Abstract
BackgroundAnorexia nervosa (AN) is characterized by dysfunctional cognitions including cognitive biases at various levels of information processing. However, less is known about the specificity of these biases, i.e., if they occur for eating-disorder-related information alone or also for non-eating-disorder-related emotional information in AN patients (content-specificity) and if they are unique to individuals with AN or are also shown by individuals with other mental disorders (disorder-specificity).MethodsThe present study systematically assesses cognitive biases in 12–18-year-old female adolescents with AN on three levels of information processing (attention, interpretation, and memory) and with regard to two types of information content (eating-disorder-related, i.e., stimuli related to body weight and shape, and non-eating-disorder-related). To address not only content- but also disorder-specificity, adolescents with AN will be compared not only to a healthy control group but also to a clinical control group (adolescents with major depression or particular anxiety disorders). Cognitive biases are assessed within a single experimental paradigm based on the Scrambled Sentences Task. During the task eye movements are recorded in order to assess attention biases while interpretation biases are derived from the behavioural outcome. An incidental free recall test afterwards assesses memory biases. We expect adolescents with AN to show more pronounced negative cognitive biases on all three levels of information processing and for both types of content compared to healthy adolescents. In addition, we expect the specificity of biases to translate into differential results for the two types of content: AN patients are expected to show stronger biases for disorder-related stimuli but similar or less pronounced biases for non-disorder-related stimuli compared to the clinical control group.DiscussionThis is the first study to comprehensively assess cognitive biases in adolescents with AN. It will have essential implications not only for cognitive-behavioural models of AN but also for subsequent studies aiming to modify cognitive biases in this population, thereby addressing important maintaining factors already at an early stage of the disorder.
Highlights
Anorexia nervosa (AN) is characterized by dysfunctional cognitions including cognitive biases at vari‐ ous levels of information processing
The aim of the present study is to investigate whether adolescents with AN show attention, interpretation, and memory biases
For analysis of attention biases, we will exclude trials with poor eye-tracking data quality [i.e., trials in which the total dwell time is less than 75% of the presentation time due to excessive blinks, missing data, or participants not looking at the screen; 79, 80]
Summary
Anorexia nervosa (AN) is characterized by dysfunctional cognitions including cognitive biases at vari‐ ous levels of information processing. In addition to the core symptoms, patients with AN often show dysfunctional cognitions regarding disorderrelated information, i.e., information related to food, body, and weight [e.g., 8–10] These dysfunctional cognitions manifest themselves, for example, as cognitive biases at different levels of information processing: attention to, interpretation of, and memory for eating disorder (ED)-related information. In turn, refer to tendencies to remember information consistent with one’s dysfunctional cognitions better than other information [e.g., 13], e.g., remembering situations in which someone said something negative about one’s weight or shape better than situations in which one received a compliment These cognitive biases are correlates of the disorder but are considered to play an important role in both the development and maintenance of AN [e.g., 8–11]
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