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Effects of an Appearance-Focused Interpretation Training Intervention on Eating Disorder Symptoms

Published online by Cambridge University Press:  13 March 2018

Berta J. Summers
Affiliation:
Department of Psychology, Florida State University, Tallahassee, FL, USA
Jesse R. Cougle*
Affiliation:
Department of Psychology, Florida State University, Tallahassee, FL, USA
*
Correspondence to Jesse R. Cougle, Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306, USA. E-mail: [email protected]

Abstract

Background: Previous research suggests that computerized interpretation bias modification (IBM) techniques may be useful for modifying thoughts and behaviours relevant to eating pathology; however, little is known about the utility of IBM for decreasing specific eating disorder (ED) symptoms (e.g. bulimia, drive for thinness). Aims: The current study sought to further examine the utility of IBM for ED symptoms via secondary analyses of an examination of IBM for individuals with elevated body dysmorphic disorder (BDD) symptoms (see Summers and Cougle, 2016), as these disorders are both characterized by threat interpretation biases of ambiguous appearance-related information. Method: We recruited 41 participants for a randomized trial comparing four sessions of IBM aimed at modifying problematic social and appearance-related threat interpretation biases with a placebo control training (PC). Results: At 1-week post-treatment, and relative to the PC, the IBM group reported greater reductions in negative/threat interpretations of ambiguous information in favour of positive/benign biases. Furthermore, among individuals with high pre-treatment bulimia symptoms, IBM yielded greater reductions in bulimia symptoms compared with PC at post-treatment. No treatment effects were observed on drive for thinness symptoms. Conclusions: The current study suggests that cognitive interventions for individuals with primary BDD symptoms may improve co-occurring ED symptoms such as bulimia.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2018 

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References

Aiken, L. S. and West, S. G. (1991). Multiple Regression: Testing and Interpreting Interactions. Sage.Google Scholar
Amir, N., Prouvost, C. and Kuckertz, J. M. (2012a). Lack of a benign interpretation bias in social anxiety disorder. Cognitive Behaviour Therapy, 41, 119129. doi: https://doi.org/10.1080/16506073.2012.662655Google Scholar
Amir, N., Prouvost, C. and Kuckertz, J. M. (2012b). Lack of a benign interpretation bias in social anxiety disorder. Cognitive Behaviour Therapy, 41, 119129. doi: https://doi.org/10.1080/16506073.2012.662655Google Scholar
American Psychological Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. Arlington, VA: American Psychiatric Publishing.Google Scholar
Beard, C. and Amir, N. (2008). A multi-session interpretation modification program: changes in interpretation and social anxiety symptoms. Behaviour Research and Therapy, 46, 11351141. doi: https://doi.org/10.1016/j.brat.2008.05.012Google Scholar
Beard, C. and Amir, N. (2009). Interpretation in social anxiety: when meaning precedes ambiguity. Cognitive Therapy and Research, 33, 406415. doi: https://doi.org/10.1007/s10608-009-9235-0Google Scholar
Beard, C., Weisberg, R. B. and Amir, N. (2011). Combined cognitive bias modification treatment for social anxiety disorder: a pilot trial. Depression and Anxiety, 28, 981988. doi: https://doi.org/10.1002/da.20873Google Scholar
Buhlmann, U., Wilhelm, S., McNally, R. J., Tuschen-Caffier, B., Baer, L. and Jenike, M. A. (2002). Interpretive biases for ambiguous information in body dysmorphic disorder. CNS Spectrums, 7, 435–436, 441443. doi: https://doi.org/10.1016/j.psychres.2013.12.030Google Scholar
Cardi, V., Di Matteo, R., Corfield, F. and Treasure, J. (2012). Social reward and rejection sensitivity in eating disorders: an investigation of attentional bias and early experiences. World Journal of Biological Psychiatry, 14, 622633. doi: https://doi.org/10.3109/15622975.2012.665479Google Scholar
Cardi, V., Esposito, M., Bird, G., Rhind, C., Yiend, J., Schifano, S. et al. (2015). A preliminary investigation of a novel training to target cognitive biases towards negative social stimuli in anorexia nervosa. Journal of Affective Disorders, 188, 188193. doi: https://doi.org/10.1016/j.jad.2015.08.019Google Scholar
Cooper, M. (1997). Bias in interpretation of ambiguous scenarios in eating disorders. Behaviour Research and Therapy, 35, 619626. doi: https://doi.org/10.1016/S0005-7967(97)00021-1Google Scholar
Cristea, I. A., Kok, R. N. and Cuijpers, P. (2015). Efficacy of cognitive bias modification interventions in anxiety and depression: meta-analysis. British Journal of Psychiatry, 206, 716. doi: https://doi.org/10.1192/bjp.bp.114.146761Google Scholar
Fairburn, C. G. (2008). Cognitive Behavior Therapy and Eating Disorders. Guilford Publications.Google Scholar
Fairburn, C. G. and Beglin, S. J. (1994). Assessment of eating disorders: interview or self-report questionnaire? International Journal of Eating Disorders, 16, 363370. doi: https://doi.org/10.1002/1098-108X(199412)16:4<363::AID-EAT2260160405>3.0.CO;2-3.0.CO;2->Google Scholar
Fang, A., Sawyer, A. T., Aderka, I. M. and Hofmann, S. G. (2013). Psychological treatment of social anxiety disorder improves body dysmorphic concerns. Journal of Anxiety Disorders, 27, 684691. doi: https://doi.org/10.1016/j.janxdis.2013.07.005Google Scholar
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. (1995). Structured Clinical Interview for DSM-IV axis I Disorders-Patient Edition (SCID-I/P, version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
Garner, D. M., Olmstead, M. P. and Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 1534. doi: https://doi.org/10.1002/1098-108X(198321)2:2<15::AID-EAT2260020203>3.0.CO;2-63.0.CO;2-6>Google Scholar
Hallion, L. S. and Ruscio, A. M. (2011). A meta-analysis of the effect of cognitive bias modification on anxiety and depression. Psychological Bulletin, 137, 940958. doi: https://doi.org/10.1037/a0024355Google Scholar
Hartmann, A. S., Greenberg, J. L. and Wilhelm, S. (2013). The relationship between anorexia nervosa and body dysmorphic disorder. Clinical Psychology Review, 33, 675685. doi: https://doi.org/10.1016/j.cpr.2013.04.002Google Scholar
Hindash, A. H. and Amir, N. (2012). Negative interpretation bias in individuals with depressive symptoms. Cognitive Therapy and Research, 36, 502511. doi: https://doi.org/10.1007/s10608-011-9397-4Google Scholar
Hirsch, C. R., Hayes, S., Matthews, A., Hirsch, C. R., Hayes, S. and Matthews, A. (2009). Looking on the bright side: accessing benign meanings reduces worry. Journal of Abnormal Psychology, 118, 4454. doi: https://doi.org/10.1037/a0013473Google Scholar
Hrabosky, J. I., Cash, T. F., Veale, D., Neziroglu, F., Soll, E. A., Garner, D. M. et al. (2009). Multidimensional body image comparisons among patients with eating disorders, body dysmorphic disorder, and clinical controls: a multisite study. Body Image, 6, 155163. doi: https://doi.org/10.1016/j.bodyim.2009.03.001Google Scholar
Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K. et al. (2010). Research domain criteria (rdoc): toward a new classification framework for research on mental disorders. American Journal of Psychiatry, 167, 748751. doi: https://doi.org/10.1176/appi.ajp.2010.09091379Google Scholar
Jackman, L. P., Williamson, D. A., Netemeyer, R. G. and Anderson, D. A. (1995). Do weight-preoccupied women misinterpret ambiguous stimuli related to body size? Cognitive Therapy and Research, 19, 341355. doi: https://doi.org/10.1007/bf02230404Google Scholar
Konstantakopoulos, G., Varsou, E., Dikeos, D., Ioannidi, N., Gonidakis, F., Papadimitriou, G. and Oulis, P. (2012). Delusionality of body image beliefs in eating disorders. Psychiatry Research, 200, 482488. doi: https://doi.org/10.1016/j.psychres.2012.03.023Google Scholar
Kuckertz, J. M., Amir, N., Tobin, A. C. and Najmi, S. (2013). Interpretation of ambiguity in individuals with obsessive-compulsive symptoms. Cognitive Therapy and Research, 37, 232241. doi: https://doi.org/10.1007/s10608-012-9478-zGoogle Scholar
Martinelli, M. K., Holzinger, J. B. and Chasson, G. S. (2014). Validation of an interpretation bias assessment for body dissatisfaction. Body Image, 11, 557561. doi: https://doi.org/10.1016/j.bodyim.2014.08.010Google Scholar
Mathews, A. and Mackintosh, B. (2000). Induced emotional interpretation bias and anxiety. Journal of Abnormal Psychology, 109, 602615. doi: https://doi.org/10.1037/0021-843X.109.4.602Google Scholar
Menne-Lothmann, C., Viechtbauer, W., Höhn, P., Kasanova, Z., Haller, S. P., Drukker, M. et al. (2014). How to boost positive interpretations? A meta-analysis of the effectiveness of cognitive bias modification for interpretation. PLoS One, 9. doi: https://doi.org/10.1371/journal.pone.0100925Google Scholar
Moody, T. D., Shen, V. W., Hutcheson, N. L., Henretty, J. R., Sheen, C. L., Strober, M. and Feusner, J. D. (2017). Appearance evaluation of others’ faces and bodies in anorexia nervosa and body dysmorphic disorder. International Journal of Eating Disorders, 50, 127138. doi: https://doi.org/10.1002/eat.22604Google Scholar
Murphy, R., Straebler, S., Cooper, Z. and Fairburn, C. G. (2010). Cognitive behavioral therapy for eating disorders. The Psychiatric Clinics of North America, 33, 611627. doi: https://doi.org/10.1016/j.psc.2010.04.004Google Scholar
Nevonen, L., Clinton, D. and Norring, C. (2006). Validating the EDI-2 in three Swedish female samples: eating disorders patients, psychiatric outpatients and normal controls. Nordic Journal of Psychiatry, 60, 4450. doi: https://doi.org/10.1080/08039480500504537Google Scholar
National Institute for Health and Care Excellence (NICE) (2004). Eating Disorders: Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. British Psychological Society (UK).Google Scholar
Olatunji, B. O., Broman-Fulks, J. J., Ciesielski, B. G., Zawilinski, L. L., Shewmaker, S. and Wall, D. (2012). A taxometric investigation of the latent structure of eating disorders. Psychiatry Research, 197, 97102. doi: https://doi.org/10.1016/j.psychres.2011.12.016Google Scholar
Phillips, K. A., Hollander, E. E., Rasmussen, S. A., Aronowitz, B. R., DeCaria, C. C. and Goodman, W. K. (1997). A severity rating scale for body dysmorphic disorder: development, reliability, and validity of a modified version of the yale-brown obsessive compulsive scale. Psychopharmacology Bulletin, 33, 1722.Google Scholar
Pringle, A., Harmer, C. J. and Cooper, M. J. (2011). Biases in emotional processing are associated with vulnerability to eating disorders over time. Eating Behaviors, 12, 5659. doi: https://doi.org/10.1016/j.eatbeh.2010.08.003Google Scholar
Rodgers, R. F. and DuBois, R. H. (2016). Cognitive biases to appearance-related stimuli in body dissatisfaction: a systematic review. Clinical Psychology Review, 46, 111. doi: 10.1016/j.cpr.2016.04.006Google Scholar
Rosser, B. A., Moss, T. and Rumsey, N. (2010). Attentional and interpretative biases in appearance concern: an investigation of biases in appearance-related information processing. Body Image, 7, 251254. doi: https://doi.org/10.1016/j.bodyim.2010.02.007Google Scholar
Schoemaker, C., van Strien, T. and van der Staak, C. (1994). Validation of the eating disorders inventory in a nonclinical population using transformed and untransformed responses. International Journal of Eating Disorders, 15, 387393. doi: https://doi.org/10.1002/eat.2260150409Google Scholar
Sheehan, D., Janavs, J., Baker, R., Harnett-Sheehan, K. and Knapp, E. (2006). Mini International Neuropsychiatric Interview (m.I.N.I.). Tampa: University of South Florida.Google Scholar
Smeets, E., Jansen, A. and Roefs, A. (2011). Bias for the (un)attractive self: on the role of attention in causing body (dis)satisfaction. Health Psychology, 30, 360367. doi: https://doi.org/10.1037/a0022095Google Scholar
Steinman, S. A. and Teachman, B. A. (2010). Modifying interpretations among individuals high in anxiety sensitivity. Journal of Anxiety Disorders, 24, 7178. doi: https://doi.org/10.1016/j.janxdis.2009.08.008Google Scholar
Striegel-Moore, R. H., Rosselli, F., Perrin, N., DeBar, L., Wilson, G. T., May, A. and Kraemer, H. C. (2009). Gender difference in the prevalence of eating disorder symptoms. International Journal of Eating Disorders, 42, 471474. doi: https://doi.org/10.1002/eat.20625Google Scholar
Striegel Weissman, R. and Rosselli, F. (2017). Reducing the burden of suffering from eating disorders: unmet treatment needs, cost of illness, and the quest for cost-effectiveness. Behaviour Research and Therapy, 88, 4964. doi: 10.1016/j.brat.2016.09.006Google Scholar
Summers, B. J. and Cougle, J. R. (2016). Modifying interpretation biases in body dysmorphic disorder: evaluation of a brief computerized treatment. Behaviour Research and Therapy, 87, 117127. doi: https://doi.org/10.1016/j.brat.2016.09.005Google Scholar
Thiel, A., and Paul, T. (2006). Test–retest reliability of the Eating Disorder Inventory 2. Journal of Psychosomatic Research, 61, 567569. doi: https://doi.org/10.1016/j.jpsychores.2006.02.015Google Scholar
Wagner, R., MacCaughelty, C., Rufino, K., Pack, T., Poplack, J., George, K. and Ruscitti, C. (2016). Effectivenes of a track-based model for treating eating disorders in a general psychiatric hospital. Bulletin of the Menninger Clinic, 80, 4959. doi: https://doi.org/10.1521/bumc.2016.80.1.49Google Scholar
Wilson, G. T., Grilo, C. M. and Vitousek, K. M. (2007). Psychological treatment of eating disorders. American Psychologist, 62, 199216. doi: https://doi.org/10.1037/0003-066X.62.3.199Google Scholar
Yiend, J., Parnes, C., Shepherd, K., Roche, M.-K. and Cooper, M. J. (2014). Negative self-beliefs in eating disorders: a cognitive-bias-modification study. Clinical Psychological Science, 2, 756766. doi: https://doi.org/10.1177/2167702614528163Google Scholar
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