Approach and avoidance: Relations with the thin body ideal in women with disordered eating behavior

Leins, Judith; Waldorf, Manuel; Kollei, Ines; Rinck, Mike; Steins‐Loeber, Sabine

doi:10.1016/j.psychres.2018.08.029

Cited by 14 publications

(17 citation statements)

References 38 publications

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“…It is possible that the focus on approach behaviornamely the start with the most blurred and small picture size going to the highest solution and biggest size -is not as sensitive in highly pathological samples as the AAT design which allows participants to "move" pictures away or toward oneself and which focusses on reaction times. On the other hand, the only study that applied an AAT in (questionnaire-defined) patients with eating disturbances and BID (Leins et al, 2018) did not include self-images and it is therefore not easy to compare the two studies. Interestingly, Leins et al (2018) also failed to replicate an approach bias toward thin pictures, illustrating how difficult it generally is to reliably capture approach-avoidance behavior toward body images.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the only study that applied an AAT in (questionnaire-defined) patients with eating disturbances and BID (Leins et al, 2018) did not include self-images and it is therefore not easy to compare the two studies. Interestingly, Leins et al (2018) also failed to replicate an approach bias toward thin pictures, illustrating how difficult it generally is to reliably capture approach-avoidance behavior toward body images. This might also be caused by their use of computer-generated bodily stimuli (avatars; e.g., Woud et al, 2011;Leins et al, 2018;Dondzilo et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…Higher levels of body dissatisfaction, thin-ideal internalization and dietary restraint were associated with greater approach bias, whereas avoidance behavior was not correlated with self-reported levels of eating disturbances and BID. There is only one study (Leins et al, 2018) that applied the AAT in women with self-reported eating disturbances (categorized as ED symptoms present vs. absent based on Eating Disorder Examination Questionnaire cut-off scores according to Mond et al, 2004): participants were asked to operate a joystick to either push or pull images of normal weight or underweight pictures toward or away from them (images would zoom larger in proportion to joystick pull movement and zoom smaller for push movements). They failed to replicate the former finding of an approach bias toward thin pictures.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…At first sight, this may seem odd, however, other studies obtained similar results in related domains. Using an AAT approach, Leins et al () failed to find an approach bias towards thin figures, or associations between BMI and body dissatisfaction in a clinical sample. Thus, it may be that in a clinical sample, features that normally impact social interactions, such as body dissatisfaction, a heightened BMI, or drive to thinness, are overridden by more powerful underlying (dysfunctional) processes.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, an avoidance‐bias to overweight models was positively correlated with body dissatisfaction and eating pathology as well as the BMI of the participants. Based on this finding, Leins, Waldorf, Kollei, Rinck, and Steins‐Loeber () presented a computerized Approach‐Avoidance task (AAT) using normal weight and underweight pictures to a transdiagnostic sample of women with various ED symptoms, as well as to healthy controls. They failed to replicate the former finding of an approach bias towards thin pictures, possibly due to the relatively low reliability of the AAT (Reinecke, Becker, & Rinck, ).…”

Section: Introductionmentioning

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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Implicit approach‐avoidance tendencies toward food and body stimuli absent in individuals with anorexia nervosa, bulimia nervosa, and healthy controls

Kollei

Leins

Rinck

et al. 2021

Intl J Eating Disorders

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Objective: Body and food-related information are thought to activate cognitive biases and contribute to the maintenance of eating disorders (ED). Approachavoidance biases may play an important role in the maintenance of dietary restriction and excessive food intake. Therefore, the present study aimed to examine approachavoidance biases toward food and body stimuli in individuals with anorexia nervosa (AN), bulimia nervosa (BN), and healthy controls (HC). Methods:The study included 42 individuals with AN, 24 individuals with BN, and 38 HCs. We used two implicit Approach-Avoidance Tasks (AAT) to assess approachavoidance biases: participants completed a Food-AAT (high-calorie vs. low-calorie food) and a Body-AAT (thin vs. normal weight bodies). Additionally, explicit ratings of food and body stimuli were assessed.Results: There were no significant Group Â Stimulus Â Direction interactions in the implicit Food-AAT or implicit Body-AAT. In explicit ratings, individuals with AN and BN reported less urge to eat and more regret if they ate high-calorie and low-calorie food; individuals with AN and BN rated normal weight bodies as less normal weight, less attractive and less desirable than HCs. There were no group differences in explicit ratings of the thin body.Discussion: We did not find evidence for biased approach-avoidance tendencies toward food or body stimuli in individuals with AN or BN. Future studies are necessary to understand conflicting findings regarding approach-avoidance biases toward food and body stimuli in individuals with ED.

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Approach and avoidance: Relations with the thin body ideal in women with disordered eating behavior

Cited by 14 publications

References 38 publications

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

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

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

Implicit approach‐avoidance tendencies toward food and body stimuli absent in individuals with anorexia nervosa, bulimia nervosa, and healthy controls

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