Time course of attentional biases toward body shapes: The impact of body dissatisfaction

Temporal dynamics of spatial attentional biases toward weight-related words among females with weight dissatisfaction

Attentional bias toward weight-related stimuli plays a crucial role in the development and maintenance of body image disturbances. However, the temporal dynamics of attentional biases responsible for the previously reported behavioral effects caused by the task-irrelevant but spatial-relevant weight-related stimuli presented in the peripheral visual field among females with high weight dissatisfaction (HWD) remain unclear. The present study combined the modified dot-probe task and event-related potentials to explore the temporal dynamics of spatial attentional biases toward weight-related words among females with HWD. The results showed significantly larger N2pc amplitudes were elicited by fat-related and thin-related words than neutral words only in the HWD group. Moreover, only fat-related words elicited a significant PD for the HWD group, and the PD amplitudes were larger in the HWD group than in the control group. These findings revealed that weight-related words initially captured spatial allocation among females with HWD, and then fat-related words were actively suppressed after the initial capturing.

Attentional suppression of weight-related distractors among females with weight dissatisfaction

Although many studies have investigated attentional biases toward weight-related information among individuals with weight dissatisfaction, the mechanisms underlying the processing of task-irrelevant and spatial-irrelevant weight-related information as distractors remain unclear. Participants were assigned to groups according to their levels of weight dissatisfaction to address this question. Participants with high weight dissatisfaction (HWD) were assigned to the experimental group; those with low weight dissatisfaction (LWD) were assigned to a control group. By recording event-related potentials during a visual search task along the median vertical line, fatness-related/thinness-related/neutral words and scrambled strokes were presented horizontally in pairs as task-irrelevant distractors. The results showed that intact words facilitated fast attentional orienting compared to scrambled strokes, as revealed by the significant N2pc for all types of intact words for both the HWD and LWD groups. More importantly, only fatness- and thinness-related words elicited the evident PD in the HWD group, and the PD amplitudes were larger in the HWD group compared to the LWD group. These findings suggest that weight-related distractors were actively suppressed after initial attentional orienting among females with HWD. This reveals the mechanisms of attentional biases toward weight-related information among females with HWD and contributes to the model of the cognitive-behavioral theory of body image disturbance. These results may help enhance prevention and interventions for reducing weight dissatisfaction.

Body dissatisfaction and selective attention to thin-ideal bodies: The moderating role of attentional control

It has been widely hypothesised that elevated body dissatisfaction is characterised by a biased pattern of attentional selectivity that reflects increased attention to stimuli portraying the thin-ideal. Empirical evidence in support of this notion, however, has been inconsistent. The current study aimed to examine the potential moderating role of attentional control in the association between body dissatisfaction and selective attentional responding to thin-ideal bodies. Female undergraduate students (N = 232) completed a self-report measure of body dissatisfaction followed by performance-based measures of attentional control and selective attention. Results provided support for the moderating role of attentional control. Specifically, a positive association between body dissatisfaction and biased selective attention towards thin-ideal bodies was evident only amongst individuals with relatively low levels of attentional control. A general association between body dissatisfaction and selective attention was not observed. These findings may explain previous inconsistent findings and highlight the importance of considering the potential role of attentional control in the expression of body dissatisfaction-linked attentional responding to thin-ideal bodies.

The relationship between body dissatisfaction and attentional bias to thin bodies in Malaysian Chinese and White Australian women: a dot probe study

Studies suggest that an attentional bias to thin bodies is common among those with high levels of body dissatisfaction, which is a risk factor for, and symptom of, various eating disorders. However, these studies have predominantly been conducted in Western countries with body stimuli involving images of White people. In a preregistered study, we recruited 150 Malaysian Chinese women and 150 White Australian women for a study using standardized images of East Asian and White Australian bodies. To measure attentional bias to thin bodies, participants completed a dot probe task which presented images of women who self-identified their ethnicity as East Asian or as White Australian. Contrary to previous findings, we found no evidence for an association between body dissatisfaction and attentional bias to thin bodies. This lack of association was not affected by participant ethnicity (Malaysian Chinese versus White Australian) or ethnic congruency between participants and body stimuli (own-ethnicity versus other-ethnicity). However, the internal consistency of the dot probe task was poor. These results suggest that either the relationship between body dissatisfaction and attentional bias to thin bodies is not robust, or the dot probe task may not be a reliable measure of attentional bias to body size.

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.

Attention Biases for Eating Disorder-Related Stimuli Versus Social Stimuli in Adolescents with Anorexia Nervosa - An Eye-Tracking Study

Anorexia nervosa (AN) is characterized by attention biases for eating disorder-related information as well as altered attentional processing of social information. However, little is known about the interplay between the altered attentional processing of these two types of information. The present study investigates attention biases for eating disorder-related information (pictures of bodies) versus social information (pictures of faces), in adolescents with AN. Attention biases were assessed via eye-tracking during a passive-viewing task in which female bodies and faces were presented simultaneously and thus competed directly for attention. Female adolescents (13-18 years) with AN (n = 28) were compared to a clinical comparison group (adolescents with major depression; n = 20) and a comparison group of adolescents with no mental illness (n = 24). All groups looked longer at bodies than at faces, i.e., showed attention biases for bodies in maintenance of attention. These biases were more pronounced in adolescents with AN than in both comparison groups, particularly for underweight bodies, at the expense of looking less at social stimuli. The results indicate "dual" attention biases in adolescents with AN (i.e., towards bodies and away from emotional faces) which could have a twofold negative impact on eating disorder psychopathology: increased attention to eating disorder-related information might directly influence eating disorder symptoms while less attention to social information might have an indirect influence through the amplification of interpersonal difficulties.

Is body dissatisfaction related to an attentional bias towards low weight bodies in non-clinical samples of women? A systematic review and meta-analysis

Body dissatisfaction is defined as the negative subjective evaluation of one's body and is considered a risk factor for, and symptom of, eating disorders. Some studies show women with high body dissatisfaction display an attentional bias towards low weight bodies; however, this finding is not consistent, and results are yet to be systematically synthesised. We conducted a qualitative and quantitative synthesis of cross-sectional studies investigating the relationship between body dissatisfaction and attentional bias to low weight bodies in non-clinical samples of women. We searched PubMed, Scopus, Web of Science, PsycINFO, ProQuest, and OpenGrey for studies up until September 2022. We identified 34 eligible studies involving a total of 2857 women. A meta-analysis of 26 studies (75 effects) found some evidence from gaze tracking studies for a positive association between body dissatisfaction and attentional bias to low weight bodies. We found no evidence for an association from studies measuring attention using the dot probe task, electroencephalogram (EEG) recording, or the modified spatial cueing task. The results together provide partial support for the positive association between body dissatisfaction and attentional bias to low weight bodies in women. These findings can be used to inform future attentional bias research.

Spatial attentional biases toward height-related words in young males with physical stature dissatisfaction

By recording event-related potentials (ERPs) during a dot-probe task, the present study examined the neural dynamics of attentional bias toward height-related words among height dissatisfied males. Sixty male participants screened by Negative Physical Self Scale-Stature Concerns subscale (NPS-S) were assigned into a high height dissatisfaction (HHD) group and a low height dissatisfaction (LHD) group. The results showed that tall-related versus neutral words elicited larger N2pc for both HHD and LHD groups, whereas short-related versus neutral words elicited larger N2pc only for the HHD group. Additionally, an evident Pd was elicited by tall-related words for the HHD group, but not for the LHD group. Taken together, these findings revealed attentional biases toward height-related information for HHD individuals on a neural level. Specifically, HHD individuals showed an enhanced spatial attention oriented toward both tall-related and short-related words, and then, the allocated attention to the tall-related words was terminated by an active suppression mechanism.

Relationship between Attention to Body Shape, Social Physique Anxiety, and Personal Characteristics of Brazilians: A Structural Equation Model

People can develop eating disorders due to excessive body image concerns. The primary objective of this study was to examine the relationship between attention to body shape, social physique anxiety, and personal characteristics in a sample of Brazilians. The secondary objective was to evaluate the correlation of the constructs with the participants' body composition. First, 1795 individuals (70% female; M_age = 25.5 ± 6.6 years) completed the Attention to Body Shape Scale, the Social Physique Anxiety Scale, and a sociodemographic questionnaire. Then, 286 participants (58% female; M_age = 25.3 ± 5.7 years) underwent a bioimpedance exam to identify body composition. Structural equation modeling was used to estimate the relationship between the variables. The greater the attention to body shape, the greater the expectations of negative physical evaluation and the less comfort with physical presentation. Younger age, female gender, consumption of supplements/substances for body change, restrictive diets, physical inactivity, poor self-assessment of food quality, and overweight/obesity were related to negative body concerns. An expectation of negative physical evaluation was positively correlated with body fat and negatively with muscle mass. Comfort with physical presentation was negatively correlated with fat and positively with muscle. These results can support preventive strategies aimed at reducing eating disorders resulting from body image concerns.

The effect of attention on body size adaptation and body dissatisfaction

Attentional bias to low-fat bodies is thought to be associated with body dissatisfaction-a symptom and risk factor of eating disorders. However, the causal nature of this relationship is unclear. In three preregistered experiments, we trained 370 women to attend towards either high- or low-fat body stimuli using an attention training dot probe task. For each experiment, we analysed the effect of the attention training on (i) attention to subsequently presented high- versus low-fat body stimuli, (ii) visual adaptation to body size, and (iii) body dissatisfaction. The attention training had no effect on attention towards high- or low-fat bodies in an online setting (Experiment 1), but did increase attention to high-fat bodies in a laboratory setting (Experiment 2). Neither perceptions of a 'normal' body size nor levels of body dissatisfaction changed as a result of the attention training in either setting. The results in the online setting did not change when we reduced the stimulus onset-asynchrony of the dot probe task from 500 to 100 ms (Experiment 3). Our results provide no evidence that the dot probe training task used here has robust effects on attention to body size, body image disturbance or body dissatisfaction.

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.

Blinded by bodies: Elevated eating disorder symptomatology is associated with increased attentional priority for thin bodies

Selective processing of female thin-ideal body imagery is associated with greater body dissatisfaction, and eating disorder-specific rumination has been shown to mediate this relationship. Across two studies, we employed a modified rapid serial visual presentation task (similar to that used within the emotion-induced blindness literature), such that participants searched for a task-relevant target that was sometimes preceded by a thin body, non-thin body, or neutral task-irrelevant distractor. Our first experiment (N = 372) revealed a "body-induced blindness" in an unselected female sample, such that bodies in general distracted attention more than neutral images, and non-thin bodies distracted more than thin-ideal bodies. In our second experiment, female participants were selected based on eating disorder symptomatology (N = 114). Females that exhibited elevated eating disorder symptoms were distracted more by thin bodies compared to those low in symptomatology, greater distraction from thin bodies was associated with greater body dissatisfaction, and this relationship was mediated by eating disorder-specific rumination. Altogether, our findings illustrate the persistent nature of attentional distortions that occur early in cognitive processing and across time for those high in eating disorder symptomatology.

Body image in and out of the lab: Correspondence between lab-based attentional bias data and body shape dissatisfaction experiences in daily life

Accumulating lab-based studies have identified attentional biases in processing of negative appearance-related information among individuals with elevated trait body shape and weight dissatisfaction (BD). How these biases translate into experiences of BD in daily life remains unclear and, hence, was the focus of the present study. Thirty-eight women aged between 18-40 years completed a baseline survey and modified dot-probe task with both fat and thin appearance-related stimuli in a laboratory setting. Participants also downloaded a smartphone app that prompted them 10 times per day for 7 days to rate current body dissatisfaction. Results revealed that heightened BD in daily life tended to be transitory, and followed by a substantially lower rating of BD by the next survey (∼1-2 h later). For individuals with elevated trait BD and facilitated attention towards thin body images, this reduction in state BD was more gradual. Surprisingly, delayed disengagement towards thin body images was associated with greater reduction in state BD. Consistent with the hypothesis, moderating effects were not observed when initial state BD level was low. Susceptibility for immediate, short-term attentional biases towards appearance-related information may be a vulnerability factor for the prolonged persistence of negative body image experiences in daily life.

Body Size Judgments at 17 ms: Evidence From Perceptual and Attitudinal Body Image Indexes

Evidence related to temporal control for stimuli presentation of whole-body image is generally associated with attentional bias to ideal thin bodies. Few studies present evidence concerning whole-body stimuli recognition during fast visual exposure intervals. The aim of this study was to evaluate the accuracy and reaction times for the judgment of different sized body silhouettes presented at 17 ms in a non-clinical sample. Thirty-one participants were divided in attitudinal and perceptual body image groups based on Figure Rating Scale output and performed two experiments. First experiment assessed perception and the clarity of visual experience for human and non-human body stimuli at 17 ms. A general accuracy of 69.17% was registered with no differences between perceptual and attitudinal body image groups. These results indicated that the way participants perceive their own bodies does not influence the recognition of general visual silhouette stimuli. It was also observed that the clarity of visual experience is positively correlated to stimuli recognition accuracy. In the second experiment participants had to respond in a seven-point Likert scale if the presented image of body silhouettes were bigger, equal or thinner than their own bodies. Trials were divided in two blocks based on spatial rotation, half at 0° and half at 180°. General accuracy for body silhouettes recognition was 41.1%. Greater accuracy recognition for regular positioned stimuli was observed. Attitudinal dimension of body image was not a predictor of differential performance whereas perceptual body image groups recorded contrasting recognition performance. Distorted body image participants presented higher accuracy than undistorted body image participants, with greater accuracy to thinner silhouette figures. Women had significantly higher overall accuracy than men considering both experimental blocks. When comparing the cumulative accuracy curves across experimental trials, an exposure effect was registered only for the first experiment. Results showed that body silhouette stimuli were judged in a fast exposure interval with differential accuracy rates only for perceptual body image groups. Such evidence signals that conscious body image can be associated to implicit detection of visual human body stimuli. Future studies should further test how traditional explicit body image outputs perform within experimental approaches.

Looking at the Figures: Visual Adaptation as a Mechanism for Body-Size and -Shape Misperception

Many individuals experience body-size and -shape misperception (BSSM). Body-size overestimation is associated with body dissatisfaction, anxiety, depression, and the development of eating disorders in individuals who desire to be thinner. Similar symptoms have been noted for those who underestimate their muscularity. Conversely, individuals with high body mass indices (BMI) who underestimate their adiposity may not recognize the risks of or seek help for obesity-related medical issues. Although social scientists have examined whether media representations of idealized bodies contribute to the overestimation of fat or underestimation of muscle, other scientists suggest that increases in the prevalence of obesity could explain body-fat underestimation as a form of renormalization. However, these disparate approaches have not advanced our understanding of the perceptual underpinnings of BSSM. Recently, a new unifying account of BSSM has emerged that is based on the long-established phenomenon of visual adaptation, employing psychophysical measurements of perceived size and shape following exposure to "extreme" body stimuli. By inducing BSSM in the laboratory as an aftereffect, this technique is rapidly advancing our understanding of the underlying mental representation of human bodies. This nascent approach provides insight into real-world BSSM and may inform the development of therapeutic and public-health interventions designed to address such perceptual errors.

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.

The causal role of selective attention for thin-ideal images on negative affect and rumination

BACKGROUND AND OBJECTIVES

Attentional bias towards thin-ideal body images has been implicated as a vulnerability factor for eating disorder symptomatology. However, the nature and causal basis of its relationship with other cognitive vulnerability factors, namely, eating disorder-specific rumination and negative mood, remains unclear. Accordingly, the current study investigated the causal influence of attentional bias towards thin-ideal images on emotional and ruminative vulnerability, in response to a body image-related stressor.

METHODS

An established attentional bias modification (ABM) procedure, the modified dot probe task, was used for the assessment and manipulation of attentional bias. Female undergraduate students (N = 110) aged between 17 and 24 years were randomly assigned to either 'attend' towards or 'avoid' thin-ideal images. Pre- and post-attentional training, participants completed the dot probe task, as well as state measures of rumination and negative mood. Additionally, following post-ABM assessment of attentional bias, participants were given a body image-related stressor.

RESULTS

Results showed that participants trained to attend to thin bodies reported heightened negative mood, in response to the stressor, compared with participants trained to avoid thin bodies. On the other hand, groups did not demonstrate a differential increase in eating disorder-specific rumination in response to the stressor.

LIMITATIONS

The current findings will require replication with clinical samples. Additionally, state rumination and negative mood were assessed via single items.

CONCLUSIONS

These results provide the first causal evidence for the role of attentional bias towards thin-ideal images in negative emotional vulnerability. Importantly, these results suggest attentional bias may serve as a risk factor for mood reactivity and a potential target for strategies designed to enhance emotional resilience.

Visual processing of one's own body over the course of time: Evidence for the vigilance-avoidance theory in adolescents with anorexia nervosa?

OBJECTIVE

The vigilance-avoidance theory postulates a specific threat-related pattern of attention deployment, characterized by initial orientation towards fear-evoking stimuli and subsequent directing of attention away from them. The current eye-tracking study was the first to examine the applicability of the theory for patients with eating disorders, who perceive their own body as a highly aversive, threat-evoking stimulus.

METHOD

N = 56 female adolescents with anorexia nervosa (AN) and n = 43 healthy controls (HC) aged 13-18 viewed own-body pictures while their eye movements were recorded. Relative fixation times on self-defined unattractive body areas were compared between the groups by sequencing the overall presentation time of 6,000 ms into six intervals à 1,000 ms.

RESULTS

Participants with AN showed a significantly stronger attentional bias for unattractive body areas than HC within the time intervals 1, 2, and 3. However, for intervals 4, 5, and 6, no significant group differences occurred. Within the AN group, the bias for unattractive body areas was significantly stronger in interval 1 compared to intervals 4, 5, and 6; whereas within the HC group, a stable pattern of attention deployment emerged. In AN, early attention deployment was positively correlated with the negative affect reported after photo presentation.

DISCUSSION

The early vigilance in AN and the subsequent decrease in attention to unattractive body parts is in line with our assumptions. However, no indication of attentional avoidance was found. The current findings partially support the vigilance-avoidance theory for the exposure to one's own body in adolescents with AN.

The mediating role of rumination in the relation between attentional bias towards thin female bodies and eating disorder symptomatology

The present study sought to investigate the association between selective attentional processing of body images, rumination, and eating disorder symptoms in young women. Seventy-three undergraduate female students (ages 17–24) completed a modified dot-probe task to assess whether young women showed a differential attentional bias pattern towards thin and non-thin female bodies. Participants also completed self-report measures of eating disorder pathology. It was found that increased reports of dietary restraint and body dissatisfaction were associated with both greater attentional bias towards thin bodies and avoidance of non-thin bodies (as compared to neutral images), although the former relationship was stronger than the latter. The results suggest attentional vigilance to thin-ideal images plays a greater role in the potential development and/or maintenance of eating disorder symptoms, at least in a university sample of young women. Results also revealed that eating disorder-specific rumination mediated the relationship between attentional bias to thin ideal images and eating disorder symptoms. These findings build on existing research and theories, for example the impaired disengagement model of rumination, and have potential clinical applications such as specifically targeting ruminative and/or attentional processes in the prevention and/or treatment of eating disorder symptoms.