Heightened attentional capture by visual food stimuli in anorexia nervosa.

Neimeijer, Renate; Roefs, Anne; Jong, Peter J. de

doi:10.1037/abn0000275

Cited by 23 publications

(24 citation statements)

References 28 publications

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“…Contrary to our expectations, adolescents with AN did not demonstrate the same pathological attention pattern as adults with AN and did not differ in their food‐related attention biases from adolescents without AN. The observation that all adolescents displayed biased attention toward foods in early and late attention phases corroborates previous research demonstrating increased attention approach toward foods in adolescents with AN (Neimeijer, Roefs, & de Jong, ) and non‐clinical groups (Werthmann, Jansen, Vreugdenhil, et al, ; Werthmann et al, ). The finding that cognitive processes for disorder‐relevant cues are less disturbed in adolescents versus adults with AN is also in line with previous research showing differential patterns of cognitive biases in adults versus adolescents with AN (Horndasch, Kratz, et al, ; Horndasch, Roesch, et al, ).…”

Section: Discussionsupporting

confidence: 87%

Same, same but different: Attention bias for food cues in adults and adolescents with anorexia nervosa

Werthmann

Simic

Konstantellou

et al. 2019

Intl J Eating Disorders

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Objective: Attention processing for food may be biased in people with Anorexia Nervosa (AN). However, previous studies have had inconsistent results. This is likely to be due to indirect assessment of attention, which does not inform on the underlying attention processes, and/or the heterogeneity of participants across studies, testing either adults or adolescents with AN, that is, people at very different developmental and illness stages.Method: Eye-tracking was employed as a direct assessment of attention during a visual probe task with food versus non-food pictures. Attention bias for food was measured in 39 adults and 34 adolescents with AN and in 53 adults and 31 adolescents without AN.Results: All participants had a direction bias for food, specifically for high-calorie food.However, adults with AN subsequently avoided maintaining attention on food versus non-food cues, compared to adults without AN. Adolescents with or without AN demonstrated increased attention maintenance on food versus non-food cues, and, contrary to our hypothesis, did not differ in their attention bias for food cues. Accordingly, adults with AN differed significantly from adolescents with AN in attention maintenance for food cues: while adolescents with AN showed significantly increased attention maintenance on food stimuli, adults avoided maintaining attention on food cues.Discussion: Adults with AN may apply attention strategies to facilitate restrictive eating. This strategy is absent in adolescents with AN. This difference in food-related attention bias between adolescents and adults with AN suggests that attention biases develop over time as the illness progresses. K E Y W O R D Sanorexia nervosa, attention bias, eye-tracking, food, visual probe

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Section: Discussionsupporting

confidence: 87%

Same, same but different: Attention bias for food cues in adults and adolescents with anorexia nervosa

Werthmann

Simic

Konstantellou

et al. 2019

Intl J Eating Disorders

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“…Effects of image presentation on reaction time and accuracy. 13 AN (R) 25 (11.0) 15 (1.54) Yes Yes Distraction during working memory task: AN > HC Distraction during inhibitory control task: AN < HC 7 20 HC 22 (5.0) 22.38 (2.66) Neimeijer et al, 2017 [ 18 ] Visual target detection task. Effects of image presentation on accuracy.…”

Section: Resultsmentioning

confidence: 99%

“…On the other hand, attention to a food stimulus predicts consumption of that food (i.e., the opposite of dietary restriction [ 17 ]) in healthy individuals. As such, an alternative hypothesis is that individuals with AN would show reduced attentional bias towards food, and that this is a mechanism that facilitates dietary restriction [ 18 ]. Attention paradigms incorporating pictures of food have been administered to individuals with AN to test these competing hypotheses, to assess whether altered attention to food underlies maladaptive dietary restriction.…”

Section: Resultsmentioning

confidence: 99%

“…The difference in task performance when food images are presented as distractor items (as compared to neutral distractors) indicates an attentional bias. Individuals with AN were less accurate than healthy controls (HC) in an attention task when distracted by food-related stimuli, with no group difference in the presence of neutral stimuli [ 18 ]. One study reported no differential effect of food versus other distractors on working memory accuracy among individuals with AN or HC [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

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What can food-image tasks teach us about anorexia nervosa? A systematic review

Lloyd

Steinglass

2018

J Eat Disord

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A salient feature of anorexia nervosa (AN) is the persistent and severe restriction of food, such that dietary intake is inadequate to maintain a healthy body weight. Experimental tasks and paradigms have used illness-relevant stimuli, namely food images, to study the eating-specific neurocognitive mechanisms that promote food avoidance. This systematic review, completed in accordance with PRISMA guidelines, identified and critically evaluated paradigms involving images of food that have been used to study AN. There were 50 eligible studies, published before March 10th 2018, identified from Medline and PsychINFO searches, and reference screening. Studies using food image-based paradigms were categorised into three methodologic approaches: neuropsychology, neurophysiology, and functional magnetic resonance imaging (fMRI). Paradigms were reviewed with a focus on how well they address phenomena central to AN. Across tasks, differences between individuals with AN and healthy peers have been identified, with the most consistent findings in the area of reward processing. Measuring task performance alongside actual eating behaviour, and using experimental manipulations to probe causality, may advance understanding of the mechanisms of illness in AN.

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“…Despite these and other indications of links between anxiety and eating disorders ( 2 , 9 – 14 ), there is a paucity of research into the potential pathophysiological mechanisms of anxiogenesis in AN. For example, it is presently unclear to what extent subjective experiences of anxiety reported by individuals with AN are primarily due to anxious traits (that might generate heightened but nonspecific arousal levels), or whether they are exaggerated by aversive anticipation, and if so, whether aversive anticipation is generalized or is selectively modulated by specific contexts such as hypervigilance toward food cues ( 15 , 16 ), intolerance of uncertainty ( 11 ), or discomfort with bodily sensations ( 17 ). Furthermore, it is unknown whether anxiety related to sympathetically mediated interoceptive sensations is generally heightened in AN, if it is additionally impacted by anticipatory or after-effects of eating, or both.…”

Section: Introductionmentioning

confidence: 99%

Interoceptive Anxiety and Body Representation in Anorexia Nervosa

et al. 2018

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Individuals with anorexia nervosa (AN) typically display anxious traits prior to the onset of food avoidance and weight loss that characterize the disorder. Meal associated anxiety is an especially common clinical feature in these patients, and heightened sensitivity to sympathetically mediated interoceptive sensations has also been observed. However, it remains unclear how heightened interoceptive sensitivity relates to experiences of anxiety before and after meals. To investigate this relationship, we experimentally induced anxiety and panic symptoms with isoproterenol, a peripheral sympathetic agonist similar to adrenaline, across several different conditions: during panic provocation, during anticipation of a 1,000 Calorie meal, and after meal consumption. Fifteen AN and 15 age- and sex-matched healthy comparisons received bolus infusions of isoproterenol and saline in a double-blinded, randomized design. Participants rated anxiety symptoms after each infusion, completed panic rating scales, and traced the location of perceived palpitations on a manikin to index interoceptive “body map” representation. The AN group reported significantly elevated anxiety relative to healthy comparisons during infusions before and after the meal, but surprisingly, not during panic provocation. These symptoms were accompanied by geographical differences in patterns of perceived heartbeat sensations across each condition. In particular, the AN group localized heartbeat sensations disproportionately to the chest during meal related saline infusions, when no cardiorespiratory modulation actually occurred. The AN group also showed a trend toward higher panic attack rates during the meal anticipation period. Correcting for anxiety levels reported during saline infusions abolished group differences in anxiety change across all conditions, suggesting a significant contribution of anxious traits in AN. The observation of meal related “visceral illusions” provides further evidence that AN is associated with abnormal interoceptive representation of the heartbeat and suggests that meal consumption, particularly when anticipated, preferentially alters the processing of interoception related signals in AN.

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Heightened attentional capture by visual food stimuli in anorexia nervosa.

Cited by 23 publications

References 28 publications

Same, same but different: Attention bias for food cues in adults and adolescents with anorexia nervosa

Same, same but different: Attention bias for food cues in adults and adolescents with anorexia nervosa

What can food-image tasks teach us about anorexia nervosa? A systematic review

Interoceptive Anxiety and Body Representation in Anorexia Nervosa

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