Validity of Virtual Reality Body Exposure to Elicit Fear of Gaining Weight, Body Anxiety and Body-Related Attentional Bias in Patients with Anorexia Nervosa

Abstract

Fear of gaining weight (FGW), body image disturbances, associated anxiety and body-related attentional bias are the core symptoms of anorexia nervosa (AN) and play critical roles in its development and maintenance. The aim of the current study is to evaluate the usefulness of virtual reality-based body exposure software for the assessment of important body-related cognitive and emotional responses in AN. Thirty female patients with AN, one of them subclinical, and 43 healthy college women, 25 with low body dissatisfaction (BD) and 18 with high BD, owned a virtual body that had their silhouette and body mass index. Full-body illusion (FBI) over the virtual body was induced using both visuo-motor and visuo-tactile stimulation. Once the FBI was induced, the FBI itself, FGW, body anxiety and body-related attentional bias toward weight-related and non-weight-related body areas were assessed. One-way analyses of covariance (ANCOVA), controlling for age, showed that AN patients reported higher FGW, body anxiety and body-related attentional bias than healthy controls. Unexpectedly, patients with AN reported significantly lower FBI levels than healthy participants. Finally, Pearson correlations showed significant relationships between visual analog scales and body-related attentional bias measures, compared to other eating disorder measures. These results provide evidence about the usefulness of virtual reality-based body exposure to elicit FGW and other body-related disturbances in AN patients. Thus, it may be a suitable intervention for reducing these emotional responses and for easing weight recovery.

AN-VR-BE. A Randomized Controlled Trial for Reducing Fear of Gaining Weight and Other Eating Disorder Symptoms in Anorexia Nervosa through Virtual Reality-Based Body Exposure

“…Since the procedures conducted in the pre-assessment (photography, visuomotor, and visuo-tactile stimulations and ET assessment task procedures) have been described in a previous study by our group, this section has been summarized. For a detailed description, see [ 69 ].…”

“…While the virtual avatar was being created, the patients had to complete all the pre-assessment questionnaires. The patients were then immersed in the VR environment, in which they underwent visuomotor and visuo-tactile stimulation procedures, adapted from previous studies [ 69 , 70 , 71 , 72 ], to elicit FBI over the virtual body. Both procedures lasted three minutes, and at the end, the FBI, body-related anxiety and the FGW that they were experiencing at that moment were assessed using the VAS.…”

“…The Open Gaze and Mouse Analyzer (OGAMA) software was used to prepare the ET data. For further details on this procedure, see [ 69 ].…”

Advances in Eating Disorders

“…To address this important health issue, the current Special Issue collected 21 articles examining the most recent and relevant scientific findings regarding advances in ED. The published articles comprised three reviews and 18 research articles focusing on different aspects, such as genetic [ 7 ] and epigenetic factors [ 8 ], biomarkers [ 9 ], comorbidity [ 10 , 11 , 12 , 13 , 14 ], clinical phenotypes [ 15 , 16 ], neurocognition [ 12 , 17 , 18 , 19 , 20 , 21 ], treatment predictors [ 22 ], and treatment models and therapeutic targets [ 19 , 23 , 24 , 25 , 26 , 27 ]. Altogether, these studies may provide increased knowledge about the pathogenesis, the risk factors, the maintenance factors, and the most appropriate treatments tools for ED.…”

“…[ 25 ] describe the effectiveness and safety of a rapid clinical high-caloric refeeding strategy for patients with AN. Regarding the use of new technologies as an adjuvant therapeutic tool, the findings from Porras-García et al [ 24 ] provide evidence about the usefulness of virtual reality-based body exposure to elicit fear of gaining weight and other body-related disturbances in patients with AN. On the other hand, Philipp et al [ 27 ] demonstrated that parental expressed emotion (associated with higher distress and a lack of skills) was reduced after interventions for caregivers (namely the SUCCEAT program), and that this reduction positively influenced patients’ outcomes.…”