Attention orienting and inhibitory control across anorexia nervosa types: an antisaccade eye-tracking study

Patients with Anorexia Nervosa experience difficulties in processing emotional stimuli within social contexts, which may contribute to some clinical manifestations of the disorder. However, it remains unclear whether emotional processing differs between the restrictive and binge-eating/purging types of AN. The study aimed to examine attentional biases towards emotional stimuli in restrictive, binge-eating/purging Anorexia Nervosa patients, and healthy controls. The sample included 28 restrictive (mean age = 16.5 years) and 20 binge-eating/purging patients (mean age = 25.5), and 29 healthy controls (mean age = 25.0). Attentional orienting and inhibitory control to neutral, happy, sad, and angry faces were assessed using prosaccade and antisaccade tasks with eye-tracking technology. Error rates and saccade latencies were analyzed for the prosaccade and antisaccade tasks using 4 (Valence) × 3 (Group) mixed ANCOVAs, with age and educational level as covariates. No significant differences or significant interactions were found in the prosaccade task. In the antisaccade task, the restrictive group showed a higher percentage of antisaccade errors when presented with sad and angry faces than with neutral faces. In contrast, unlike the AN-R and HC groups, Binge-eating/purging patients showed shorter antisaccade latencies to happy than to neutral faces. Overall, attentional processing of emotional facial expressions appears to differ depending on Anorexia Nervosa type, with restrictive patients showing greater difficulty inhibiting attention in response to distressing socio-emotional information, while binge-eating/purging patients showed a different pattern of attentional disengagement from positive information. These findings highlight the importance of considering differences in socio-emotional processing when tailoring interventions to Anorexia Nervosa type.