of the physical attractiveness between a group and its group members has been given less attention. For this reason, Van Osch et al. proposed and tested that the perceived physical attractiveness of a group is greater than the average attractiveness of its members (GA-effect), while Walker and Vul found that an individual as a group member is perceived to be more attractive in group context than in isolation (cheerleader effect). Our present work seeks to replicate these two effects on a sample of 1005 Chinese participants to check whether such effects also exist in China, a collectivist culture. Participants were asked to rate the degree of attractiveness presented in each photo stimuli and in each rating condition, and the results show that: (a) the participants' ratings of physical attractiveness of a group was significantly higher than the average attractiveness of its members (i.e., replicating the GA-effect); (b) the participants' ratings of physical attractiveness of an individual was evaluated higher in a group than in isolation (i.e., replicating the cheerleader effect); and (c) the larger the group size, the larger the GA-effect. This validating study may aid in understanding human behavior, judgments, and perceptions according to the GA-effect and the cheerleader effect used in a different context in China.

Body image disturbance in children and adolescents with anorexia nervosa and bulimia nervosa: a systematic review

PURPOSE

While several meta-analyses and reviews revealed a worse body image disturbance (BID) in adults with anorexia nervosa (AN) or bulimia nervosa (BN) than in controls, no systematic evidence is available on BID in children and adolescents. Since the usual onset of AN and BN is before the age of 21 years, being aware of BID in children and adolescents is crucial for preventing and treating eating disorders. This systematic review aims to provide an initial overview of differences in the BID components perception, global subjective satisfaction, affect/cognition, and behavior between children and adolescents with AN and BN and healthy controls.

METHODS

We conducted a systematic data search in PubMed and PsycINFO based on a priori eligibility criteria (AN or BN group; gender-matched healthy control group; each group n ≥ 20; maximum age 19 years; BID outcome compared between groups; published in English or German).

RESULTS

We were able to include k = 8 records. Compared to healthy controls, children and adolescents with AN and BN scored higher in the BID components perception, global subjective satisfaction, affect/cognition, and behavior.

CONCLUSIONS

As previously found in adults, BID in children and adolescents is associated with AN and BN. Interventions and treatments are needed to alleviate BID in children and adolescents with BN and AN. We also noted that we need more investigations on BID differences in children and adolescents to improve the database.

LEVEL OF EVIDENCE

Level I, Systematic review.

Virtual Reality Body Exposure Therapy for Anorexia Nervosa. A Case Report With Follow-Up Results

Objective

Exposure-based therapies such as mirror exposure may help to improve the results of classic cognitive behavioral therapy in anorexia nervosa (AN). Virtual reality (VR)-based procedures provide interesting novelties for targeting body-related concerns. This study aimed to provide preliminary evidence of the usefulness of a VR body exposure therapy in a patient diagnosed with AN.

Method

Fear of gaining weight (FGW), body anxiety, drive for thinness, body image disturbances, body mass index and body-related attentional bias were assessed before and after the intervention, as well as 5 months later. Five sessions of VR body exposure therapy were included within the standard course of cognitive behavioral therapy. The sessions involved a systematic and hierarchical exposure of the patient to a virtual representation of her own silhouette, with the body mass index of the avatar progressively increasing in subsequent sessions.

Results

After the intervention, there was a clear reduction in AN symptoms such as the FGW, drive for thinness, body-related anxiety and dissatisfaction. Body mass index values rose continuously during the intervention and reached healthy levels. Finally, there was a notable change in the dysfunctional body-related attentional bias. Almost all these improvements were maintained after 5 months, except for the FGW.

Conclusion

To the best of our knowledge, this study is the first to focus on treating the FGW and body-related concerns in AN using a VR-based paradigm. To pursue this study further and assess the effectiveness of this new VR software, larger controlled clinical trials are needed.

How do you feel when you check your body? Emotional states during a body-checking episode in normal-weight females

PURPOSE

Cognitive-behavioral theories posit that body checking decreases negative emotions, but increases levels of arousal. However, few studies have investigated the effects of body checking on the course of emotional states. Therefore, the current study examined how normal-weight females with higher and lower eating, weight, and shape concerns feel during a checking episode of their most-liked and least-liked body parts.

METHODS

In an online design, levels of negative emotions and arousal were retrospectively assessed before, during, immediately after, and 15 min after an individually remembered body-checking episode. Participants (N = 355) also rated their subjective satisfaction with specific body parts.

RESULTS

Levels of negative emotions were lower 15 min after the checking episode of most-liked and least-liked body parts than before the episode. However, negative emotions increased during the checking episode of least-liked body parts, but subsided thereafter. The levels of arousal increased during the checking episodes of most-liked and least-liked body parts and decreased afterwards, and females with higher concerns reported greater levels of arousal than females with lower concerns. Furthermore, females with higher concerns reported more body checking than those with lower concerns.

CONCLUSIONS

The results support the assumptions of the cognitive-behavioral theories, as body checking led to a decrease in negative emotions in the longer term, and levels of arousal increased during the checking episode. The greater levels of arousal in females with higher concerns, and their pronounced body-checking behavior, might enhance their existing concerns and increase the risk of disordered eating.

LEVEL OF EVIDENCE

Level V, descriptive study.

Body-related attentional bias as mediator of the relationship between body mass index and body dissatisfaction

Body image disturbance, consisting of an affective (body dissatisfaction) and perceptual (body distortion) component, is not only found in eating disorders, but is also present in healthy individuals, affecting their psychological well-being and everyday life. A higher body mass index is associated with higher body dissatisfaction, whereas results in relation to body distortion are mixed. Furthermore, body dissatisfaction is associated with a weight-related attentional bias. This study aimed to investigate the mediating role of a weight-related attentional bias in the relationship between body mass index and body image disturbance. Forty-one college women took part in a virtual reality and eye tracking procedure, in which the illusion of owning a virtual avatar with their body measurements was induced. During this procedure, body-related attentional bias was measured and afterwards body image disturbance was assessed. Mediation analysis revealed that weight-related attentional bias mediated the relationship between body mass index and body dissatisfaction (but not distortion). These findings suggest that modifying weight-related attentional bias would be a useful treatment target for improving body dissatisfaction. In addition, virtual reality technology could serve as an innovative method for modifying attentional bias in an ecologically valid way. HIGHLIGHTS: This Virtual Reality and Eye-Tracking study expands our knowledge about the relation between body mass index, body-related attention and body image disturbances. The results suggest that attentional bias towards weight-related body parts mediates the relation between BMI and body dissatisfaction. On the contrary, the relation between BMI and body distortion was not significant.

Neuromarketing as a strategic tool for predicting how Instagramers have an influence on the personal identity of adolescents and young people in Spain

Instagram is the fastest growing social network and has an audience that shares lifestyles related to their interest in beauty and fashion. However, the exposure of adolescents to images that promote the slender beauty ideal can lead to body dissatisfaction, as they place a lot of importance on the likes and comments they receive regarding the comparison of their appearance with that of other users. The popularity of influencers and their opinion leadership has resulted in the convergence of a given body image with the promotion of products and brands. Through the use of neuromarketing techniques -attention through eye tracking, and emotion using galvanic skin response-, the objective of this research is to determine the cognitive perception that Spanish adolescents and young people have of the stimuli transmitted by influencers on Instagram, surpassing classic content analysis of social networks and offering the innovative technique of registering unconscious reactions of the audience, both toward the body image as well as toward the brands promoted by influencers who are akin to the audience. The results suggest that adolescents place greater attention and emotional intensity on the nude body appeal of influencers compared to young adults, and show only scarce interest in brands.

Is It Possible to Train the Focus on Positive and Negative Parts of One's Own Body? A Pilot Randomized Controlled Study on Attentional Bias Modification Training

Dysfunctional body- and shape-related attentional biases are involved in the etiology and maintenance of eating disorders (ED). Various studies suggest that women, particularly those with ED diagnoses, focus on negatively evaluated parts of their own body, which leads to an increase in body dissatisfaction. The present study aims to empirically test the hypothesis that non-ED women show an attentional bias toward negative body parts and that the focus on positive and negative parts of one’s own body can be modified by attentional bias modification training based on a dot-probe task. Although several studies have measured body-related attentional biases by using pictures of participants’ own bodies, the approach of investigating attentional bias via a dot-probe task while presenting pictures of the participants’ own body parts and modifying the biased attention using such pictures is novel. Women (n = 60) rank-ordered 10 parts of their own body regarding their attractiveness. To examine and modify the attentional focus, pictures of the self-defined positive and negative parts of one’s own body were presented by means of a dot-probe task. A paired-sample t-test revealed no difference between reaction times to negative compared to positive body parts, indicating no attentional bias toward negative parts of one’s own body. A two-way ANOVA revealed a main effect of time for pictures of positive and negative parts of one’s own body, with a decrease in reaction times from pre- to post-training. However, there was no significant interaction between time and training condition concerning reaction times to positive and negative body parts. Our findings replicate previous evidence of a balanced attentional pattern regarding one’s own body in women without ED diagnoses. However, the dot-probe task failed to modify the attentional focus. As the modifiability of state body image increases with more pronounced body dissatisfaction, the next step would be to test this approach in clinical samples of women with ED diagnoses.

A systematic and methodological review of attentional biases in eating disorders: Food, body, and perfectionism

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.

Eye-tracking study on the effects of happiness and sadness on body dissatisfaction and selective visual attention during mirror exposure in bulimia nervosa

OBJECTIVE

Abundant research points to the central role of body image disturbances in the occurrence of eating disorders (ED). While emotional arousal has been identified as a trigger for binge eating in bulimia nervosa (BN), empirical knowledge on the influence of emotions on body image in individuals with BN is scarce. The present study sought to experimentally examine effects of a positive and negative emotion induction on body dissatisfaction and selective attention towards negatively valenced body parts among people with BN.

METHOD

In a randomized-controlled cross-over design, happiness and sadness were induced by film clips one-week apart in women with BN (n = 23) and non-ED controls (n = 26). After the emotion induction, participants looked at their body in a full-length mirror, while their attentional allocation was recorded with the help of a mobile eye tracker. Participants repeatedly rated their momentary body dissatisfaction.

RESULTS

Induction of happiness led to a significant decrease in self-reported body dissatisfaction. Furthermore, attentional bias (higher gaze duration and frequency) towards the most disliked body part relative to the most liked body part was significantly greater in the sadness than happiness condition in BN. No significant effects of emotion induction on gaze duration and gaze frequency during mirror exposure were found for controls.

DISCUSSION

In line with assumptions of current models on ED, findings support the notion that emotional state influences the body image of patients with BN.

Fashion Promotion on Instagram with Eye Tracking: Curvy Girl Influencers Versus Fashion Brands in Spain and Portugal

The rise of Instagram, as the fastest growing social network in Spain and Portugal, and its incorporation into the communication strategies of beauty and fashion brands have posed some risks for younger followers in relation to the development of identity and self-esteem. A physical appearance acceptance movement has also begun, based on interaction with images, on which the social network is also based. The purpose of this research was to determine how attention is paid to fashion promotion and to the awareness of physical appearance acceptance by curvy influencers in comparison with communications by fashion brands on Instagram. The quantitative and qualitative methodology is based on the use of a biometric eye tracking technique applied to a sample of 120 participants from Spain and Portugal, matching the profile of the main users of Instagram: urban university women under 25 years old with an interest in fashion, and a self-perception as a curvy woman. The results point to more attention focused on the imperfections for which curvy influencers are raising awareness than on the fashion they promote when these awareness factors are more visible, as well as more attention focused on the fashion accessories worn by curvy brand models than those worn by the influencers, with specific and significant differences between Spanish and Portuguese audiences.

Body Checking bei Frauen mit hohen und niedrigen Figur- und Gewichtssorgen

Zusammenfassung. Theoretischer Hintergrund: Gemäß Theorien zu Essstörungen ist die Aufrechterhaltung von Body Checking (BC)-Verhalten mit zwei divergierenden kognitiv-affektiven Prozessen assoziiert, d. h. Anstieg an Arousal versus Abnahme negativer emotionaler Valenz. Fragestellung: Ziel ist die Replikation einer Online-Studie zur Untersuchung, ob BC mit beiden postulierten Prozessen einhergeht und welche Relevanz die subjektive Attraktivität der kontrollierten Körperpartien hierbei hat. Methode: 125 Frauen mit hohen versus niedrigen Figur- und Gewichtssorgen schätzten ihr Level an Arousal und negativer emotionaler Valenz in erinnerten BC-Episoden der subjektiv unattraktivsten und attraktivsten Körperpartien ein. Ergebnisse: Nur bei Frauen mit hohen Figur- und Gewichtssorgen in BC-Episoden der subjektiv unattraktivsten Körperpartien traten sowohl ein Anstieg an Arousal als auch eine Abnahme negativer emotionaler Valenz ein. Schlussfolgerungen: Beide postulierten Prozesse wurden nachgewiesen.

Gender Differences in Affective and Evaluative Responses to Experimentally Induced Body Checking of Positively and Negatively Valenced Body Parts

Body checking (BC) is defined as behavior aimed at gaining information on body shape, size, or weight. Besides its occurrence as a transdiagnostic symptom in eating disorders (EDs), BC is widespread in non-clinical populations. It is associated with body dissatisfaction and the development of body image disturbances and ED. Males and females differ in terms of body dissatisfaction and associated BC strategies. However, the question of a gender-related intensity of negative affect and state body satisfaction as reactions to BC remains open. Therefore, the present experimental study aimed to examine gender differences in affective and evaluative responses to BC. We tested n = 60 women and n = 60 men in a crossover design, implementing two experimental conditions and one control condition. In the negative body checking condition (NBC), participants received standardized instructions to check negatively valenced body parts. In the positive body checking condition (PBC), by contrast, participants were asked to check positively valenced body parts. The control condition (CBC) consisted of playing a computer game. Before and after checking of one’s own body, participants rated negative body-related affect, i.e., guilt, shame, and disgust, and state body satisfaction. The results indicate that both NBC and PBC led to an increase in negative affect for men and women. Eating pathology predicted negative affect after checking in NBC for both genders. Men reported a significantly higher state body satisfaction in all conditions, whereas only women showed decreased body satisfaction in NBC. These findings suggest that BC of any body part (i.e., positively or negatively valenced) leads to increased negative affect for both genders. Eating pathology significantly influences the affective responses to BC for both genders. Changes in state body satisfaction, however, only occur in females. An explanation might be that men generally report higher body satisfaction, resulting in a more stable body image. Females and males with pathological eating behavior seem to be more vulnerable to changes in negative affect. As negative affect is equally increased after NBC and PBC for both genders, BC might play a central role in the maintenance of body image disturbances in males and females.

Hormones Matter? Association of the Menstrual Cycle With Selective Attention for Liked and Disliked Body Parts

Body dissatisfaction is wide spread among women and is considered a risk factor for eating pathology. Therefore, it is clinically relevant to investigate potential influencing factors. While previous research has mainly revealed inconsistent findings for attentional processes in body perception, the present study aimed to investigate the association of menstrual cycle phase with body satisfaction and its perception. In a within subject design, 16 women with a natural menstrual cycle (NC) and 19 women who used hormonal contraception (HC) rated their bodily attractiveness and underwent a 3-minute mirror exposure while their eye movements were recorded at two different times during their cycle (NC: ovulation vs. late luteal phase; HC: mid vs. end of cycle). At ovulation, NC women felt more attractive and gazed less at unattractive body parts in contrast to the late luteal phase, where they felt less attractive and gazed more at unattractive body parts. There was no difference in the gaze pattern for the attractive body parts at ovulation and late luteal phase. Notably, HC women showed a balanced gazed pattern at attractive and unattractive body at both times. The menstrual cycle phase is associated with women's self-rated attractiveness and selective attention when looking at their own body. It should therefore be taken into account in clinical research addressing body image.

Sustained hypervigilance for one's own body in women with weight and shape concerns: Competition effects in early visual processing investigated by steady-state visual evoked potentials (SSVEP)

This study aimed to analyze the covert attentional time course in early body processing areas in women with high body concerns. Therefore, we assessed the effect of pictures of one's own body and other bodies as distractions from a demanding dot detection task in 24 women with low and 20 women with high body concerns. Participants were instructed to attend to flickering dots eliciting steady-state visual evoked potentials (SSVEP) measured by EEG. Both groups showed a sustained SSVEP amplitude reduction, which was more pronounced for average-weight or thin bodies than for overweight bodies. For women with high body concerns, SSVEP amplitudes decreased more in the case of pictures of their own body. The results indicate covert vigilance and maintenance patterns for body stimuli, especially for bodies representing the thin ideal. Moreover, women with high body concerns attend more to information about their own body, which might maintain body dissatisfaction.

Eye-tracking research in eating disorders: A systematic review

OBJECTIVE

Those with eating disorders (EDs) show attentional biases to disorder-relevant stimuli, such as food and body shape information. However, attentional bias research in EDs largely relies on reaction time based measures, which are limited in their ability to assess different components and the time course of attention. Eye-tracking paradigms have therefore been utilized to provide greater ecological validity, and directly capture the detailed sequence of processes in perception and attention. While numerous studies have examined eye movements in the mood, anxiety, and psychotic disorders, there has been a lack of studies in EDs. The purpose of this qualitative review is to provide a summary of eye-tracking studies in clinical ED populations.

METHOD

The review was conducted using the PRISMA guidelines. Electronic databases were systematically searched to identify studies examining gaze parameters in ED compared to healthy controls (HCs). Thirty-one studies met inclusion criteria.

RESULTS

Across ED diagnoses, there was evidence of attentional biases towards food and body stimuli. In addition, differential patterns of attention to social information, and differences in smooth pursuit and saccadic eye movements were found in anorexia nervosa (AN).

DISCUSSION

Findings are discussed in relation to research in other psychiatric disorders, and recommendations for future studies using eye-tracking in EDs are given. The findings add to the wider literature on attentional biases in EDs, and provide potential avenues for treatment. IJED-18-0331.R1. Investigación de seguimiento ocular en trastornos de la conducta alimentaria: una revisión sistemática.

Double standards in body evaluation? How identifying with a body stimulus influences ratings in women with anorexia nervosa and bulimia nervosa

OBJECTIVE

Women with eating disorders (ED) evaluate their own body more negatively than do women without ED. However, it is unclear whether this negative rating is due to objective bodily features or different standards for one's own body and others' bodies. Therefore, the purpose of this study was to examine whether women with ED apply double standards when rating bodies by disentangling the objective features of one's own body from the feelings of ownership.

METHOD

We presented n = 34 women with anorexia nervosa, n = 31 women with bulimia nervosa, and n = 114 healthy controls with pictures of thin, average-weight, overweight, athletic, and hypermuscular bodies. Identity was manipulated by showing each body once with the participant's own face and once with the face of another woman. Participants were instructed to report their emotional state according to valence and arousal and to rate body attractiveness, body fat, and muscle mass.

RESULTS

Women with anorexia nervosa and bulimia nervosa displayed greater self-deprecating double standards in body fat rating than did women without ED, as quantified by the difference between the ratings of the same body with one's own versus another woman's face. Double standards reflected in valence, arousal and attractiveness ratings were significantly more pronounced in women with anorexia nervosa than in women without ED.

DISCUSSION

The double standards found may be due to an activation of dysfunctional self-related body schemata, which distort body evaluation depending on identity. Double standards related to body fat were characteristic for women with ED, but not for women without ED.

Lives on the Line: The Online Lives of Girls and Women With and Without a Lifetime Eating Disorder Diagnosis

This study aimed to compare the scope, internet use patterns, and degree of online need satisfaction of girls and women with and without a lifetime eating disorder (ED) diagnosis. Participants were 122 females aged 12-30, 53 with a lifetime ED diagnosis recruited via a hospital-based treatment program, and 69 age-matched controls recruited via normative social media sites. Participants completed questionnaires assessing disordered eating, body image, positive and negative affect, general distress, and life satisfaction, and completed an online survey about the scope of their internet use, the frequency of watching and posting pictures and videos, online friendships and social comparison, fulfillment of needs online, and mood after internet use. All questionnaire scores differed significantly between groups in the expected directions. Whereas overall, ED and control groups spent similar amounts of time online (6.21, SD = 5.13), they spent this time differently. ED participants reported devoting 56.7% of their online time to eating, weight and body image, versus 29.1% for controls, and spent significantly more time than controls on forums and blogs (t = -5.3, p < 0.0001, Cohen's d = 0.87). They also engaged more often in social comparison (t = 3.6, p < 0.005, Cohen's d = 0.65), had a higher online-offline friend ratio (t = 3.7, p < 0.0001, Cohen's d = 0.65), and more online friends with ED (t = 5.4, p < 0.0001, Cohen's d = 0.89). In comparison to controls, ED participants reported that their use of forums and blogs gave them more eating- and weight-related advice, and a greater sense of belonging, social support, and safety resulting from anonymity, with effect sizes of 0.63-0.96. However, they also reported more negative affect after posting online. Most online behaviors and patterns correlated positively with measures of symptomatology and negatively with measures of psychological health, in both groups. Internet use was rarely addressed in therapy. Professionals, families and friends should help people with disordered eating and EDs to broaden the scope of their internet use. They should invest less in food- and weight-related forums/blogs, expand their "real life" social lives and develop their interpersonal skills, so that their legitimate needs can be satisfied face-to-face, rather than virtually. Clinicians should address the online lives of their ED clients in therapy.

Dense Connectivity Based Two-Stream Deep Feature Fusion Framework for Aerial Scene Classification

Aerial scene classification is an active and challenging problem in high-resolution remote sensing imagery understanding. Deep learning models, especially convolutional neural networks (CNNs), have achieved prominent performance in this field. The extraction of deep features from the layers of a CNN model is widely used in these CNN-based methods. Although the CNN-based approaches have obtained great success, there is still plenty of room to further increase the classification accuracy. As a matter of fact, the fusion with other features has great potential for leading to the better performance of aerial scene classification. Therefore, we propose two effective architectures based on the idea of feature-level fusion. The first architecture, i.e., texture coded two-stream deep architecture, uses the raw RGB network stream and the mapped local binary patterns (LBP) coded network stream to extract two different sets of features and fuses them using a novel deep feature fusion model. In the second architecture, i.e., saliency coded two-stream deep architecture, we employ the saliency coded network stream as the second stream and fuse it with the raw RGB network stream using the same feature fusion model. For sake of validation and comparison, our proposed architectures are evaluated via comprehensive experiments with three publicly available remote sensing scene datasets. The classification accuracies of saliency coded two-stream architecture with our feature fusion model achieve 97.79%, 98.90%, 94.09%, 95.99%, 85.02%, and 87.01% on the UC-Merced dataset (50% and 80% training samples), the Aerial Image Dataset (AID) (20% and 50% training samples), and the NWPU-RESISC45 dataset (10% and 20% training samples), respectively, overwhelming state-of-the-art methods.