title: Does habituation really happen? Investigation of psycho-biological responses to body exposure in bulimia nervosa.
abstract: BACKGROUND
  Body exposure is a common and effective treatment for body image disturbance in bulimia nervosa (BN). However, little is known about treatment mechanisms. Based on models of emotional processing and neurovisceral integration, we expected to observe a) initial activation and b) habituation of cognitive-affective and autonomic responding within one and between two standardized body exposure sessions.
  
  
  METHODS
  A group of 13 women with BN and 13 healthy controls (HC) were repeatedly exposed to their bodies. Prior to and after treatment with three individualized mirror exposure sessions participants received a session of standardized exposure to videographic recordings of their body. Subjective ratings of body-related emotions and thoughts were assessed repeatedly throughout the standardized exposure sessions and autonomic responses were recorded continuously.
  
  
  RESULTS
  Subjective and sympathetic responses were activated initially in both groups. Cognitive-affective responses habituated within the standardized sessions in both groups, whereas between the standardized sessions habituation was only found in women with BN. Increasing sympathetic responses were found within the sessions in both groups.
  
  
  CONCLUSIONS
  The results support cognitive-affective habituation during body exposure in BN and to a lesser extent in HC. Autonomic responses however did not show a corresponding pattern and did not distinguish between groups. Implications for body exposure research and practice are discussed.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Albert-Ludwigs-University Freiburg, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Trentowska
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Eberhard Karls University Tübingen, Germany. Electronic address: jennifer.svaldi@uni-tuebingen.de.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Svaldi
authors.affiliation: Department for Psychology & Centre for Cognitive Neuroscience, University of Salzburg, Austria.
authors.forename: Jens
authors.initials: J
authors.lastname: Blechert
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Albert-Ludwigs-University Freiburg, Germany.
authors.forename: Brunna
authors.initials: B
authors.lastname: Tuschen-Caffier
mesh_terms: D000328:Adult; D001828:Body Image / Q000523:psychology*; D052018:Bulimia Nervosa / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology; D004644:Emotions / Q000502:physiology; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006185:Habituation, Psychophysiologic / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007171:Implosive Therapy; D014741:Video Recording; D055815:Young Adult
keywords: Autonomic responses; Body image exposure; Bulimia nervosa; Cognitions; Eating disorder; Habituation process