Abstract
Body image interventions have been shown to reduce self-reported cognitive-emotional facets of body image disturbance in binge eating disorder (BED). However, more objective assessment methods are required to evaluate the effects of these interventions. Therefore, the present study aimed at investigating the usefulness of vocally encoded emotional arousal as physiological correlate of body dissatisfaction during mirror exposure in women with BED. Women with BED (n = 60) and weight-matched controls (CG; n = 60) participated in an experimental thought-sampling procedure including a mirror exposure and a control condition in a repeated-measures design. Fundamental frequency as a vocal correlate of emotional arousal as well as negative, neutral, and positive body-related cognitions during both conditions were analyzed. In line with our hypotheses, the BED group verbalized more negative, and less positive and neutral body-related cognitions during the mirror exposure condition compared to the CG. Contrary to our hypotheses, though, there was a stronger increase in physiological arousal between the control and the mirror exposure condition in the CG relative to the BED group. Furthermore, a significant negative correlation between fundamental frequency and the severity of cognitive-emotional body image disturbances emerged. The findings indicate a cognitive-emotional over-involvement with physical appearance during mirror exposure in women with BED compared to weight-matched controls in the absence of a corresponding physiological pattern. Results are discussed in terms of an impaired ability of women with BED to show adequate physiological responses to body-related stress. In addition, methodological recommendations for future research are presented.
Highlights
According to the Diagnostic and Statistical Manual of Mental Disorders [1] binge eating disorder (BED) is characterized by recurrent episodes of binge eating accompanied by feelings of loss of control in the absence of inappropriate compensatory weight regulation behavior as in bulimia nervosa (BN)
In accordance with our hypothesis, a cognitive-affective overinvolvement with physical appearance was observed in women with BED compared to weight-matched controls
The results concerning the quantitative content analysis is in line with previous studies on psychological responses to mirror exposure in women with BED [25, 45]
Summary
According to the Diagnostic and Statistical Manual of Mental Disorders [1] binge eating disorder (BED) is characterized by recurrent episodes of binge eating accompanied by feelings of loss of control in the absence of inappropriate compensatory weight regulation behavior as in bulimia nervosa (BN). The cognitive-affective component, which comprises attitudes, cognitions, and emotions regarding one’s own body (e.g., body dissatisfaction, overvaluation of shape and weight), seems to be especially relevant in distinguishing patients with BED from weight-matched individuals without an eating disorder These results underline the assumption that body image disturbances in women with BED are a result of increased weight, but of eating pathology [8, 9]. Negative mood preceding binge episodes is most frequently triggered by weight and shape related issues [15] This corroborates findings from an experimental study in which desire to binge and salivation during mirror exposure relative to a control condition were only increased in women with BED but not in weight-matched controls [16]. Elevated levels of weight concern negatively influenced remission rates during a 4-year follow-up period following CBT treatment in another study [18]
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