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

Abstract

In anorexia nervosa, aberrant emotional reactions toward body stimuli have been discussed. We investigated heart rate as a physiological marker when viewing body stimuli and hypothesized altered HR reactions toward those highly significant and emotional stimuli in anorexia nervosa. In total, 37 anorexia nervosa patients and 43 control participants viewed pictures of women of five different weight categories, while their cardiac activity was recorded. R-R intervals following picture onset were determined, and means were calculated for three distinct time periods. The overall change in HR relative to baseline across all picture categories was greater in the patient group than in the control group (significant effect of “group”, p = 0.002, partial η2 = 0.120). A significant decrease in HR 2 to 8 s after picture presentation was found for pictures of women of extreme weight in both participant groups (significant “category ∗ time segment interaction”, p = 0.01, partial η2 = 0.037) and correlated with scores of sociocultural attitudes toward the appearance for the extremely underweight category (r = −0.33, p = 0.005). Therefore, differential HR reactions for anorexia nervosa patients and control participants were found for body stimuli in general. The highest HR decelerations in response to pictures of strongly underweight and overweight women may reflect emotional processes such as anxiety due to social comparison.

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

“…AN patients also showed no HR differences from Healthy Controls (HC) viewing body-related stimuli (Lutz et al, 2019). AN patients had higher HR changes compared to HC, with a pronounced deceleration after viewing extreme-weight images (Horndasch et al, 2023). More research is needed to clarify the relationship between visual stimuli and HR in AN.…”

Exploring the neurofunctional impairments and cognitive biases concerning food and body related stimuli in anorexia nervosa: An integrated EEG and eye-tracking study protocol

“…Patients with AN exhibit difficulty in emotion processing and regulation, particularly in response to disorder-related stimuli (e.g., food and body-related stimuli) [22][23][24]. Exposure to such stimuli elicits heightened emotional responses in individuals with AN, indicating significant alterations in their emotion processing systems [22][23][24].…”

“…Patients with AN exhibit difficulty in emotion processing and regulation, particularly in response to disorder-related stimuli (e.g., food and body-related stimuli) [22][23][24]. Exposure to such stimuli elicits heightened emotional responses in individuals with AN, indicating significant alterations in their emotion processing systems [22][23][24]. Research has shown increased activity in the right amygdala of patients with AN-R compared to Healthy Controls (HCs) when exposed to food pictures [25], as well as enhanced amygdala activity in response to body and shape stimuli [26,27].…”