Zusammenfassung
Hintergrund
Körperbezogene Sorgen sind ein hochprävalentes Phänomen mit Relevanz für verschiedene psychische Störungen, wie die körperdysmorphe Störung oder Essstörungen. Die Ätiologie körperbezogener Sorgen wird u. a. durch verzerrte Informationsverarbeitungsprozesse erklärt. Während bereits Evidenz für einige kognitive Verzerrungen bei körperbezogenen Sorgen besteht, wurden Befunde zur Aufmerksamkeitsverzerrung („attention bias“) für sozial-bedrohliche Reize bei körperbezogenen Sorgen bislang nicht systematisch zusammengefasst.
Ziel der Arbeit
Die vorliegende Arbeit stellt eine Übersicht der Befundlage experimenteller Studien zum Attention bias für sozial-bedrohliche Reize bei körperbezogenen Sorgen dar und diskutiert mögliche Einflussfaktoren.
Material und Methoden
Die Ergebniszusammenstellung erfolgt auf Basis eines systematischen Reviews. Neben der Befundlage werden Charakteristika der Stichproben sowie der experimentellen Paradigmen extrahiert und diskutiert.
Ergebnisse
Die Analyse der 15 identifizierten Studien ergibt eine ambivalente Befundlage, mit einer Tendenz zum Vorliegen eines Attention bias hin zu sozial-bedrohlichen Reizen. Die genaue Betrachtung zeigt bei weiblichen, klinischen Stichproben und bei Verwendung von Gesichtern als Stimulusmaterial eine stärkere Evidenz.
Schlussfolgerung
Die Befunde liefern Hinweise auf das Vorliegen eines Attention bias für sozial-bedrohliche Reize bei Frauen mit klinischen körperbezogenen Sorgen. Eine Ursache könnte in erhöhten sozialen Ängsten in dieser Gruppe liegen. Möglicherweise kann der Einsatz der Attention-bias-Modifikation in der Therapie von Störungen mit körperbezogenen Sorgen sinnvoll sein. Zukünftige Studien sollten die Rolle des Attention bias in der Ätiologie dieser Störungsbilder prüfen.
Abstract
Background
Body-related concerns are highly prevalent phenomena that are relevant for various mental disorders, such as body dysmorphic disorder and eating disorders. The etiology of body-related concerns is partly explained by distorted information processing. While there is evidence for some types of cognitive biases with respect to body-related concerns, findings on a potential attention bias for socially threatening stimuli have not yet been systematically reviewed.
Objective
The present study reviewed the findings from experimental research on attention bias for socially threatening stimuli with body-related concerns and discusses possible influencing factors.
Material and methods
A systematic review of the literature was conducted integrating the empirical findings of relevant studies. Besides extracting results on a possible attention bias, sample characteristics and experimental paradigms were assessed to evaluate their potential influences.
Results
The 15 identified studies showed mixed evidence with a tendency towards the presence of attention bias towards socially threatening stimuli. A more detailed consideration showed that the evidence is stronger for female clinical samples and for studies that applied threatening faces as experimental stimuli.
Conclusion
The results of this review point towards a potential attention bias for socially threatening stimuli in women with clinically relevant body-related concerns. A cause could lie in heightened social anxiety in this group. Interventions for attention bias modification might constitute promising adjuncts in the treatment of disorders with body-related concerns. Future studies should therefore evaluate the role of this bias in the etiology of these mental disorders.
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Notes
Suchalgorithmus PubMed: ((„Body Image“[MeSH] OR „Body Dysmorphic Disorders“[MeSH] OR body image OR eating disorders OR body dissatisfaction OR body dysmorphic disorder OR body dysmorphia) AND (attention bias OR attentional bias OR biased attention OR selective attention OR threat bias OR „Attentional Bias“[MeSH]) AND Humans[MeSH]). Suchalgorithmus PsycINFO und Psyndex: ((body image OR eating disorders OR body dissatisfaction OR body dysmorphic disorder OR body dysmorphia) AND (attention bias OR attentional bias OR biased attention OR selective attention OR threat bias)).
Literatur
Amir N, Elias J, Klumpp H, Przeworski A (2003) Attentional bias to threat in social phobia: facilitated processing of threat or difficulty disengaging attention from threat? Behav Res Ther 41:1325–1335
Bar-Haim Y, Lamy D, Pergamin L, Bakermans-Kranenburg MJ, Van Ijzendoorn MH (2007) Threat-related attentional bias in anxious and nonanxious individuals: a meta-analytic study. Psychol Bull 133:1–24
Beard C, Sawyer AT, Hofmann SG (2012) Efficacy of attention bias modification using threat and appetitive stimuli: a meta-analytic review. Behav Ther 43:724–740
Berenson KR, Gyurak A, Ayduk Ö, Downey G, Garner MJ et al (2009) Rejection sensitivity and disruption of attention by social threat cues. J Res Personal 43:1064–1072
Van den Berg PA, Mond J, Eisenberg M, Ackard D, Neumark-Sztainer D (2010) The link between body dissatisfaction and self-esteem in adolescents: Similarities across gender, age, weight status, race/ethnicity, and socioeconomic status. J Adolesc Health 47:290–296
Cardi V, Di Matteo R, Corfield F, Treasure J (2013) Social reward and rejection sensitivity in eating disorders: An investigation of attentional bias and early experiences. World J Biol Psychiatry 14:622–633 (Studie ging in den Review ein)
Cardi V, Esposito M, Bird G, Rhind C, Yiend J, Schifano S et al (2015) A preliminary investigation of a novel training to target cognitive biases towards negative social stimuli in Anorexia Nervosa. J Affect Disord 188:188–193 (Studie ging in den Review ein)
Cash TF, Thériault J, Annis NM (2004) Body image in an interpersonal context: adult attachment, fear of intimacy and social anxiety. J Soc Clin Psychol 23:89–103
Cisler JM, Koster EH (2010) Mechanisms of attentional biases towards threat in anxiety disorders: an integrative review. Clin Psychol Rev 30:203–216
Cohen R, Irwin L, Newton-John, Slater A (2019) #bodypositivity: A content analysis of body positive accounts on Instagram. Body Image 29:47–57
Cserjési R, Vermeulen N, Lénárd L, Luminet O (2011) Reduced capacity in automatic processing of facial expression in restrictive anorexia nervosa and obesity. Psychiatry Res 188:253–257 (Studie ging in den Review ein)
DeWall CN, Bushman BJ (2011) Social acceptance and rejection: the sweet and the bitter. Curr Dir Psychol Sci 20:256–260
Ehrlich KB, Gerson SA, Vanderwert RE, Cannon EN, Fox NA (2015) Hypervigilance to rejecting stimuli in rejection sensitive individuals: behavioral and neurocognitive evidence. Pers Individ Dif 85:7–12
Enock PM, Hofmann SG, McNally RJ (2014) Attention bias modification training via smartphone to reduce social anxiety: a randomized, controlled multi-session experiment. Cognit Ther Res 38:200–216
Falkai P, Wittchen HU (2015) Diagnostisches und Statistisches Manual Psychischer Störungen DSM‑5. Hogrefe, Göttingen.
Fang A, Hofmann SG (2010) Relationship between social anxiety disorder and body dysmorphic disorder. Clin Psychol Rev 30:1040–1048
Gilon Mann T, Hamdan S, Bar-Haim Y, Lazarov A, Enoch-Levy A et al (2018) Different attention bias patterns in anorexia nervosa restricting and binge/purge types. Eur Eat Disord Rev 26:293–301 (Studie ging in den Review ein)
Green MJ, Phillips ML (2004) Social threat perception and the evolution of paranoia. Neurosci Biobehav Rev 28:333–342
Griffiths S, Angus D, Murray SB, Touyz S (2014) Unique associations between young adult men’s emotional functioning and their body dissatisfaction and disordered eating. Body Image 11:175–178 (Studie ging in den Review ein)
Hakamata Y, Lissek S, Bar-Haim Y, Britton JC, Fox NA et al (2010) Attention bias modification treatment: a meta-analysis toward the establishment of novel treatment for anxiety. Biol Psychiatry 68:982–990
Harrison A, Tchanturia K, Treasure J (2010a) Attentional bias, emotion recognition, and emotion regulation in anorexia: State or trait? Biol Psychiatry 68(8):755–761. https://doi.org/10.1016/j.biopsych.2010.04.037 (Studie ging in den Review ein)
Harrison A, Sullivan S, Tchanturia K, Treasure J (2010b) Emotional functioning in eating disorders: attentional bias, emotion recognition and emotion regulation. Psychol Med 40(11):1887–1897. https://doi.org/10.1017/s0033291710000036 (Studie ging in den Review ein)
Izgiç F, Akyüz G, Doğan O, Kuğu N (2004) Social phobia among university students and its relation to self-esteem and body image. Can J Psychiatry 49:630–634
Kanakam N, Krug I, Raoult C, Collier D, Treasure J (2013) Social and emotional processing as a behavioural endophenotype in eating disorders: a pilot investigation in twins. Eur Eat Disord Rev 21:294–307 (Studie ging in den Review ein)
Levinson CA, Rodebaugh TL (2015) Negative social-evaluative fears produce social anxiety, food intake, and body dissatisfaction: evidence of similar mechanisms through different pathways. Clin Psychol Sci 3:744–757
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. https://doi.org/10.1371/journal.pmed.1000100
Maner JK, Holm-Denoma JM, Van Orden KA, Gailliot MT, Gordon KH, Joiner TE (2006) Evidence for attentional bias in women exhibiting bulimotypic symptoms. Int J Eat Disord 39:55–61 (Studie ging in den Review ein)
Manuel A, Wade TD (2013) Emotion regulation in broadly defined anorexia nervosa: association with negative affective memory bias. Behav Res Ther 51:417–424 (Studie ging in den Review ein)
Mogg K, Bradley BP (2016) Anxiety and attention to threat: cognitive mechanisms and treatment with attention bias modification. Behav Res Ther 87:76–108
Park LE, Calogero RM, Young AF, DiRaddo AM (2010) Appearance-based rejection sensitivity predicts body dysmorphic disorder symptoms and cosmetic surgery acceptance. J Soc Clin Psychol 29:489–509
Paxton SJ, Neumark-Sztainer D, Hannan PJ, Eisenberg ME (2006) Body dissatisfaction prospectively predicts depressive mood and low self-esteem in adolescent girls and boys. J Clin Child Adolesc Psychol 35:539–549
Pergamin-Hight L, Naim R, Bakermans-Kranenburg MJ, van IJzendoorn MH, Bar-Haim Y (2015) Content specificity of attention bias to threat in anxiety disorders: a meta-analysis. Clin Psych Rev 35:10–18
Richter A, Ridout N (2011) Self-esteem moderates affective reactions to briefly presented emotional faces. J Res Pers 45:328–331
Rodgers RF, DuBois RH (2016) Cognitive biases to appearance-related stimuli in body dissatisfaction: a systematic review. Clin Psychol Rev 46:1–11
Schieber K, Kollei I, de Zwaan M, Martin A (2018) The dysmorphic concern questionnaire in the German general population: psychometric properties and normative data. Aesthetic Plast Surg 42:1412–1420
Schmidt J, Martin A (2017) Du magst mich nicht, weil ich hässlich bin! Aussehensbezogene Zurückweisungssensitivität und Validierung der deutschsprachigen Appearance-based Rejection Sensitivity-Scale (ARS-D). Z Klin Psychol Psychother 46:157–168
Schneier FR, Kimeldorf MB, Choo TH, Steinglass JE, Wall MM et al (2016) Attention bias in adults with anorexia nervosa, obsessive-compulsive disorder, and social anxiety disorder. J Psychiatr Res 79:61–69 (Studie ging in den Review ein)
Schober I, Renwick B, De Jong H, Kenyon M, Sharpe H et al (2013) Threat-related attentional bias in anorexia nervosa. Int J Eat Disord 47:168–173 (Studie ging in den Review ein)
Sharpe E, Wallis DJ, Ridout N (2016) The influence of variations in eating disorder-related symptoms on processing of emotional faces in a non-clinical female sample: an eye-tracking study. Psychiatry Res 240:321–327 (Studie ging in den Review ein)
Swinbourne JM, Touyz SW (2007) The comorbidity of eating disorders and anxiety disorders: a review. Eur Eat Disord Rev 15:253–274
Tiggemann M (2004) Body image across the adult life span: stability and change. Body Image 1:29–41
Toh WL, Castle DJ, Rossell SL (2017) Attentional biases in body dysmorphic disorder (BDD): eye-tracking using the emotional Stroop task. Compr Psychiatry 74:151–161 (Studie ging in den Review ein)
Veale D (2004) Advances in a cognitive behavioural model of body dysmorphic disorder. Body Image 1:113–125
Williamson DA, White MA, York-Crowe E, Stewart TM (2004) Cognitive-behavioral theories of eating disorders. Behav Mod 28:711–738
Wilson C, Wallis DJ (2013) Attentional bias and slowed disengagement from food and threat stimuli in restrained eaters using a modified Stroop task. Cognit Ther Res 37:127–138 (Studie ging in den Review ein)
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L. Wambach und J. Schmidt geben an, dass kein Interessenkonflikt besteht.
Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
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Wambach, L., Schmidt, J. „Attention bias“ für sozial-bedrohliche Reize bei körperbezogenen Sorgen. Psychotherapeut 65, 71–78 (2020). https://doi.org/10.1007/s00278-020-00406-0
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DOI: https://doi.org/10.1007/s00278-020-00406-0