Virtual Rejection and Overinclusion in Eating Disorders: An Experimental Investigation of the Impact on Emotions, Stress Perception, and Food Attitudes

Abstract

(1) Background: the investigation of how interpersonal functioning affects eating psychopathology has been receiving increasing attention in the last decade. This study evaluates the impact of virtual social inclusion or ostracism on emotions, perceived stress, eating psychopathology, and the drive to binge or restrict in patients across the eating disorder spectrum. (2) Methods: a group of 122 adolescent and adult females with different eating disorder diagnoses were compared to 50 healthy peers with regards to their performance on, and responses to the Cyberball task, a virtual ball-tossing game. Each participant was randomly assigned to playing a social inclusion or a social exclusion block of the Cyberball task and completed self-report assessments of emotions, perceived stress and urge to restrict/binge before and after the task. (3) Results: patients with anorexia nervosa showed a more negative impact on psychological well-being evaluated with the need threat scale after the excluding block, while patients with bulimia nervosa reported more negative effects after the overincluding condition. Patients with binge eating disorder showed a reduction in specific negative emotions after the overincluding block, unlike all other participants. (4) Conclusions: findings show significant correlations between restraint thoughts in patients with bulimia nervosa and binge thoughts in patients with binge eating disorder after being exposed to the inclusion condition. Different reactions in cognitive and emotional states of patients with eating disorders after different interpersonal scenarios confirm the impact of inclusive or exclusive relationships on eating psychopathology, with specific and different responses across the eating disorder spectrum, that have been discussed, linked to their eating behavioral cognition.

Neural underpinnings of threat bias in relation to loss-of-control eating behaviors among adolescent girls with high weight

“…Indeed, research supports the role of positive social engagement in the improvement of weight outcomes among adults ( 84 ), children ( 85 ), and adolescents ( 86 , 87 ). A recent study demonstrated that thoughts about binge eating reduced following an interpersonal scenario characterized by social inclusion in a Cyberball task among individuals with BED ( 88 ), which aligns with current findings linking positive social cues and lower palatable food intake. Engagement of the dlPFC, which supports cognitive control processes, powerfully modulates engagement of the ventral stream, a series of brain regions beginning in the occipital cortex that represents the identity of objects.…”

Mediation role of interpersonal problems between insecure attachment and eating disorder psychopathology

“…As a proof of this, patients recalled social difficulties as preceding their ED and worsening after illness onset [ 26 ]. Experimental studies have demonstrated heightened sensitivity to social stress [ 27 , 28 ] and attentional bias towards social rejection [ 29 ] in individuals with EDs and interpersonal difficulties have been shown to predict treatment outcome [ 30 ].…”