Characteristics and content of intrusive images in patients with eating disorders

Abstract

The aim of this study was to examine the characteristics and content of intrusive images in patients with different subtypes of eating disorders (EDs). Data were collected from 74 ED patients, 22 dieting, and 29 nondieting controls. Participants completed a set of self‐report questionnaires. Intrusive images of ED patients were significantly more repetitive, detailed, vivid, and distressing than intrusive images of dieting and/or nondieting controls. Most of the intrusive images were the same for the ED subtypes; however, patients with anorexia nervosa were more likely to report an observer vantage perspective than patients with bulimia nervosa, who were more likely to report a field vantage perspective. As expected, intrusive images' content was related to body checking (weight and shape) or negative self (evaluated by themselves or others). Finally, there were significant associations between intrusive images' vividness and weight and shape concerns. These findings indicate that intrusive images may be a core element of EDs and targeting intrusive images in therapy may be helpful.

Imagine food, weight and shape: mental imagery in women with eating disorders compared with healthy controls

“…However, the characteristics of these spontaneous mental images appear to be problematic. Spontaneous mental images related to eating, weight or shape were more vivid, negative and anxiety provoking, and involved more sensory modalities in individuals with eating disorder than in dieting and non-dieting controls (Kadriu et al, 2019;Somerville et al, 2007). Furthermore, spontaneous mental images of food were experienced as more distressing and were associated with a lower sense of control by individuals with binge eating behaviour than by healthy controls (Dugué et al, 2016).…”

“…Several studies have shown that spontaneous mental imagery is also common in other mental disorders (Hackmann and Holmes, 2004), such as agoraphobia (Day et al, 2004), social phobia (Hackmann et al, 2000), hypochondria (Muse et al, 2010), obsessive compulsive disorder (Speckens et al, 2007), body dysmorphic disorder (Osman et al, 2004) and eating disorders (Hinrichsen et al, 2007;Kadriu et al, 2019;Somerville et al, 2007). These images are often related to negative early memories in content and meaning, which may be a transdiagnostic phenomenon (Hackmann and Holmes, 2004;Kadriu et al, 2019). However, several studies have shown that the content and nature of these images may also be disorder specific.…”

“…Individuals with eating disorders or eating disordered behaviour reported experiencing distressing mental images (e.g. related to appearance) when worrying about their eating, weight or shape (Kadriu et al, 2019;Somerville et al, 2007), prior to self-induced vomiting (Hinrichsen et al, 2007), or prior to a binge or an episode of eating too much (Dugué et al, 2016). Some of these studies compared spontaneous mental imagery between individuals with an eating disorder (or eating disordered behaviour) and healthy controls (Dugué et al, 2016;Kadriu et al, 2019;Somerville et al, 2007).…”

“…related to appearance) when worrying about their eating, weight or shape (Kadriu et al, 2019;Somerville et al, 2007), prior to self-induced vomiting (Hinrichsen et al, 2007), or prior to a binge or an episode of eating too much (Dugué et al, 2016). Some of these studies compared spontaneous mental imagery between individuals with an eating disorder (or eating disordered behaviour) and healthy controls (Dugué et al, 2016;Kadriu et al, 2019;Somerville et al, 2007). Overall, findings of studies comparing the occurrence of spontaneous mental imagery in individuals with eating disorders and healthy controls suggested that the occurrence of spontaneous mental images may be a normal phenomenon and that the occurrence itself does not have to be pathological.…”

Why Use Predictive Processing to Explain Psychopathology? The Case of Anorexia Nervosa

“…Most commonly associated with social anxiety disorder, this phenomenon involves individuals experiencing conscious, invasive, recurrent mental imagery representing their fears (i.e. having an overweight body) (Kadriu et al 2019). One eating disordered patient describes the content of one such imagery experience, "In the image I see myself obese, with very fat thighs and a fat stomach."…”