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Cue reactivity towards bodies in anorexia nervosa – common and differential effects in adolescents and adults

Published online by Cambridge University Press:  24 July 2017

S. Horndasch ,
O. Kratz ,
J. Van Doren ,
H. Graap ,
R. Kramer ,
G. H. Moll  and
H. Heinrich
S. Horndasch*
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
O. Kratz
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
J. Van Doren
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
H. Graap
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen-Nuremberg, Erlangen, Germany
R. Kramer
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
G. H. Moll
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
H. Heinrich
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany Heckscher Klinikum, Munich, Germany
*
*Address for correspondence: S. Horndasch, M.D., Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Schwabachanlage 6/10, 91054 Erlangen, Germany. (Email: stefanie.horndasch@uk-erlangen.de)
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Abstract

Background

Aberrant reward mechanisms with regard to slim body shapes are discussed in patients with anorexia nervosa (AN). The aim of the present study was to examine of cue reactivity toward body shapes in AN via the late positive potential (LPP), an event-related electroencephalography (EEG) component. By including adolescents and adults, aspects of development and chronification could be studied (2 × 2 design).

Methods

Thirty-two female AN patients (19 adolescents and 13 adults) and 37 control participants (16 adolescents and 21 adults) were included. Standardized photographic stimuli showing women's bodies in underwear from five body mass index (BMI) categories (extremely underweight to extremely overweight) were presented. During picture evaluation, EEG activity was recorded (10–20 system). The LPP was measured in two time windows characterized by different topographies (450–700 ms: posterior; 1000–1300 ms: central).

Results

Regarding the posterior component, LPP amplitudes were clearly reduced in adult but not in adolescent patients; for both time windows the LPP showed differential patterns over BMI categories for patients and controls. Regarding the central component, a highly significant linear decrease from extremely underweight to extremely overweight body shapes was revealed in patients and no significant modulation in control participants.

Conclusions

Adolescent and adult patients show increased sustained attention toward extremely underweight bodies. In chronically ill patients, this bias appears to be accompanied by generally reduced automatic attention. The LPP findings provide a differentiated picture of aberrant cue reactivity which could be interpreted as motivated attention toward body shapes in AN.

Keywords

Adolescentsanorexia nervosabodyevent-related potentialslate positive potential
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 3 , February 2018 , pp. 508 - 518
Copyright
Copyright © Cambridge University Press 2017 

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