Eva Naumann

General and food-specific inhibitory deficits in binge eating disorder

OBJECTIVE To investigate behavioral inhibition in individuals with binge eating disorder (BED) compared with overweight and obese individuals without BED (No-BED). METHOD Participants with BED (n = 31) and the weight-matched No-BED group (n = 29) completed an inhibitory control task (stop-signal task, SST) with food and neutral stimuli. RESULTS The BED group needed more time to stop an ongoing response, as indicated by increased stop signal reaction time (SSRT) relative to the No-BED group. Additionally, compared with the No-BED group, the BED group displayed more difficulty inhibiting responses elicited by food stimuli. The deficits in behavioral response inhibition were also found to be related to the severity of reported symptoms. DISCUSSION There is a general deficit in late stage behavioral inhibition in BED, and this may be particularly pronounced in the context of food stimuli.

Emotion regulation strategies in depressive and anxiety symptoms in youth: a meta-analytic review

The role of emotion regulation in subclinical symptoms of mental disorders in adolescence is not yet well understood. This meta-analytic review examines the relationship between the habitual use of prominent adaptive emotion regulation strategies (cognitive reappraisal, problem solving, and acceptance) and maladaptive emotion regulation strategies (avoidance, suppression, and rumination) with depressive and anxiety symptoms in adolescence. Analyzing 68 effect sizes from 35 studies, we calculated overall outcomes across depressive and anxiety symptoms as well as psychopathology-specific outcomes. Age was examined as a continuous moderator via meta-regression models. The results from random effects analyses revealed that the habitual use of all emotion regulation strategies was significantly related to depressive and anxiety symptoms overall, with the adaptive emotion regulation strategies showing negative associations (i.e., less symptoms) with depressive and anxiety symptoms whereas the maladaptive emotion regulation strategies showed positive associations (i.e., more symptoms). A less frequent use of adaptive and a more frequent use of maladaptive emotion regulation strategies were associated with depressive and anxiety symptoms comparably in the respective directions. Regarding the psychopathology-specific outcomes, depressive and anxiety symptoms displayed similar patterns across emotion regulation strategies showing the strongest negative associations with acceptance, and strongest positive associations with avoidance and rumination. The findings underscore the relevance of adaptive and also maladaptive emotion regulation strategies in depressive and anxiety symptoms in youth, and highlight the need to further investigate the patterns of emotion regulation as a potential transdiagnostic factor.

Attentional bias for food cues in binge eating disorder

The aim of the present study was to investigate an attentional bias toward food stimuli in binge eating disorder (BED). To this end, a BED and a weight-matched control group (CG) completed a clarification task and a spatial cueing paradigm. The clarification task revealed that food stimuli were faster detected than neutral stimuli, and that this difference was more pronounced in BED than in the CG. The spatial cueing paradigm indicated a stimulus engagement effect in the BED group but not in the CG, suggesting that an early locus in stimulus processing contributes to differences between BED patients and obese controls. Both groups experienced difficulty disengaging attention from food stimuli, and this effect was only descriptively larger in the BED group. The effects obtained in both paradigms were found to be correlated with reported severity of BED symptoms. Of note, this relationship was partially mediated by the arousal associated with food stimuli relative to neutral stimuli, as predicted by an account on incentive sensitization.

Rumination but not distraction increases eating-related symptoms in anorexia and bulimia nervosa.

Recent models of eating disorders emphasize the importance of ruminative thinking in the occurrence of unhealthy eating behavior. Hence, the aim of the current study was to examine the influence of induced rumination and distraction on the desire to engage in eating-related symptoms in anorexia (AN) and bulimia nervosa (BN). After a sadness induction, either a ruminative or distractive emotion regulation style was encouraged in women with AN (n = 38), BN (n = 37), and non-eating disordered controls (CG; n = 36). At baseline and after the emotion regulation induction feelings of sadness, desire to abstain from eating (DTA) and desire to binge (DTB) were assessed. Main results reveal that rumination led to a significant increase of DTA in the AN group and of DTB in patients with BN. In the CG, DTA significantly decreased after distraction. Although there were significant increases in subjective sadness in the rumination condition, no changes were found in the distraction condition. The results suggest that rumination in response to sadness has a detrimental effect on eating-related symptoms in eating disorders.

Differential caloric intake in overweight females with and without binge eating: effects of a laboratory-based emotion-regulation training.

Negative emotions are among the best predictors for the occurrence of binge eating attacks in binge eating disorder (BED). Evidence from self-report and experimental studies suggests that this link may be mediated by deficits in emotion regulation (ER). Therefore, the aim of the present study was to experimentally test the effects of a short laboratory-based ER training on caloric intake in BED. Thirty-nine women with BED and 42 overweight females without BED were randomly assigned to a laboratory-based ER training focusing on either expressive suppression or cognitive reappraisal. They were then given a negative mood induction with the instruction to adopt the learned ER strategy, which was followed by a bogus taste-test. Independent of group membership, caloric intake was significantly higher in the suppression compared to the reappraisal condition. Furthermore, the BED group displayed significantly higher habitual suppression and significantly lower habitual reappraisal scores than the overweight group. The data suggest that therapeutic interventions focusing on the mediation of more adaptive affect-regulation skills may be useful for the reduction of binge eating episodes.

The effects of emotion regulation on the desire to overeat in restrained eaters

The aim of the present study was to test whether emotion regulation (ER) strategies are underlying processes in the link between negative emotions and the desire to overeat (DTE) in high restrained eaters (HR). Forty-eight female HR and 46 female low restrained eaters (LR) watched three sadness inducing film clips. Thereby, participants were randomly assigned to and trained in one of three conditions while watching the first two clips: to suppress upcoming emotions, to accept upcoming emotions or to reappraise the situation. After that, they participated in an experiment in which the learned ER strategy was implemented while watching the third sadness inducing film clip. DTE and sadness were assessed prior to and at the end of each clip. Additionally, physiological measures of the sympathetic and parasympathetic branch were obtained. In the HR group emotion acceptance and suppression lead to a significant increase of the DTE from baseline to post-film, while there was no change in DTE in the reappraisal condition. However, psychophysiological measures were not moderated by ER strategies. The results are discussed in terms of the limited resource model.

Cognitive interference and a food-related memory bias in binge eating disorder.

The present study was concerned with cognitive interference and a specific memory bias for eating-related stimuli in binge eating disorder (BED). Further objectives were to find out under which circumstances such effects would occur, and whether they are related with each other and with reported severity of BED symptoms. A group of women diagnosed with BED and a matched sample of overweight controls completed two paradigms, an n-back task with lures and a recent-probes task. The BED group generally experienced more interference in the n-back task. Additionally, they revealed selectively increased interference for food items in the recent-probes task. Findings can be reconciled with the view that control functions are generally impaired in BED, and that there is an additional bias for eating-related stimuli, both of which were related with reported severity of BED symptoms.

Impaired Early-Response Inhibition in Overweight Females with and without Binge Eating Disorder

Objective Several studies report increased reward sensitivity towards food in overweight individuals. By contrast, data is inconclusive with respect to response inhibition in overweight individuals without binge eating disorder (BED). Hence, the latter was addressed in the present study in a group of overweight/obese females with and without BED and a normal-weight control group without eating disorders. Method A group of women with BED (n = 29), a group of overweight women without BED (n = 33) and normal-weight females (n = 30) participated in a pictorial priming paradigm, with food items (relevant primes) and office utensils (neutral primes) and color blobs (neutral primes) as stimuli. Increased response priming effects (i.e. priming with switches between stimulus categories) were taken as indicators of deficient behavioral inhibition. Results Priming effects for neutral primes were moderate and comparable across all groups. However, primes associated with the food task set lead to increased priming effects in both overweight groups. But, effects were comparable for overweight/obese participants with and without BED. Discussion Results suggest that early response inhibition in the context of food is impaired in overweight individuals compared to normal-weight individuals.

Effects of rumination and acceptance on body dissatisfaction in binge eating disorder.

Overvaluation of shape and weight and the corresponding body dissatisfaction are a maintenance factor for the psychopathology of binge eating disorder (BED). Evidence suggests potential benefits of various emotion regulation (ER) strategies in the modification of body dissatisfaction. Therefore, in the present study body dissatisfaction was experimentally induced in women with BED (n=30) using model pictures. Then, participants were instructed to either ruminate on present emotions and thoughts or accept whatever thoughts and feelings come up. Body dissatisfaction and mood were assessed prior to, immediately after and 4 minutes after the induction. Main results reveal that ER strategies had no differential impact on body dissatisfaction. However, in the rumination condition mood significantly worsened over time. Overall, the results suggest that ER strategies have a limited impact on the experience of body dissatisfaction in BED. However, having an impact on mood, they may be important with regard to the maintenance of pathological eating behaviour in BED. Association.

Startling Sweet Temptations: Hedonic Chocolate Deprivation Modulates Experience, Eating Behavior, and Eyeblink Startle

Many individuals restrict their food intake to prevent weight gain. This restriction has both homeostatic and hedonic effects but their relative contribution is currently unclear. To isolate hedonic effects of food restriction, we exposed regular chocolate eaters to one week of chocolate deprivation but otherwise regular eating. Before and after this hedonic deprivation, participants viewed images of chocolate and images of high-calorie but non-chocolate containing foods, while experiential, behavioral and eyeblink startle responses were measured. Compared to satiety, hedonic deprivation triggered increased chocolate wanting, liking, and chocolate consumption but also feelings of frustration and startle potentiation during the intertrial intervals. Deprivation was further characterized by startle inhibition during both chocolate and food images relative to the intertrial intervals. Individuals who responded with frustration to the manipulation and those who scored high on a questionnaire of impulsivity showed more relative startle inhibition. The results reveal the profound effects of hedonic deprivation on experiential, behavioral and attentional/appetitive response systems and underscore the role of individual differences and state variables for startle modulation. Implications for dieting research and practice as well as for eating and weight disorders are discussed.