Social reward and rejection sensitivity in eating disorders: An investigation of attentional bias and early experiences

Abstract

Objectives. People with eating disorders (EDs) have difficulties with social functioning. One explanatory mechanism is a problem with over-sensitivity to rejection and/or low sensitivity to social reward. The aim of this study is to investigate attentional bias to facial stimuli in people with a lifetime diagnosis of EDs and healthy controls (HCs) and to test whether these attentional biases are linked to adverse early experiences. Methods. Forty-six participants with a current diagnosis of EDs (29 with anorexia nervosa (AN) and 17 with bulimia nervosa (BN)), 22 participants recovered from an eating disorder (13 with past AN and nine with past BN) and 50 HCs completed a dot-probe task with faces expressing rejection and acceptance. Participants reported on parental style and adverse early experiences. Results. People with a lifetime diagnosis of EDs show an attentional bias to rejecting faces and a difficulty disengaging attention from these stimuli. Also, they had a sustained attentional avoidance of accepting faces. HCs demonstrated the opposite attentional pattern. The attentional bias to rejection was correlated with adverse childhood experiences. Conclusions. People with an EDs show vigilance to rejection and avoidance of social reward. This may contribute to the causation or maintenance of the illness.

Key words::

• Eating disorders
• attentional bias
• rejection sensitivity
• social reward
• early experiences
• social functioning

Acknowledgements

This work was in part funded by a Department of Health NIHR Programme Grant for Applied Research (Reference number RP-PG-0606-1043). This work was also supported by the NIHR Biomedical Research Centre for Mental Health. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The authors acknowledge S. Dandeneau for the rejecting and accepting faces used in the dot-probe. Valentina Cardi is supported by a scholarship from the Region Abruzzo (Progetto Speciale Multiasse “Reti per l'Alta Formazione” —P.O. F. S. E. 2007-2013, Piano Operativo 2009-2010-2011). Freya Corfield is supported by the Psychiatry Research Trust.

Statement of Interest

The authors report no financial interests or potential conflict of interest.