Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-26T17:59:06.882Z Has data issue: false hasContentIssue false
  • English
  • Français

Investigating vulnerability to eating disorders: biases in emotional processing

Published online by Cambridge University Press:  12 August 2009

A. Pringle ,
C. J. Harmer  and
M. J. Cooper
A. Pringle
Affiliation:
Department of Experimental Psychology, University of Oxford, Oxford, UK
C. J. Harmer
Affiliation:
University Department of Psychiatry, University of Oxford, Oxford, UK
M. J. Cooper*
Affiliation:
Isis Education Centre, University of Oxford, Warneford Hospital, Oxford, UK
*
*Address for correspondence: Dr M. J. Cooper, Isis Education Centre, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Biases in emotional processing and cognitions about the self are thought to play a role in the maintenance of eating disorders (EDs). However, little is known about whether these difficulties exist pre-morbidly and how they might contribute to risk.

Method

Female dieters (n=82) completed a battery of tasks designed to assess the processing of social cues (facial emotion recognition), cognitions about the self [Self-Schema Processing Task (SSPT)] and ED-specific cognitions about eating, weight and shape (emotional Stroop). The 26-item Eating Attitudes Test (EAT-26; Garner et al. 1982) was used to assess subclinical ED symptoms; this was used as an index of vulnerability within this at-risk group.

Results

Regression analyses showed that biases in the processing of both neutral and angry faces were predictive of our measure of vulnerability (EAT-26). In the self-schema task, biases in the processing of negative self descriptors previously found to be common in EDs predicted vulnerability. Biases in the processing of shape-related words on the Stroop task were also predictive; however, these biases were more important in dieters who also displayed biases in the self-schema task. We were also able to demonstrate that these biases are specific and separable from more general negative biases that could be attributed to depressive symptoms.

Conclusions

These results suggest that specific biases in the processing of social cues, cognitions about the self, and also about eating, weight and shape information, may be important in understanding risk and preventing relapse in EDs.

Keywords

Dieterseating disordersemotional processingvulnerability
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 4 , April 2010 , pp. 645 - 655
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, NH (1968). Likableness ratings of 555 personality-trait words. Journal of Personality and Social Psychology 9, 272–279.CrossRefGoogle ScholarPubMed
Baron, RM, Kenny, DA (1986). The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology 51, 1173–1182.CrossRefGoogle ScholarPubMed
Cooper, MJ (2001). Eating disorders, culture and cognition. In Cultural Cognition and Psychopathology (ed. Schumaker, J. F. and Ward, T.), pp. 95–106. Praeger: Westport, CT.Google Scholar
Cooper, MJ (2005). Cognitive theory in anorexia nervosa and bulimia nervosa: progress, development and future directions. Clinical Psychology Review 25, 511–531.CrossRefGoogle ScholarPubMed
Cooper, MJ, Cowen, P (2009). Negative self-beliefs in relation to eating disorder and depressive symptoms: different themes are characteristic of the two sets of symptoms in those with eating disorders and/or depression. Journal of Cognitive Psychotherapy 23, 147–159.CrossRefGoogle Scholar
Cooper, MJ, Fairburn, CG (1992). Selective processing of eating, weight and shape related words in patients with eating disorders and dieters. British Journal of Clinical Psychology 31, 363–365.CrossRefGoogle ScholarPubMed
Cooper, MJ, Rose, KS, Turner, H (2005). Core beliefs and the presence or absence of eating disorder symptoms and depressive symptoms in adolescent girls. International Journal of Eating Disorders 38, 60–64.CrossRefGoogle ScholarPubMed
Cooper, MJ, Wells, A, Todd, G (2004). A cognitive model of bulimia nervosa. British Journal of Clinical Psychology 43, 1–16.CrossRefGoogle ScholarPubMed
Crisp, AH (1980). Anorexia Nervosa: Let Me Be. Academic Press: London.Google Scholar
Ekman, P, Friesen, WV (1976). Pictures of Facial Affect. Consulting Psychologists Press: Palo Alto, CA.Google Scholar
Elliott, P, Hawthorne, G (2005). Inputing missing repeated measures data: how should we proceed? Australian and New Zealand Journal of Psychiatry 39, 575–582.CrossRefGoogle Scholar
Fairburn, CG, Beglin, SJ (1994). Assessment of eating disorders: interview or self-report questionnaire? International Journal of Eating Disorders 16, 363–370.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
Fairburn, CG, Cooper, Z, Doll, HA, Davies, BA (2005). Identifying dieters who will develop an eating disorder: a prospective, population-based study. American Journal of Psychiatry 162, 2249–2255.CrossRefGoogle ScholarPubMed
Fairburn, CG, Cooper, Z, Shafran, R (2003). Cognitive behaviour therapy for eating disorders: a ‘transdiagnostic’ theory and treatment. Behaviour Research and Therapy 41, 509–528.CrossRefGoogle ScholarPubMed
Fairburn, CG, Shafran, R, Cooper, Z (1999). A cognitive behavioural theory of anorexia nervosa. Behaviour Research and Therapy 37, 1–13.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1996). Structured Clinical Interview for Axis I and II DSM-IV Disorders – Patient Edition (SCID-IV/P). New York State Psychiatric Institute, Biometrics Research Department: New York.Google Scholar
Garner, D, Bemis, K (1982). A cognitive-behavioral approach to anorexia nervosa. Cognitive Therapy and Research 6, 123–150.CrossRefGoogle Scholar
Garner, DM, Olmsted, MP, Bohr, Y, Garfinkel, PE (1982). The Eating Attitudes Test: psychometric features and clinical correlates. Psychological Medicine 12, 871–878.CrossRefGoogle ScholarPubMed
Gendall, K, Joyce, P, Sullivan, P, Bulik, C (1998). Personality and dimensions of dietary restraint. International Journal of Eating Disorders 24, 371–379.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Harmer, CJ, Bhagwagar, Z, Perrett, DI, Vollm, BA, Cowen, PJ, Goodwin, GM (2003). Acute SSRI administration affects the processing of social cues in healthy volunteers. Neuropsychopharmacology 28, 148–152.CrossRefGoogle ScholarPubMed
Jacobi, C, Hayward, C, de Zwaan, M, Kraemer, HC, Agras, WS (2004). Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for a general taxonomy. Psychological Bulletin 130, 19–65.CrossRefGoogle ScholarPubMed
Jänsch, C, Harmer, C, Cooper, MJ (2009). Emotional processing in women with anorexia nervosa and in healthy volunteers. Eating Behaviours. Published online: 11 June 2009. doi: 10.1016/j.eatbeh.2009.06.001.CrossRefGoogle ScholarPubMed
Jones, L, Harmer, C, Cowen, P, Cooper, M (2008). Emotional face processing in women with high and low levels of eating disorder related symptoms. Eating Behaviours 9, 389–397.CrossRefGoogle ScholarPubMed
Kessler, H, Schwarze, M, Filipic, S, Traue, H, von Wietersheim, J (2006). Alexithymia and facial emotion recognition in patients with eating disorders. International Journal of Eating Disorders 39, 245–251.CrossRefGoogle ScholarPubMed
Kucharska-Pietura, K, Nikolaou, V, Masiak, M, Treasure, J (2004). The recognition of emotion in the faces and voice of anorexia nervosa. International Journal of Eating Disorders 35, 42–47.CrossRefGoogle ScholarPubMed
Legenbauer, T, Vocks, S, Rüddel, H (2008). Emotional recognition, emotional awareness and cognitive bias in individuals with bulimia nervosa. Journal of Clinical Psychology 64, 687–702.CrossRefGoogle ScholarPubMed
Markus, H (1977). Self-schemata and processing information about the self. Journal of Personality and Social Psychology 35, 63–78.CrossRefGoogle Scholar
Mendlewicz, L, Linkowski, P, Bazelmans, C, Philippot, P (2005). Decoding emotional facial expressions in depressed and anorexic patients. Journal of Affective Disorders 89, 195–199.CrossRefGoogle ScholarPubMed
Munafò, MR, Hayward, G, Harmer, C (2006). Selective processing of social threat cues following acute tryptophan depletion. Journal of Psychopharmacology 20, 33–39.Google Scholar
Nelson, HE (1982). National Adult Reading Test (NART): Test Manual. NFER-Nelson: Windsor.Google Scholar
Nylander, I (1971). The feeling of being fat and dieting in a school population. An epidemiologic interview investigation. Acta Socio-medica Scandinavica 3, 17–26.Google Scholar
Pike, KM, Rodin, J (1991). Mothers, daughters, and disordered eating. Journal of Abnormal Psychology 100, 198–204.CrossRefGoogle ScholarPubMed
Pollatos, O, Herbert, BM, Schandry, R, Gramann, K (2008). Impaired central processing of emotional faces in anorexia nervosa. Psychosomatic Medicine 70, 701–708.CrossRefGoogle ScholarPubMed
Stice, E, Killen, J, Hayward, C, Taylor, B (1998 a). Support for the continuity hypothesis of bulimic pathology. Journal of Consulting and Clinical Psychology 66, 784–790.CrossRefGoogle ScholarPubMed
Stice, E, Mazotti, L, Krebs, M, Martin, S (1998 b). Predictors of adolescent dieting behaviors: a longitudinal study. Psychology of Addictive Behaviors 12, 195–205.Google Scholar
Striegel-Moore, RH, Silberstein, LR, Rodin, J (1986). Toward an understanding of risk factors for bulimia. American Psychologist 41, 246–263.CrossRefGoogle ScholarPubMed
Stroop, JR (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology: General 18, 643–662.CrossRefGoogle Scholar
Teasdale, JD, Segal, ZV, Williams, JMG, Ridgeway, VA, Soulsby, JM, Lau, MA (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615–623.CrossRefGoogle ScholarPubMed
Turken, AU, Swick, D (1999). Response selection in the human anterior cingulated cortex. Nature Neuroscience 2, 2920–2924.CrossRefGoogle Scholar
Vitousek, K, Hollon, S (1990). The investigation of schematic content and processing in eating disorders. Cognitive Therapy and Research 14, 191–214.CrossRefGoogle Scholar
Vitousek, KB, Ewald, LS (1993). Self-representation in eating disorders: a cognitive perspective. In The Self in Emotional Distress: Cognitive and Psychodynamic Perspectives (ed. Segal, Z. V. and Blatt, S. J.), pp. 221–257. Guilford Press: New York.Google Scholar
Waller, G, Cordery, H, Corstorphine, E, Hinrichsen, H, Lawson, R, Mountford, V, Russell, K (2007 a). Cognitive Behavioural Therapy for Eating Disorders: A Comprehensive Treatment Guide. Cambridge University Press: Cambridge.Google Scholar
Waller, G, Kennerley, H, Ohanian, V (2007 b). Schema-focused cognitive behaviour therapy with eating disorders. In Cognitive Schemas and Core Beliefs in Psychiatric Disorders: A Scientist Practitioners' Guide (ed. Riso, L. P., du Toit, P. T. and Young, J. E.), pp. 139–175. American Psychiatric Association: New York.CrossRefGoogle Scholar
Waller, G, Shah, R, Ohanian, V, Elliott, P (2001). Core beliefs in bulimia nervosa and depression: the discriminant validity of Young's Schema Questionnaire. Behaviour Therapy 32, 139–153.CrossRefGoogle Scholar
Williams, JMG, Williams, AM, MacLeod, C (1996). The emotional Stroop task and psychopathology. Psychological Bulletin 120, 3–24.CrossRefGoogle ScholarPubMed
Young, AW, Rowland, D, Calder, AJ, Etcoff, NL, Seth, A, Perrett, DI (1997). Facial expression megamix: tests of dimensional and category accounts of emotion recognition. Cognition 63, 271–313.CrossRefGoogle ScholarPubMed
Zigmond, AS, Snaith, RP (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandanivica 67, 361–370.CrossRefGoogle ScholarPubMed
Zonnevijlle-Bendek, MJS, van Goozen, SHM, Cohen-Kettenis, PT, van Elburg, A, van Engeland, H (2002). Do adolescent anorexia nervosa patients have deficits in emotional functioning? European Child and Adolescent Psychiatry 11, 38–42.Google Scholar