Selective Visual Attention Towards Oneself and Associated State Body Satisfaction: an Eye-Tracking Study in Adolescents with Different Types of Eating Disorders

Abstract

The development of eating disorders is associated with a body-related attentional bias. Although eating disorders are especially prevalent in adolescence, so far, no study has analyzed gaze patterns and state body image in response to viewing one's own body in youth. To fill this gap, the present study aimed to examine a body-related attentional bias and state body satisfaction in adolescents with various forms of eating disorders. Girls with anorexia nervosa, restrictive type (AN-R; n = 30), anorexia nervosa, binge eating/purging type (AN-BP; n = 26), bulimia nervosa (BN; n = 22), clinical controls with anxiety disorders (n = 20) and healthy controls (n = 43) looked at photographs of their own and a peer's body, while their spontaneous eye movements were recorded. After stimulus presentation, state body satisfaction and individual attractiveness ratings for areas of the presented stimuli were assessed. An analysis of variance revealed that participants of all subgroups showed an attentive preference for unattractive areas of one's own body. Girls with AN-R attended significantly longer to unattractive body areas than both control groups and significantly shorter to attractive body areas than healthy controls. State body dissatisfaction was more prominent in all eating disorder subgroups, with significantly lower scores in BN compared to AN-R. In general, the higher the state body dissatisfaction, the stronger was the deficit orientation on one's own body. The attentional bias towards unattractive body areas, which is most pronounced in AN-R, indicates that interventions aiming to modify distorted attention might be promising in the prevention and treatment of eating disorders in adolescence.

Where Do You Look Visual Attention to Human Bodies across the Weight Spectrum in Individuals with Normal Weight or with Obesity

“…In contrast, several studies in the field of eating disorders found differences regarding the exploration pattern of body stimuli in anorexia nervosa (e.g. [30,31,32,33,34]) and bulimia nervosa (e.g. [34,35,36,37]) compared to healthy controls.…”

Visual processing of one's own body over the course of time: Evidence for the vigilance‐avoidance theory in adolescents with anorexia nervosa?

“…In line with these theoretical assumptions, previous research has found that females with body image disturbance or diagnosed eating disorders show an attentional bias when looking at their own body (e.g., Bauer et al, 2017;Jansen, Nederkoorn, & Mulkens, 2005;Tuschen-Caffier et al, 2015). According to a substantial number of studies, this bias seems to be characterized by stronger attention to self-defined unattractive body areas of one's own body (e.g., Bauer et al, 2017;Jansen et al, 2005;Roefs et al, 2008;Tuschen-Caffier et al, 2015). However, some studies contradict these findings.…”

“…Participants were asked to look at the body pictures, but did not receive any further instructions in order to minimize the influence on their natural gaze behavior and thus enhance ecological validity. As this study was part of a larger project on various aspects related to body-related attention (see Bauer et al, 2017), participants were also presented with an additional photo set of an unknown female's body. This additional photo set-consisting of four body pictures which were taken under the same conditions as the participants' individual photos-was shown either before or after the set of own-body pictures.…”

Double standards in body evaluation? How identifying with a body stimulus influences ratings in women with anorexia nervosa and bulimia nervosa

“…With regard to the cognitive‐affective component, previous studies employing various questionnaires found that women with ED report a higher dissatisfaction with their own body than do women without ED (Cash & Deagle, ; Hrabosky et al, ; Vossbeck‐Elsebusch et al, ). In line with these self‐ratings, studies in which participants were asked to evaluate characteristics of their own body found that women with ED rate their own body more critically than do nonclinical controls, that is, as less attractive or with more body fat (Bauer et al, ; Horndasch et al, ; Von Wietersheim et al, ). To establish whether such a negative view of one's own body is “justified,” Jansen, Smeets, Martijn, and Nederkoorn () asked two community panels to rate the attractiveness of bodies of women with similar body mass indexes (BMI), but with higher or lower levels of ED symptoms, and compared their ratings with the self‐ratings provided by these women.…”