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Treatment of the populations included in this study may be informed by an understanding of the different amounts of symptoms of comorbid psychopathology that confer additional distress and impairment above and beyond disordered eating behavior.

Background: Women with eating disorders generally perform more poorly on measures of alexithymia, defined as difficulty identifying and describing emotions, and theory of mind, or the ability to infer what others are thinking and feeling. The extent to which these abilities may be influenced by variables such as self-focused attention, or directing attention toward internally generated information, has yet to be investigated. Thus, the purpose of the present study was to examine differences between women high and low in disordered eating symptoms on measures of emotional awareness and facial affect recognition under conditions of high and low self-focused attention. Methods: University women scoring high or low on a measure of disordered eating (n = 79) were randomly assigned to a condition of high or low self-focused attention. Outcomes included alexithymia (self-rated ability to identify and describe emotions), emotional awareness (ability to describe the emotions of oneself and others), and facial affect recognition. Scores on a measure of negative affect were statistically controlled. Results: Women with high disordered eating symptom scores rated themselves as having more difficulties identifying, but not describing emotions after controlling for negative affect, but demonstrated greater difficulties describing their own and others' emotions on a measure of emotional awareness. In the self-focused attention condition, women scored lower on self emotional awareness and were quicker to identify expressions of negative facial affect regardless of eating disorder symptom status than women in the non-self-focused attention condition. There were no significant interactions between eating disorder status and self-focused attention. Conclusions: Further examination of different types of emotion recognition and description in oneself and others as well as processes that may influence these abilities is warranted.

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