Testing the specificity of interpretation biases in women with eating disorder symptoms: An online experimental assessment

Objective: Cognitive biases, such as memory, attention, and interpretation bias, are thought to play a central role in the development and maintenance of eating disorders (EDs). The aim of the present study was to investigate whether the interpretation bias is ED-specific or can be generalized to comorbid disorder-related threats in women with high levels of ED symptoms. Method: In an online study, we measured interpretation bias using the modified Sentence Word Association Paradigm (SWAP), comparing women with (n = 39) and without (sub)threshold eating disorders (n = 56). We assessed endorsement and rejection rates as well as reaction times in response to a positive/neutral or a negative ED-specific, social anxiety-specific (SAD), or generalized anxiety-specific (GAD) interpretive word following an ambiguous sentence. Results: In ambiguous situations, women with high ED symptoms selected more negative (p <.001) and fewer positive/neutral ED-related interpretations (p <.001). Negative interpretations were endorsed significantly faster (p <.001), while positive interpretations were rejected faster in this group (p <.001). These women also manifested negative SAD-specific interpretation bias patterns in reaction time measures. Nevertheless, ED severity was best predicted by the endorsement of negative ED-specific stimuli, whereas ED and SAD reaction time measures seemed to have a negligible effect. Discussion: The results indicate that the interpretation bias might be ED-specific. The SWAP can be a useful tool for the further investigation of the etiological relevance of the interpretation bias as well as for the development of modification training interventions.