Food related attention bias modification training for anorexia nervosa and its potential underpinning mechanisms

Abstract

Treatment outcomes in anorexia nervosa (AN) remain suboptimal, evidencing the need for better and more targeted treatments. Whilst the aetiology of AN is complex, cognitive processes such as attention bias (AB) have been proposed to contribute to maintaining food restriction behaviour. Attention bias modification raining (ABMT) has been investigated in other eating disorders (EDs) such as binge eating disorder (BED) as a means of modifying AB for food and of changing eating behaviour. Promising findings have been reported, but the mechanisms underlying ABMT are poorly understood. We hypothesise that in AN, ABMT has the potential to modify maladaptive eating behaviours related to anxiety around food and eating and propose two mechanistic models; (1) ABMT increases general attentional control (which will improve control over disorder-relevant thoughts) or (2) ABMT promotes stimulus re-evaluation. In this second case, the effects of ABMT might arise via changes in the subjective value of food stimuli (i.e. reward processing) or via habituation, with both resulting in a reduced threat response. Investigating the clinical potential of ABMT in AN holds the promise of a novel, evidence-based adjunctive treatment approach. Importantly, understanding ABMT's underlying mechanisms will help tailor treatment protocols and improve understanding of the cognitive characteristics of AN and other EDs.

Indirect Health Effects of COVID-19: Unhealthy Lifestyle Behaviors during the Lockdown in the United Arab Emirates

“…In this study, one in three participants reported lower physical activity levels during lockdown. This significant prevalence of lower physical activity was also reported by a cross-sectional survey among Lebanese adults, whereby 41% reported no physical activity or exercise during lockdown [ 25 ]. In fact, staying home for a prolonged period of time may lead to more prevalent sedentary behavior such as excessive sitting/reclining, increased screen time activities (video games, TV watching, use of mobile devices) [ 26 ].…”

What was the impact of a global pandemic (COVID-19) lockdown period on experiences within an eating disorder service? A service evaluation of the views of patients, parents/carers and staff

“…A balance of risks should be considered as families are within the same “bubble” and pose limited additional risk, whereas the reduction in treatment effectiveness could be life threatening. Future research must aim to understand how best to adapt treatments, such as FBT, for virtual delivery to ensure that it is safe and effective [ 10 ].…”

Cognitive Interpersonal Model for Anorexia Nervosa Revisited: The Perpetuating Factors that Contribute to the Development of the Severe and Enduring Illness

“…These include cognitive remediation approaches that focus on cultivating a flexible, big picture style of thinking [73], cognitive skills training for social avoidance [74], and go/no-go inhibition training [75], which may be of value for the binge-purge form of the illness. Food-related attention bias modification training is also being investigated as an add-on intervention for AN, following directions from anxiety disorder research [76,77].…”