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      Emotion recognition deficits in eating disorders are explained by co-occurring alexithymia

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          Abstract

          Previous research has yielded inconsistent findings regarding the ability of individuals with eating disorders (EDs) to recognize facial emotion, making the clinical features of this population hard to determine. This study tested the hypothesis that where observed, emotion recognition deficits exhibited by patients with EDs are due to alexithymia, a co-occurring condition also associated with emotion recognition difficulties. Ability to recognize facial emotion was investigated in a sample of individuals with EDs and varying degrees of co-occurring alexithymia, and an alexithymia-matched control group. Alexithymia, but not ED symptomology, was predictive of individuals' emotion recognition ability, inferred from tolerance to high-frequency visual noise. This relationship was specific to emotion recognition, as neither alexithymia nor ED symptomology was associated with ability to recognize facial identity. These findings suggest that emotion recognition difficulties exhibited by patients with ED are attributable to alexithymia, and may not be a feature of EDs per se.

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          Eating Disorder Examination Questionnaire (EDE-Q): norms for young adult women.

          J. Mond, P. Hay, B. Rodgers … (2006)
          In order to establish norms for the Eating Disorder Examination Questionnaire (EDE-Q) among young adult women, the questionnaire was administered to a large general population sample of women aged 18-42 yr in the Australian Capital Territory (ACT) region of Australia. Normative data were derived for EDE-Q subscales and for the occurrence of specific eating disorder behaviours, for each of five age bands (18-22, 23-27, 28-32, 33-37, 38-42 yr). Mean scores (SDs) for the Restraint, Eating Concern, Weight Concern and Shape Concern subscales for the total sample (n = 5,255) were, respectively, 1.30 (1.40), 0.76 (1.06), 1.79 (1.51) and 2.23 (1.65). The mean global score was 1.52 (1.25). The regular occurrence of objective and subjective overeating episodes was reported by 10.6% and 12.7% of participants, respectively. The regular use of self-induced vomiting, laxative misuse, and use of diuretics, was reported by 1.4%, 1.0%, and 0.3%, of participants, respectively, while 2.2% of participants reported regularly using diet pills. "Extreme dietary restraint" and "excessive exercise" were reported by 3.4% and 4.9% of participants, respectively. Both attitudinal and behavioural features of eating disorder psychopathology tended to decrease with increasing age. These data will inform researchers intending to use the EDE-Q in epidemiological studies.
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            Emotional functioning in eating disorders: attentional bias, emotion recognition and emotion regulation.

            A. Harrison, S. Sullivan, K Tchanturia … (2010)
            Interpersonal processes, anxiety and emotion regulation difficulties form a key part of conceptual models of eating disorders (EDs), such as anorexia nervosa (AN) and bulimia nervosa (BN), but the experimental findings to support this are limited. The Reading the Mind in the Eyes task, the Difficulties in Emotion Regulation Scale (DERS) and a computerized pictorial (angry and neutral faces) Stroop task were administered to 190 women [50 with AN, 50 with BN and 90 healthy controls (HCs)]. Those with an ED showed attentional biases to faces in general (medium effect), but specifically to angry faces over neutral faces (large effect) compared to HCs. The ED group also reported significantly higher emotion regulation difficulties (large effect) than HCs. There was a small difference between the ED and HC groups for the emotion recognition task (small-medium effect), particularly in the restricting AN (RAN) group. Depression and attentional bias to faces significantly predicted emotion regulation difficulties in a regression model. The data provide support for conceptualizations of EDs that emphasize the role of emotional functioning in the development and maintenance of EDs. Further research will concentrate on exploring whether these findings are state or trait features of EDs.
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              The socio-emotional processing stream in Anorexia Nervosa.

              A. Oldershaw, D Hambrook, D. Stahl … (2011)
              The significance of socio-emotional factors in development and maintenance of Anorexia Nervosa (AN) has been noted, but the literature is poorly integrated without clear models guiding research or treatment. This systematic review retrieved experimental studies of social-cognitive or affective processing in AN and categorised them using Ochsner's "Social-Emotional Processing Stream." Ochsner's "Processing Stream", based on healthy data, comprises five constructs: (1) acquisition of and (2) recognition and response to social-affective stimuli, (3) low-level and (4) high-level mental state inference and (5) context-sensitive emotion regulation. Thirty-seven experimental studies in Anorexia Nervosa were identified, mapping on to four of the five constructs (not Construct 3). A meta-analysis of nine affect recognition studies was conducted. AN patients demonstrated impairments in each of the four domains with preliminary reports that some difficulties are trait-like, and others ameliorate following recovery. Socio-emotional data was integrated with previous reports of neural abnormalities to generate an AN specific model of socio-emotional processing. Additional research is required for further definition and to translate experimental findings into clinical practice. Copyright © 2010 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): R Soc Open Sci
                Journal ID (iso-abbrev): R Soc Open Sci
                Journal ID (publisher-id): RSOS
                Journal ID (hwp): royopensci
                Title: Royal Society Open Science
                Publisher: The Royal Society Publishing
                ISSN (Electronic): 2054-5703
                Publication date Collection: January 2015
                Publication date (Electronic): 21 January 2015
                Publication date PMC-release: 21 January 2015
                Volume: 2
                Issue: 1
                Electronic Location Identifier: 140382
                Affiliations
                [1 ]MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London , London WC2R 2LS, UK
                [2 ]Section of Eating Disorders, Psychological Medicine, Institute of Psychiatry, King's College London , London WC2R 2LS, UK
                [3 ]Department of Psychology, City University London , London EC1R 0JD, UK
                [4 ]Institute of Cognitive Neuroscience, University College London , London WC1N 3AR, UK
                Author notes
                Author for correspondence: Rebecca Brewer e-mail: rebecca.1.brewer@ 123456kcl.ac.uk
                Article
                Publisher ID: rsos140382
                DOI: 10.1098/rsos.140382
                PMC ID: 4448790
                PubMed ID: 26064585
                SO-VID: b58b4d6d-3ba2-4352-bfa5-bc5e6cd33201
                Copyright © © 2015 The Authors.
                License:

                © 2015 The Authors. Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited.

                History
                Date received : 15 October 2014
                Date accepted : 20 December 2014
                Categories
                Subject: 1001
                Subject: 205
                Subject: 14
                Subject: 42
                Subject: Psychology and Cognitive Neuroscience
                Custom metadata
                cover-date January, 2015

                Keywords: alexithymia,facial expressions,emotions,face perception,eating disorders
                Data availability:
                Keywords: alexithymia, facial expressions, emotions, face perception, eating disorders

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