Examining implicit attitudes toward emaciation and thinness in anorexia nervosa.
OBJECTIVE
To determine if females with anorexia nervosa (AN) associate emaciation with beauty by examining implicit attitudes toward emaciated bodies relative to thin bodies.


METHODS
Thirty women with AN and 29 healthy control women were primed by viewing images of either emaciated or thin women. Participants then completed a lexical decision task (LDT), wherein they distinguished words from nonwords as quickly and accurately as possible. Response times were measured. Real words consisted of beautiful, ugly, neutral, and positive words. Body mass index (BMI) was measured and several clinical interviews were completed, including the Eating Disorders Examination Questionnaire 4 (EDEQ-4).


RESULTS
There was a significant effect of group in the emaciated condition; participants with AN responded faster to both beautiful and ugly words than control women did. Eating disorder symptom severity (as measured by the EDEQ-4 subscales) predicted the strength of the association between emaciation and beauty.


CONCLUSIONS
At an implicit, automatic level, women with AN in this study had stronger associations between emaciation and both beauty and ugliness than control women did, suggesting that women with AN may have atypical beliefs about beauty. Thin ideal internalization is an important factor in the development and maintenance of eating disorders; the type of thin ideal being internalized may be important to consider, particularly given the extent to which pro-eating disorder websites promote idealization of emaciation. The associations found by using the LDT highlight the utility of implicit measures, particularly when conducting assessments involving sensitive or atypical beliefs.
Department of Psychology, Miami University, Oxford, Ohio.
April R
AR
Smith
Thomas E
TE
Joiner
Dorian R
DR
Dodd
D000293:Adolescent; D000856:Anorexia Nervosa / Q000523:psychology*; D001290:Attitude; D001504:Beauty; D001828:Body Image; D015992:Body Mass Index; D016022:Case-Control Studies; D004614:Emaciation / Q000523:psychology*; D005260:Female; D006801:Humans; D011795:Surveys and Questionnaires; D013851:Thinness / Q000523:psychology*; D055815:Young Adult
anorexia nervosa; beliefs; cognition; implicit attitudes; thin ideal