Eating Disorders Information (EDI)

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Recovery from Anorexia includes development of neural coping mechanisms for negative emotional reactions to bodies

Posted by a.marlow on January 18, 2013 at 6:35 PM

How do recovered anorexics emotionally react to negative images of the body? Does recovery involve dampening one’s emotional reaction to them, or simply finding other ways of coping?

A recent study by Pruis et al in the International Journal of Eating Disorders has found that women who have recovered from eating disorders retain a greater emotional reaction to negative images of bodies as opposed to neutral or positive images as compared with a control group, and from this they conclude that recovery from anorexia nervosa does not include a dampening of one’s emotional responses to negative body images, but merely the development of mental coping mechanisms that prevent these emotional responses from disturbing cognition.

The researchers specifically looked at three parts of the brain, and found unexpected results from a fourth. Their intention was initially focused on the amygdala, which is related to one's initial fearful and/or emotional response to stimuli; a subregion of the fusiform that particularly responds to bodies; and the lateral prefrontal cortex, which is supposed to regulate emotions.

While they found no difference between the recovered anorexics and the control group in terms of how their lateral prefrontal cortexes reacted to a working memory task, they did find increased activity in the recovered anorexics' amygdalas and fusiforms and, unexpectedly, a suppression of activity in their medial prefrontal cortexes.

The increased activity in the amygdala and fusiform is seen as evidence of a greater emotional response by the recovered anorexics' to the stimulus of a negative body image. This could be taken as a 'scar' left behind by the anorexia, an indication that these particular women were predisposed to get anorexia, or perhaps evidence that their recovery is not quite complete on a psychological level.

An increase in activity of the lateral prefrontal cortex was hypothesised as the means by which the recovered anorexics' emotional responses to negative body images could be mediated. However, there was no difference between the activity here in the recovere anorexic group and the control group. This in itself is a result, given that those still ill with anorexia show reduced activity in the lateral prefrontal cortex; however, it was not the result the researchers were looking for.

What they found instead was asuppression of the medial prefrontal cortex, which was hypothesised to be involved in the control of self-referential emotional responses in order to allow other cognitive processes to continue. 

The practical results of such research for therapists are as follows: recovery from anorexia does not necessarily involve salvation from one's initial negative emotional response upon seeing a negatively rated body image, but it does involve the learning of coping mechanisms to prevent these emotional responses from blocking other cognitive processes, these perhaps being expressed in the increase to normal levels of activity in the lateral prefrontal cortex and in the suppression of activity in the medial prefrontal cortex. 



Pruis, T. A., Keel, P. K., & Janowsky, J.S., 2012. Recovery from Anorexia Nervosa Includes Neural Compensation for Negative Body Image. International Journal of Eating Disorders, 45, pp. 919-931

Categories: neuropsychology

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