Negative interpretation bias in females with bulimia nervosa

Abstract

Persons with bulimia nervosa (BN) often experience psychosocial difficulties, in particular heightened sensitivity to social rejection and a negative bias toward their social environment. Conversely, social competence and close friendships are protective against mental ill health. The aims of this study were to evaluate the interpretation of ambiguous social scenarios in females with and without BN and to assess the relationship between interpretation biases and clinical characteristics. Females with BN (n = 35) and controls (n = 35) were recruited via social media. Participants completed the Eating Disorder Examination Questionnaire (EDE-Q), Adult Rejection Sensitivity Questionnaire, the Depression Anxiety and Stress Scales (DASS), and finished sentence stems depicting ambiguous social scenarios. Completed sentence stems were rated as positive, neutral, or negative by blinded researchers. Females with BN made fewer positive and more negative interpretations of sentence stems than controls. The frequency of negative interpretations correlated positively with clinical symptoms on the EDE-Q, A-RSQ, and DASS. A negative interpretation bias was found in females with BN, which aligns with the finding shown by Cardi et al. that females with anorexia nervosa have a negative interpretation bias toward ambiguous social scenarios. This bias was not only associated with eating disorder psychopathology but also with depression, anxiety, and stress, highlighting a potential transdiagnostic role. Interventions that address psychosocial difficulties might prevent the onset, reduce symptoms, and improve prognosis.