Body dissatisfaction in binge eating disorder: cognitive and affective mechanisms of maintenance

体型和体重对自我评价的过度影响以及相应的身体不满是暴食症（BED）的核心特征（Wilfley, Schwartz, Spurrell, & Fairburn, 2000a），也是治疗效果不佳的预测因子（Masheb & Grilo, 2008）。根据图式理论概念（Williamson, White, York-Crowe, & Stewart, 2004），身体不满代表了身体图式所代表的自己身体的消极认知和情感内涵。这种与身体相关的消极自我图式可以被显著刺激激活，例如，与自我或另一个身体的对抗。他们进一步被认为有选择地影响与身体相关问题的记忆、判断和注意力过程（Wilson, Fairburn, Agras, Walsh, & Kraemer, 2002）。进一步假设，在行为层面上，这种信息加工的扭曲被认为是可观察到的，如身体检查和回避身体相关信息，这反过来又被认为有助于维持和加剧消极的身体相关图式。该模型的第一个经验证据表明，有明显饮食失调症状的女性的特点是，与他人身体相比，对自我的注意力分配增加（Blechert, Ansorge, & Tuschen-Caffier, 2010），对自我喜欢的身体部位的注意力分配增加，而对自我不喜欢的身体部位的注意力分配增加（Jansen, Nederkoorn, & Mulkens, 2005）。自己的研究也证实了患有BED的女性的这些结果（Svaldi, Caffier, & Tuschen-Caffier, 2011a, 2011b）。然而，目前尚不清楚(a)这些机制是否可以改变，以及(b)所描述的注意模式的改变是否会导致身体满意度的提高。为此，目前的项目计划评估在重复照镜子干预之前和之后观察自己和他人身体时的注意过程，之前已经证明这种干预对减少身体不满是有效的（Trentowska, Bender, & Tuschen-Caffier，已被接受）。

The undue influence of shape and weight on self-evaluation and the corresponding body dissatisfaction are a core feature of binge eating disorder (BED) (Wilfley, Schwartz, Spurrell, & Fairburn, 2000a) and a predictor of poor treatment outcome (Masheb & Grilo, 2008). According to schema-theoretical conceptions (Williamson, White, York-Crowe, & Stewart, 2004), body dissatisfaction represents the negative cognitive and affective connotation of the own body represented in the body schema. Such negative body-related self-schemas can be activated by salient stimuli, e.g., the confrontation with the self or the other body. They are further presumed to selectively influence memory, judgment and attentional processes with regard to body-related issues (Wilson, Fairburn, Agras, Walsh, & Kraemer, 2002). It is further assumed that at the behavioral level such distortions in information processing are presumed to be observable as body checking and avoidance of body-related information, which in turn are thought to contribute to the maintenance and aggravation of the negative body-related schemas. First empirical evidence for the model suggest that women with pronounced eating disorder symptoms are characterized by an increased attention allocation towards the self- compared to the other-body (Blechert, Ansorge, & Tuschen-Caffier, 2010) and by an increased attention allocation towards self-liked compared to self-disliked body parts (Jansen, Nederkoorn, & Mulkens, 2005). Own research confirms these results also for women with BED (Svaldi, Caffier, & Tuschen-Caffier, 2011a, 2011b). However, at this point it is still unclear whether (a) these mechanisms are modifiable, and (b) whether a modification of the described attentional patterns leads to an improvement of body satisfaction. To this end, the current project plans to assess attentional processes when looking at self and other body prior to and after an intervention consisting of repeated mirror exposures, which has previously been shown to be effective in the reduction of body dissatisfaction (Trentowska, Bender, & Tuschen-Caffier, accepted).