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      • Record: found
      • Abstract: found
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      How certainty appraisal might improve both body dissatisfaction and body overestimation in anorexia nervosa: a case report

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          Abstract

          Background

          Patients with anorexia nervosa often report a conscious alteration of body image representation, with both body overestimation and body dissatisfaction. Cognitive and behavioural therapy is effective for treating many psychiatric disorders but often fails to treat anorexia nervosa and body image distortions. Although patients are aware of their weight loss, they continue to feel overweight - as if there were a conflict between a previous (maybe already false) body representation and the new one. These distortions are linked to negative emotions focused on the body but which can extend to the self (e.g. disgust and sadness).

          Case Presentation

          The present case report is the first in which the Appraisal Tendency Framework has been applied to decrease body image distortions in a patient with anorexia nervosa. The Appraisal Tendency Framework is usually used to understand how emotions influence decision making. Here, we report on a 24-year-old woman who suffered from anorexia nervosa and body image distortions, and was treated as an inpatient with conventional cognitive and behavioural therapy for an eating disorder. Body image distortions were assessed before and after the patient completed an adaptation of the Iowa Gambling Task, coupled with the induction of a heuristic processing emotion. We hypothesized that allowing the patient to focus on the emotional cues in the modified Iowa Gambling Task would improve her decisions about her true body shape.

          Conclusion

          All body image measures were improved after the protocol. Consequently, we suggest that the Appraisal Tendency Framework might be a valuable means of investigating body image issues in eating disorders and anorexia nervosa. Further studies are required to expand and detail these findings.

          Electronic supplementary material

          The online version of this article (10.1186/s40337-018-0216-0) contains supplementary material, which is available to authorized users.

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          Most cited references19

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          Deciding advantageously before knowing the advantageous strategy.

          A Bechara, H. Damasio, D. Tranel … (1997)
          Deciding advantageously in a complex situation is thought to require overt reasoning on declarative knowledge, namely, on facts pertaining to premises, options for action, and outcomes of actions that embody the pertinent previous experience. An alternative possibility was investigated: that overt reasoning is preceded by a nonconscious biasing step that uses neural systems other than those that support declarative knowledge. Normal participants and patients with prefrontal damage and decision-making defects performed a gambling task in which behavioral, psychophysiological, and self-account measures were obtained in parallel. Normals began to choose advantageously before they realized which strategy worked best, whereas prefrontal patients continued to choose disadvantageously even after they knew the correct strategy. Moreover, normals began to generate anticipatory skin conductance responses (SCRs) whenever they pondered a choice that turned out to be risky, before they knew explicitly that it was a risky choice, whereas patients never developed anticipatory SCRs, although some eventually realized which choices were risky. The results suggest that, in normal individuals, nonconscious biases guide behavior before conscious knowledge does. Without the help of such biases, overt knowledge may be insufficient to ensure advantageous behavior.
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            Judgment under emotional certainty and uncertainty: the effects of specific emotions on information processing.

            Larissa Tiedens, Susan Linton (2001)
            The authors argued that emotions characterized by certainty appraisals promote heuristic processing, whereas emotions characterized by uncertainty appraisals result in systematic processing. The 1st experiment demonstrated that the certainty associated with an emotion affects the certainty experienced in subsequent situations. The next 3 experiments investigated effects on processing of emotions associated with certainty and uncertainty. Compared with emotions associated with uncertainty, emotions associated with certainty resulted in greater reliance on the expertise of a source of a persuasive message in Experiment 2, more stereotyping in Experiment 3, and less attention to argument quality in Experiment 4. In contrast to previous theories linking valence and processing, these findings suggest that the certainty appraisal content of emotions is also important in determining whether people engage in systematic or heuristic processing.
            Article 0 comments Cited 259 times – based on 0 reviews     Review now
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              Assessing the effectiveness of a large database of emotion-eliciting films: A new tool for emotion researchers

              Alexandre Schaefer, Frédéric Nils, Xavier Madrigal-Sánchez … (2010)
              Article 0 comments Cited 184 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                M. Metral: morgane.metral@univ-smb.fr
                M. Mailliez: +33-479-758-390 , melody.mailliez@univ-smb.fr
                Journal
                Journal ID (nlm-ta): J Eat Disord
                Journal ID (iso-abbrev): J Eat Disord
                Title: Journal of Eating Disorders
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2050-2974
                Publication date (Electronic): 5 October 2018
                Publication date PMC-release: 5 October 2018
                Publication date Collection: 2018
                Volume: 6
                Electronic Location Identifier: 29
                Affiliations
                [1 ]University Grenoble Alpes, University Savoie Mont Blanc, LIP/PC2S, F-38000 Grenoble, France
                [2 ]ISNI 0000 0004 0410 8799, GRID grid.462771.1, University Grenoble Alpes, , University Savoie Mont Blanc, CNRS, LPNC, ; F-38000 Grenoble, France
                Article
                Publisher ID: 216
                DOI: 10.1186/s40337-018-0216-0
                PMC ID: 6172742
                SO-VID: 6c1424d5-f7b6-46fd-8cdd-1d33d5d7f942
                Copyright © © The Author(s). 2018
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 4 May 2018
                Date accepted : 5 September 2018
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © The Author(s) 2018

                Keywords: anorexia nervosa,body overestimation,body dissatisfaction,appraisal tendency framework,cognitive appraisal of (un)certainty
                Data availability:
                Keywords: anorexia nervosa, body overestimation, body dissatisfaction, appraisal tendency framework, cognitive appraisal of (un)certainty

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