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Anzaed 2013 info_biases
- 1. DRIVE FOR MUSCULARITY AND MUSCULARITY-ORIENTED DISORDERED EATING: THE ROLE OF SET SHIFTING DIFFICULTIES AND WEAK CENTRAL COHERENCE Griffiths, S., Murray, S. B., & Touyz, S. (In-press). Drive for muscularity and muscularity-oriented disordered eating: The role of set shifting difficulties and weak central coherence. Body Image. 10.1016/j.bodyim.2013.04.002 Scott Griffiths Prof. Stephen Touyz Dr. Stuart Murray
- 2. INTRODUCTION – SET SHIFTING AND CENTRAL COHERENCE › Information processing biases in eating disorders have received considerable attention, particularly - Set shifting difficulties – a relative inability to change a pattern of thinking or behaviour to be in accordance with situational demands - Weak central coherence – a style of thinking that is 1) biased toward detail and accompanied by 2) poor global integration › Large body of evidence suggests that people with eating disorders have: - Poorer set shifting/cognitive flexibility (Roberts et al. 2007) - Weaker central coherence (Lopez et al. 2008) › These information processing biases biases are enduring traits as opposed to unstable states (Danner et al. 2012, Kanakam et al. 2012) 4
- 3. INTRODUCTION – SET SHIFTING AND CENTRAL COHERENCE IN MALES WITH EATING DISORDERS › Few studies have investigated information processing biases in men with eating disorders. - Evidence that males with EDs have poorer set shifting and poorer global integration of information › No evidence about these biases in relation to muscularity - Muscularity arguably as important as body fat in males (Bergeron & Tylka, 2007) - Muscle dysmorphia argued by many to be an ED (e.g., Murray et al. 2010) › Might set shifting difficulties and weak central coherence predict drive for muscularity and disordered eating? - Drive for thinness and disordered eating are associated with set shifting difficulties and weak central coherence in women (Fassino et al. 2002; Sherman et al. 2006). 5
- 4. STUDY AIMS AND HYPOTHESES › Aim - To investigate whether set shifting difficulties and weak central were uniquely associated with drive for muscularity and muscularity-oriented disordered eating amongst male undergraduates › Hypotheses: - 1) Drive for muscularity would be uniquely positively associated with a) set shifting difficulties and b) weak central coherence - 2) Muscularity-oriented disordered eating would be uniquely positively associated with a) set shifting difficulties and b) weak central coherence 6
- 5. METHODS - PARTICIPANTS › 91 male first-year psychology students - Mean age of 20 - Mean BMI of 23 - Mean predicted IQ of 109 - No current or previous history of an eating disorder - No current diagnosis of depression or obsessive-compulsive disorder - No history of a serious head injury involving ongoing complications 7
- 6. METHODS - OUTCOME VARIABLES The two outcome variables 1. Drive for muscularity - Drive for Muscularity Scale (DMS; McCreary & Sasse, 2000). - α = .88 2. Muscularity-oriented disordered eating - Modified version of the Eating Disorder Examination – Questionnaire (EDE-Q; Fairburn & Beglin, 1994). - α= .84 › BMI and IQ also examined 8
- 7. METHODS - PREDICTOR VARIABLES (SET SHIFTING & CENTRAL COHERENCE) Wisconsin Card Sort Test (WCST; Heaton et al. 1993) Matching Familiar Figures Test (MFFT; Kagan, 1964) › "Perseverative errors" = repetitive responses to a rule despite a shift in the rule that requires a different response. › Calculate "efficiency index" (Southgate, Tchanturia& Treasure, 2008) › More perseverative errors = poorer set shifting. - Efficiency = -(Zerrors + Zlatency) › Higher efficiency index = weaker central coherence 9
- 8. RESULTS – DESCRIPTIVE STATISTICS AND CORRELATION MATRIX Variable Range Mean(SD 1. ) 1. BMI 18–32.6 23.3 (3.9) – 2. IQ predicted from the NART 98–117 109 (3.9) .09 – 3. Set shifting (# of perseverative errors on the WCST) 2–17 7.8(2.8) -.03 -.18 – 4. Central coherence (efficiency index) -1.7–1.8 0 (0.9) .05 -.23* -.06 5. Drive for muscularity 0.1–4.7 2 (0.9) .18 .32** .36** .29** – 6. Disordered eating 0.0–3.3 1.2 (0.7) .37** -.01 .24* * p< .05 ** p<. 01 2. 3. 4. 5. – .01 .50** 10
- 9. RESULTS – TWO SIMULTANEOUS MULTIPLE REGRESSIONS PREDICTING 1) DRIVE FOR MUSCULARITY AND 2) MUSCULARITYORIENTED DISORDERED EATING β η2 IQ predicted from the NART -.17 .03 Set shifting (# of perseverative errors on the WCST) .24* .06 Central coherence (efficiency on the MFFT) .25* .07 R2 1) Drive for muscularity 2) Muscularity-oriented disordered eating .17** .19** BMI .37** Set shifting (# of perseverative errors on the WCST) .24* .06 * p< .05 ** p<. 01 11
- 10. DISCUSSION - WHY ARE THESE FINDINGS IMPORTANT? 1. First evidence to link set shifting or central coherence to the "other half" of male body image and eating problems 2. Preliminary evidence to suggest that new therapies based on remediating cognitive biases (e.g., CRT) in AN and BN may be useful for treating muscularity-focused body image and eating pathology 3. Preliminary evidence for the presence of information processing biases in muscle dysmorphia 4. Clinicians should note that otherwise healthy-BMI males with muscularity concerns might have cognitive barriers that inhibit changes to maladaptive patterns of thinking and behaviour 12
- 11. LIMITATIONS › Symptoms of depression and OCD were not controlled for - May be partly responsible for cognitive processing biases (Giel et al., 2012) - Controlled for in ongoing clinical study › Participants were non-clinical young adults - However, muscularity-oriented concerns thought to peak during young adulthood (Olivardia et al. 2004) › MFFT is predominantly a measure of detail-processing ability, not global integration (also, not widely used) - Ongoing clinical study uses the ROFT 13
- 12. DRIVE FOR MUSCULARITY AND MUSCULARITY-ORIENTED DISORDERED EATING: THE ROLE OF SET SHIFTING DIFFICULTIES AND WEAK CENTRAL COHERENCE Griffiths, S., Murray, S. B., & Touyz, S. (In-press). Drive for muscularity and muscularity-oriented disordered eating: The role of set shifting difficulties and weak central coherence. Body Image. 10.1016/j.bodyim.2013.04.002 Scott Griffiths Prof. Stephen Touyz Dr. Stuart Murray
Editor's Notes
- Hi, I’m Scott Griffiths, I’m a PhD student at the University of Sydney. I’m studying eating and body image disorders in males under the supervision of Stephen Touyz.
- Lots of males, especially young males, suffer from body dissatisfaction. In fact, we might be approaching a point at which body dissatisfaction in young men is normative. The blue and red graphs are frequency histograms depicting the mean scores of 286 male psychology undergraduates who completed the Male Body Attitudes Scale for a related but separate study to the one I am presenting today. The blue graph is the frequency histogram for mean scores on the Muscle Dissatisfaction subscale of the Male Body Attitudes Scale, which measures males’ dissatisfaction with their muscularity. Similarly, the body fat dissatisfaction subscale measures dissatisfaction with body fatBoth scales ask participants to rate their level of agreement with statements about the body, such as “I think my arms should be more muscular” or “I think I have too much fat on my body”. Both measures use the 6-point Likert scales at the bottom of each histogram. The mean level of muscle dissatisfaction in these 286 males is 3.14, which corresponds to someone agreeing “sometimes” to “often” with questions such as “I wish my chest was broader” and “I think I have too little muscle mass on my body.” Worryingly, almost 1 in 5 or 20% are, on average, agreeing “often” to “always” with these statements.Body fat concerns appear less marked overall than muscle concerns, but high nonetheless.Thus, amongst University of Sydney psychology graduates at least, muscle dissatisfaction is almost the norm.
- Evidence suggests that these biases are enduring traits as opposed to unstable states, i.e. they exist prior to the development of psychopathologySet shifting difficulties and weak central coherence are present in women recovered from AN and in unaffected sisters of AN sufferers (Danner et al. 2012; Roberts, Tchanturia & Treasure, 2012; Tenconi et al. 2010).Weak central coherence is present in women recovered from AN and unaffected sisters (Danner et al. 2012; Lopez et al. 2009; Tenconi et al. 2010)Twin studies (identical and non-identical) suggess that both biases are heritable, and weak central coherence is especially heritable (Kanakam et al. 2012)
- Researchers have focused on two biases in the way that people with eating disorders process information in the world around themThe first bias, set shifting difficulties, refers to difficulties in changing a pattern of thinking or behaviour once it is establishedThe second bias, weak central coherence, refers to a style of thinking that is preferential toward detail at the expense of global integrationConsiderable amount of evidence has implicated these biases in eating disordersEvidence from twin studies and family studiessuggests that these biases are enduring traits as opposed to unstable states, i.e. they exist prior to the development of psychopathology.
- Goddard et al. (2013) compared males with healthy control males and found poorer set shifting and some evidence for weaker central coherenceHowever, there is no information about how these biases relate to muscularity.This gap in the literature is problematic because muscle dissatisfaction appears to be equally important to body fat dissatisfaction in males, and muscle dysmorphia, a condition likened to “reverse anorexia” and which represents the drive for muscularity taken to the extreme, is argued by a growing number of researchers to be an eating disorder.Set shifting difficulties and weak central coherence might predict drive for muscularity and disordered eating. Evidence that drive for thinness and eating pathology correlate positively (some of the time) with these biases in women provides evidence for this assertion.
- The two outcome variables were drive for muscularity and muscularity-oriented disordered eating. The eating disorders examination – questionnare was modified because the original version is insensitive toward disordered eating behaviour motivated by the desire to increase muscle mass.
- Set shifting and central coherence were the two predictor variables. Set shifting ability was operationalised as the number of perseverative errors on the Wisconsin Card Sort Test, where more errors = poorer set shiftingCentral coherence was operationalised as performance on the Matching Familiar Figures Test, where a higher efficiency index = weaker central coherence. Wisconsin Card Sort TestStimulus card is matched to 1 of the 4 category cards (according to a categorisation rule (colour, shape or number).Rule changes after 4 consecutive correct responses"Perseverative errors" = repetitive responses to a rule despite a shift in the rule that requires a different response.More perseverative errors = poorer set shifting.Matching Familiar Figures Test"I will be recording both your speed and your accuracy" (word order is counterbalanced).2 practice trials, 12 test trials.Performance based on latency to first response and total number of errors.Calculate "efficiency index" (Southgate, Tchanturia & Treasure, 2008)Efficiency = -(Zerrors + Zlatency)Higher efficiency index = weaker central coherence
- The correlations in bold are of primary interest, and show that drive for muscularity was positively correlated with errors on the Wisconsin Card Sort Test and with the efficiency index yielded from the Matching Familiar Figures Test. This indicates that increased drive for muscularity tended to be associated with poorer set shifting and weaker central coherence. Similarly, muscularity-oriented disordered eating was positively associated with set shifting difficulties, but not weak central coherence.
- Drive for muscularity was uniquely positively associated with greater set shifting difficulties and weaker central coherence, and muscularity-oriented disordered eating was uniquely positively associated with greater set shifting difficulties. Partial eta-squares of .06 to .07 indicate that the magnitude of these significant effects was medium, suggesting that these influences are far from trivial.
- First evidence to link information processing biases with the other half, i.e. muscularity-focused body image and eating concernsPreliminary evidence that therapies such as cognitive remediation therapy that directly address these biases may be useful for men with muscularity-focused body image and eating pathologyPreliminary evidence that these biases will be present in muscle dysmorphia, which is a hypothesis currently being borne out in our ongoing clinical comparison of men with muscle dysmorphia and men with classical “thinness-oriented” eating disordersThese findings offer a cautionary note to clinicians that males with otherwise healthy BMIs may harbour cognitive impediments that make it additionaly difficult for them to change their behaviours and/or beliefs
- Several limitations of this study are noted. First, we did not control for symptoms of depression and obsessive-compulsive dis- order. Although participants self-reported no current diagnosis of depression or obsessive-compulsive disorder, there is recent evidence that these disorders may be partly responsible for the information-processing biases seen in women with anorexia ner- vosa (Giel et al., 2012). Future research should assess and control for symptomatology of both these disorders. Second, partici- pants in the study were nonclinical young adults, and although muscularity-oriented body image concerns often peak during this time (Olivardia et al., 2004), the extent to which these results would generalise to other male populations (e.g., older men) is unclear. Third, the MFFT is predominantly a measure of detail-processing ability. Future examinations of central coherence should use addi- tional tests that focus on global integration. Finally, the study design was correlational, which precludes making causal inferences.