# Measuring Implicit Approach‐Avoidance Tendencies Using Self‐Depicting Body Pictures in Female Adults With Bulimia Nervosa, High Body Dissatisfaction and Healthy Controls

## TL;DR

This study investigates body-related avoidance behavior in women with bulimia nervosa and high body dissatisfaction using a novel approach-avoidance task with self-pictures.

## Contribution

The study introduces a novel slider-based AAT with self-depicting body pictures and examines the role of self-reference and cognitive load in body-related avoidance.

## Key findings

- The AAT did not show evidence of body-related avoidance behavior.
- Participants reacted faster to compatible trials in the flanker task, independent of group or picture type.
- Future studies should consider body checking and manipulate self-reference cues in body pictures.

## Abstract

Body dissatisfaction is an important factor for the etiology and maintenance of eating disorders such as bulimia nervosa (BN). At the behavioral level, body dissatisfaction often manifests itself in excessive body‐related avoidance, thought to act as a negative reinforcer. The Approach‐Avoidance Task (AAT) is an implicit measure of avoidance behavior, but the literature on body‐related avoidance measured by the AAT is inconclusive. In the present study, we considered self‐reference and cognitive load as important dimensions to better understand AAT‐evoked biases.

Adult female participants with BN (n = 21), high body dissatisfaction (n = 20), and healthy controls (n = 20) completed a novel, slider‐based AAT with task‐irrelevant self‐depicting body pictures and scrambled versions of these pictures as control stimuli. We further induced cognitive load through a flanker task to assess possible moderating effects.

There was no significant Group × Picture Type × Motion Direction interaction for either motion onset or motion duration. The results further revealed a standard flanker effect in that participants reacted faster to compatible trials; but this was independent of Group membership, Picture Type, and Motion Direction.

In sum, the AAT did not yield evidence of body‐related avoidance behavior. Future studies should control for the occurrence of body checking (i.e., increased focus on disliked body parts which could activate approach‐biases) during AAT, manipulate the strength of self‐reference, e.g., by presenting/omitting facial cues in self‐depicting body pictures, and consider the task relevance of (and thus overt attention to) the body pictures.