Watch out! A path from anxiety to anorexia nervosa through biased attention?

Abstract

Objective: Evidence points towards heightened anxiety and attention biases (AB) towards disorder-specific (threatening) stimuli in patients with anorexia nervosa (AN). To date, it is unclear how anxiety and AB interact in eating disorders (ED). The present study tests the causal role of anxiety by inducing anxiety before a dot-probe task with either ED-specific stimuli or unspecific negative (threat-related) information. We expected that anxiety would elicit AB for ED-specific, but not for unspecific threat-related stimuli.Methods: Adolescents with AN (AN, n = 32) or depression (DEP, n = 27) and healthy controls (HC, n = 29) underwent an anxiety induction or a low anxiety control task before a pictorial dot-probe task with either under-/overweight body-related pictures or non-disorder-related threatening pictures (angry faces). BMI, level of ED symptoms, anxiety, stress, and depression were assessed at baseline. Results: The anxiety induction did not affect the observed attention pattern.AN showed an AB towards underweight body pictures compared to HC, whereas no disorder-unspecific threat-related AB emerged. Regression analyses revealed that only anxiety predicted the AB towards underweight body pictures. Discussion: Further experimental research may integrate eye tracking as an additional tool, or collect information on body dissatisfaction to obtain a better understanding of how anxiety biases attention.

Seeing oneself as an unattractive loser: Similar interpretation and memory biases in adolescents with anorexia nervosa and adolescents with depression or anxiety

“…The presence of more general, non-ED-related biases (that are similar to those found in individuals with other mental disorders such as depression and anxiety; e.g., Mathews & MacLeod, 2005) challenges the assumption that individuals with AN are characterised particularly by content-specific biases, that is, biases for information related to their ED (Williamson et al, 1999). However, only few studies so far have addressed the content-specificity hypothesis by assessing biases for both, ED-related and non-ED-related information within one study (e.g., Hermans et al, 1998;Korn et al, 2020;Radix et al, 2023). Their results indicated biases only for ED-related information, contrasting those of studies investigating biases for non-ED-related information separately.…”

“…An additional limitation of the previous literature is that most studies have been conducted in adults with AN. Studies in adolescents are scarce: Only few studies reported attention biases (e.g., Radix et al, 2023;Sfärlea et al, 2023) and only one study reported negative interpretation biases (for social information; Rowlands et al, 2021) in adolescents with AN compared to adolescents with no mental disorders, despite the facts that (i) the incidence of AN is highest in adolescence (Solmi et al, 2022) and (ii) major cognitive and affective development is ongoing during adolescence (e.g., Steinberg, 2005), making it difficult to transfer results obtained in adult samples on adolescents. As comprehensive knowledge of cognitive biases in adolescents with AN is lacking, the aim of the present study was to systematically investigate whether adolescents with AN show cognitive biases on different levels of information processing and to examine to what extent these biases are specific for ED-related information and to what extent they are general negative biases (content-specificity).…”