Heightened Attentional Capture by Visual Food Stimuli in Anorexia Nervosa

The present study was designed to test the hypothesis that anorexia nervosa (AN) patients are relatively insensitive to the attentional capture of visual food stimuli. Attentional avoidance of food might help AN patients to prevent more elaborate processing of food stimuli and the subsequent generation of craving, which might enable AN patients to maintain their strict diet. Participants were 66 restrictive AN spectrum patients and 55 healthy controls. A single-target rapid serial visual presentation task was used with food and disorder-neutral cues as critical distracter stimuli and disorder-neutral pictures as target stimuli. AN spectrum patients showed diminished task performance when visual food cues were presented in close temporal proximity of the to-be-identified target. In contrast to our hypothesis, results indicate that food cues automatically capture AN spectrum patients' attention. One explanation could be that the enhanced attentional capture of food cues in AN is driven by the relatively high threat value of food items in AN. Implications and suggestions for future research are discussed. General Scientific Summary The current study tested the hypothesis that people with anorexia nervosa show attentional avoidance of food. This might help them to persist in their restrictive food intake. In contrast with the hypothesis, it was shown that anorexia patients were highly distracted by food pictures compared to healthy controls

Automatic approach tendencies toward high and low caloric food in restrained eaters:Influence of task-relevance and mood

Objective: Although restrained eaters are motivated to control their weight by dieting, they are often unsuccessful in these attempts. Dual process models emphasize the importance of differentiating between controlled and automatic tendencies to approach food. This study investigated the hypothesis that heightened automatic approach tendencies in restrained eaters would be especially prominent in contexts where food is irrelevant for their current tasks. Additionally, we examined the influence of mood on the automatic tendency to approach food as a function of dietary restraint. Methods: An Affective Simon Task-manikin was administered to measure automatic approach tendencies where food is task-irrelevant, and a Stimulus Response Compatibility task (SRC) to measure automatic approach in contexts where food is task-relevant, in 92 female participants varying in dietary restraint. Prior to the task, sad, stressed, neutral, or positive mood was induced. Food intake was measured during a bogus taste task after the computer tasks. Results: Consistent with their diet goals, participants with a strong tendency to restrain their food intake showed a relatively weak approach bias toward food when food was task-relevant (SRC) and this effect was independent of mood. Restrained eaters showed a relatively strong approach bias toward food when food was task-irrelevant in the positive condition and a relatively weak approach in the sad mood. Conclusion: The weak approach bias in contexts where food is task-relevant may help high-restrained eaters to comply with their diet goal. However, the strong approach bias in contexts where food is task-irrelevant and when being in a positive mood may interfere with restrained eaters' goal of restricting food-intake

Evaluative Conditioning as a Body Image Intervention for Adolescents With Eating Disorders

Objective: The aim was to investigate whether a computer-based evaluative conditioning intervention improves body image in adolescents with an eating disorder. Positive effects were found in earlier studies in healthy female students in a laboratory and a field setting. This study is the first to test evaluative conditioning in a clinical sample under less controlled circumstances. Method: Fifty-one adolescent girls with an eating disorder and a healthy weight were randomly assigned to an experimental condition or a placebo-control condition. The computerized intervention consisted of six online training sessions of 5 min, in which participants had to click on pictures of their own and other people's bodies. Their own pictures were systematically followed by portraits of friendly smiling faces. In the control condition, participants were shown the same stimuli, but here, a stimulus was always followed by another stimulus from the same category, so that own body was not paired with smiling faces. Before, directly after, three weeks after, and 11 weeks after the intervention, self-report measures of body image and general self-esteem were administered. Automatic self-associations were also measured with an Implicit Association Test. Results: In contrast to our hypotheses, we did not find an effect of the intervention on self-report questionnaires measuring body satisfaction, weight and shape concern, and general self-esteem. In addition, the intervention did not show positive effects on implicit associations regarding self-attractiveness. Conclusions: These findings do not support the use of evaluative conditioning in its present form as an intervention for adolescents in clinical practice

Automatic approach/avoidance tendencies towards food and the course of anorexia nervosa

OBJECTIVE: The aim of the present study was to investigate the role of automatic approach/avoidance tendencies for food in Anorexia Nervosa (AN). We used a longitudinal approach and tested whether a reduction in eating disorder symptoms is associated with enhanced approach tendencies towards food and whether approach tendencies towards food at baseline are predictive for treatment outcome after one year follow up. METHOD: The Affective Simon Task-manikin version (AST-manikin) was administered to measure automatic approach/avoidance tendencies towards high-caloric and low-caloric food in young AN patients. Percentage underweight and eating disorder symptoms as indexed by the EDE-Q were determined both during baseline and at one year follow up. RESULTS: At baseline anorexia patients showed an approach tendency for low caloric food, but not for high caloric food, whereas at 1 year follow up, they have an approach tendency for both high and low caloric food. Change in approach bias was neither associated with change in underweight nor with change in eating disorder symptoms. Strength of approach/avoidance tendencies was not predictive for percentage underweight. DISCUSSION: Although approach tendencies increased after one year, approach tendencies were neither associated with concurrent change in eating disorder symptoms nor predictive for treatment success as indexed by EDE-Q. This implicates that, so far, there is no reason to add a method designed to directly target approach/avoidance tendencies to the conventional approach to treat patients with a method designed to influence the more deliberate processes in AN

Temporal attention for visual food stimuli in restrained eaters

<p>Although restrained eaters try to limit their food intake, they often fail and indulge in exactly those foods that they want to avoid. A possible explanation is a temporal attentional bias for food cues. It could be that for these people food stimuli are processed relatively efficiently and require less attentional resources to enter awareness. Once a food stimulus has captured attention, it may be preferentially processed and granted prioritized access to limited cognitive resources. This might help explain why restrained eaters often fail in their attempts to restrict their food intake. A Rapid Serial Visual Presentation task consisting of dual and single target trials with food and neutral pictures as targets and/or distractors was administered to restrained (n = 40) and unrestrained (n = 40) eaters to study temporal attentional bias. Results indicated that (1) food cues did not diminish the attentional blink in restrained eaters when presented as second target; (2) specifically restrained eaters showed an interference effect of identifying food targets on the identification of preceding neutral targets', (3) for both restrained and unrestrained eaters, food cues enhanced the attentional blink; (4) specifically in restrained eaters, food distractors elicited an attention blink in the single target trials. In restrained eaters, food cues get prioritized access to limited cognitive resources, even if this processing priority interferes with their current goals. This temporal attentional bias for food stimuli might help explain why restrained eaters typically have difficulties maintaining their diet rules. (C) 2012 Elsevier Ltd. All rights reserved.</p>

Reduced automatic approach tendencies towards task-relevant and task-irrelevant food pictures in Anorexia Nervosa

BACKGROUND AND OBJECTIVES: Anorexia Nervosa (AN) patients are characterized by an excessive restriction of their food-intake. Prior research using an Affective Simon Task (AST) with food as a task-irrelevant feature, provided evidence for the view that AN patients' ability to refrain from food is facilitated by reduced automatic approach tendencies towards food. However, because food was task-irrelevant (i.e., participants had to base their reaction on the perspective of the picture and not on its content), the findings may in fact reflect a relatively strong ability to ignore the content of the food stimuli rather than weakened approach towards food per se. Therefore, this study also included a Stimulus Response Compatibility (SRC) task with food as task-relevant feature that could not be ignored, because the required response depended on the [food vs non-food] content of the pictures. METHODS: AN spectrum patients (n = 63), and a comparison group of adolescents without eating pathology (n = 57) completed both a SRC task with food as task-relevant feature, and an Affective Simon Task AST with food as task-irrelevant feature. RESULTS: AN patients showed reduced approach tendencies for high caloric food. Only the SRC uniquely predicted the presence of AN. LIMITATIONS: Comparison between tasks was hampered because the SRC only included high caloric food stimuli, whereas the AST included high and low caloric food stimuli. CONCLUSION: Patients with AN are characterized by weakened automatic approach of high caloric food. This might 'help' restrict their food-intake even in a condition of starvation