Stimulus-response compatibility tests of implicit preference for food and body image to identify people at risk for disordered eating: a validation study

The aim of this study was to incorporate implicit measures of relevant social cognition into eating disorder research. Fifty-three females diagnosed with an eating disorder (ED), and 41 at-risk females were recruited via ED support websites, along with 23 healthy females for comparison. Computerised online tests assessing subconscious normative ideal body image (IBI-BIAT) and personalised self-identification body image (PBI-BIAT) associations and food preferences (FP-AAT) were administered, followed by the modified version of the Eating Disorder Examination Questionnaire (EDE-Q). Anthropometric data, age, need for social approval, self-reported measures of self-esteem, normative perception and body image satisfaction were recorded. Self-reported diagnosed ED status was corroborated with BMI and EDE-Q. Diagnostic performance of the implicit measures was assessed with ROC analysis. Those diagnosed with ED showed significantly stronger automatic preferences for and self-identification with thin body image, compared to healthy females, but no differences were found in food preferences. The IBI-BIAT showed better diagnostic power than PBI-BIAT, correctly classifying 87% of the diagnosed participants. No correlation was found between IBI-BIAT and the explicit measures. The results suggest that the underlying subconscious social cognitive factors of pathological eating are linked to body image, not to food items per se. (C) 2014 Elsevier Ltd. All rights reserved.