Electrodermal Response to Mirror Exposure in Relation to Subjective Emotional Responses, Emotional Competences and Affectivity in Adolescent Girls With Restrictive Anorexia and Healthy Controls

Abstract

Objective: Body image disturbances and the attendant negative emotions are two of the major clinical symptoms of eating disorders. The objective of the present experimental study was to shed more light on the degree of association or dissociation between the physiological and emotional response to mirror exposure in patients with restrictive mental anorexia, and on the relationships between the physiological response and characteristics connected with emotional processing.Materials and Methods: Thirty adolescent girls with the restrictive type of anorexia and thirty matched healthy controls underwent bilateral measurement of skin conductance (SC) during rest, neutral stimulus exposure, and mirror exposure, and completed a set of measures focused on emotion regulation competencies, affectivity, and eating disorder pathology.Results: Compared to healthy controls, girls with restrictive anorexia rated mirror exposure as a subjectively more distressful experience. Differences in skin conductance response (SCR) were not significant; however, variance in SCR was substantially greater in the group of anorexia patients as compared to healthy controls. The overall skin conductance level (SCL) was lower in anorexia patients. Increase in SCR during mirror exposure, as opposed to exposure to neutral stimuli, was positively related to the tendency to experience negative emotions, interoceptive sensitivity, body dissatisfaction and suppression, but not to other symptoms of eating pathology or emotional awareness. A post hoc analysis suggested that physiological reactivity might be associated with interoceptive sensitivity to mirror exposure especially in anorectic patients.Conclusion: The study seems to demonstrate some degree of dissociation between psychophysiological reactivity and subjective response to body exposure in patients with restrictive anorexia. Factors affecting differences in psychophysiological responsiveness to body exposure in anorectic patients require further exploration.

Momentary physiological indices related to eating disorders: A systematic and methodological review

“…Differently, AN participants primarily demonstrated lower EDA than healthy samples (Clarke et al, 2016;Knejzlíková et al, 2021;Palomba et al, 2017), except when presented with body-related words or with food-related stimuli after consuming food (Soussignan et al, 2010;Steward et al, 2022). Knejzlíková et al (2021) observed higher EDA variability in AN compared to HC, but no differences during a mirror exposure. Patients with BN showed lower EDA than subclinical restrictive eaters but did not differ from controls (Tuschen-Caffier & Vögele, 1999).…”

Heart Rate as a Correlate for the Emotional Processing of Body Stimuli in Anorexia Nervosa

“…These studies, however, generally used longer measurement intervals [ 31 ]. Other psychophysiological measures, such as skin conductance reactivity, were also reported to be blunted in AN under various conditions [ 19 ].…”

“…Other studies also suggest blunted psychophysiological responses to emotional content in AN, e.g., attenuated startle reflex reactivity to fear-inducing material [ 17 ], but similar peripheral physiological responses to emotion-eliciting film clips as in healthy women [ 18 ]. Adolescent AN patients who performed a body-related task (mirror exposure) showed a dissociation between psychophysiological reactivity (no differences in skin conductance responses compared to typical developing girls) and subjective responses (more negative emotion ratings) [ 19 ]. Similarly, in patients with AN, when looking at their own and other body silhouettes, there was no correlation between another psychophysiological measure—the pupil psychosensory reflex—and self-reported emotional arousal.…”

“I’m Not Only a Body”: Change in Thoughts about the Body after Mirror Exposure Treatment in Women with Obesity—An Exploratory Study

“…Among body exposure treatments, the two most widely used and verified modalities are guided exposure (the person is told which parts of the body to pay attention to: “beautiful” or “ugly” parts) and pure exposure (the person must pay attention to their whole body, with no guidance as to which parts to attend to). The literature finds conflicting results on whether guided exposure treatments show a greater reduction in BD, especially focusing on body parts considered “negative/ugly” [ 19 , 20 ] compared to those without such guidance [ 16 , 29 , 30 ]. However, one fact that has been widely established is that both can be clinically effective in improving BD, body checking/avoidance behaviors, and patients’ moods [ 16 , 31 ].…”