Remember the Past: Body-related Autobiographical Memories in Patients with an Eating Disorder

Like many other mental disorders, eating disorders are marked by insufficient
recovery after treatment. One factor playing a role in the persistence of
eating disorders may be a persevering negative body image. Recent research
suggests that the emotion of disgust towards the own body is closely connected
to body image disturbances and (other) eating disorder symptoms. This
pre-dominance of disgust in defining patients* body image is likely to bias
information processing to information that is congruent with that body image.
Importantly, memories about past aversive experiences involving the own body
(e.g., receiving an insulting comment about one*s appearance) may become highly
accessible. Specific autobiographical memories may be a source of powerful
emotions. Thus, accessing specific memories with a disgust-related content
would likely result in the experience of intense disgust. Disgust is a powerful
defensive emotion that elicits a strong urge to avoid disgust-elicitors.
Therefore, in order to avoid feeling intense disgust, eating disorders-patients
may avoid specific memories through (1) controlled avoidance to prevent
experiencing disgust during abstract (top-down, generative) memory retrieval
and (2) re-active avoidance to escape from feeling disgusted during
concrete/direct (bottom-up, associative) memory retrieval. We hypothesize that
abstract memory retrieval leads to fewer specific memories than concrete
retrieval and that this reduced memory specificity is related to negative body
image scores and a patient*s motivation to prevent experiencing disgust. In
addition, we hypothesize that concrete retrieval results in more specific and
disgust-eliciting memories than abstract retrieval, and that negative body
image scores predict stronger tendencies to escape from memories because of the
elicited disgust.

The main objectives of this project are to increase our knowledge of factors
playing a role in the maintenance of body image concerns in eating disorder
patients. More specifically, we will examine the involvement of disgust-based
avoidance of specific autobiographical memories about patients* own bodies in
concrete and abstract memory retrieval.

The design of the study is a observational within-participants study with two
measurement occasions (T1 & T2) comparing abstract and concrete retrieval of
body-related memories on two versions of the Autobiographical Memory Test
(AMT). We attempt to elicit the different retrieval processes by asking eating
disorder patients to recall personal memories in response to body-related cue
words that are either abstract (generative retrieval; abstract AMT) or concrete
(direct retrieval; concrete AMT). Each AMT will be administered on one
measurement occasion (T1/T2), and the order will be counterbalanced across
participants.

Participants will be asked to fill out six questionnaires, engage in the two
AMTs and rate their memories after each of the AMTs. In total, the time
investment will be 100 minutes. Recalling potentially negative memories may
elicit negative affect in the patients. Because all patients will be in
treatment at the time of the study, any negative effects of the study can be
discussed with their therapists. The study is expected to advance our current
understanding of the persistence of body image disturbances in patients with an
eating disorder. Both hypothesized forms of avoidance are expected to
ultimately result in representations of body-related memories at a
semantic-categorical level (e.g., *I always look gross at the beach*). Since
autobiographical memories serve as a crucial source of how people define
themselves, a bias towards disgust-congruent over-general memories will likely
affirm and maintain the negative body image by obstructing the processing of
potentially corrective information.