Effects of an attentional bias modification training on eating behavior in binge eating disorder

01.01.2016 bis 31.12.2019

Objective episodes of binge eating are the central symptom of binge eating disorder. Cognitive models of eating disorders suggest that disorder-typical stimuli such as high caloric food activate selective memory, interpretation and attentional processes, assumed to substantially contribute to the maintenance of pathological eating behavior. In accordance, women with BED compared to overweight women without BED display increased attention towards food stimuli. To date it is unclear, though, (a) whether these mechanisms are modifiable, and (b) whether a modification of the described attentional processes reduces the frequency of binge eating episodes in patients diagnosed with BED. To this end, based on previous studies the present project plans to assess the attentional processing of disorder-typical and neutral stimuli when looking at food pictures in two experiments using eye tracking and EEG in overweight individuals with and without BED. The experimental paradigms will be administered prior to and after an attentional bias modification training, which is based on a dot probe task. In this task, individuals are required to classify the side of appearance (right, left) of an imperative stimulus (the probe; usually a dot) by key press as fast and as accurately as possible. In the AMT, the imperative stimulus over-proportionally often replaces the neutral stimulus. As such, the training aims at a reduction of the disorder typical bias. Participants are thereby thought to implicitly learn to divert their attention away from disorder typical stimuli. Currently the AMT is piloted at the centers of Tübingen and Freiburg. The AMT control condition (AMT-C) will be carried out comparably to the AMT condition, with the difference that in the AMT-C condition in trials with eating related stimuli the probe will appear equally often at the side of the food and neutral stimulus.
In the project 50 patients with a diagnosis of BED and 25 overweight control participants will be recruited at each center. In both centers, only BED participants will receive the AMT. Central outcome measures are (a) changes in the attention allocation (as assessed by the experimental paradigms), (b) eaten calories in a bogus taste test, and (c) eating-related pathology as assessed by an expert interview (EDE; pre, post, 3 months follow-up).