title: Explicit and implicit emotional expression in bulimia nervosa in the acute state and after recovery.
abstract: Expression of emotional state is considered to be a core facet of an individual's emotional competence. Emotional processing in BN has not been often studied and has not been considered from a broad perspective. This study aimed at examining the implicit and explicit emotional expression in BN patients, in the acute state and after recovery. Sixty-three female participants were included: 22 BN, 22 recovered BN (R-BN), and 19 healthy controls (HC). The clinical cases were drawn from consecutive admissions and diagnosed according to DSM-IV-TR diagnostic criteria. Self reported (explicit) emotional expression was measured with State-Trait Anger Expression Inventory-2, State-Trait Anxiety Inventory, and Symptom Check List-90 items-Revised. Emotional facial expression (implicit) was recorded by means of an integrated camera (by detecting Facial Feature Tracking), during a 20 minutes therapeutic video game. In the acute illness explicit emotional expression [anxiety (p<0.001) and anger (p<0.05)] was increased. In the recovered group this was decreased to an intermediate level between the acute illness and healthy controls [anxiety (p<0.001) and anger (p<0.05)]. In the implicit measurement of emotional expression patients with acute BN expressed more joy (p<0.001) and less anger (p<0.001) than both healthy controls and those in the recovered group. These findings suggest that there are differences in the implicit and explicit emotional processing in BN, which is significantly reduced after recovery, suggesting an improvement in emotional regulation.
authors.affiliation: Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Salomé
authors.initials: S
authors.lastname: Tárrega
authors.affiliation: Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
authors.forename: Ana B
authors.initials: AB
authors.lastname: Fagundo
authors.affiliation: Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Clinical Sciences Department, School of Medicine, University of Barcelona, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Jiménez-Murcia
authors.affiliation: Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Roser
authors.initials: R
authors.lastname: Granero
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Giner-Bartolomé
authors.affiliation: Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Forcano
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sánchez
authors.affiliation: Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Santamaría
authors.affiliation: Faculty of Social Sciences and Economics, University of Geneva, Geneva, Switzerland.
authors.forename: Maher
authors.initials: M
authors.lastname: Ben-Moussa
authors.affiliation: Faculty of Social Sciences and Economics, University of Geneva, Geneva, Switzerland.
authors.forename: Nadia
authors.initials: N
authors.lastname: Magnenat-Thalmann
authors.affiliation: Faculty of Social Sciences and Economics, University of Geneva, Geneva, Switzerland.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Konstantas
authors.affiliation: Serious Game Interactive (SGI), Copenhagen, Denmark.
authors.forename: Mikkel
authors.initials: M
authors.lastname: Lucas
authors.affiliation: Serious Game Interactive (SGI), Copenhagen, Denmark.
authors.forename: Jeppe
authors.initials: J
authors.lastname: Nielsen
authors.affiliation: MobiHealth B.V., Enschede, The Netherlands.
authors.forename: Richard G A
authors.initials: RG
authors.lastname: Bults
authors.affiliation: NetUnion, Lausanne, Switzerland.
authors.forename: Tony
authors.initials: T
authors.lastname: Lam
authors.affiliation: Wire Communications Laboratory, University of Patras, Patras, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Kostoulas
authors.affiliation: Wire Communications Laboratory, University of Patras, Patras, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Fakotakis
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
authors.forename: Nadine
authors.initials: N
authors.lastname: Riesco
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
authors.forename: Ines
authors.initials: I
authors.lastname: Wolz
authors.affiliation: Department of Cardiology, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Comín-Colet
authors.affiliation: Eating Disorders Unit, Institute of Psychiatry, King's College, London, United Kingdom.
authors.forename: Valentina
authors.initials: V
authors.lastname: Cardi
authors.affiliation: Eating Disorders Unit, Institute of Psychiatry, King's College, London, United Kingdom.
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
authors.affiliation: CIBER, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Fernández-Formoso
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Clinical Sciences Department, School of Medicine, University of Barcelona, Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Instituto Salud Carlos III, Barcelona, Spain.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Menchón
authors.affiliation: Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Clinical Sciences Department, School of Medicine, University of Barcelona, Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Aranda
mesh_terms: D000208:Acute Disease; D000328:Adult; D000786:Anger; D001007:Anxiety / Q000150:complications; D052018:Bulimia Nervosa / Q000150:complications / Q000523:psychology*; D004644:Emotions; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D055815:Young Adult