Abstract
Cognitive biases, such as memory, attention, and interpretation bias, are thought to play a central role in the development and maintenance of eating disorders (EDs). The aim of the present study was to investigate whether the interpretation bias is ED-specific or can be generalized to comorbid disorder-related threats in women with high levels of ED symptoms. In an online study, we measured interpretation bias using the modified Sentence Word Association Paradigm (SWAP), comparing women with (n = 39) and without (sub)threshold eating disorders (n = 56). We assessed endorsement and rejection rates as well as reaction times in response to a positive/neutral or a negative ED-specific, social anxiety-specific (SAD), or generalized anxiety-specific (GAD) interpretive word following an ambiguous sentence. In ambiguous situations, women with high ED symptoms selected more negative (p < .001) and fewer positive/neutral ED-related interpretations (p < .001). Negative interpretations were endorsed significantly faster (p < .001), while positive interpretations were rejected faster in this group (p < .001). These women also manifested negative SAD-specific interpretation bias patterns in reaction time measures. Nevertheless, ED severity was best predicted by the endorsement of negative ED-specific stimuli, whereas ED and SAD reaction time measures seemed to have a negligible effect. The results indicate that the interpretation bias might be ED-specific. The SWAP can be a useful tool for the further investigation of the etiological relevance of the interpretation bias as well as for the development of modification training interventions.
Highlights
The results suggested that the cognitive bias modification for IB (CBM-I) was more useful for increasing positive interpretations related to appearance than those related to self-worth (Matheson, Wade, & Yiend, 2018)
A cutoff score of 3.18 points has been reported to indicate the presence of an eating disorder (ED) in samples with bulimia nervosa and was used in this study to differentiate between a group with high ED symptoms (ED+) and a group with few or no symptoms (ED−)
The main purpose of this online study was to clarify whether the interpretation bias (IB) is specific to ED-related content or whether it extends to threats relating to highly comorbid disorders
Summary
The advertisements included brief information about the study, the inclusion criteria, reimbursement, and the necessity to install Inquisit 4 Web player 4.0.8.0 (Millisecond) on their personal computer by following a link. After informed consent was obtained from the participants, they were screened for inclusion and exclusion criteria. During both the recruitment and consent stage, participants were informed and agreed to take part in a study with the aim to examine interpretation biases in eating disorders. Prior to the following task, participants were instructed to participate using a computer and not to use a mobile device. They we asked to choose a situation in which they did not need to leave their computer for the 15 min in order to minimize possible distractions from their surroundings, and to close other running programs.
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