Attentional Bias, Emotion Recognition, and Emotion Regulation in Anorexia: State or Trait?

Background: Anorexia nervosa (AN) is associated with difficulties in emotion recognition and regulation and with attentional biases to social affective stimuli. This study aimed to examine these factors in a group of women following long-term recovery from AN. Methods: The Reading the Mind in the Eyes task, Difficulties in Emotion Regulation Scale, and a computerized pictorial Stroop task (angry and neutral faces) were administered to 175 women: 50 with acute AN, 35 recovered from AN, and 90 healthy control subjects (HCs). Results: The recovered group had a significantly higher social and angry-threat attentional bias than HCs, with medium effect sizes, and significantly lower scores on the emotion recognition measure than HCs, with a medium effect size. On the other hand, the recovered group did not significantly differ from the HC group in terms of emotion regulation. Conclusions: Attentional biases to social affective pictorial stimuli and difficulties with emotion recognition appear to be traits associated with a lifetime history of AN, whereas emotion regulation difficulties appear to remit when the individual successfully recovers from the illness.