Abstract
Background
The present study examined the relative roles of approach and avoidance motivation in eating pathology using a multi-method approach combining self-report and physiological measures. The potential effect of internalized ideals and fears was also investigated.
Methods
Fifty-seven undergraduate women completed a picture-viewing task in which they viewed images of women’s bodies (thin and non-thin) and affective images. Self-report ratings of valence and arousal were measured along with physiological indicators of approach (postauricular reflex) and avoidance (startle blink reflex) motivation.
Results
Greater eating pathology was associated with more negative valence ratings of both thin and non-thin images. There was a significant interaction between valence ratings of non-thin bodies and fear of the unattractive self in relation to eating pathology, such that eating pathology was highest in those who rated non-thin images as more unpleasant and internalized fears of being/becoming unattractive. Thin-ideal internalization did not significantly interact with ratings of thin images to predict eating pathology. There were no significant findings when examining physiological data.
Conclusions
Results from self-report measures suggest that eating pathology is associated with avoidant reactions to both thin and non-thin bodies and highlight the importance of internalized appearance-related fears.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The dataset and syntax are publicly available via the Open Science Framework: https://osf.io/vkqnx/?view_only=4997fa4827b54899a04ca47dec34b237.
References
Aardema, F., Radomsky, A. S., Moulding, R., Wong, S. F., Bourguignon, L., & Giraldo-O’Meara, M. (2021). Development and validation of the multidimensional version of the fear of self questionnaire: Corrupted, culpable and malformed feared possible selves in obsessive-compulsive and body-dysmorphic symptoms. Clinical Psychology & Psychotherapy, 28, 1160–1180. https://doi.org/10.1002/cpp.2565.
Ahern, A. L., Bennett, K. M., & Hetherington, M. M. (2008). Internalization of the ultra-thin ideal: Positive implicit associations with underweight fashion models are associated with drive for thinness in young women. Eating Disorders, 16, 294–307. https://doi.org/10.1080/10640260802115852.
Anderson, L. M., Berg, H., Brown, T. A., Menzel, J., & Reilly, E. E. (2021). The role of disgust in eating disorders. Current Psychiatry Reports, 23, 1–12. https://doi.org/10.1007/s11920-020-01217-5.
Ata, R. N., & Thompson, J. K. (2010). Weight bias in the media: A review of recent research. Obesity Facts, 3, 41–46. https://doi.org/10.1159/000276547.
Benning, S. D., Patrick, C. J., & Lang, A. R. (2004). Emotional modulation of the post-auricular reflex. Psychophysiology, 41, 426–432. https://doi.org/10.1111/j.1469-8986.00160.x.
Berg, K. C., Peterson, C. B., Frazier, P., & Crow, S. J. (2012). Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: A systematic review of the literature. International Journal of Eating Disorders, 45, 428–438. https://doi.org/10.1002/eat.20931.
Blumenthal, T. D., Cuthbert, B. N., Filion, D. L., Hackley, S., Lipp, O. V., & Boxtel, A. V. (2005). Committee report: Guidelines for human startle eyeblink electromyographic studies. Psychophysiology, 42, 1–15. https://doi.org/10.1111/j.1469-8986.2005.00271.x.
Bradley, M. M., & Lang, P. J. (1994). Measuring emotion: The self-assessment manikin and the semantic differential. Journal of Behavior Therapy and Experimental Psychiatry, 25, 49–59. https://doi.org/10.1016/0005-7916(94)90063-9.
Brockmeyer, T., Burdenski, K., Anderle, A., Voges, M. M., Vocks, S., Schmidt, H., Wünsch-Leiteritz, W., Leiteritz, A., & Friederich, H. C. (2020). Approach and avoidance bias for thin-ideal and normal-weight body shapes in anorexia nervosa. European Eating Disorders Review, 28, 536–550. https://doi.org/10.1002/erv.2744.
Brown, Z., & Tiggemann, M. (2016). Attractive celebrity and peer images on Instagram: Effect on women’s mood and body image. Body Image, 19, 37–43. https://doi.org/10.1016/j.bodyim.2016.08.007.
Clarke, J., Ramoz, N., Fladung, A. K., & Gorwood, P. (2016). Higher reward value of starvation imagery in anorexia nervosa and association with the Val66Met BDNF polymorphism. Translational Psychiatry, 6(e829), 1–7. https://doi.org/10.1038/tp.2016.98.
Cserjési, R., Vermeulen, N., Luminet, O., Marechal, C., Nef, F., Simon, Y., & Lénárd, L. (2010). Explicit vs. implicit body image evaluation in restrictive anorexia nervosa. Psychiatry Research, 175, 148–153. https://doi.org/10.1016/j.psychres.2009.07.002.
Culbert, K. M., Racine, S. E., & Klump, K. L. (2015). Research Review: What we have learned about the causes of eating disorders - a synthesis of sociocultural, psychological, and biological research. Journal of Child Psychology and Psychiatry, 56, 1141–1164. https://doi.org/10.1111/jcpp.12441.
Dalley, S. E., & Buunk, A. P. (2009). Thinspiration vs. fear of fat. Using prototypes to predict frequent weight-loss dieting in females. Appetite, 52, 217–221. https://doi.org/10.1016/j.appet.2008.09.019.
Dodd, D. R., Velkoff, E. A., Forrest, L. N., Fussner, L. M., & Smith, A. (2017). Beauty in the eye of the beholder: Using facial electromyography to examine the association between eating disorder symptoms and perceptions of emaciation among undergraduate women. Body Image, 21, 47–56. https://doi.org/10.1016/j.bodyim.2017.02.002.
Dondzilo, L., Rieger, E., Jayawardena, N., & Bell, J. (2019). Drive for thinness versus fear of fat: Approach and avoidance motivation regarding thin and non-thin images in women. Cognitive Therapy and Research, 43, 585–593. https://doi.org/10.1007/s10608-018-9989-3.
Elliot, A. J. (2006). The hierarchical model of approach-avoidance motivation. Motivation and Emotion, 30, 111–116. https://doi.org/10.1007/s11031-006-9028-7.
Erdur, L., Weber, C., Zimmermann-Viehoff, F., Rose, M., & Deter, H. C. (2017). Affective responses in different stages of anorexia nervosa: Results from a startle-reflex paradigm. European Eating Disorders Review, 25, 114–122. https://doi.org/10.1002/erv.2502.
Fairburn, C., & Beglin, S. (1994). Assessment of eating disorders: Interview or self-report questionnaire? International Journal of Eating Disorders, 16, 363–370. https://doi.org/10.1002/1098-108X(199412)16:4%3C363::AID-EAT2260160405%3E3.0.CO;2.
Fairburn, C. G., Cooper, Z., & O’Connor, M. (2008). Eating Disorder Examination (16.0D). In C.G. (Ed.). Cognitive behavior therapy and eating disorders (pp. 265–308). Guilford Press.
Friederich, H. C., Kumari, V., Uher, R., Riga, M., Schmidt, U., Campbell, I. C., Herzog, W., & Treasure, J. (2006). Differential motivational responses to food and pleasurable cues in anorexia and bulimia nervosa: A startle reflex paradigm. Psychological Medicine, 36, 1327–1335. https://doi.org/10.1017/S0033291706008129.
Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000–2018 period: A systematic literature review. The American Journal of Clinical Nutrition, 109, 1402–1413. https://doi.org/10.1093/ajcn/nqy342.
Grillon, C., & Baas, J. (2003). A review of the modulation of the startle reflex by affective states and its application in psychiatry. Clinical Neurophysiology, 114, 1557–1579. https://doi.org/10.1016/s1388-2457(03)00202-5.
Hayes, A. F. (2022). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (3rd ed.). Guilford Press.
Kärkkäinen, U., Mustelin, L., Raevuori, A., Kaprio, J., & Keski-Rahkonen, A. (2018). Do disordered eating behaviours have long-term health-related consequences? European Eating Disorders Review, 26, 22–28. https://doi.org/10.1002/erv.2568.
Khan, S., & Petróczi, A. (2015). Stimulus-response compatibility tests of implicit preference for food and body image to identify people at risk for disordered eating: A validation study. Eating Behaviors, 16, 54–63. https://doi.org/10.1016/j.eatbeh.2014.10.015.
Kollei, I., Leins, J., Rinck, M., Waldorf, M., Kuhn, M., Rauh, E., & Steins-Loeber, S. (2022). Implicit approach-avoidance tendencies toward food and body stimuli absent in individuals with anorexia nervosa, bulimia nervosa, and healthy controls. The International Journal of Eating Disorders, 55, 85–97. https://doi.org/10.1002/eat.23638.
Krieglmeyer, R., Deutsch, R., De Houwer, J., & De Raedt, R. (2010). Being moved: valence activates approach-avoidance behavior independently of evaluation and approach-avoidance intentions. Psychological Science, 21, 607–613. https://doi.org/10.1177/0956797610365131
Lang, P. J. (1995). The emotion probe: Studies of motivation and attention. The American Psychologist, 50, 372–385. https://doi.org/10.1037//0003-066x.50.5.372.
Lang, P. J., & Bradley, M. M. (2010). Emotion and the motivational brain. Biological Psychology, 84, 437–450. https://doi.org/10.1016/j.biopsycho.2009.10.007
Lang, P. J., Bradley, M. M., & Cuthbert, B. N. (1998). Emotion and motivation: Measuring affective perception. Journal of Clinical Neurophysiology, 15, 397–408. https://doi.org/10.1097/00004691-199809000-00004.
Lang, P. J., Bradley, M. M., & Cuthbert, B. N. (2008). International affective picture system (IAPS): Affective ratings of pictures and instruction manual. Technical report A-8. Gainsville, FL:University of Florida.
Legenbauer, T., Radix, A. K., Naumann, E., & Blechert, J. (2020). The body image approach test (BIAT): A potential measure of the behavioral components of body image disturbance in anorexia and bulimia nervosa? Frontiers in Psychology, 11(30), 1–10. https://doi.org/10.3389/fpsyg.2020.00030.
Leins, J., Waldorf, M., Kollei, I., Rinck, M., & Steins-Loeber, S. (2018). Approach and avoidance: Relations with the thin body ideal in women with disordered eating behavior. Psychiatry Research, 269, 286–292. https://doi.org/10.1016/j.psychres.2018.08.029.
Levinson, C. A., Vanzhula, I. A., & Christian, C. (2019). Development and validation of the eating disorder fear questionnaire and interview: Preliminary investigation of eating disorder fears. Eating Behaviors, 35, 101320. https://doi.org/10.1016/j.eatbeh.2019.101320.
Levitt, D. H. (2003). Drive for thinness and fear of fat: Separate yet related constructs? Eating Disorders, 11, 221–234. https://doi.org/10.1080/10640260390218729.
Lipson, S., & Sonneville, K. (2017). Eating disorder symptoms among undergraduate and graduate students at 12 U.S. colleges and universities. Eating Behaviors, 24, 81–88. https://doi.org/10.1016/j.eatbeh.2016.12.003.
Lydecker, J. A., Cotter, E. W., Palmberg, A. A., Simpson, C., Kwitowski, M., White, K., & Mazzeo, S. E. (2016). Does this tweet make me look fat? A content analysis of weight stigma on twitter. Eating and Weight Disorders, 21, 229–235. https://doi.org/10.1007/s40519-016-0272-x
Mai, S., Gramann, K., Herbert, B. M., Friederich, H. C., Warschburger, P., & Pollatos, O. (2015). Electrophysiological evidence for an attentional bias in processing body stimuli in bulimia nervosa. Biological Psychology, 108, 105–114. https://doi.org/10.1016/j.biopsycho.2015.03.013.
Markus, H., & Nurius, P. (1986). Possible selves. American Psychologist, 41, 954–969. https://doi.org/10.1037//0003-066X.41.9.954.
McComb, S. E., & Mills, J. S. (2022). Eating and body image characteristics of those who aspire to the slim-thick, thin, or fit ideal and their impact on state body image. Body Image, 42, 375–384. https://doi.org/10.1016/j.bodyim.2022.07.017.
Moussally, J. M., Rochat, L., Posada, A., & Van der Linden, M. (2017). A database of body-only computer-generated pictures of women for body-image studies: Development and preliminary validation. Behavior Research Methods, 49, 172–183. https://doi.org/10.3758/s13428-016-0703-7.
Murray, S. B., Treanor, M., Liao, B., Loeb, K. L., Griffiths, S., & Le Grange, D. (2016). Extinction theory & anorexia nervosa: Deepening therapeutic mechanisms. Behaviour Research and Therapy, 87, 1–10. https://doi.org/10.1016/j.brat.2016.08.017.
Prnjak, K., Pemberton, S., Helms, E., & Phillips, J. G. (2020). Reactions to ideal body shapes. The Journal of General Psychology, 147, 361–380. https://doi.org/10.1080/00221309.2019.1676190.
Puhl, R. M., & Lessard, L. M. (2020). Weight stigma in youth: Prevalence, consequences, and considerations for clinical practice. Current Obesity Reports, 9, 402–411. https://doi.org/10.1007/s13679-020-00408-8.
Racine, S. E., Suissa-Rocheleau, L., Martin, S. J., & Benning, S. D. (2021). Implicit and explicit motivational responses to high- and low-calorie food in women with disordered eating. International Journal of Psychophysiology, 159, 37–46. https://doi.org/10.1016/j.ijpsycho.2020.11.
Rieger, E., Dolan, A., Thomas, B., & Bell, J. (2017). The effect of interpersonal rejection on attentional biases regarding thin-ideal and non-thin images: The moderating role of body weight- and shape-based self-worth. Body Image, 22, 78–86. https://doi.org/10.1016/j.bodyim.2017.06.002.
Rodgers, R. F., DuBois, R., Frumkin, M. R., & Robinaugh, D. J. (2018). A network approach to eating disorder symptomatology: Do desire for thinness and fear of gaining weight play unique roles in the network? Body Image, 27, 1–9. https://doi.org/10.1016/j.bodyim.2018.07.004.
Rodgers, R. F., Fischer, L. E., Murray, S. B., & Franko, D. L. (2022a). Integrating fear of fatness into sociocultural models of body image and eating concerns. Eating Behaviors, 46, 101653. https://doi.org/10.1016/j.eatbeh.2022.101653.
Rodgers, R. F., Wertheim, E. H., Paxton, S. J., Tylka, T. L., & Harriger, J. A. (2022b). #Bopo: Enhancing body image through body positive social media- evidence to date and research directions. Body Image, 41, 367–374. https://doi.org/10.1016/j.bodyim.2022.03.008.
Sandt, A. R., Sloan, D. M., & Johnson, K. J. (2009). Measuring appetitive responding with the postauricular reflex. Psychophysiology, 46, 491–497. https://doi.org/10.1111/j.1469-8986.2009.00797.x.
Schaefer, L. M., Burke, N. L., Thompson, J. K., Dedrick, R. F., Heinberg, L. J., Calogero, R. M., Bardone-Cone, A. M., Higgins, M. K., Frederick, D. A., Kelley, M., Anderson, D. A., Schaumberg, K., Nerini, A., Stefanile, C., Dittmar, H., Clark, E., Adams, Z., Macwana, S., Klump, K. L., Vercellone, A. C., Paxton, S. J., & Swami, V. (2015). Development and validation of the sociocultural attitudes towards appearance questionnaire-4 (SATAQ-4). Psychological Assessment, 27, 54–67. https://doi.org/10.1037/a0037917.
Slof-Op't Landt, M. C. T., van Furth, E. F., van Beijsterveldt, C. E. M., Bartels, M., Willemsen, G., de Geus, E. J., & Boomsma, D. I. (2017). Prevalence of dieting and fear of weight gain across ages: A community sample from adolescents to the elderly. International Journal of Public Health, 62, 911–919. https://doi.org/10.1007/s00038-017-0948-7.
Smith, C. A. (2012). The confounding of fat, control, and physical attractiveness for women. Sex Roles, 66, 628–631. https://doi.org/10.1007/s11199-011-0111-5
Spring, V. L., & Bulik, C. M. (2014). Implicit and explicit affect toward food and weight stimuli in anorexia nervosa. Eating Behaviors, 15, 91–94. https://doi.org/10.1016/j.eatbeh.2013.10.017.
Stice, E. (2001). A prospective test of the dual-pathway model of bulimic pathology: Mediating effects of dieting and negative affect. Journal of Abnormal Psychology, 110, 124–135. https://doi.org/10.1037//0021-843x.110.1.124.
Theory, assessment, and treatment of body image disturbance. American Psychological.
Thompson, J. K., Heinberg, L. J., Altabe, M., & Tantleff-Dunn (1999). S. Exacting beauty: Theory, assessment, and treatment of body image disturbance. American Psychological Association.
Thompson, J. K., & Stice, E. (2001). Thin-ideal internalization: Mounting evidence for a new risk factor for body-image disturbance and eating pathology. Current Directions in Psychological Science, 10, 181–183. https://doi.org/10.1111/1467-8721.00144.
van Hoeken, D., & Hoek, H. W. (2020). Review of the burden of eating disorders: Mortality, disability, costs, quality of life, and family burden. Current Opinion in Psychiatry, 33, 521–527. https://doi.org/10.1097/YCO.0000000000000641.
Verma, J. P. (2016). One way repeated measures design. In J. P. Verma (Ed.), Repeated measures design for empirical researchers (pp. 72–90). John Wiley & Sons, Inc.
Watson, K. K., Werling, D. M., Zucker, N. L., & Platt, M. L. (2010). Altered social reward and attention in anorexia nervosa. Frontiers in Psychology, 1, 1–8. https://doi.org/10.3389/fpsyg.2010.00036
Wilson, S. (2020). Fear of self in eating disorders. Journal of Obsessive Compulsive and Related Disorders, 27, 100562. https://doi.org/10.1016/j.jocrd.2020.100562.
Wilson, S., Acar, M., Hirji, R., & Racine, S. E. (submitted). Unattractive, corrupted, and culpable feared self-themes: Expanding our understanding of self-concept in individuals with eating pathology. PsyArXiv. https://doi.org/10.31234/osf.io/3beqr
Wilson, S., Mehak, A., & Racine, S. E. (2023). Exposure to thin and non-thin bodies elicits ‘feeling fat’: Validation of a novel state measure. Eating Behaviours, 48, 1–6. https://doi.org/10.1016/j.eatbeh.2022.101700
Woud, M. L., Anschutz, D. J., Van Strien, T., & Becker, E. S. (2011). Measuring thinspiration and fear of fat indirectly. A matter of approach and avoidance. Appetite, 56, 451–455. https://doi.org/10.1016/j.appet.2010.12.012.
Acknowledgements
We would like to thank the research assistants for their invaluable help with data collection. We would also like to acknowledge Vittoria Trolio for her guidance when setting up the study and for her help with recruitment and data collection
Funding
This research was supported by grants from the Fonds de Recherche du Québec – Santé (#269717, #300007) awarded to Samantha Wilson, the Canadian Institutes of Health Research (#175959) awarded to Adrienne Mehak, and the Canada Research Chairs Program awarded to Sarah Racine. These funding sources had no role in collection, analysis, or interpretation of data, writing of the manuscript, or in the decision to submit the manuscript for publication.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Wilson, S., Mehak, A. & Racine, S.E. Self-Reported and Physiological Reactions to Thin and Non-Thin Bodies: Understanding Motivational Processes Associated with Disordered Eating. Cogn Ther Res (2024). https://doi.org/10.1007/s10608-024-10466-0
Accepted:
Published:
DOI: https://doi.org/10.1007/s10608-024-10466-0