Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.
Biol Psychiatry. 2011 Apr 1;69(7):661-7. doi: 10.1016/j.biopsych.2010.09.047. Epub 2010 Dec 3.
Etiologic models of anorexia nervosa (AN) suggest that cognitive factors play a crucial role in the disorder's psychopathology. Attentional aspects of food processing in AN remain largely unknown. Both an early attentional bias (vigilance) and inattentiveness (avoidance) to food pictures have been reported in patients with eating disorders. The study's aim was to examine the vigilance-avoidance hypothesis concerning food information processing by unraveling the time course of attention deployment in individuals with AN.
We used eye-tracking to examine continuous attention deployment in 19 individuals with AN during free visual exploration of food pictures versus nonfood pictures compared with 18 fasted and 20 nonfasted healthy control subjects.
Compared with healthy control subjects, AN patients allocated overall less attention to food pictures but showed no early attentional bias toward food pictures. Attentional engagement for food pictures was most pronounced in fasted healthy control subjects. The extent of attention deployment in AN patients was associated with indicators of the disorder's severity.
Gaze data suggest that individuals with AN show no early vigilance but later avoidance when confronted with food information. This suggests that initially, AN patients perceive incentive salience from food information because they process food pictures in the same way healthy control subjects do. The time course of attention deployment suggests that it is only after a first phase of stimulus encoding and labeling as food that individuals with AN avoid food pictures. This pattern of attention deployment is probably mediated by disorder-specific dysfunctional cognitions.
神经性厌食症（AN）的病因模型表明，认知因素在该障碍的发病机制中起着至关重要的作用。AN 患者对食物加工的注意方面仍知之甚少。有研究报道，进食障碍患者存在对食物图片的早期注意偏向（警觉）和不注意（回避）。本研究旨在通过揭示 AN 个体对食物信息处理的注意分配时间过程，检验有关食物信息加工的警觉回避假说。
我们使用眼动追踪技术，在自由视觉探索食物图片和非食物图片时，比较 19 名 AN 患者、18 名禁食和 20 名非禁食健康对照者的连续注意力分配。
与健康对照组相比，AN 患者对食物图片的总体注意力分配较少，但对食物图片没有早期的注意偏向。在禁食的健康对照组中，对食物图片的注意力投入最为明显。AN 患者的注意力分配程度与该障碍严重程度的指标相关。
眼动数据表明，AN 患者在面对食物信息时没有早期警觉，但随后会回避。这表明，最初，AN 患者从食物信息中感知到激励显著性，因为他们以与健康对照组相同的方式处理食物图片。注意力分配的时间过程表明，只有在对食物进行第一次刺激编码和标记之后，AN 患者才会回避食物图片。这种注意力分配模式可能是由特定于疾病的功能障碍认知介导的。
