Eyes on the body: Assessing attentional bias toward body-related stimuli in Anorexia Nervosa

Objective: The aim of the present study was to assess whether patients with Anorexia Nervosa (AN) presented an attentional bias toward pictures of other women's bodies, as this bias could implicitly promote self-other comparisons thus increasing body/weight concerns. Methods: The sample included 48 healthy controls (HC) and 54 patients with AN. All participants performed a dot-probe task with pictures of bodies or body parts of underweight (UWB), normal weight (NWB) and overweight (OWB) women, while their gaze was recorded with an eye-tracking system. Two indices of attentional bias, a gaze direction bias and a gaze duration bias were extracted. Results: The models conducted on both direction bias and duration bias showed a significant main effect of group, revealing a stronger attentional bias toward bodies in patients as compared to controls. One sample t-tests conducted on the direction bias of patients with AN revealed that they presented a significant positive bias at 500 ms toward all the bodies. At 1500 ms, instead, they presented a positive bias toward UWB and an avoidance bias of OWB. HC instead presented an initial avoidance of all body stimuli, and an avoidance of NWB and OWB at 1500 ms. Discussion: Our results revealed a stronger attentional bias toward other women's bodies in patients than in HC. Moreover, patients presented a tendency to focalize their attention on UWB while they avoided maintaining their attention on OWB. This pattern might promote upward social comparisons, which are usually associated with negative self-evaluation and increased levels of body dissatisfaction.