Borgers Tiana, Krüger Nathalie, Vocks Silja, Thomas Jennifer J, Plessow Franziska, Hartmann Andrea S
Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.
Unit of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Knollstr. 15, 49069, Osnabrück, Germany.
J Eat Disord. 2021 Feb 18;9(1):26. doi: 10.1186/s40337-021-00379-8.
Fear of weight gain is a characteristic feature of anorexia nervosa (AN), and reducing this fear is often a main target of treatment. However, research shows that 20% of individuals with AN do not report fear of weight gain. Studies are needed that evaluate the centrality of fear of weight gain for AN with a method less susceptible to deception than self-report.
We approximated implicit fear of weight gain by measuring implicit drive for thinness using implicit association tests (IATs). We asked 64 participants (35 AN, 29 healthy controls [HCs]) to categorize statements as pro-dieting vs. non-dieting and true vs. false in a questionnaire-based IAT, and pictures of underweight vs. normal-weight models and positive vs. negative words in a picture-based IAT using two response keys. We tested for associations between implicit drive for thinness and explicitly reported psychopathology within AN as well as group differences between AN and HC groups.
Correlation analyses within the AN group showed that higher implicit drive for thinness was associated with more pronounced eating disorder-specific psychopathology. Furthermore, the AN group showed a stronger implicit drive for thinness than HCs in both IATs.
The results highlight the relevance of considering fear of weight gain as a continuous construct. Our implicit assessment captures various degrees of fear of weight gain in AN, which might allow for more individually tailored interventions in the future.
对体重增加的恐惧是神经性厌食症（AN）的一个特征，减轻这种恐惧通常是治疗的主要目标。然而，研究表明，20%的神经性厌食症患者并未表现出对体重增加的恐惧。需要开展研究，采用比自我报告更不易受欺骗影响的方法来评估对体重增加的恐惧在神经性厌食症中的核心地位。
我们通过使用内隐联想测验（IAT）测量对瘦的内隐驱力，来近似对体重增加的内隐恐惧。我们让64名参与者（35名神经性厌食症患者、29名健康对照者[HCs]）在基于问卷的IAT中，使用两个反应键将陈述分类为支持节食与不支持节食以及真实与虚假，并在基于图片的IAT中，将体重过轻与正常体重模型的图片以及积极与消极词汇进行分类。我们测试了对瘦的内隐驱力与神经性厌食症患者明确报告的精神病理学之间的关联，以及神经性厌食症组与健康对照组之间的组间差异。
神经性厌食症组内的相关分析表明，对瘦的内隐驱力越高，与更明显的饮食失调特异性精神病理学相关。此外，在两个IAT中，神经性厌食症组对瘦的内隐驱力均强于健康对照组。
研究结果突出了将对体重增加的恐惧视为一个连续结构的相关性。我们的内隐评估捕捉到了神经性厌食症患者对体重增加的不同程度的恐惧，这可能有助于未来制定更具个性化的干预措施。
