Abstract

BackgroundRecent research has identified several cognitive biases in patients with eating disorders, such as a tendency to interpret ambiguous information about one’s own body in a negative way. The so-called “negative interpretation bias” is considered to be a key factor in maintaining maladaptive cognitions and behaviors in eating disorders. Studies on modification of the negative interpretation bias in eating disorders have yielded mixed results. This randomized controlled pilot study examined whether a specially adapted, computerized version of the Scrambled Sentences Task modifies negative interpretation bias in women with elevated body dissatisfaction.MethodsThe sample consisted of 40 normal-weight women with elevated body dissatisfaction, randomly assigned either to an intervention or a no-intervention control group (each n = 20). The intervention group received six sessions (within two weeks) of a newly-developed interpretation bias modification training that involved unscrambling positively valenced, body image-related sentences. The control group received no intervention. In both groups, body image-related negative interpretation bias (main outcome), trait body dissatisfaction and thin-ideal cue reactivity were assessed at baseline and two weeks later. Additionally, in the intervention condition, the trajectory of expected reductions in the thin-ideal internalization was measured during each training session.ResultsIn both conditions, body image-related negative interpretation bias and trait body dissatisfaction decreased significantly from pre- to post-assessment; however, a specific effect imparted by the interpretation bias modification training was not found. Groups did not differ in thin-ideal cue reactivity. In the intervention group, thin-ideal internalization decreased significantly over the training sessions.ConclusionsThe findings do not support use of body image-related interpretation bias modification in its current form in the treatment of body dissatisfaction. Further research involving different versions of the training and clinical samples is warranted.

Highlights

  • Recent research has identified several cognitive biases in patients with eating disorders, such as a tendency to interpret ambiguous information about one’s own body in a negative way

  • We found a decrease in body image-related negative interpretation bias and body dissatisfaction from before to after the intervention

  • There were two dropouts, one due to intercurrent illness and another due to an error in the screening process whereby a participant had been included despite her Body Mass Index (BMI) of 28.76, which exceeds the normal range according to the World Health Organization (WHO) (Fig. 1)

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Summary

Introduction

Recent research has identified several cognitive biases in patients with eating disorders, such as a tendency to interpret ambiguous information about one’s own body in a negative way. In the development and maintenance of eating disorders, cognitive schemata take a key role as they are assumed to affect thoughts and behavior in a maladaptive manner and lead to excessive preoccupation with one’s own body and eating behavior [1,2,3,4,5] These schemata foster biased information processing [2, 6, 7], such as the tendency to interpret ambiguous information in a negative manner Negative interpretation bias is commonly assessed using fictional ambiguous scenarios (e.g. two friends giggling behind oneself), where participants are either required to spontaneously generate an interpretation (sentence completion task), or to rate the likelihood of a given interpretation [10, 11] These measurements are rather explicit in nature and may be susceptible to demand characteristics, selection and response bias [12], as well as social desirability [13]. Implicit measures for negative interpretation bias serve as a helpful addition since they are less affected by cognitive control and enable capturing of less deliberate, spontaneous cognitive processes [13, 14]

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