Improving emotion recognition in anorexia nervosa: An experimental proof‐of‐concept study

Abstract

Objective: Previous research has found increasing evidence for difficulties in emotion recognition ability (ERA) and social cognition in anorexia nervosa (AN), and recent models consider these factors to contribute to the development and maintenance of the disorder. However, there is a lack of experimental studies testing this hypothesis.Therefore, the present proof-of-concept study examined whether ERA can be improved by a single session of a computerized training in AN, and whether this has short-term effects on eating disorder symptoms.Method: Forty inpatients (22.20 ± 7.15 years) with AN were randomly assigned to receive a single session of computerized training of ERA (TERA) or a sham training (training the recognition of different types of clouds). ERA, self-reported eating disorder symptoms, and body mass index (BMI) were assessed within 3 days before and after training.Results: After training, both groups showed improved ERA, reduced self-reported eating disorder symptoms, and an increased BMI. As compared to patients in the control group, patients who received TERA showed greater improvements in ERA and self-reported eating disorder symptoms.Discussion: ERA can be effectively trained in patients with AN. Moreover, short-term improvements in self-reported eating disorder symptoms provide tentative support for the hypothesis that difficulties in ERA contribute to the maintenance of AN, and that specific trainings of ERA hold promise as an additional component in AN treatment. Future studies are needed to replicate these findings in larger samples, and to investigate long-term effects and transfer into real-world settings. K E Y W O R D S eating disorders, emotion perception, emotion recognition training, emotional theory of mind, social cognition, training of emotion recognition ability

Reduced emotion recognition from nonverbal cues in anorexia nervosa

“…We recently examined such an intervention in a proof‐of‐concept study using the Training for Emotion Recognition Abilities , a 30‐min online training of ERA (Schlegel, Vicaria, et al., 2017). In comparison to an active control group, the training led to greater short‐term improvements in ERA and self‐reported ED symptoms (Preis et al., 2020). This is all more interesting since other interventions such as Cognitive Remediation and Emotions Skills Training (Davies et al., 2012) and administration of oxytocin (Kim et al., 2015) failed to ameliorate ERA in AN.…”

Time to make a change: A call for more experimental research on key mechanisms in anorexia nervosa

“…The clear advantages of an experimental design raise the question as to why experimental studies on key processes in AN are so scarce (e.g., Glashouwer, van der Veer, Adipatria, de Jong, & Vocks, 2019). For example, when examining the scientific literature over the last 5 years, only eight studies were published in which an experimental design was used in an AN sample (between-subjects designs, as in Figure 1: Hartmann, Thomas, Greenberg, Rosenfield, & Wilhelm, 2015;Loeber et al, 2016;Naumann, Tuschen-Caffier, Voderholzer, Schäfer, & Svaldi, 2016;Turton, Cardi, Treasure, & Hirsch, 2018;Preis et al, 2020; within-subjects designs: Cardi, Esposito, Clarke, Schifano, & Treasure, 2015;Svaldi et al, 2016;Leppanen et al, 2017]. 1 At least three important obstacles exist for performing experimental studies in AN.…”

Emotion Recognition Ability as a Predictor of Well-Being During the COVID-19 Pandemic

“…In line with previous studies, habitual cognitive emotion regulation emerged as a strong predictor of SWB (Jermann et al, 2006). However, ERA—a performance-based ability that can be successfully improved through brief training programs (e.g., Preis et al, 2020)—independently contributed to well-being, even though effect sizes were small. The present study thus adds to the evidence that ERA is not only relevant to interpersonal success but may also represent a protective factor against negative affect.…”