Different attention bias patterns in anorexia nervosa restricting and binge/purge types

Mann, Tal Gilon; Hamdan, Sami; Bar‐Haim, Yair; Lazarov, Amit; Enoch‐Levy, Adi; Dubnov-Raz, Gal; Treasure, Janet; Stein, Dan J.

doi:10.1002/erv.2593

Cited by 19 publications

(14 citation statements)

References 59 publications

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“…Moreover, patients with recANr showed greater activation of the visual cortex than did those with recANbp. This is consistent with a previous study reporting that patients with restricting AN had a larger attentional bias to threat word stimuli related to ED (e.g., FAT) than did healthy controls, whereas patients with binge-purging AN showed avoidance of threat word stimuli related to ED [ 56 ]. Our result suggests that differential patterns of attention allocation between patients with restricting AN and those with binge purging AN may remain even after recovery.…”

Section: Discussionsupporting

confidence: 92%

Neural correlates of body comparison and weight estimation in weight-recovered anorexia nervosa: a functional magnetic resonance imaging study

Kodama

Moriguchi

Takeda³

et al. 2018

BioPsychoSocial Med

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BackgroundThe neural mechanisms underlying body dissatisfaction and emotional problems evoked by social comparisons in patients with anorexia nervosa (AN) are currently unclear. Here, we elucidate patterns of brain activation among recovered patients with AN (recAN) during body comparison and weight estimation with functional magnetic resonance imaging (fMRI).MethodsWe used fMRI to examine 12 patients with recAN and 13 healthy controls while they performed body comparison and weight estimation tasks with images of underweight, healthy weight, and overweight female bodies. In the body comparison task, participants rated their anxiety levels while comparing their own body with the presented image. In the weight estimation task, participants estimated the weight of the body in the presented image. We used between-group region of interest (ROI) analyses of the blood oxygen level dependent (BOLD) signal to analyze differences in brain activation patterns between the groups. In addition, to investigate activation outside predetermined ROIs, we performed an exploratory whole-brain analysis to identify group differences.ResultsWe found that, compared to healthy controls, patients with recAN exhibited significantly greater activation in the pregenual anterior cingulate cortex (pgACC) when comparing their own bodies with images of underweight female bodies. In addition, we found that, compared with healthy controls, patients with recAN exhibited significantly smaller activation in the middle temporal gyrus corresponding to the extrastriate body area (EBA) when comparing their own bodies, irrespective of weight, during self-other comparisons of body shape.ConclusionsOur findings from a group of patients with recAN suggest that the pathology of AN may lie in an inability to regulate negative affect in response to body images via pgACC activation during body comparisons. The findings also suggest that altered body image processing in the brain persists even after recovery from AN.Electronic supplementary materialThe online version of this article (10.1186/s13030-018-0134-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 92%

Neural correlates of body comparison and weight estimation in weight-recovered anorexia nervosa: a functional magnetic resonance imaging study

Kodama

Moriguchi

Takeda³

et al. 2018

BioPsychoSocial Med

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“…However, there was no mention as to subtyping the patients in this study to restrictive vs. binge/purge pathology. It is of note, in this respect, that a previous study of our group [69], found a significant difference in attention bias patterns between patients with AN-R and AN-B/P, an issue not investigated in previous studies assessing attention bias in AN.…”

Section: Discussionmentioning

confidence: 52%

The complexity of the interaction between binge-eating and attention

et al. 2019

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Objective To investigate whether binge-eating in patients with eating disorders (EDs) is associated with attentional deficits. Methods We studied ED patients with binge-eating (n = 51), no binge-eating (n = 59) and controls (n = 58). ED patients were assessed following the stabilization of weight and ED pathology. Attention assessment included evaluation of attention deficit hyperactivity disorder (ADHD) diagnosis, the Adult ADHD Self-Report (ASRS) and ADHD Rating Scale-IV-Home Version (ADHD-RS) questionnaires, and attention functioning assessed with neuropsychological tools. The severity of eating-related pathology, depression, anxiety and obsessionality was also monitored. Results Patients with binge-eating showed more ADHD symptomatology on the ADHD-RS compared with non-binge-eating patients. No differences were found between binge-eating and non-binge-eating patients in ADHD diagnosis and neuropsychological functioning. Among the specific ED subtypes, patients with anorexia nervosa binge/purge type (AN-B/P) showed the highest rates of ADHD symptomatology on the ADHD-RS, and were characterized with sustained attention deficits. Conclusion Binge-eating is not associated with attention deficits as measured by objective neuropsychological tools. Nonetheless, it is associated with attentional difficulties as measured with the self-reported ADHD-RS. AN-B/P patients are the only ED category showing objective sustained attention deficits.

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“…The general and social threat words were taken from Bar-Haim et al (2010) assessing the use of ABMT in different types of anxiety. The ED-related threat words were used in our previous study of attention bias in AN (Gilon-Mann et al, 2018). They were first rated for emotional valence by 15 independent judges working in the adult and adolescent ED departments of the Sheba Medical Center (clinical psychologists, clinical social workers, psychiatrists and dieticians -all not part of the research team).…”

Section: Instrumentsmentioning

confidence: 99%

Attention bias modification add‐on to inpatient treatment for young women with anorexia nervosa—A randomized controlled trial

Dikstein

Gilon‐Mann

Halevi‐Yosef

et al. 2022

Euro Eating Disorders Rev

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Patients with anorexia nervosa (AN) display elevated anxiety and attention biases (ABs) in threat processing. Attention bias modification treatment (ABMT) is considered promising for anxiety disorders, but its potential for AN is limited. In this study, 154 young women hospitalised because of AN were assigned to ED-related and anxiety-related threat stimuli, or to a non-ABMT intervention control condition in a randomized control trial. Hundred-andten patients completed the study. ABMT was an add-on to the regular inpatient treatment. Research participants completed two pretreatment training sessions and eight biweekly sessions of ABMT. AB, ED-related symptoms, depression, anxiety and stress were assessed before and after ABMT in the research groups, and, similarly, 5 weeks apart, in the controls. We found that despite the different patterns of change in AB between the three groups following ABMT, the reduction in AB, or the between-group differences in AB-reduction, were not significant. While the severity of ED-symptoms, depression, anxiety and stress was reduced following ABMT, or control condition, in all groups, there were no between-group differences in these changes. Changes in AB were not correlated with baseline and pre-posttreatment changes in ED-related and comorbid symptomatology. Methodological and inpatient treatment-related considerations may explain our negative ABMT-related results.

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Different attention bias patterns in anorexia nervosa restricting and binge/purge types

Cited by 19 publications

References 59 publications

Neural correlates of body comparison and weight estimation in weight-recovered anorexia nervosa: a functional magnetic resonance imaging study

Neural correlates of body comparison and weight estimation in weight-recovered anorexia nervosa: a functional magnetic resonance imaging study

The complexity of the interaction between binge-eating and attention

Attention bias modification add‐on to inpatient treatment for young women with anorexia nervosa—A randomized controlled trial

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