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Atypical Self-Focus Effect on Interoceptive Accuracy in Anorexia Nervosa

View Article: PubMed Central - PubMed

ABSTRACT

Background: : Interoceptive abilities are known to be affected in anorexia nervosa (AN). Previous studies could show that private self-focus can enhance interoceptive accuracy (IAcc) in healthy participants. As body dissatisfaction is high in AN, confrontation with bodily features such as the own face might have a directly opposed effect in AN. Whether patients with AN can benefit from self-focus in their IAcc and whether this pattern changes over the time-course of cognitive behavioral therapy was investigated in this study.

Methods: : Fifteen patients with AN from the Psychosomatic Clinic in Windach were assessed three times in the time course of a standardized cognitive-behavioral therapy. They were compared to 15 controls, recruited from Ulm University and tested in a comparable setting. Both groups performed the heartbeat perception task assessing IAcc under two conditions either enhancing (“Self”) or decreasing (“Other”) self-focused attention. Furthermore, body dissatisfaction was assessed by a subscale of the Eating Disorder (ED) Inventory 2.

Results: : Patients with AN scored higher in IAcc when watching others’ faces as compared to one’s own face while performing the heartbeat perception task. The opposite pattern was observed in controls. IAcc remained reduced in AN as compared to controls in the time-course of cognitive-behavioral therapy, while body-dissatisfaction improved in AN. High body dissatisfaction was related to poorer IAcc in the “Self” condition.

Conclusions: : Our findings suggest that using self-focused attention reduces IAcc in AN while the opposite pattern was observed in controls. Confronting anorexic patients with bodily features might increase body-related avoidance and therefore decrease IAcc. The current study introduces a new perspective concerning the role of interoceptive processes in AN and generates further questions regarding the therapeutic utility of methods targeting self-focus in the treatment of AN.

No MeSH data available.


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Distribution of IAcc (condition “Self”) and body dissatisfaction contrasting controls and anorexics at T1.
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Figure 2: Distribution of IAcc (condition “Self”) and body dissatisfaction contrasting controls and anorexics at T1.

Mentions: In a last step we correlated IAcc during “self” and “other” with mean body dissatisfaction score obtained from questionnaire (N = 30, total sample). Due to multiple comparisons, we corrected the alpha error accordingly (p values smaller 0.008 are considered significant). We observed significant inverse correlations between IAcc during “Self” condition and body dissatisfaction at T1 (r = −0.49, p = 0.006) and T2 (r = −0.53; p = 0.002), while all other correlation coefficients were also inverse, but substantially smaller and did not reach significance (“Self” at T3: r = −0.33, p = 0.07; “Other” at T1: r = −0.37, p = 0.04; T2: r = −0.33, p = 0.07; T3: r = −0.35, p = 0.06). To compare the distribution between both groups, we plotted the scatter plots between IAcc during the condition “Self” at T1 contrasting anorexics and controls (see Figure 2).


Atypical Self-Focus Effect on Interoceptive Accuracy in Anorexia Nervosa
Distribution of IAcc (condition “Self”) and body dissatisfaction contrasting controls and anorexics at T1.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037175&req=5

Figure 2: Distribution of IAcc (condition “Self”) and body dissatisfaction contrasting controls and anorexics at T1.
Mentions: In a last step we correlated IAcc during “self” and “other” with mean body dissatisfaction score obtained from questionnaire (N = 30, total sample). Due to multiple comparisons, we corrected the alpha error accordingly (p values smaller 0.008 are considered significant). We observed significant inverse correlations between IAcc during “Self” condition and body dissatisfaction at T1 (r = −0.49, p = 0.006) and T2 (r = −0.53; p = 0.002), while all other correlation coefficients were also inverse, but substantially smaller and did not reach significance (“Self” at T3: r = −0.33, p = 0.07; “Other” at T1: r = −0.37, p = 0.04; T2: r = −0.33, p = 0.07; T3: r = −0.35, p = 0.06). To compare the distribution between both groups, we plotted the scatter plots between IAcc during the condition “Self” at T1 contrasting anorexics and controls (see Figure 2).

View Article: PubMed Central - PubMed

ABSTRACT

Background: : Interoceptive abilities are known to be affected in anorexia nervosa (AN). Previous studies could show that private self-focus can enhance interoceptive accuracy (IAcc) in healthy participants. As body dissatisfaction is high in AN, confrontation with bodily features such as the own face might have a directly opposed effect in AN. Whether patients with AN can benefit from self-focus in their IAcc and whether this pattern changes over the time-course of cognitive behavioral therapy was investigated in this study.

Methods: : Fifteen patients with AN from the Psychosomatic Clinic in Windach were assessed three times in the time course of a standardized cognitive-behavioral therapy. They were compared to 15 controls, recruited from Ulm University and tested in a comparable setting. Both groups performed the heartbeat perception task assessing IAcc under two conditions either enhancing (“Self”) or decreasing (“Other”) self-focused attention. Furthermore, body dissatisfaction was assessed by a subscale of the Eating Disorder (ED) Inventory 2.

Results: : Patients with AN scored higher in IAcc when watching others’ faces as compared to one’s own face while performing the heartbeat perception task. The opposite pattern was observed in controls. IAcc remained reduced in AN as compared to controls in the time-course of cognitive-behavioral therapy, while body-dissatisfaction improved in AN. High body dissatisfaction was related to poorer IAcc in the “Self” condition.

Conclusions: : Our findings suggest that using self-focused attention reduces IAcc in AN while the opposite pattern was observed in controls. Confronting anorexic patients with bodily features might increase body-related avoidance and therefore decrease IAcc. The current study introduces a new perspective concerning the role of interoceptive processes in AN and generates further questions regarding the therapeutic utility of methods targeting self-focus in the treatment of AN.

No MeSH data available.


Related in: MedlinePlus