The Influence of Negative Affect on Working Memory Updating of Food Stimuli Among Adolescents With Anorexia Nervosa

Difficulty updating information in working memory has been proposed to underlie ruminative thinking in individuals with anorexia nervosa (AN). However, evidence regarding updating difficulties in AN remains inconclusive, particularly among adolescents. It has been proposed that exposure to negative emotion and disorder-salient stimuli may uniquely influence updating in AN. This study examined the influence of exposure to negative emotion on updating of food and non-food stimuli among adolescents with AN.

The study included 41 female adolescents with restrictive AN (M _age = 15.2) and 43 female controls (M _age = 16.9) who performed a modified version of the N-back task requiring updating of food and non-food content after supraliminal exposure to emotionally neutral and negative images.

Medium-to-large effects revealed significantly higher updating errors among adolescents with AN compared to controls for food targets and after exposure to negative stimuli. In contrast, during exposure to both negative images and food targets, the groups performed similarly, as this condition also increased updating errors among controls. Additionally, a higher proportion of updating errors was associated with greater eating disorder symptoms severity.

The findings indicate that exposure to negative emotion and food stimuli separately compromise working memory updating in adolescents with AN. These results underscore the role of environmental triggering cues in compromising working memory updating in AN and highlight the importance of considering ecological cues when evaluating cognitive functioning in eating disorders.