Selective Visual Attention during Mirror Exposure in Anorexia and Bulimia Nervosa

Abstract

ObjectiveCognitive theories suggest that body dissatisfaction results from the activation of maladaptive appearance schemata, which guide mental processes such as selective attention to shape and weight-related information. In line with this, the present study hypothesized that patients with anorexia nervosa (AN) and bulimia nervosa (BN) are characterized by increased visual attention for the most dissatisfying/ugly body part compared to their most satisfying/beautiful body part, while a more balanced viewing pattern was expected for controls without eating disorders (CG).MethodEye movements were recorded in a group of patients with AN (n = 16), BN (n = 16) and a CG (n = 16) in an ecologically valid setting, i.e., during a 3-min mirror exposure.ResultsEvidence was found that patients with AN and BN display longer and more frequent gazes towards the most dissatisfying relative to the most satisfying and towards their most ugly compared to their most beautiful body parts, whereas the CG showed a more balanced gaze pattern.DiscussionThe results converge with theoretical models that emphasize the role of information processing in the maintenance of body dissatisfaction. Given the etiological importance of body dissatisfaction in the development of eating disorders, future studies should focus on the modification of the reported patterns.

Eye‐tracking research in eating disorders: A systematic review

“…Cognitive theories of body dissatisfaction propose that schemas related to body image give rise to a number of cognitive biases affecting attention, memory, interpretation, and judgement. Indeed, several studies included here reported that the more dissatisfied participants were with their body, the stronger their attentional bias was Blechert et al, 2010;Svaldi et al, 2012;Svaldi et al, 2016;Tuschen-Caffier et al, 2015). Indeed, several studies included here reported that the more dissatisfied participants were with their body, the stronger their attentional bias was Blechert et al, 2010;Svaldi et al, 2012;Svaldi et al, 2016;Tuschen-Caffier et al, 2015).…”

“…Generally, AN, BN, and BED displayed an attentional bias for parts of their body they deemed unattractive, a pattern which was weaker or not present in HC (Freeman et al, 1991;Svaldi et al, 2011;Svaldi et al, 2016;Tuschen-Caffier et al, 2015). Again, in those with AN, this bias seems to be automatic (Bauer, Schneider, Waldorf, Cordes, et al, 2017).…”

“…For example, when examining attention to body parts, a few studies did not exclude the head/face from the body stimuli (Cornelissen et al, 2016;Freeman et al, 1991;Svaldi et al, 2016;Tuschen-Caffier et al, 2015;Von Wietersheim et al, 2012). The lack of standardization of outcome measures may have influenced the way in which the results were reported.…”

“…Despite these limitations, some innovative techniques were demonstrated, for example using head mounted eye-tracking devices to measure gaze towards participants' own image in a mirror (Svaldi et al, 2016;Tuschen-Caffier et al, 2015). This technique is particularly fitted to ED populations, given the body checking behaviors often seen in this group.…”

Eye‐tracking study on the effects of happiness and sadness on body dissatisfaction and selective visual attention during mirror exposure in bulimia nervosa

“…In an experimental study by Jansen, Nederkoorn, and Mulkens (2005), participants' selective visual attention during presentation of body pictures was measured with the help of a remote eye-tracking device. Correspondingly, in other eye-tracking studies, patients with BN as well as patients with anorexia nervosa (AN) displayed longer and more frequent gazes toward their most disliked compared to their most liked body parts during a brief mirror exposure task (Bauer et al, 2017;Tuschen-Caffier et al, 2015). The reversed attention pattern was found in healthy controls (i.e., self-serving bias with main focus on their own beautiful body parts and increased attention toward unattractive parts of other bodies).…”