Critical incidents in anorexia nervosa: perspectives of those with a lived experience

Leppänen, Jenni; Tosunlar, Lara; Blackburn, Rachael; Williams, Steven; Tchanturia, Kate; Sedgewick, Felicity

doi:10.1186/s40337-021-00409-5

Cited by 4 publications

(3 citation statements)

References 84 publications

(44 reference statements)

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“…The films were chosen based on themes that were identified in a previous qualitative study asking people with lived experience of anorexia nervosa about critical life events ( Leppanen et al, 2021 ) to ensure they will cover themes relevant for people with eating disorders and can thus be used in later case-control studies. The positive themes selected for the two tasks included receiving emotional support, positive messages and reminders from friends and loved ones, and feeling confident.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of film stimuli for the assessment of social-emotional processing: a pilot study

Leppänen

Patsalos

Surguladze

et al. 2022

PeerJ

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Background Difficulties in top-down and bottom-up emotion generation have been proposed to play a key role in the progression of psychiatric disorders. The aim of the current study was to develop more ecologically valid measures of top-down interpretation biases and bottom-up evoked emotional responses. Methods A total of 124 healthy female participants aged 18–25 took part in the study. We evaluated two sets of 18 brief film clips. The first set of film clips presented ambiguous social situations designed to examine interpretation biases. Participants provided written interpretations of each ambiguous film clip which were subjected to sentiment analysis. We compared the films in terms of the valence of participants interpretations. The second set of film clips presented neutral and emotionally provoking social scenarios designed to elicit subjective and facial emotional responses. While viewing these film clips participants mood ratings and facial affect were recorded and analysed using exploratory factor analyses. Results Most of the 18 ambiguous film clips were interpreted in the expected manner while still retaining some ambiguity. However, participants were more attuned to the negative cues in the ambiguous film clips and three film clips were identified as unambiguous. These films clips were deemed unsuitable for assessing interpretation bias. The exploratory factor analyses of participants’ mood ratings and evoked facial affect showed that the positive and negative emotionally provoking film clips formed their own factors as expected. However, there was substantial cross-loading of the neutral film clips when participants’ facial expression data was analysed. Discussion A subset of the film clips from the two tasks could be used to assess top-down interpretation biases and bottom-up evoked emotional responses. Ambiguous negatively valenced film clips should have more subtle negative cues to avoid ceiling effects and to ensure there is enough room for interpretation.

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Section: Methodsmentioning

confidence: 99%

Evaluation of film stimuli for the assessment of social-emotional processing: a pilot study

Leppänen

Patsalos

Surguladze

et al. 2022

PeerJ

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“…The films were chosen based on themes that were identified in a previous qualitative study asking people with lived experience of AN about critical life events (Leppanen et al, 2021).…”

Section: Film Stimulimentioning

confidence: 99%

Evaluation of film stimuli for the assessment of social-emotional processing

Leppänen¹,

Patsalos²,

Surguladze³

et al. 2021

Preprint

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Background: Social-emotional difficulties have been proposed to play a key role in the progression of psychiatric disorders, including anorexia nervosa. The aim of the current study was to build on existing work and develop more ecologically valid measures of interpretation biases and evoked emotional responses. Methodology: 124 healthy female participants aged 18 – 25 took part in the study. We evaluated two sets of 18 brief film clips to be used in two tasks assessing interpretation of ambiguous scenarios and reactions to emotionally provoking scenes. Written interpretations were coded, the valence of the interpretations was analysed, and an ambiguity check was conducted. Evoked facial affect and mood ratings in response to each film clip during the second, evoked emotions task were analysed using exploratory factor analyses. Results: Most of the film clips were interpreted in the expected neutral, positive, and negative manner while still retaining some ambiguity. However, participants were more attuned to the negative cues in the ambiguous film clips and three film clips were identified as unambiguous. The exploratory factor analyses showed that the positive and negative film clips used in the evoked emotions task formed their own factors as expected. However, there was substantial cross-loading of the neutral film clips when participants’ facial expression data was analysed.Discussion: A subset of the film clips evaluated here could be used to assess interpretation biases and evoked emotional responses among people with anorexia nervosa. Ambiguous negatively valenced film clips should have more subtle negative cues to ensure there is enough room for interpretation. Additionally, care should be taken to ensure optimal recording conditions if evoked facial expressions are to be assessed.

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“…Yet, a significant minority of individuals with an eating disorder fail to present for treatment, terminate treatment prematurely, or fail to respond to our most effective interventions [ 37 – 39 ]. Additionally, people with lived experiences of eating disorders consistently report that recovery is largely influenced by a sense of connection to self and others [ 19 , 20 , 40 – 42 ]. Finding strategies that allow individuals with eating disorders to be comfortable with others may increase the effectiveness of existing interventions, increase willingness to seek help, and may provide alternative sources of reinforcement that may compete with the reinforcement of disordered eating, such as the drive for thinness that constitutes a core aspect of AN.…”

Section: Introductionmentioning

confidence: 99%

Experiences of mimicry in eating disorders

et al. 2022

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Background People unknowingly mimic the behaviors of others, a process that results in feelings of affiliation. However, some individuals with eating disorders describe feeling “triggered” when mimicked. This study explores the effects of implicit non-verbal mimicry on individuals with a history of an eating disorder (ED-His) compared to healthy controls (HCs). Method Women (N = 118, nED-His = 31; Mage = 21 years) participated in a laboratory task with a confederate trained to either discreetly mimic (Mimicry condition) or not mimic (No-Mimicry condition) the mannerisms of the participant. Participants rated the likability of the confederate and the smoothness of the interaction. Results Participants in the No-Mimicry condition rated the confederate as significantly more likable than in the Mimicry condition, and ED-His rated the confederate as more likable than HCs. ED-His in the Mimicry condition rated the interaction as less smooth than HCs, whereas this pattern was not found in the No-Mimicry condition. Among ED-His, longer disorder duration (≥ 3.87 years) was associated with less liking of a confederate who mimicked and more liking of a confederate who did not mimic. Conclusions We discuss the implications of these findings for interpersonal therapeutic processes and group treatment settings for eating disorders. Plain English summary Our study on subtle, nonverbal mimicry revealed differences in social behavior for women with a history of an eating disorder compared to healthy women. For participants with an eating disorder history, a longer duration of illness was associated with a worse pattern of affiliation, reflected in lower liking of a mimicker. Further research on how diverging processes of affiliation may function to perpetuate the chronicity of eating disorders and implications for treatment is needed.

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Critical incidents in anorexia nervosa: perspectives of those with a lived experience

Cited by 4 publications

References 84 publications

Evaluation of film stimuli for the assessment of social-emotional processing: a pilot study

Evaluation of film stimuli for the assessment of social-emotional processing: a pilot study

Evaluation of film stimuli for the assessment of social-emotional processing

Experiences of mimicry in eating disorders

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