Improving emotion recognition in anorexia nervosa: An experimental proof-of-concept study

Objective: Previous research has found increasing evidence for difficulties in emotion recognition ability (ERA) and social cognition in anorexia nervosa (AN), and recent models consider these factors to contribute to the development and maintenance of the disorder. However, there is a lack of experimental studies testing this hypothesis. Therefore, the present proof‐of‐concept study examined whether ERA can be improved by a single session of a computerized training in AN, and whether this has short‐term effects on eating disorder symptoms. Method: Forty inpatients (22.20 ± 7.15 years) with AN were randomly assigned to receive a single session of computerized training of ERA (TERA) or a sham training (training the recognition of different types of clouds). ERA, self‐reported eating disorder symptoms, and body mass index (BMI) were assessed within 3 days before and after training. Results: After training, both groups showed improved ERA, reduced self‐reported eating disorder symptoms, and an increased BMI. As compared to patients in the control group, patients who received TERA showed greater improvements in ERA and self‐reported eating disorder symptoms. Discussion: ERA can be effectively trained in patients with AN. Moreover, short‐term improvements in self‐reported eating disorder symptoms provide tentative support for the hypothesis that difficulties in ERA contribute to the maintenance of AN, and that specific trainings of ERA hold promise as an additional component in AN treatment. Future studies are needed to replicate these findings in larger samples, and to investigate long‐term effects and transfer into real‐world settings

Correlation of trait fantasy with the slopes of the BOLD response.

<p>The statistical maps are shown superimposed on the averaged T1-weighted dataset of all subjects. Yellow/orange colours signify positive correlations.</p

Stimulation paradigm.

<p>Stimulation paradigm.</p

Means (<i>M</i>), standard deviations (<i>SD</i>) and differences between the groups (<i>t</i>-tests) in age, self-pain ratings, POM ratings and the SPF.

<p><i>Note</i>. <i>POM</i>, <i>Pain of model; SPF</i>, <i>Saarbruecker Persoenlichkeitsfragebogen</i>. Self-pain ratings and POM ratings were each measured on 11-point NRSs (0–10).</p><p>Means (<i>M</i>), standard deviations (<i>SD</i>) and differences between the groups (<i>t</i>-tests) in age, self-pain ratings, POM ratings and the SPF.</p

Example of pain picture and neutral picture.

<p>Example of pain picture and neutral picture.</p

Correlation of personal distress with the slopes of the BOLD response.

<p>The statistical maps are shown superimposed on the averaged T1-weighted dataset of all subjects. Yellow/orange colours signify positive correlations.</p

One sample t-test against zero for the slopes of the BOLD response (pain pictures > neutral pictures) across the whole sample.

<p>The statistical maps are shown superimposed on the averaged T1-weighted dataset of all subjects. Blue/green colours signify negative slopes of the BOLD response significantly different from zero, i.e. neural habituation.</p

Two sample t-test between the groups’ slopes of the BOLD response (pain exposure versus touch exposure).

<p>The statistical maps are shown superimposed on the averaged T1-weighted dataset of all subjects. Yellow/orange colours signify larger values of the slopes of the BOLD response, i.e. less neural habituation.</p

Cluster maxima of clusters for which the ratings of trait fantasy correlated with the slopes of the BOLD response across the whole sample (n = 62).

<p>Thresholds are based on cluster-level thresholding with an initial threshold of <i>p</i> < .01 and a cluster threshold of <i>p</i> < .05 (minimum cluster size: 1944 mm³).</p