Two sides of the same coin? A new instrument to assess body checking and avoidance behaviors in eating disorders

Legenbauer, Tanja; Martin, Franziska; Blaschke, Ariane; Schwenzfeier, Anne; Blechert, Jens; Schnicker, Katja

doi:10.1016/j.bodyim.2017.02.004

Cited by 54 publications

(34 citation statements)

References 33 publications

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“…In regard to ED subtypes, Legenbauer et al () reported significantly higher levels of body checking among individuals with AN relative to both BED and EDNOS, and among individuals with BN relative to BED. Another study (Calugi et al, ) reported significantly higher levels of body checking among BN relative to AN; however, no significant differences were found between EDNOS, and BN or AN groups, respectively.…”

Section: Resultsmentioning

confidence: 99%

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Body checking and body avoidance in eating disorders: Systematic review and meta‐analysis

Nikodijevic

Buck

Fuller‐Tyszkiewicz

et al. 2018

Euro Eating Disorders Rev

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This review sought to systematically review and quantify the evidence related to body checking and body avoidance in eating disorders (EDs) to gauge the size of effects, as well as examine potential differences between clinical and nonclinical populations, and between different ED subtypes. PsycINFO, PsycARTICLES, PsycEXTRA, Cochrane Library, and MEDLINE databases were searched for academic literature published until October 2017. A grey literature search was also conducted. Fifty-two studies were identified for the systematic review, of which 34 were eligible for meta-analysis. Only female samples were included in the meta-analysis. ED cases experienced significantly higher body checking (d = 1.26, p < .001) and body avoidance (d = 1.88, p < .001) overall relative to healthy controls, but neither behaviour varied by ED subtype. In nonclinical samples, body checking (r = .60) and body avoidance (r = .56) were significantly correlated with ED pathology (p < .001). These findings support transdiagnostic theoretical models and approaches to ED treatment and early intervention programmes.

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Section: Resultsmentioning

confidence: 99%

“…Only one study (Lewer et al, ) found no significant differences between the two groups. In regard to ED subtypes, five studies (Amin et al, ; Blechert et al, ; Legenbauer et al, ; Shafran et al, ; Vocks et al, ) found no significant differences in body avoidance scores across AN, BN, BED, and/or EDNOS groups.…”

Section: Resultsmentioning

confidence: 99%

Body checking and body avoidance in eating disorders: Systematic review and meta‐analysis

Nikodijevic

Buck

Fuller‐Tyszkiewicz

et al. 2018

Euro Eating Disorders Rev

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“…However, there were no strong indications of such heterogeneity at the descriptive level (see Figure S4). Although eating behavior as well as body checking (e.g., Legenbauer et al, ) strongly differ among EDs, the characteristic of interest in our study, Body Avoidance, is typically shared across these EDs (Legenbauer et al, ; for a meta‐analysis see Walker, White, & Srinivasan, ).…”

Section: Discussionmentioning

confidence: 78%

“…The BCAQ (Legenbauer et al, ) is a novel 27‐item self‐report inventory measuring body‐related avoidance, checking and reassurance behavior. The questionnaire exhibits a three‐factor structure (avoidance behavior, checking behavior and reassurance seeking), good psychometric properties regarding reliability (Cronbach's alpha between.79 and.92 for the subscales) and sufficient convergent and discriminant validity.…”

Section: Methodsmentioning

confidence: 99%

Body image avoidance affects interpersonal distance perception: A virtual environment experiment

Welsch

Hecht

Kolar

et al. 2019

Euro Eating Disorders Rev

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Objective: Eating disorders have a considerable influence on social contacts. The avoidance towards the own body may result in the avoidance of others.Previous research has found a preference for larger interaction distances in individuals with eating disorders (ED) as compared to control participants (CG). We aimed to replicate these findings and to investigate whether the body weight of the interactant moderates the effect. Method:We recruited a female sample with mixed ED subtypes (n = 21) and a female CG (n = 28). Participants were immersed in a virtual environment and engaged in a number of fictitious social interactions. They approached a virtual person until a comfortable distance for interaction was reached. The approached virtual persons differed with respect to body weight in five levels (underweight to obese). Results:Our results indicate that interpersonal distance varies as a U-shaped function of the avatar's body weight, and that higher levels of body avoidance, present in ED individuals, magnify this effect. Conclusions: We discuss our results with regard to the role of perspective and disgust to provide a useful framework and to motivate future studies in the domain of body avoidance in social interactions. Highlights• We immersed individuals with eating disorders into a virtual environment and presented virtual people of different body weights • Individuals with eating disorders maintain a larger interpersonal distance compared to healthy controls and underweight and obese virtual people evoke larger distances than normal-weighted virtual people • It seems that this effect is attenuated in individuals with eating disorders, probably due to avoidance of their own body K E Y W O R D S eating disorder, body image, interpersonal distance, virtual reality

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“…In Anorexia nervosa (AN), perceptual and attitudinal aspects of BID are classified as necessary diagnostic criteria in the Diagnostic and Statistical Manual for Mental Disorders (DSM-V, American Psychiatric Association [APA], 2013); whereas Bulimia nervosa (BN) criteria require presence of the attitudinal aspects only. This emphasizes the multifaceted nature of BID symptoms which range from perceptual deficits (e.g., seeing oneself fatter than one is), cognitive-affective/attitude distortion (e.g., thinking negatively about one's body) to dysfunctional body-related behaviors such as checking (BC) and avoidance behavior (BA; e.g., Cash and Deagle, 1997;Legenbauer et al, 2013Legenbauer et al, , 2017Vossbeck-Elsebusch et al, 2015). Evidence for perceptual and cognitive-affective BID symptoms in ED patients is accumulating, whereas research focusing on bodyimage related behavior is still scarce.…”

Section: Introductionmentioning

confidence: 99%

The Body Image Approach Test (BIAT): A Potential Measure of the Behavioral Components of Body Image Disturbance in Anorexia and Bulimia Nervosa?

et al. 2020

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A disturbed body image with fluctuating behavioral patterns of body related avoidance (BA) and body checking (BC) characterizes individuals with eating disorders (EDs) such as anorexia (AN) or bulimia nervosa (BN). So far, these behavioral body image components are mostly assessed via self-report instruments thereby neglecting their behavioral and partially automatic characteristics. Therefore, behavioral measures of BA and BC are needed. The present study investigates a behavioral assessment task for BA and BC in a sample of patients with diagnosed EDs and healthy controls. The sample consisted of 40 women diagnosed with either BN (N = 19) or AN (N = 21; ED sample) and 24 non-eating disordered, healthy female controls (HC). Within the Body Image Approach Task (BIAT) participants viewed photos of their own body (self-image) and a matched control body (other-image) by zooming the photos closer toward them (image became more focused) on the screen. The BIAT yields zoom-levels recorded separately for self-relative to other-images. Further measures were attractiveness ratings of these body images as well as questionnaire measures of BA, BC, and general ED symptomatology. Results showed that despite strong body dissatisfaction and clearly negative ratings of self-relative to other-images in both EDs, no group differences were found in approach to self-images on zoom-level as measured with the BIAT. Correlational analysis in each group indicated that zoom-level was positively related to BA scores in the HC group only. Yet, stepwise regression analyses revealed that attractiveness ratings explained most of the variance accounted by BA in predicting zoom-level. In sum, the BIAT seems suitable to assess BA and self-rated body attractiveness, but only in healthy individuals with subclinical levels on these constructs. It does not seem to capture the body image satisfaction or the behavioral components of body image disturbances in AN or BN or it conflates the opposed influences of BA and BC. Further experimentation is needed to adapt measures of behavioral body image components to the processes evoked in patients with ED during confrontation with body images.

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Two sides of the same coin? A new instrument to assess body checking and avoidance behaviors in eating disorders

Cited by 54 publications

References 33 publications

Body checking and body avoidance in eating disorders: Systematic review and meta‐analysis

Body checking and body avoidance in eating disorders: Systematic review and meta‐analysis

Body image avoidance affects interpersonal distance perception: A virtual environment experiment

The Body Image Approach Test (BIAT): A Potential Measure of the Behavioral Components of Body Image Disturbance in Anorexia and Bulimia Nervosa?

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