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Attention Bias Modification Training in Anorexia Nervosa
Attention Bias Modification Training, or ABMT, is a technique originally used for Anxiety Disorders and is, according to Mercado [1], “a form of cognitive bias modification training with the potential for modifying AB triggered by different stimuli.” This form of modification training is used to train an individual’s attention towards stimuli that are not compatible with their disorder.
In Anorexia Nervosa, then, ABMT can be used to help selectively capture the attention of the individual towards salient stimuli, such as food, compared to stimuli that are deemed as neutral. The process can occur subconsciously, and it is thought to influence subsequent behavior, such as restriction in Anorexia Nervosa.
Shifting Attention
Patients with Eating Disorders, specifically Anorexia Nervosa, exhibit particular attention bias towards negative Eating Disorder related stimuli, which is what reinforces their Eating Disorder behaviors. For these individuals, according to Brockmeyer [2], “Attentional Bias Modification strategies might be particularly helpful in changing cognitive biases to negative social stimuli through modification and attentional pathways.”
In other words, by shifting the individuals’ attention more favorably towards stimuli that will negate their Eating Disorder behaviors, they can subconsciously begin to interpret these stimuli in a favorable light and, in essence, rewire their brains to become more recovery-inclined.
The way in which ABMT fits into psychological treatment for Anorexia Nervosa is that it can, according to Campbell [3], “diverting the patient’s attention away from anxiety by implicitly retuning automatic attentional bias. Since Eating Disorders are a result of biological, psychological, and societal causes, there is a piece of both the illness and recovery that has to do with the brain pathways.
ABMT targets these specific cognitive processes by modifying the way the individual responds to certain stimuli. According to Campbell [3], “By repeatedly directing attention toward or away from illness-specific stimuli, relevant automatic cognitive processes are modifiable.”
Applications
While Eating Disorder treatment is most effective when integrating a variety of therapeutic techniques and interventions, incorporating ABMT into the mix for treatment can imply longer-lasting results as it targets the cognitive aspects of the disorder. For successful treatment, one must always target all of the different aspects of the illness.
The cognitive distortions inherent in Anorexia Nervosa become deep-seated and make recovery incredibly challenging for the individual. (For example, thinking that certain foods are “good” or “bad” become hard-wired for the individual).
In restructuring the way the individual responds to certain stimuli, they can develop different ways of thinking that are more congruent with recovery (such as in intuitive eating, where there are no food labels). These new neural pathways lead to alternative forms of behavior, which are the beneficial steps of Eating Disorder recovery.
Resources:
[1] Mercado, D., Schmidt, U., O’Daly, O.G., et al. Food related attention bias modification training for anorexia nervosa and its potential underpinning mechanisms. J Eat Disord 8, 1 (2020). https://doi.org/10.1186/s40337-019-0276-9 [2] Brockmeyer, Timo, Schmidt, Ulrike et al. The ABBA Study. J Vol 17. (2016). https://www.researchgate.net/publication/308667789_The_ABBA_study_-_approach_bias_modification_in_bulimia_nervosa_and_binge_eating_disorder_Study_protocol_for_a_randomised_controlled_trial [3] Campbell, Ian. Review of Attentional Bias Modification. (Nov 2013). https://www.researchgate.net/publication/256425541_Review_of_Attentional_Bias_Modification_A_Brain-directed_Treatment_for_Eating_DisordersAbout the Author:
Emma Demar, LMSW is a therapist at Intrinpsych Woman on the Upper East Side of Manhattan. She holds an LMSW from Fordham University and holds a BA in Creative Writing from Trinity College. Emma recently completed a 2-Year Fellowship at Intrinpsych where she was expertly trained in Eating Disorders and DBT.
She uses a holistic approach in working with her patients, drawing from her background in Psychodynamic, CBT, and DBT, and she likes to begin where the client is and work from a strengths-based perspective. She specializes in Eating Disorders, OCD and related mental health disorders. Emma uses a direct, honest and open approach in working with her patients, who are generally women ages 12 to 32. She freelance writes for various mental health websites, and she blogs on her own website, thattrendytherapist.com.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Reviewed & Approved on April 24, 2020, by Jacquelyn Ekern MS, LPC
Published April 24, 2020, on EatingDisorderHope.com
