Abstract
Body dissatisfaction is a core feature of eating disorders (EDs) and plays an essential role in the development and maintenance of anorexia nervosa (AN). In the current study, a computer based body exposure intervention is conducted and evaluated regarding short-term effects on body dissatisfaction, psychopathology, viewing patterns, and stress reactivity. Within a randomized controlled trial (RCT) female adolescents and young women with AN are either receiving the intervention or treatment as usual (TAU). Furthermore, in a transdiagnostic approach, a highly body-dissatisfied group of clinical control participants obtaining the intervention will be surveyed to identify AN-specific processes. The standardized four-session body exposure intervention using photographs of the own body is adapted from a manualized body image treatment program for computer use. Psychopathology (body dissatisfaction, body image avoidance, body checking, depression, anxiety) is assessed via standardized questionnaires before and after the intervention. During each session, attentional biases regarding one's own body are measured via eye tracking, stress levels are measured via subjective ratings, heart rate variability, as well as salivary cortisol and alpha amylase. Between- and within-subject effects will be assessed. The pilot study aims to identify short-term effects of the intervention on body dissatisfaction and attentional bias, as well as to investigate the potential underlying mechanism of physiological habituation.
Highlights
Anorexia nervosa (AN) has a lifetime prevalence of between 0.5 and 2%, with a peak age of onset between 13 and 18 years [1]
Investigating the effect of a three-session mirror exposure on psychophysiological sympathetic reactivity (HR, heart rate variability (HRV), skin conductance) in women with bulimia nervosa (BN) vs. healthy controls showed an initial response within the sessions in both groups, but no physiological habituation between the sessions; thereby, the initial response was an unexpected decreasing sympathetic activity which might be explained by the stronger feelings of sadness compared to fear [28]
While there is data available on the efficacy of body exposure interventions for reducing Body image (BI) disturbances in women with eating disorders (EDs) and high body dissatisfaction [20, 25], there is a lack of available data regarding the efficacy of body exposures with children and adolescents
Summary
Anorexia nervosa (AN) has a lifetime prevalence of between 0.5 and 2%, with a peak age of onset between 13 and 18 years [1]. ED patients showed higher cortisol levels than control participants during a single 40-min body exposure task in a study exploring neuroendocrine (salivary cortisol) and physiological (skin conductance, heart rate) responses in women with EDs, compared to healthy controls. Investigating the effect of a three-session mirror exposure on psychophysiological sympathetic reactivity (HR, HRV, skin conductance) in women with BN vs healthy controls showed an initial response within the sessions in both groups, but no physiological habituation between the sessions; thereby, the initial response was an unexpected decreasing sympathetic activity which might be explained by the stronger feelings of sadness compared to fear [28]. Until now, exact physiological mechanisms which go along with repeated body exposure in patients with AN or high body dissatisfaction are not yet clarified, with no study, to the authors’ knowledge, investigating these in adolescents
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