{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:55:07Z","timestamp":1787770507101,"version":"build-2784847793"},"reference-count":40,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>In anorexia nervosa, aberrant emotional reactions toward body stimuli have been discussed. We investigated heart rate as a physiological marker when viewing body stimuli and hypothesized altered HR reactions toward those highly significant and emotional stimuli in anorexia nervosa. In total, 37 anorexia nervosa patients and 43 control participants viewed pictures of women of five different weight categories, while their cardiac activity was recorded. R-R intervals following picture onset were determined, and means were calculated for three distinct time periods. The overall change in HR relative to baseline across all picture categories was greater in the patient group than in the control group (significant effect of \u201cgroup\u201d, p = 0.002, partial \u03b72 = 0.120). A significant decrease in HR 2 to 8 s after picture presentation was found for pictures of women of extreme weight in both participant groups (significant \u201ccategory \u2217 time segment interaction\u201d, p = 0.01, partial \u03b72 = 0.037) and correlated with scores of sociocultural attitudes toward the appearance for the extremely underweight category (r = \u22120.33, p = 0.005). Therefore, differential HR reactions for anorexia nervosa patients and control participants were found for body stimuli in general. The highest HR decelerations in response to pictures of strongly underweight and overweight women may reflect emotional processes such as anxiety due to social comparison.<\/jats:p>","DOI":"10.3390\/bs13030215","type":"journal-article","created":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T03:06:43Z","timestamp":1677726403000},"page":"215","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Heart Rate as a Correlate for the Emotional Processing of Body Stimuli in Anorexia Nervosa"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7512-3262","authenticated-orcid":false,"given":"Stefanie","family":"Horndasch","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0265-0333","authenticated-orcid":false,"given":"Elisabeth","family":"Sharon","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5584-0961","authenticated-orcid":false,"given":"Anna","family":"Eichler","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holmer","family":"Graap","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen-Nuremberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunther H.","family":"Moll","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7334-950X","authenticated-orcid":false,"given":"Oliver","family":"Kratz","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1007\/s00406-015-0603-3","article-title":"Perception and evaluation of women\u2019s bodies in adolescents and adults with anorexia nervosa","volume":"265","author":"Horndasch","year":"2015","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1007\/s10508-008-9424-z","article-title":"Eating and body image disturbances in male-to-female and female-to-male transsexuals","volume":"38","author":"Vocks","year":"2009","journal-title":"Arch. Sex Behav."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1037\/1528-3542.1.3.276","article-title":"Emotion and motivation I: Defensive and appetitive reactions in picture processing","volume":"1","author":"Bradley","year":"2001","journal-title":"Emotion"},{"key":"ref_4","unstructured":"Birbaumer, N.\u00d6.A. (1993). The Organization of Emotions, Hogrefe-Huber."},{"key":"ref_5","unstructured":"Appley, M.H., and Trumbull, R. (1967). Psychological Stress: Issues in Research, Appleton-Century-Crofts."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ijpsycho.2006.09.003","article-title":"Heart rate response after emotional picture presentation is modulated by interoceptive awareness","volume":"63","author":"Pollatos","year":"2007","journal-title":"Int. J. Psychophysiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s40337-021-00372-1","article-title":"Physiological, emotional and neural responses to visual stimuli in eating disorders: A review","volume":"9","author":"Burmester","year":"2021","journal-title":"J. Eat. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.appet.2010.10.002","article-title":"Information processing of food pictures in binge eating disorder","volume":"55","author":"Svaldi","year":"2010","journal-title":"Appetite"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0301-0511(01)00093-X","article-title":"Food deprivation and emotional reactions to food cues: Implications for eating disorders","volume":"57","author":"Drobes","year":"2001","journal-title":"Biol. Psychol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1002\/1098-108X(199103)10:2<169::AID-EAT2260100205>3.0.CO;2-Y","article-title":"Effects of mood on heart rate reactivity in bulimia nervosa","volume":"10","author":"Laberg","year":"1991","journal-title":"Int. J. Eat. Disord."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1002\/eat.22387","article-title":"Altered interoceptive awareness in anorexia nervosa: Effects of meal anticipation, consumption and bodily arousal","volume":"48","author":"Khalsa","year":"2015","journal-title":"Int. J. Eat. Disord."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1037\/0021-843X.115.3.567","article-title":"Affect regulation and food intake in bulimia nervosa: Emotional responding to food cues after deprivation and subsequent eating","volume":"115","author":"Mauler","year":"2006","journal-title":"J. Abnorm. Psychol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/NMD.0000000000001458","article-title":"Interoceptive Awareness and Anorexia Nervosa: When Emotions Influence the Perception of Physiological Sensations","volume":"210","author":"Wollast","year":"2022","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1037\/a0029922","article-title":"Psychophysiological reactions to objectified weight-classified stimuli","volume":"2","author":"Green","year":"2013","journal-title":"Psychol. Pop. Media Cult."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/S0306-4603(97)80002-0","article-title":"Cue reactivity to food- and body-related stimuli in restrained and unrestrained eaters","volume":"22","author":"Overduin","year":"1997","journal-title":"Addict. Behav."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1111\/psyp.12160","article-title":"\u201cGlass fairies\u201d and \u201cbone children\u201d: Adolescents and young adults with anorexia nervosa show positive reactions towards extremely emaciated body pictures measured by the startle reflex paradigm","volume":"51","author":"Reichel","year":"2014","journal-title":"Psychophysiology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1002\/eat.23022","article-title":"Blunted emotion-modulated startle reflex in anorexia nervosa","volume":"52","author":"Brockmeyer","year":"2019","journal-title":"Int. J. Eat. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"630426","DOI":"10.3389\/fpsyg.2021.630426","article-title":"Emotion and Psychophysiological Responses During Emotion-Eliciting Film Clips in an Eating Disorders Sample","volume":"12","author":"French","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"673597","DOI":"10.3389\/fpsyg.2021.673597","article-title":"Electrodermal Response to Mirror Exposure in Relation to Subjective Emotional Responses, Emotional Competences and Affectivity in Adolescent Girls With Restrictive Anorexia and Healthy Controls","volume":"12","author":"Knejzlikova","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1002\/erv.2881","article-title":"Pupil psychosensory reflex in response to own and standardised silhouettes in patients with anorexia nervosa","volume":"30","author":"Couton","year":"2022","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"104438","DOI":"10.1016\/j.appet.2019.104438","article-title":"Emotion regulation across eating pathology: A meta-analysis","volume":"143","author":"Prefit","year":"2019","journal-title":"Appetite"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1007\/s40519-019-00768-8","article-title":"Emotion regulation, emotion recognition, and empathy in adolescents with anorexia nervosa","volume":"24","author":"Nalbant","year":"2019","journal-title":"Eat. Weight Disord."},{"key":"ref_23","unstructured":"Schneider, S., Pflug, V., In-Albon, T., and Margraf, J. (2017). Kinder-DIPS Open Access: Diagnostisches Interview bei psychischen St\u00f6rungen im Kindes-und Jugendalter, Forschungs-und Behandlungszentrum f\u00fcr psychische Gesundheit, Ruhr-Universit\u00e4t Bochum."},{"key":"ref_24","unstructured":"Schneider, S., and Margraf, J. (2006). Diagnostisches Interview bei Psychischen St\u00f6rungen, Springer. [3rd ed.]."},{"key":"ref_25","unstructured":"Paul, T., and Thiel, A. (2005). Eating Disorder Inventory-2, Hogrefe."},{"key":"ref_26","first-page":"365","article-title":"A German version of the Eating Disorder Inventory EDI-2","volume":"47","author":"Thiel","year":"1997","journal-title":"Psychother. Psychosom. Med. Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.bodyim.2009.01.002","article-title":"Validation of the German version of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-G)","volume":"6","author":"Knauss","year":"2009","journal-title":"Body Image"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1007\/s001120170107","article-title":"Perzentile f\u00fcr den Body-mass-Index f\u00fcr das Kindes-und Jugendalter unter Heranziehung verschiedener deutscher Stichproben","volume":"149","author":"Wabitsch","year":"2001","journal-title":"Mon. Kinderheilkd."},{"key":"ref_29","unstructured":"Weir, C.B., and Jan, A. (2022). BMI Classification Percentile and Cut Off Points, StatPearls."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/S0140-6736(10)62226-X","article-title":"Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: A systematic review of observational studies","volume":"377","author":"Fleming","year":"2011","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1002\/erv.2791","article-title":"Heart rate variability as a biomarker for anorexia nervosa: A review","volume":"29","author":"Peyser","year":"2021","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1017\/S0033291706008129","article-title":"Differential motivational responses to food and pleasurable cues in anorexia and bulimia nervosa: A startle reflex paradigm","volume":"36","author":"Friederich","year":"2006","journal-title":"Psychol. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0301-0511(02)00114-X","article-title":"The effects of pictures of emotional faces on tonic and phasic autonomic cardiac control in women and men","volume":"62","year":"2003","journal-title":"Biol. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1002\/eat.23638","article-title":"Implicit approach-avoidance tendencies toward food and body stimuli absent in individuals with anorexia nervosa, bulimia nervosa, and healthy controls","volume":"55","author":"Kollei","year":"2022","journal-title":"Int. J. Eat. Disord."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1002\/erv.2744","article-title":"Approach and avoidance bias for thin-ideal and normal-weight body shapes in anorexia nervosa","volume":"28","author":"Brockmeyer","year":"2020","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"23","DOI":"10.3389\/fnhum.2011.00023","article-title":"The implicit nature of the anti-fat bias","volume":"5","author":"Schupp","year":"2011","journal-title":"Front. Hum. Neurosci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/erv.2812","article-title":"Weight bias and linguistic body representation in anorexia nervosa: Findings from the BodyTalk project","volume":"29","author":"Behrens","year":"2021","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.ijpsycho.2015.04.014","article-title":"Reduced emotional and cardiovascular reactivity to emotionally evocative stimuli in major depressive disorder","volume":"97","author":"Jin","year":"2015","journal-title":"Int. J. Psychophysiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1002\/eat.23276","article-title":"Improving emotion recognition in anorexia nervosa: An experimental proof-of-concept study","volume":"53","author":"Preis","year":"2020","journal-title":"Int. J. Eat. Disord."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1017\/S0033291717002604","article-title":"Advances in the treatment of anorexia nervosa: A review of established and emerging interventions","volume":"48","author":"Brockmeyer","year":"2018","journal-title":"Psychol. Med."}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/13\/3\/215\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:45:55Z","timestamp":1760121955000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/13\/3\/215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,2]]},"references-count":40,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["bs13030215"],"URL":"https:\/\/doi.org\/10.3390\/bs13030215","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,2]]}}}