Fear of self has been proposed as a transdiagnostic construct, playing a role in not only obsessive compulsive disorder (OCD), but in related disorders as well. In this article, empirical support for the association between eating disorders (EDs) and the fear of self will be reviewed. Support for the fear of self in EDs will be contextualized within the theory of possible selves, self-discrepancy theory, and motivation frameworks. Most of the research that will be presented pertains to a feared overweight self. The relevance of broadening the scope of feared self-domains attributed to EDs beyond weight to include those pertaining to character will be advocated. Furthermore, risk factors theorized to lead to the development and investment in a feared self in OCD are examined and evidence for their applicability to EDs is presented. Treatment strategies targeting self-concept and the fear of self in EDs are also described, highlighting the clinical relevance of integrating this construct into the conceptualization of EDs. Finally, recommendations for future research are proposed.
There is growing support for fear of self as a transdiagnostic construct implicated in obsessive-compulsive disorder (OCD) and eating disorders. However, few studies have examined how perceived proximity to a feared self may be associated with the relationship between fear of self and eating pathology. A community sample of women (N = 290) completed an online questionnaire battery. Eating pathology was positively associated with the feared unattractive self and, to a lesser extent, with feared corrupted and culpable selves, suggesting the relevance of a range of feared selves in eating pathology. There was a significant interaction between fear of the unattractive self and perceived proximity to this feared self (operationalized as ‘feeling fat’) in relation to eating pathology.
A biobehavioral examination of emotion-enhanced reward processing as mechanism underlying negative urgency and its association with binge eating
‘Feeling fat’ refers to the subjective experience of being overweight and relates to severity of eating pathology. Despite research suggesting that ‘feeling fat’ fluctuates across contexts, this construct is almost exclusively assessed in terms of frequency or as a trait. Examining state ‘feeling fat’ in response to external stimuli can inform us of the nature of this construct. A community sample of women (N = 290) viewed affective images and images of women at different body weights. Self-Assessment Manikin (SAM) valence and arousal rating scales as well as a novel SAM ‘feeling fat’ scale were rated for each image. Theoretically-related constructs (i.e., trait ‘feeling fat’, thin-ideal internalization, body dissatisfaction, eating pathology) were measured. Body images elicited greater state ‘feeling fat’ than affective images, with images of thin-ideal non-conforming bodies producing higher state ‘feeling fat’ than thin-ideal conforming bodies. Positive correlations were observed between state ‘feeling fat’ in response to thin-ideal conforming images and all variables of interest, whereas associations between these variables and ‘feeling fat’ in response to thin-ideal non-conforming images were small and often non-significant. The development of a state measure of ‘feeling fat’ allows for the investigation of triggers of this bodily experience and will facilitate future research.
Objective: The present study examined the relative roles of approach and avoidance motivation in eating pathology using a multi-method approach combining self-report and physiological measures. The potential effect of internalized ideals and fears was also investigated. Method: Fifty-nine undergraduate women completed a picture-viewing task in which they viewed images of women’s bodies (thin and non-thin) and affective images. Self-report ratings of valence and arousal were measured along with physiological indicators of approach (postauricular reflex) and avoidance (startle blink reflex) motivation. Results: Greater eating pathology was associated with more negative valence ratings of both thin and non-thin images. There was a significant interaction between valence ratings of non-thin bodies and fear of the unattractive self in relation to eating pathology, such that eating pathology was highest in those who rated non-thin images as more unpleasant and internalized fears of being/becoming unattractive. Thin-ideal internalization did not significantly interact with ratings of thin images to predict eating pathology. There were no significant findings when examining physiological data. Conclusions: Results from self-report measures suggest that eating pathology is associated with avoidant reactions to both thin and non-thin bodies and highlight the importance of internalized appearance-related fears.
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