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

形状和体重对自我评估的不适当影响以及相应的身体不满是暴食障碍(Bed)的核心特征(Wilfley，Schwartz，Sprrell，&Fairburn，2000a)和不良治疗结果的预测因素(Masheb&Grilo，2008)。根据图式理论的概念(Williamson，White，York-Crowe，&Stewart，2004)，身体不满代表了身体图式所代表的自身的负面认知和情感内涵。这种消极的与身体有关的自我图式可以被显著的刺激激活，例如，与自我或他者的对抗。它们还被认为选择性地影响与身体有关的记忆、判断和注意过程(威尔逊、费尔伯恩、阿格拉斯、沃尔什和克莱默，2002)。我们进一步假设，在行为层面上，信息加工中的这种扭曲被认为是可以观察到的，比如身体检查和对身体相关信息的回避，这反过来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，与他人相比，患有明显进食障碍症状的女性的特征是对自我的注意力分配增加(Blechert，Ansorge，&Tuschen-Caffier，2010)，与自我不喜欢的身体部位相比，对自我喜欢的身体分配的注意力增加(Jansen，Nederkoorn，&Mulkens，2005)。自己的研究证实了这些结果也适用于有床的女性(Svaldi，Caffier和Tuschen-Caffier，2011a，2011b)。然而，在这一点上，仍然不清楚(A)这些机制是否可以修改，以及(B)所描述的注意模式的修改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反复镜子暴露的干预前后观察自我和其他身体时的注意过程，这之前已经被证明在减少身体不满方面是有效的(Trentowska，Bender和Tuschen-Caffier，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).