Approach and avoidance bias for thin-ideal and normal-weight body shapes in anorexia nervosa.

OBJECTIVE: The two studies aimed to examine implicit affective evaluations of thin-ideal and normal-weight body shapes in women with anorexia nervosa (AN), taking identification with body shapes into account. METHOD: In study 1, approach-avoidance bias for thin-ideal and normal-weight bodies was assessed in 40 women with AN and 40 healthy women by using an Approach-Avoidance Task and female avatar bodies with a standard face as stimuli. In study 2, 39 women with AN and 38 healthy women underwent a similar task but identification with bodies was manipulated by presenting bodies once with the participant's own face and once with another woman's face. RESULTS: In study 1, patients with AN did not differ from healthy participants in their automatic approach-avoidance tendencies towards thin-ideal and normal-weight bodies. In study 2, no definite approach bias for a thin self and no avoidance bias for thin other women or for a normal-weight self were found. However, as compared to healthy women, those with AN showed a less positive implicit evaluation of thin other women, and an implicit preference for thin bodies depicted as themselves over thin bodies depicted as another woman. CONCLUSIONS: The findings suggest that intra-sexual competition for being slim is increased in AN. HIGHLIGHTS: Patients with AN did not generally differ from healthy participants in their automatic approach-avoidance tendencies towards thin-ideal and normal-weight bodies Women with AN showed a less positive implicit evaluation of thin other women Women with AN showed an implicit preference for thin bodies depicted as themselves over thin bodies depicted as another woman.