A systematic review of attentional biases in disorders involving binge eating.

Monika Stojek, Lisa M Shank, Anna Vannucci, Diana M Bongiorno, Eric E Nelson, Andrew J Waters, Scott G Engel, Kerri N Boutelle, Daniel S Pine, Jack A Yanovski, Marian Tanofsky-Kraff

Journal: Appetite 2018;123():367-389

PMID: 29366932

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Plain Language Summary

Binge eating behaviour is a feature of certain eating disorders (such as binge eating disorder (BED), bulimia nervosa (BN) and binge-purge subtype of anorexia nervosa (AN). It can also be a problem for those who do not meet the criteria for an eating disorder diagnosis. The presence of binging, and a loss of control is a risk for eating disorder development, psychological distress and/or excess body weight. It is important to explore the factors that may cause or maintain binge eating behaviour. Attentional bias (AB; paying attention to some things and ignoring others) is thought to contribute to the development of eating disorders when it is maladaptive. This systematic review of 50 cross-sectional designed articles explores findings on AB to food cues, weight and shape cues and threatening cues. The review found that people with binge eating behaviour may be oversensitive to the rewarding properties of food and have increased AB for weight/shape cues, suggesting it needs to be considered when supporting people who binge. Longitudinal research is needed to explore if AB is a factor in the development of eating disorders and binge eating.

Abstract

OBJECTIVE

Attentional bias (AB) may be one mechanism contributing to the development and/or maintenance of disordered eating. AB has traditionally been measured using reaction time in response to a stimulus. Novel methods for AB measurement include eye tracking to measure visual fixation on a stimulus, and electroencephalography to measure brain activation in response to a stimulus. This systematic review summarizes, critiques, and integrates data on AB gathered using the above-mentioned methods in those with binge eating behaviors, including binge eating, loss of control eating, and bulimia nervosa.

METHOD

Literature searches on PubMed and PsycInfo were conducted using combinations of terms related to binge eating and biobehavioral AB paradigms. Studies using AB paradigms with three categories of stimuli were included: food, weight/shape, and threat. For studies reporting means and standard deviations of group bias scores, Hedges' g effect sizes for group differences in AB were calculated.

RESULTS

Fifty articles met inclusion criteria and were reviewed. Individuals who binge eat in the absence of compensatory behaviors show an increased AB to food cues, but few studies have examined such individuals' AB toward weight/shape and threatening stimuli. Individuals with bulimia nervosa consistently show an increased AB to shape/weight cues and socially threatening stimuli, but findings for AB to food cues are mixed.

DISCUSSION

While there are important research gaps, preliminary evidence suggests that the combination of AB to disorder-specific cues (i.e., food and weight/shape) and AB toward threat may be a potent contributor to binge eating. This conclusion underscores previous findings on the interaction between negative affect and AB to disorder-specific cues. Recommendations for future research are provided.

Address: Department of Psychiatry, Emory University School of Medicine, Emory Veterans Program, 12 Executive Park Drive, Atlanta, GA, 30329, USA.; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA.; Section on Development and Affective Neuroscience, National Institute of Mental Health, NIH, DHHS, 15K North Drive, Bethesda, MD, 20892, USA.; The Research Institute at Nationwide Children's Hospital, Center for Biobehavioral Health, 700 Children's Drive, Columbus, OH, 43205, USA; Ohio State University, Department of Pediatrics, 700 Children's Drive, Columbus, OH 43205, USA.; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.; Neuropsychiatric Research Institute, 120 8th Street, Fargo, ND 58107, USA.; Department of Psychiatry, Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, MC 0874, La Jolla, CA, 92037, USA.; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA.; Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA. Electronic address: [email protected].

DOI: 10.1016/j.appet.2018.01.019

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MeSH Terms: Attentional Bias, Binge-Eating Disorder, Body Mass Index, Body Weight, Bulimia Nervosa, Cues, Electroencephalography, Emotions, Humans, Obesity, Randomized Controlled Trials as Topic