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Self-focused attention in anorexia nervosa

Authors

  • Nancy Zucker PhD,

    Corresponding author
    1. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
    2. Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
    • Correspondence to: Nancy Zucker, PhD, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, P.O. Box 3454, Durham, NC 27710. E-mail: zucke001@mc.duke.edu

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  • H. Ryan Wagner PhD,

    1. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
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  • Rhonda Merwin PhD,

    1. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
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  • Cynthia M. Bulik PhD,

    1. Department of Psychiatry, UNC School of Medicine, University of North Carolina, Chapel Hill, North Carolina
    2. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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  • Ashley Moskovich MA,

    1. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
    2. Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
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  • Lori Keeling MPH, MA,

    1. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
    2. Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
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  • Rick Hoyle PhD

    1. Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
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  • Supported by K23-MH-070418, R01-MH078211-01, RC1-MH-088678 from National Institute of Mental Health (NIMH), by P30 DA023026 from Zucker; National Institute on Drug Abuse (NIDA) Grant (Hoyle).

ABSTRACT

Objective

The clinical presentation of anorexia nervosa (AN) is characterized by preoccupation with body experience, intrusive concerns regarding shape, and pathological fears of weight gain. These symptoms are suggestive of unrelenting self-focused attention. No research to date has characterized self-focused attention (SFA) in AN nor examined neurocognitive features that may facilitate an excessive, rigid, or sustained focus on one's appearance.

Method

This study examined SFA, body image disturbance, and executive functioning in women with current anorexia nervosa (AN-C; n = 24), a history of AN who were weight-restored at the time of the study (WR; n = 19), and healthy controls (n = 24).

Results

Private and public SFA were highest among WR and lowest among AN-C. Shape concerns were negatively correlated with SFA, especially among AN-C, after controlling for depression and social anxiety symptoms.

Discussion

Lower levels of SFA among AN-C were unexpected and suggest the acute state of AN may lessen pathological self-focus, negatively reinforcing symptoms. In addition, body image concerns may distract from general SFA. Deficits in executive attention may explain these findings, as each one unit increase in perseverative errors among AN-C participants was associated with an almost one-half unit decrease in public SFA. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:9–14)

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