Psychophysiological Changes during Pure vs Guided Mirror Exposure Therapies in Women with High Body Dissatisfaction: What Are They Learning about Their Bodies?

This study aimed to examine the psychophysiological changes resulting from two mirror exposure treatments that are effective at reducing body dissatisfaction. Thirty-five university women with body dissatisfaction and subclinical eating disorders were randomly assigned to one of two groups: pure (n = 17) or guided exposure (n = 18). The participants received six sessions of treatment. Their thoughts, feelings and avoidance behaviours were assessed after each session. Their subjective discomfort, heart rate and skin conductance were assessed within the sessions. Both groups showed improvement in cognitive-affective and avoidance behaviour symptoms. Nevertheless, the pure exposure group showed faster habituation of subjective discomfort and a greater physiological response than the guided exposure group. These findings suggest that both procedures are effective interventions for improving body image disturbances, although psychophysiological changes observed within session suggest that each technique would act through different processes. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Testing the efficacy of pure versus guided mirror exposure in women with bulimia nervosa: A combination of neuroendocrine and psychological indices.

BACKGROUND AND OBJECTIVES: Body exposure improves body image problems in women with eating disorders. However it has almost always been combined with other interventions. Thus, the efficacy of body exposure alone (i.e., pure exposure) remains largely unclear. We aimed to compare the efficacy of two body exposure techniques through psychological and neuroendocrine indices recorded within and between successive sessions. METHOD: Twenty-nine women with high body dissatisfaction and diagnosis of bulimia nervosa were randomly assigned to one of two treatment groups: Pure Exposure (n = 14) or Guided Exposure (n = 15). Participants received 6 exposure sessions. After each session, changes in thoughts (positive/negative) and body satisfaction were assessed. Also, we assessed the body discomfort experienced by participants within and between sessions. Finally, the changes in salivary cortisol levels within and between the initial and final treatment sessions were measured. RESULTS: Both groups showed a reduction in negative thoughts and a progressive increase in positive thoughts throughout the treatment. However, the increase in body satisfaction and the reduction in subjective discomfort within the sessions were greater in the pure exposure group. The cortisol levels during the initial and final treatment sessions decreased in both groups. LIMITATIONS: Methodological limitations are reported. CONCLUSIONS: These results suggest that pure and guided exposures are effective interventions for improving thoughts and neuroendocrine responses, although pure exposure increased more body satisfaction feelings in bulimic women. Subjective discomfort also showed different patterns of change within and along sessions for each treatment. Reasons for these results are discussed.

Feeling bad posing as a model: an objective manner of study upward own-body comparisons in body-dissatisfied women.

Emotional effects of upward body comparisons are suggested to occur automatically. A startle reflex paradigm was used to objectively examine the emotions elicited by viewing a picture of one's own body adopting a model pose or a neutral pose, in 30 women with high body dissatisfaction (HBD) and 33 women with low body dissatisfaction (LBD). In-task emotional responses in perceived valence, arousal and control were assessed. Additionally, post-task positive/negative and body-related beauty feelings were recorded. The results revealed that HBD women, compared with LBD women, showed (i) less pleasure, higher activation and less control whilst viewing their own bodies and (ii) less pleasure, more negative/ugliness feelings and an increased startle response when viewing themselves posing as models. The data showed that their own bodies provoked an immediate negative emotional state in HBD women. However, greater aversive psychophysiological mechanisms were automatically activated only when these women posed as models, suggesting that they made upward own-body comparisons.