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. 2020 Oct 5;9(10):3210.
doi: 10.3390/jcm9103210.

Validity of Virtual Reality Body Exposure to Elicit Fear of Gaining Weight, Body Anxiety and Body-Related Attentional Bias in Patients with Anorexia Nervosa

Bruno Porras-Garcia  1 , Marta Ferrer-Garcia  1 , Eduardo Serrano-Troncoso  2 , Marta Carulla-Roig  2 , Pau Soto-Usera  2 , Helena Miquel-Nabau  1 , Nazilla Shojaeian  1 , Isabel de la Montaña Santos-Carrasco  3 , Bianca Borszewski  3 , Marina Díaz-Marsá  3 , Isabel Sánchez-Díaz  4 , Fernando Fernández-Aranda  4 , José Gutiérrez-Maldonado  1
Affiliations

Validity of Virtual Reality Body Exposure to Elicit Fear of Gaining Weight, Body Anxiety and Body-Related Attentional Bias in Patients with Anorexia Nervosa

Bruno Porras-Garcia et al. J Clin Med. .

Abstract

Fear of gaining weight (FGW), body image disturbances, associated anxiety and body-related attentional bias are the core symptoms of anorexia nervosa (AN) and play critical roles in its development and maintenance. The aim of the current study is to evaluate the usefulness of virtual reality-based body exposure software for the assessment of important body-related cognitive and emotional responses in AN. Thirty female patients with AN, one of them subclinical, and 43 healthy college women, 25 with low body dissatisfaction (BD) and 18 with high BD, owned a virtual body that had their silhouette and body mass index. Full-body illusion (FBI) over the virtual body was induced using both visuo-motor and visuo-tactile stimulation. Once the FBI was induced, the FBI itself, FGW, body anxiety and body-related attentional bias toward weight-related and non-weight-related body areas were assessed. One-way analyses of covariance (ANCOVA), controlling for age, showed that AN patients reported higher FGW, body anxiety and body-related attentional bias than healthy controls. Unexpectedly, patients with AN reported significantly lower FBI levels than healthy participants. Finally, Pearson correlations showed significant relationships between visual analog scales and body-related attentional bias measures, compared to other eating disorder measures. These results provide evidence about the usefulness of virtual reality-based body exposure to elicit FGW and other body-related disturbances in AN patients. Thus, it may be a suitable intervention for reducing these emotional responses and for easing weight recovery.

Keywords: anorexia nervosa; body anxiety; body image disturbances; body-related attentional bias; fear of gaining weight; virtual reality.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript or in the decision to publish the results.

Figures

Figure 1
Figure 1
Weight-related and non-weight-related areas of interest on the female virtual avatar.
Figure 2
Figure 2
Differences between patients with Anorexia Nervosa (AN) and women with high and low body dissatisfaction (BD) (means and standard errors) in the complete fixation time (in milliseconds; ms) and the number of fixations on individual weight-related areas of interest (AOIs). Post-hoc analyses: ** p < 0.01 and * p < 0.05.
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