From Bad to Worse: Safety Behaviors Exacerbate Eating Disorder Fears
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Participants
2.3. Materials
2.3.1. Vignette Task
“Below several events are described. We ask you to evaluate these events as if they are happening to you. There are no right or wrong answers; we are interested in the way you evaluate them. Try to identify with the events as much as possible and to imagine how you would feel. The descriptions sometimes resemble each other. Therefore, it is important that you read all descriptions very carefully from beginning to end.”
“You come home after a long day. In the kitchen you see a large box of your favorite chocolate.”
“You eat a small piece of chocolate and leave the kitchen. After a few minutes, you find yourself again in the kitchen. You have an intense craving for chocolate. This time you get out the whole box and start to eat. You only stop once the box is empty. You put away the box, walk to the bathroom and make yourself throw up into the toilet.”
“You take the chocolate bars and eat two small pieces. You put away the box, walk to the bathroom and make yourself throw up into the toilet.”
“You eat a small piece of chocolate and leave the kitchen. After a few minutes, you find yourself again in the kitchen. You have an intense craving for chocolate. This time you get out the whole box and start to eat. You only stop once the box is empty. You put away the box and sit down in front of the tv in the living room in order to watch your favorite tv show.”
“You take the chocolate bars and eat two small pieces. You put away the box and sit down in front of the tv in the living room in order to watch your favorite tv show.”
2.3.2. Questionnaires
2.4. Procedure
2.5. Statistical Analysis Plan
3. Results
3.1. Participants
3.2. Manipulation Check
3.3. How Do Safety Behaviors Affect Threat Perception in Individuals with an Eating Disorder and Healthy Controls? (Hypothesis 1 and 2)
3.4. Do Safety Behaviors Affect Threat Perception Differently in Dangerous vs. Safe Situations? (Hypothesis 3)
3.5. Robustness Checks
4. Discussion
Limitations and Future Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Factor | Description of Objective Danger | ||
---|---|---|---|
Dangerous | Safe | ||
Description of safety behavior | Safety behavior | Safety behavior—Dangerous | Safety behavior—Safe |
No safety behavior | No safety behavior—Dangerous | No safety behavior—Safe |
Variable | 1. | 2. | 3. |
---|---|---|---|
Danger | |||
Threat | 0.86 * | ||
Pleasantness | −0.51 * | −0.55 * | |
Want for experience | −0.41 * | −0.44 * | 0.77 * |
HC (n = 82) | ED (n = 108) | t | df | p | |
---|---|---|---|---|---|
Age | 25.11 (6.54) | 28.16 (10.17) | 2.51 | 183.40 | 0.013 |
BMI | 23.13 (3.59) | 19.20 (3.54) | −7.46 | 185 | <0.001 |
Lowest BMI After 18th Birthday | 20.71 (2.61) | 15.90 (3.22) | −10.93 | 186 | <0.001 |
Illness Duration (Years) | - | 11.11 (8.86) | - | - | - |
Currently in Treatment (%) | - | 69 (63.9%) | - | - | - |
Treatment Duration (years) | - | 7.12 (6.48) | - | - | - |
EDEQ Global Score | 1.56 (1.34) | 4.21 (1.13) | 14.47 | 157.87 | <0.001 |
EDEQ Eating Restraint | 1.15 (1.26) | 4.11 (1.37) | 15.29 | 188 | <0.001 |
EDEQ Eating Concerns | 0.99 (1.14) | 3.40 (1.37) | 13.19 | 185.94 | <0.001 |
EDEQ Weight Concerns | 1.97 (1.68) | 4.50 (1.33) | 11.17 | 150.07 | <0.001 |
EDEQ Shape Concerns | 2.11 (1.65) | 4.83 (1.14) | 12.73 | 136.64 | <0.001 |
DASS Depression | 8.73 (9.35) | 24.67 (11.54) | 10.49 | 186.41 | <0.001 |
DASS Anxiety | 7.02 (7.73) | 17.79 (10.90) | 7.94 | 185.95 | <0.001 |
DASS Stress | 11.27 (9.80) | 23.87 (9.79) | 8.77 | 187 | <0.001 |
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Spix, M.; Melles, H.; Jansen, A. From Bad to Worse: Safety Behaviors Exacerbate Eating Disorder Fears. Behav. Sci. 2023, 13, 574. https://doi.org/10.3390/bs13070574
Spix M, Melles H, Jansen A. From Bad to Worse: Safety Behaviors Exacerbate Eating Disorder Fears. Behavioral Sciences. 2023; 13(7):574. https://doi.org/10.3390/bs13070574
Chicago/Turabian StyleSpix, Michelle, Hanna Melles, and Anita Jansen. 2023. "From Bad to Worse: Safety Behaviors Exacerbate Eating Disorder Fears" Behavioral Sciences 13, no. 7: 574. https://doi.org/10.3390/bs13070574
APA StyleSpix, M., Melles, H., & Jansen, A. (2023). From Bad to Worse: Safety Behaviors Exacerbate Eating Disorder Fears. Behavioral Sciences, 13(7), 574. https://doi.org/10.3390/bs13070574