“Glass fairies” and “bone children”: Adolescents and young adults with anorexia nervosa show positive reactions towards extremely emaciated body pictures measured by the startle reflex paradigm

Authors

  • Valeska A. Reichel,

    Corresponding author
    1. Department of Child and Adolescent Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
    2. Department of Psychiatry and Psychotherapy, Universitätsklinikum Halle (Saale), Halle, Germany
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  • Nora Schneider,

    1. Department of Child and Adolescent Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
    2. Cognitive Science Nutrition & Health Department, Nestec Ltd., Nestlé Research Center, Lausanne, Switzerland
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  • Barbara Grünewald,

    1. Cognitive Science Nutrition & Health Department, Nestec Ltd., Nestlé Research Center, Lausanne, Switzerland
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  • Thorsten Kienast,

    1. Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
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  • Ernst Pfeiffer,

    1. Department of Child and Adolescent Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
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  • Ulrike Lehmkuhl,

    1. Department of Child and Adolescent Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
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  • Alexander Korte

    Corresponding author
    1. Department of Child and Adolescent Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
    2. Department of Child and Adolescent Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
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Abstract

In this study, we investigated the emotional processing of extremely emaciated body cues in adolescents and young adults with (n = 36) and without (n = 36) anorexia nervosa (AN), introducing a new picture type, which was taken from websites that promote extreme thinness and is targeted specifically at adolescents interested in extreme thinness. A startle reflex paradigm was used for implicit reactions, while a self-assessment instrument was used for subjective responses. We found a significant group difference with a startle inhibition (appetitive response) among the patients and a startle potentiation (aversive response) among the controls, whereas no such difference for subjective measures was found. The results are in contrast to previous studies, which proposed a general failure to activate the appetitive motivational system in AN, but in keeping with findings from other addictions, where the same response pattern has been found. Implications for prevention and therapy are discussed.

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