Body-related Cognitions Research Articles

Computer-Assisted Avatar-Based Treatment for Dysfunctional Beliefs and Eating-Disorder Symptomatology: A Randomized Control Pilot Study

Dysfunctional beliefs influence the pathogenesis and maintenance of eating disorders. Cognitive-behavioral therapy (CBT) aims to modify these specific beliefs and mediate functional patterns of appraisal and thinking. The present pilot study aims to experimentally validate a computer-assisted avatar-based treatment (CAT-DB) to reduce dysfunctional body-related cognitions and symptom severity in a sample with subclinical eating disorder symptomatology. In a randomized controlled trial, 48 participants were assigned to either the control group or CAT-DB. The conviction of individual body-related cognitions and eating disorder-specific symptom expression was measured shortly before the beginning of the intervention (pre-measurement), directly after the intervention (post-measurement), and 14 days later (follow-up). There was a significant interaction effect for symptom severity, as reductions in eating disorder-specific symptomatology were significantly greater in the CAT-DB group compared to the control group at follow-up. Compared to the control group, CAT-DB resulted in non-significant but expected improvements in individual body-related automatic thoughts. The present study offers preliminary evidence suggesting that CAT-DB could be efficacious in addressing certain symptoms associated with eating disorders. Further studies with representative clinical samples diagnosed with eating disorders are needed to provide more evidence of the efficacy of CAT-DB as a support for classical CBT in a variety of therapeutic and research contexts.

Efficacy and mechanisms of change in exposure-based and cognitive stand-alone body image interventions in women with overweight and obesity

ObjectiveBody dissatisfaction is highly prevalent in overweight and obesity, while evidence for the efficacy of body image interventions is still scarce. This interventional pilot study investigates the efficacy and mechanisms of change of two stand-alone body image interventions in women with overweight and obesity. MethodsWomen with overweight and obesity (n = 76) were randomly assigned to five weekly sessions of either a mirror exposure (ME) or a cognitive restructuring intervention (CR) or to a wait-list control group (WCG). Primary outcome measures were self-reported body dissatisfaction and interview-based shape concerns; depression, self-esteem and emotional eating served as secondary outcome measures. Experimental paradigms were used prior to and after the interventions to analyze possible mechanisms of change: (a) Implicit Associations Tests to assess weight-related attitudes (b) eye-tracking experiments to assess visual processing of body pictures and (c) a thought-sampling procedure to assess body-related cognitions and arousal. ResultsAccording to intent-to-treat analyses using linear mixed-models, both interventions lead to significant improvements in body image, while there were no changes in the WCG. Different mechanisms of change were identified. ConclusionsBoth types of interventions might be effective in the reduction of self-reported body dissatisfaction and interview-based shape concerns in overweight and obesity. However, as different mechanisms drive the effects, future research should clarify which individual might best benefit from which intervention.

An examination of older men’s body image: How men 65 years and older perceive, experience, and cope with their aging bodies

We examined how older men perceived, experienced, and coped with age-related changes to their appearance, body function, and health. Data from semi-structured interviews with 28 men aged 65–83 living in a large urban Canadian city and diverse in ethnocultural background (European, East Asian, and South Asian) and sexual orientation (heterosexual and gay) were analyzed through a reflexive thematic analysis. Four overarching themes were constructed from the participants’ accounts. Participants were ambivalent about their aging bodies; they were concerned about certain changes to their bodies, yet concurrently grateful for their retained health and body function. The men stressed the need to accept age-related body changes through pragmatism, awareness of challenging body-related cognitions and emotions without overidentification or suppression, and adjustments to expectations and activities. Participants engaged in upward and downward social comparisons to assess their aging bodies in relation to others and to their younger selves. Weight concerns were prominent. The men worried about their weight, with particular attention to their stomach, and were physically active and ate a healthy diet to manage their weight. This study contributes to body image theorizing by including older diverse men and can inform interventions aiming to enhance men’s later life psychological adjustment.

Cognitive-Emotional Involvement During Mirror Exposure Is Not Accompanied by Physiological Activation in Binge Eating Disorder.

Body image interventions have been shown to reduce self-reported cognitive-emotional facets of body image disturbance in binge eating disorder (BED). However, more objective assessment methods are required to evaluate the effects of these interventions. Therefore, the present study aimed at investigating the usefulness of vocally encoded emotional arousal as physiological correlate of body dissatisfaction during mirror exposure in women with BED. Women with BED (n = 60) and weight-matched controls (CG; n = 60) participated in an experimental thought-sampling procedure including a mirror exposure and a control condition in a repeated-measures design. Fundamental frequency as a vocal correlate of emotional arousal as well as negative, neutral, and positive body-related cognitions during both conditions were analyzed. In line with our hypotheses, the BED group verbalized more negative, and less positive and neutral body-related cognitions during the mirror exposure condition compared to the CG. Contrary to our hypotheses, though, there was a stronger increase in physiological arousal between the control and the mirror exposure condition in the CG relative to the BED group. Furthermore, a significant negative correlation between fundamental frequency and the severity of cognitive-emotional body image disturbances emerged. The findings indicate a cognitive-emotional over-involvement with physical appearance during mirror exposure in women with BED compared to weight-matched controls in the absence of a corresponding physiological pattern. Results are discussed in terms of an impaired ability of women with BED to show adequate physiological responses to body-related stress. In addition, methodological recommendations for future research are presented.

Vocal arousal: a physiological correlate of body distress in women with overweight and obesity.

Numerous studies highlight the relevance of body image in the development and maintenance of overweight and obesity mostly using self-reported data. Given the importance of physiological assessment methods, the present study aimed at investigating vocally encoded emotional arousal as a correlate of body distress in women with overweight and obesity. Cognitions of women with overweight and obesity (OW; n = 22) as well as normal weight controls (NW; n = 22) were assessed by means of a thought-sampling procedure during a mirror exposure and a control condition. Fundamental frequency (f0) as a marker of vocally encoded emotional arousal as well as verbalized body-related cognitions were analyzed during this experimental task. A stronger increase in f0 between the control and the mirror exposure condition was found in OW compared to NW. Furthermore, there were significant positive correlations between vocally encoded emotional arousal and various measures of body image. The findings support the utility of vocally encoded emotional arousal as an objective physiological correlate of the evaluative dimension of body image in women with overweight and obesity. Level I, experimental study.

Modifying the implicit illness-related self-concept in patients with somatoform disorders may reduce somatic symptoms.

According to dual process theories, not only do explicit but also implicit cognitive processes play a major role in the development and maintenance of somatoform disorders(SFDs). Recent evidence [1] suggests that patients with SFD shave a stronger implicit illness-related self-concept, which is related to the experience of medically unexplained symptoms. The current study was designed to investigate a possible causal link between biased implicit associations and symptoms in SFD patients by experimentally modifying the implicit illness-related self-concept. Twenty-nine patients with SFDs (according to the DSM-IV) initially completed an Implicit Association Test(IAT) for assessing the implicit illness-related self-concept.Two weeks later, they underwent an evaluative conditioning task to modify the implicit self-concept. After this procedure, a change toward a healthier implicit self-concept was apparent in the follow-up IAT. A reduction in symptom severity and changes in health- and body-related cognitions were observed 13 days after the training in the follow-up questionnaires. The findings suggest that a biased implicit self-concept may be causally relevant for symptom experiences inpatients with SFDs. Existing cognitive behavioral treatments for SFDs might benefit from targeting implicit cognitive processes more directly.

Body-related cognitions, affect and post-event processing in body dysmorphic disorder

Background and objectivesCognitive behavioural models postulate that individuals with BDD engage in negative appearance-related appraisals and affect. External representations of one's appearance are thought to activate a specific mode of processing characterized by increased self-focused attention and an activation of negative appraisals and affect. MethodsThe present study used a think-aloud approach including an in vivo body exposure to examine body-related cognitions and affect in individuals with BDD (n = 30), as compared to individuals with major depression (n = 30) and healthy controls (n = 30). Participants were instructed to think aloud during baseline, exposure and follow-up trials. ResultsIndividuals with BDD verbalized more body-related and more negative body-related cognitions during all trials and reported higher degrees of negative affect than both control groups. A weaker increase of positive body-related cognitions during exposure, a stronger increase of sadness and anger after exposure and higher levels of post-event processing, were specific processes in individuals with BDD. LimitationsIndividuals with major depression were not excluded from the BDD group. This is associated with a reduction of internal validity, as the two clinical groups are somewhat interwoven. Key findings need to be replicated. ConclusionThe findings indicate that outcomes such as negative appearance-related cognitions and affect are specific to individuals with BDD. An external representation of one's appearance activates a specific mode of processing in BDD, manifesting itself in the absence of positive body-related cognitions, increased anger and sadness, and high levels of post-event processing. These specific processes may contribute toward maintenance of BDD psychopathology.

Peer status and victimization as possible reinforcements of adolescent girls' and boys' weight-related behaviors and cognitions.

Reciprocal longitudinal associations among weight-related behaviors and cognitions and peer relations constructs were examined among adolescent males and females. Participants included 576 adolescents aged 10-14 years, in grades 6-8. Measures assessed body dissatisfaction, negative weight-related cognitions, weight management behaviors, muscle-gaining behaviors, body mass index (BMI), likeability, popularity, and victimization at two time points, approximately 11 months apart. Multiple group path analyses were conducted to examine the reciprocal longitudinal associations between the peer relations constructs and weight-related behaviors and cognitions, controlling for participants' Time 1 BMI, pubertal development, and age. Higher levels of body dissatisfaction were associated longitudinally with decreases in popularity. Higher popularity and lower likeability each were associated longitudinally with increases in negative body-related cognitions. Higher popularity was associated longitudinally with muscle-gaining behaviors for boys. Findings suggest highly popular and disliked adolescents may be at greater risk of weight-related behaviors and cognitions than other adolescents.

Evidence for Overlap Between Idiopathic Environmental Intolerance and Somatoform Disorders

Idiopathic environmental intolerance (IEI), also known as multiple chemical sensitivity, is a chronic, polysymptomatic condition that cannot be explained by an organic disease. Physical and psychological complaints are believed to be sustained by low levels of chemically unrelated substances in the environment. At present, it is unclear whether IEI is an environmental illness or a variant of somatoform disorders (SFD). This study examined whether IEI can be distinguished from SFD with respect to self-reported symptoms, trait anxiety, body-related cognitions, and symptom attributions. We compared 54 subjects with IEI, 54 subjects with SFD but without IEI, and 44 subjects with neither IEI nor SFD on symptom scales, psychological questionnaires, and structured interviews for IEI, depression, anxiety, and SFD. More than half of the IEI subjects met Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria of SFD. This group shared both symptoms and psychological features of somatization with the SFD group. IEI subjects who did not fulfill criteria for a specific SFD were less impaired by their chemical sensitivity but differed nevertheless from nonsomatoform controls by significantly higher symptom scores, higher trait anxiety, a focus on autonomic sensations, and more pronounced somatic symptom attributions. These psychological features were significantly associated with the burden of somatic symptoms in both SFD and IEI. Furthermore, self-reported allergy but not total immunoglobulin E correlated with symptom burden in the total sample. The similarity of IEI and SFD regarding symptoms and psychological features of somatization support the hypothesis that IEI is a variant of SFD.

Body–Related Cognitions in Binge–Eating Disorder and Bulimia Nervosa

Abstract The aim of the present study was to investigate cognitive aspects of body image disturbance in binge–eating disorder and bulimia nervosa. In a sample of female volunteers, 30 women diagnosed with binge–eating disorder, 30 women with bulimia nervosa (DSM–IV), and 30 non–eating–disordered women were exposed to their physical appearance using a mirror exposure technique. Compared with the control group, both eating disorder groups reported more body–related negative cognitions. Furthermore, in the eating disorder groups, negative body–related cognitions occurred more frequently than positive or neutral cognitions. For women with bulimia nervosa, but not for women with binge–eating disorder, body–related cognitions were more present and showed a stronger negative reactivity than for non–eating–disordered women. In summary, results indicate a similar cognitive body image disturbance in bulimia nervosa and in binge–eating disorder. Results are discussed regarding the DSM–IV diagnostic criteria and mode...