1
|
Fusco G, Ciccarone S, Petrucci M, Cozzani B, Vercelli G, Cotugno A, Bufalari I. Altered processing of conflicting body representations in women with restrictive anorexia nervosa. PSYCHOLOGICAL RESEARCH 2023:10.1007/s00426-022-01788-3. [PMID: 36592180 DOI: 10.1007/s00426-022-01788-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023]
Abstract
Cognitive and affective impairments in processing body image have been observed in patients with Anorexia Nervosa (AN) and may induce the hypercontrolled and regulative behaviors observed in this disorder. Here, we aimed to probe the link between activation of body representations and cognitive control by investigating the ability to resolve body-related representational conflicts in women with restrictive AN and matched healthy controls (HC). Participants performed a modified version of the Flanker task in which underweight and overweight body images were presented as targets and distractors; a classic version of the task, with letters, was also administered as a control. The findings indicated that performance was better among the HC group in the task with bodies compared to the task with letters; however, no such facilitation was observed in AN patients, whose overall performance was poorer than that of the HC group in both tasks. In the task with body stimuli, performance among patients with AN was the worst on trials presenting underweight targets with overweight bodies as flankers. These results may reflect a dysfunctional association between the processing of body-related representations and cognitive control mechanisms that may aid clinicians in the development of optimal individualized treatments.
Collapse
Affiliation(s)
- Gabriele Fusco
- Department of Psychology, Istituto Italiano di Tecnologia, "Sapienza" University of Rome and CLN2S@SAPIENZA, Rome, Italy.
- IRCCS Santa Lucia Foundation, Rome, Italy.
| | - S Ciccarone
- Department of Psychology, Istituto Italiano di Tecnologia, "Sapienza" University of Rome and CLN2S@SAPIENZA, Rome, Italy
- IRCCS Santa Lucia Foundation, Rome, Italy
| | - M Petrucci
- Scuola di Psicoterapia Cognitiva S.r.l., Rome, Italy
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - B Cozzani
- Eating Disorders Unit, Department of Psychiatry, ASL Roma1, Rome, Italy
| | - G Vercelli
- Department of Developmental and Social Psychology, "Sapienza" University of Rome, Rome, Italy
| | - A Cotugno
- Eating Disorders Unit, Department of Psychiatry, ASL Roma1, Rome, Italy
| | - I Bufalari
- Department of Developmental and Social Psychology, "Sapienza" University of Rome, Rome, Italy
| |
Collapse
|
2
|
Ralph-Nearman C, Achee M, Lapidus R, Stewart JL, Filik R. A systematic and methodological review of attentional biases in eating disorders: Food, body, and perfectionism. Brain Behav 2019; 9:e01458. [PMID: 31696674 PMCID: PMC6908865 DOI: 10.1002/brb3.1458] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 10/05/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The current systematic and methodological review aimed to critically review existing literature utilizing implicit processing, or automatic approach- and/or avoidance-related attentional biases between eating disorder (ED) and nonclinical samples, which (a) highlights how psychophysiological methods advance knowledge of ED implicit bias; (b) explains how findings fit into transdiagnostic versus disorder-specific ED frameworks; and (c) suggests how research can address perfectionism-related ED biases. METHOD Three databases were systematically searched to identify studies: PubMed, Scopus, and PsychInfo electronic databases. Peer-reviewed studies of 18- to 39-year-olds with both clinical ED and healthy samples assessing visual attentional biases using pictorial and/or linguistic stimuli related to food, body, and/or perfectionism were included. RESULTS Forty-six studies were included. While behavioral results were often similar across ED diagnoses, studies incorporating psychophysiological measures often revealed disease-specific attentional biases. Specifically, women with bulimia nervosa (BN) tend to approach food and other body types, whereas women with anorexia nervosa (AN) tend to avoid food as well as overweight bodies. CONCLUSIONS Further integration of psychophysiological and behavioral methods may identify subtle processing variations in ED, which may guide prevention strategies and interventions, and provide important clinical implications. Few implicit bias studies include male participants, investigate binge-eating disorder, or evaluate perfectionism-relevant stimuli, despite the fact that perfectionism is implicated in models of ED.
Collapse
Affiliation(s)
- Christina Ralph-Nearman
- Laureate Institute for Brain Research, Tulsa, OK, USA.,School of Psychology, University of Nottingham, Nottingham, UK
| | - Margaret Achee
- Department of Psychology, University of Tulsa, Tulsa, OK, USA
| | | | - Jennifer L Stewart
- Laureate Institute for Brain Research, Tulsa, OK, USA.,Department of Community Medicine, University of Tulsa, Tulsa, OK, USA
| | - Ruth Filik
- School of Psychology, University of Nottingham, Nottingham, UK
| |
Collapse
|
3
|
Ferraro FR, Kramer R, Weigel S. Speed of Processing Time Slowing in Eating Disorders. THE JOURNAL OF GENERAL PSYCHOLOGY 2018; 145:79-92. [PMID: 29384467 DOI: 10.1080/00221309.2017.1421136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We applied Brinley ( 1965 ) plot analysis to the eating disorders field. Across 23 studies and 165 experimental conditions [experienced by a total of 773 eating disorder (ED) participants, including anorexia nervosa (AN), binge eating (BE), bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS) and 995 controls], the best-fit regression equation was Y (ED) = 1.08 X (CONTROL) - 31. This equation accounted for 98.2% of the variance. Thus, the ED subjects were only 1.08 times slower than the control subjects, suggesting little processing speed slowing in ED. We also examined simple reaction time [SRT; Y (ED) = .91 X (CONTROL) + 63; variance accounted for = 93.6%] and choice reaction time (CRT; Y (ED) = 1.12X (CONTROL) - 43, variance accounted for = 99.7%). These slopes are significantly different. ED subjects are more impacted when the task involves a decision component (CRT) than when it does not (SRT).
Collapse
Affiliation(s)
| | - Rachel Kramer
- a University of North Dakota , Grand Forks , ND , United States
| | | |
Collapse
|
4
|
Abstract
Eating disorders are considered psychiatric pathologies that are characterized by pathological worry related to body shape and weight. The lack of progress in treatment development, at least in part, reflects the fact that little is known about the pathophysiologic mechanisms that account for the development and persistence of eating disorders. The possibility that patients with eating disorders have a dysfunction of the central nervous system has been previously explored; several studies assessing the relationship between cognitive processing and certain eating behaviors have been conducted. These studies aim to achieve a better understanding of the pathophysiology of such diseases. The aim of this study was to review the current state of neuropsychological studies focused on eating disorders. This was done by means of a search process covering three relevant electronic databases, as well as an additional search on references included in the analyzed papers; we also mention other published reviews obtained by handsearching.
Collapse
|
5
|
Zhu Y, Hu X, Wang J, Chen J, Guo Q, Li C, Enck P. Processing of Food, Body and Emotional Stimuli in Anorexia Nervosa: A Systematic Review and Meta-analysis of Functional Magnetic Resonance Imaging Studies. EUROPEAN EATING DISORDERS REVIEW 2012; 20:439-50. [PMID: 22945872 DOI: 10.1002/erv.2197] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Yikang Zhu
- Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai; China
| | - Xiaochen Hu
- Department of Psychiatry and Psychotherapy; University of Bonn; Bonn; Germany
| | - Jijun Wang
- Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai; China
| | - Jue Chen
- Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai; China
| | - Qian Guo
- Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai; China
| | - Chunbo Li
- Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai; China
| | - Paul Enck
- Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy; University Hospital Tuebingen; Tuebingen; Germany
| |
Collapse
|
6
|
Abstract
Anorexia nervosa (AN) is a complex illness and highly challenging to treat. One promising approach to significantly advance our understanding of the underlying pathophysiology of AN involves developing a cognitive neuroscience model of illness. Cognitive neuroscience uses probes such as neuropsychological tasks and neuroimaging techniques to identify the neural underpinnings of behavior. With this approach, advances have been made in identifying higher-order cognitive processes that likely mediate symptom expression in AN. Identification of related neuropathology is beginning. Such findings led to the development of complex neurobehavioral models that aim to explain the etiology and persistence of AN. Future research will use these advanced tools to test and refine hypotheses about the underlying mechanisms of AN.
Collapse
Affiliation(s)
- Amelia Kidd
- New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit 98, New York, NY 10032, USA.
| | | |
Collapse
|
7
|
Event-related potentials during recognition of semantic and pictorial food stimuli in patients with anorexia nervosa and healthy controls with varying internal states of hunger. Psychosom Med 2012; 74:136-45. [PMID: 22291203 DOI: 10.1097/psy.0b013e318242496a] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To elucidate maladaptive central processing of food cues during recognition tasks in anorexia nervosa (AN), while considering influences of nutritional preload and presentation modality (word versus picture). METHODS Event-related potentials to food-related word and pictorial stimuli were assessed during recognition tasks in 16 patients with AN, 16 control participants with food intake before the study, and 16 control participants with a fasting period before the study. RESULTS Patients with AN showed a P3b amplitude reduction especially at the midline parietal site compared with satiated controls (5.7 [standard deviation = 3.3] versus 8.7 [3.1] μV, p < .03). Subtle recognition deficits in patients with AN were indicated by smaller "old/new" effects compared with satiated (p = .049) and fasting controls (p < .003) for pictorial stimuli. Hunger-modulated enhanced old/new effects for food pictures compared with neutral pictorial stimuli could be observed in fasting controls only (2.7 [2.6] versus 0.8 [2.2] μV, p < .01). CONCLUSIONS The presented data provide evidence for a midline parietal P3b amplitude reduction in patients with AN, which might point to reduced network activation in AN even during satiety. Observed subtle recognition deficits either represent a stable trait characteristic or a "scar" effect of chronic starvation that may play a role in the development and/or persistence of the disorder.
Collapse
|
8
|
Brooks S, Prince A, Stahl D, Campbell IC, Treasure J. A systematic review and meta-analysis of cognitive bias to food stimuli in people with disordered eating behaviour. Clin Psychol Rev 2011; 31:37-51. [DOI: 10.1016/j.cpr.2010.09.006] [Citation(s) in RCA: 164] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 08/23/2010] [Accepted: 09/15/2010] [Indexed: 11/25/2022]
|
9
|
Nikendei C, Weisbrod M, Schild S, Bender S, Walther S, Herzog W, Zipfel S, Friederich HC. Anorexia nervosa: selective processing of food-related word and pictorial stimuli in recognition and free recall tests. Int J Eat Disord 2008; 41:439-47. [PMID: 18348282 DOI: 10.1002/eat.20518] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Maladaptive processing of food cues is considered pivotal in the psychopathology of anorexia nervosa. However, the influence of hunger and differences in processing because of the type of stimuli remain largely unclear. METHOD Memory bias for food-related pictorial and semantic stimuli was assessed in a recognition and a free recall test in 16 anorexia nervosa (AN) patients, 16 control participants with food intake prior to the study (CG-FI) and 16 control participants with a fasting period prior to the study (CG-NF). RESULTS Compared with CG-FI participants, both AN and CG-NF participants responded faster to food-related as compared with neutral words (p < .001) in the recognition test. Differences were found for word but not for pictorial stimuli. No group differences were observed with respect to the number of correct retrievals in either the recognition or the free recall test. CONCLUSION The present study found behavioral indications of abnormal processing of food-related and neutral stimuli in anorectic patients similar to those found in fasted healthy controls. Results are discussed in terms of self-schemata in eating disorders, competitive interference, and levels of processing.
Collapse
Affiliation(s)
- C Nikendei
- Department of Psychosomatic and General Internal Medicine, University of Heidelberg Medical Hospital, Heidelberg, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Santel S, Münte TF, Krauel K, Rotte M, Baving L. Neuropsychologische Beeinträchtigungen und kognitive Verarbeitung von Essensreizen bei Anorexia nervosa. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2006. [DOI: 10.1024/1016-264x.17.4.239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Essstörungen stellen eine wichtige psychiatrische Behandlungsindikation dar. Es ist bekannt, dass bei diesen Erkrankungen auch klinisch relevante kognitive Defizite und Auffälligkeiten in der Informationsverarbeitung bestehen, die im Alltag der PatientInnen zu Beeinträchtigungen führen. Insbesondere im Hinblick auf die schwierige und langwierige Behandlung und hohen Rückfallquoten dieser Patientengruppe ist die Berücksichtigung dieser kognitiven Besonderheiten in der Therapie von Essstörungen wichtig. Der vorliegende Artikel beschreibt neurokognitive Auffälligkeiten bei Anorexia nervosa (AN) in verschiedenen relevanten Funktionsbereichen. Im zweiten Teil der Arbeit werden aktuelle Verhaltens- und Bildgebungsstudien zur Verarbeitung von nahrungsrelevanten Stimuli dargestellt.
Collapse
Affiliation(s)
- Stephanie Santel
- Klinik für Kinder- und Jugendpsychiatrie, Otto-von-Guericke-Universität und Städtisches Klinikum Magdeburg,
| | - Thomas F. Münte
- Abteilung Neuropsychologie und Center for Advanced Imaging, Otto-von-Guericke-Universität Magdeburg,
| | - Kerstin Krauel
- Klinik für Neurologie II und Center for Advanced Imaging, Otto-von-Guericke-Universität Magdeburg,
| | - Michael Rotte
- Klinik für Neurologie II und Center for Advanced Imaging, Otto-von-Guericke-Universität Magdeburg,
| | - Lioba Baving
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Zentrum für Integrative Psychiatrie Kiel,
| |
Collapse
|
11
|
Johansson L, Ghaderi A, Andersson G. Stroop interference for food- and body-related words: a meta-analysis. Eat Behav 2005; 6:271-81. [PMID: 15854873 DOI: 10.1016/j.eatbeh.2004.11.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2004] [Accepted: 11/29/2004] [Indexed: 11/26/2022]
Abstract
According to cognitive theories of eating disorders, biased information processing in favour of dysfunctional attitudes about food and body appearance plays a vital role in the development and maintenance of such disorders. Data from 27 studies evaluating Stroop interference for food- and body-related words with negative overtones were included in a meta-analysis in order to investigate whether such processing biases are specific to eating disordered samples. Participants were females characterised as eating disordered, non-eating disordered but nevertheless over-concerned with body appearance and eating, and normal controls. Mean Stroop interference for eating disordered females was of medium effect size (Cohen's d=0.48) and significantly larger than for both non-eating disordered females concerned with body appearance and eating, and normal control females (both d=0.21). Stroop interference for eating disordered females was thus of fairly modest magnitude where it was unclear whether such interference is specific to this sample.
Collapse
Affiliation(s)
- Linda Johansson
- Department of Psychology, Uppsala University, Box 1225, SE-751 42 Uppsala, Sweden.
| | | | | |
Collapse
|
12
|
Pönicke J, Albacht B, Leplow B. Kognitive Veränderungen beim Fasten. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2005. [DOI: 10.1026/1616-3443.34.2.86] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Auf Grund der extrem eingeschränkten Kalorienzufuhr beim Fasten kommt es zu verschiedenen hormonellen- und Stoffwechselveränderungen. Fragestellung: Sind kognitive Funktionen bei einer Fastendauer von 72 Stunden beeinträchtigt? Methode: Es wurden 15 Teilnehmer eines Buchinger-Fastenkurses und eine nach Geschlecht, Alter und höchstem Schulabschluss parallelisierte Kontrollgruppe an zwei Untersuchungszeitpunkten neuropsychologisch getestet (Aufmerksamkeit, visuo-konstruktive Fähigkeiten, konditional-assoziative Lernfähigkeit, Befindlichkeit). Ergebnisse: In der Fastengruppe ergaben sich nach 72 Stunden signifikant schlechtere Leistungen in Aufmerksamkeitstests und im konditional-assoziativen Lernen. Das allgemeine Befinden war jedoch deutlich besser ausgeprägt als in der nicht fastenden Kontrollgruppe. Das verbale Lernen, die verbale und visuo-räumliche Merkfähigkeit sowie die Visuokonstruktion waren dagegen unbeeinträchtigt. Schlussfolgerung: Bereits nach einer extremen Nahrungseinschränkung von 72 Stunden zeigen sich selektive Beeinträchtigungen der kognitiven Funktionen, welche in milder Ausprägungen denen von Anorexiepatientinnen entsprechen.
Collapse
Affiliation(s)
- Julia Pönicke
- Martin-Luther-Universität zu Halle-Wittenberg, Institut für Psychologie
| | - Birgit Albacht
- Martin-Luther-Universität zu Halle-Wittenberg, Institut für Psychologie
| | - Bernd Leplow
- Martin-Luther-Universität zu Halle-Wittenberg, Institut für Psychologie
| |
Collapse
|
13
|
Suslow T, Ohrmann P, Lalee-Mentzel J, Donges US, Arolt V, Kersting A. Incidental learning of food and emotional words in women with anorexia nervosa. Eat Weight Disord 2004; 9:290-5. [PMID: 15844402 DOI: 10.1007/bf03325084] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Prior research suggests that anorexic patients show a memory bias for fattening foods when they are processed in depth or with reference to the self. The present study examined whether anorexic subjects exhibit a bias for fattening foods when these are presented as task-irrelevant distractor stimuli. It also investigated whether anorexic patients pay less attention to emotion stimuli. A sequential word-word evaluation task was administered to 11 inpatients with anorexia nervosa and 11 non-dieting normal subjects. There were four types of distractor words: high caloric foods, positive, negative, and neutral. Anorexic patients recalled no more food words but fewer neutral and positive words than normal subjects. The present data suggest that, compared to healthy young women, anorexic patients show no memory bias for fattening foods when these data are presented as peripheral environmental information. Anorexic patients are perceptually no less sensitive to negative emotional information than normal subjects.
Collapse
Affiliation(s)
- T Suslow
- Department of Psychiatry, School of Medicine, University of Münster, Germany.
| | | | | | | | | | | |
Collapse
|
14
|
Murphy R. Zur Neuropsychologie und Neurophysiologie der Anorexia nervosa. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2004. [DOI: 10.1026/0084-5345.33.1.51] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Konvergierende neurowissenschaftliche Befunde zur Anorexia nervosa deuten darauf hin, dass Veränderungen im Zentralnervensystem mit Störungen des Essverhaltens assoziiert sein können. Fragestellung und Methode: Es soll ein Überblick über ausgewählte empirische Befunde aus den Bereichen Neuroanatomie, Neurophysiologie und Neuropsychologie gegeben werden. Ergebnisse und Schlussfolgerungen: Trotz der teilweise heterogenen Befundlage belegen die Ergebnisse, dass bei der Anorexie strukturelle und funktionelle cerebrale Veränderungen vorliegen können, denen möglicherweise eine Rolle bei der Genese und Aufrechterhaltung der Erkrankung zukommt.
Collapse
Affiliation(s)
- Roy Murphy
- Medizinisch-Psychosomatische Klinik Bad Bramstedt in Kooperation mit der Universität zu Lübeck
| |
Collapse
|