Abstract

BackgroundStudies on food cue reactivity have documented that altered responses to high-calorie food are associated with bulimic symptomatology, however, alterations in sexual motivations and behaviors are also associated clinical features in this population, which justify their inclusion as a research target. Here, we study responses to erotic cues—alongside food, neutral and aversive cues—to gain an understanding of specificity to food versus a generalized sensitivity to primary reinforcers.MethodsWe recorded peripheral psychophysiological indices –the startle reflex, zygomaticus, and corrugator responses—and self-reported emotional responses (valence, arousal, and dominance) in 75 women completing the Bulimia Test-Revised (BULIT-R). Multiple regression analysis tested whether BULIT-R symptoms were predicted by self-reported and psychophysiological responses to food versus neutral and erotic versus neutral images.ResultsThe results showed that individuals with higher bulimic symptoms were characterized by potentiated eye blink startle response during binge food (vs. neutral images) and more positive valence ratings during erotic (vs. neutral) cues.ConclusionsThe results highlight the negative emotional reactivity of individuals with elevated bulimic symptoms toward food cues, which could be related to the risk of progression to full bulimia nervosa and thereby addressed in prevention efforts. Results also point to the potential role of reactivity to erotic content, at least on a subjective level. Theoretical models of eating disorders should widen their conceptual scope to consider reactivity to a broader spectrum of primary reinforcers, which would have implications for cue exposure-based treatments.Plain English summaryWe examined appetitive and aversive cue responses in college women to investigate how bulimic symptoms relate to primary reinforcers such as food and erotic images. We recorded peripheral psychophysiological indices (the startle reflex, zygomaticus, and corrugator responses) and self-reported emotional responses (valence, arousal, and dominance) in 75 college women that were presented with the Spanish version of the Bulimia Test-Revised. The results showed that bulimic symptoms increase both psychophysiological defensiveness toward food cues and subjective pleasure toward erotic cues. The findings suggest a generalized sensitivity to primary reinforcers in the presence of bulimic symptoms, and emphasize the relevance of adopting a wider framework in research and treatment on bulimia nervosa.

Highlights

  • Studies on food cue reactivity have documented that altered responses to high-calorie food are associ‐ ated with bulimic symptomatology, alterations in sexual motivations and behaviors are associated clinical features in this population, which justify their inclusion as a research target

  • Plain English summary: We examined appetitive and aversive cue responses in college women to investigate how bulimic symptoms relate to primary reinforcers such as food and erotic images

  • The findings suggest a generalized sensitivity to primary rein‐ forcers in the presence of bulimic symptoms, and emphasize the relevance of adopting a wider framework in research and treatment on bulimia nervosa

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Summary

Introduction

Studies on food cue reactivity have documented that altered responses to high-calorie food are associ‐ ated with bulimic symptomatology, alterations in sexual motivations and behaviors are associated clinical features in this population, which justify their inclusion as a research target. Some psychiatric syndromes, such as bulimia nervosa (BN), which especially affects women [3], tend to deviate from this general pattern, at least for food cues Patients with this debilitating disorder are characterized by binge eating, inappropriate compensatory behaviors, undue influence of body weight and/or shape on self-esteem [4]. These symptoms appear to be related to altered food cue responses, it recently emerged that erotic stimuli tend to be processed differently in patients with BN, at least in terms of subjective emotional reactivity [5, 6]. This ambivalence takes the form of a discrepancy between psychophysiological responses—that show enhancement of the corrugator supercilii muscle activity and the eye-blink startle reflex, both indicating aversive responses—, and subjective responses—that tend to indicate appetitive food processing [11, 12]

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