Different Patterns of Emotional Eating and Visuospatial Deficits Whereas Shared Risk Factors Related with Social Support between Anorexia Nervosa and Bulimia Nervosa

Abstract

ObjectiveAlthough it is thought that eating disorders result from the interplay of personal and sociocultural factors, a comprehensive model of eating disorders remains to be established. The aim of this study was to determine the extent to which the childhood factors and deficit in visuoperceptual ability contribute to eating disorders.MethodsA total of 76 participants - 22 women with anorexia nervosa (AN), 28 women with bulimia nervosa (BN), and 26 healthy women of comparable age, IQ, and years of education - were examined. Neuropsychological tasks were applied to measure the visuoperceptual deficits, viz. the Rey-Osterrieth complex figure test and the group embedded figures test (GEFT). A questionnaire designed to obtain retrospective assessments of the childhood risk factors was administered to the participants.ResultsThe women with both AN and BN were less likely to report having supportive figures in their childhood and poor copy accuracy in the Rey-Osterrieth test. The women with AN were more likely to report premorbid anxiety, childhood emotional undereating and showed poor performances in the GEFT. In the final model, the factors independently contributing to the case status were less social support in childhood as a common factor for both AN and BN, and childhood emotional undereating and poor ability in the low-level visuospatial processing for AN.ConclusionOur results suggest the disturbance in the food-emotion relationship and the deficit in low-level visuospatial processing in people with AN. Lower social support appears to contribute to an increase in vulnerability to both AN and BN.

Visual processing in anorexia nervosa and body dysmorphic disorder: Similarities, differences, and future research directions

“…Studies measuring the accuracy of copy have shown either equivalent (Castro-Fornieles et al, 2009; Danner et al, 2012; Lopez et al, 2008; Sherman et al, 2006; Stedal et al, 2012) or poorer performance in AN relative to control groups (Kim, Lim, & Treasure, 2011; Lopez, Tchanturia, Stahl, & Treasure, 2009). One study found that underweight participants with AN performed worse than controls on copy, but improved after gaining 10% of body weight (Kingston, Szmukler, Andrewes, Tress, & Desmond, 1996), suggesting that the deficit may be weight-dependent.…”

“…One study found that underweight participants with AN performed worse than controls on copy, but improved after gaining 10% of body weight (Kingston, Szmukler, Andrewes, Tress, & Desmond, 1996), suggesting that the deficit may be weight-dependent. The majority of studies, which included adolescents and children along with adults, found significantly worse delayed recall in AN (Andres-Perpina et al, 2011; Camacho, 2008; Favaro et al, 2012; Lopez et al, 2008; 2009; Mathias & Kent, 1998; Pendleton-Jones, 1991; Sherman et al, 2006; Stedal et al, 2012; Tenconi et al, 2010; Thompson, 1993), or a trend for worse delayed recall (Castro-Fornieles et al, 2009), but some found equivalent performance (Danner et al, 2012; Kim, 2011; Kingston et al, 1996; Murphy, Nutzinger, Paul, & Leplow, 2002). …”

“…However, Pendleton-Jones et al (1991) found that longer time was required in both underweight and weight-restored AN adults relative to healthy controls, using the original version of the test, which required holding the figures in working memory, creating a confound between visual processing and memory. When adults and adolescents were administered a time-constrained EFT task, the AN group correctly located fewer shapes than controls (Kim et al, 2011). …”

Factors Predicting an Escalation of Restrictive Eating During Adolescence

“…However, several risk factors for developing an eating disorder characterized by extreme restrictive eating (e.g., AN) have been identified. These include: (1) psychological risk factors , such as depression, low self-esteem, weight and shape concerns, and body dissatisfaction [14,15]; (2) familial risk factors , such as family discord, parental dieting, and parental encouragement to diet [16,17]; (3) and social risk factors , such as deficient social support, general or weight-specific peer teasing, and peer dieting [17–19]. While existing studies have expanded the field's understanding of risk factors, they are limited by narrowly focusing on development of a particular disorder (e.g., AN) and over-utilization of clinic-based samples.…”

Recent Advances in Developmental and Risk Factor Research on Eating Disorders

“…Broadly, research indicates that interpersonal distrust predicts the onset, but not maintenance of EDs [60••]. Further, deficient social support may contribute to both AN and BN [89].…”