The relationship of body image with symptoms of depression and anxiety in patients with anorexia nervosa during outpatient psychotherapy: Results of the ANTOP study.

Abstract

Body image disturbance represents a central characteristic of anorexia nervosa (AN). Depression and anxiety are the most common mental comorbidities in patients with AN. This study aims to investigate the relationship of body image with symptoms of depression and anxiety during outpatient psychotherapy in AN. Analyses were conducted using the data set of the Anorexia Nervosa Treatment Outpatient Study (ANTOP) randomized controlled trial. The ANTOP study included N = 242 females with AN between 18 and 56 years of age. The trial was designed to compare enhanced cognitive behavioral therapy (CBT-E) and focal psychodynamic therapy (FPT) with optimized treatment as usual (TAU-O) for patients with AN. The analyses on body image dimensions were conducted using measures of correlations and multiple linear regression analyses to assess the relationship and longitudinal prediction of symptoms of depression and anxiety by body image dimensions. Results showed that body image perceptions were significantly associated with symptoms of depression and anxiety in patients with AN at all treatment stages. In addition, body image dimensions at early treatment stages predict depression and anxiety in follow-up measurements. The correlation of symptoms of depression and anxiety by body image perceptions increased along treatment course. The persistence of body image disturbance, while body mass index increases under treatment (persistency effect), may constitute a relevant factor contributing to the course of the most common affective comorbidities of depression and anxiety in patients with AN. Body image disturbances in patients with AN should therefore be explicitly targeted within the specialized psychotherapy of affected patients. (PsycINFO Database Record

The importance of body image disturbances for the outcome of outpatient psychotherapy in patients with anorexia nervosa: Results of the ANTOP‐study

“…It might be understood in the sense that general anxiety symptoms are too broad to capture the more specific fears of patients with AN (fear of gaining weight, fear to eat) and hence may not detect adequately body‐related anxiety of patients with AN. Reflecting the results on our own recent work (Junne et al, ; Mölbert, Thaler, et al, ; Mölbert, Klein, et al, ), the here presented results underline the importance of cognitive–emotional body image perceptions for treatment outcomes in patients with AN.…”

“…However, it is unclear so far, what exact effects body image alterations might have on the complex interplay of disease modifying factors during AN treatment. In our recent work, we have shown that body image perceptions predict symptoms of depression and anxiety in the course of outpatient treatment in patients with AN (Junne et al, 2016). On the basis of the latter findings, we hypothesize that body image dimensions predict eating disorder relevant outcomes such as the body mass index (BMI) directly or via the determination of affective symptoms in patients with AN.…”

“…Body image disturbance is a central feature of the pathology of patients with anorexia nervosa (AN), which potentially perpetuates disordered eating behaviour and affective comorbidities such as anxiety and depression (American Psychiatric Association, ; Fairburn & Brownell, ; Junne et al, ).…”

“…Body image disturbance is a central feature of the pathology of patients with anorexia nervosa (AN), which potentially perpetuates disordered eating behaviour and affective comorbidities such as anxiety and depression (American Psychiatric Association, 2013;Fairburn & Brownell, 2005;Junne et al, 2016). Cash and Hrabosky (2004) define the concept of body image as the "multifaceted psychological experience of embodiment and body-related self-perceptions and selfattitudes including thoughts, beliefs, feelings and behaviors."…”

Investigating Body Image Disturbance in Anorexia Nervosa Using Novel Biometric Figure Rating Scales: A Pilot Study

“…Recent reviews suggest that non‐visual body representations and the integration of different body representations might play a crucial role in the perceptual body image disturbance (Gaudio, Brooks, & Riva, ; Mölbert et al, ). However, discrepancies have also been observed in cognitive–affective measures of self‐body perception: women with AN usually report a high drive for thinness and high levels of body dissatisfaction but indicated satisfaction with their body weight or even a desire for weight gain in other studies (Boyd et al, ; Cash & Deagle, ; Junne et al, ; Striegel‐Moore et al, ). A synthesis of these heterogeneous observations that accounts for similarities and differences between the different assessment methods is still outstanding.…”