Body shape rather than facial emotion of others alters interpersonal distance in patients with anorexia nervosa

ObjectiveThe study investigated interpersonal distance in patients with anorexia nervosa (AN), focussing on the role of other's facial expression and morphology, also assessing physiological and subjective responses.MethodTwenty-nine patients with AN and 30 controls (CTL) were exposed to virtual characters either with an angry, neutral, or happy facial expression or with an overweight, normal-weight, or underweight morphology presented either in the near or far space while we recorded electrodermal activity. Participants had to judge their preferred interpersonal distance with the characters and rated them in terms of valence and arousal.ResultsUnlike CTL, patients with AN exhibited heightened electrodermal activity for morphological stimuli only, when presented in the near space. They also preferred larger and smaller interpersonal distances with overweight and underweight characters respectively, although rating both negatively. Finally, and similar to CTL, they preferred larger interpersonal distance with angry than neutral or happy characters.DiscussionAlthough patients with AN exhibited behavioural response to emotional stimuli similar to CTL, they lacked corresponding physiological response, indicating emotional blunting towards emotional social stimuli. Moreover, they showed distinct behavioural and physiological adjustments in response to body shape, confirming the specific emotional significance attached to body shape. Patients with anorexia nervosa (AN) show a regulation of interpersonal distances to social emotional stimuli similar to healthy controls (CTL) but lack the corresponding physiological response. Patients with AN, not CTL, prefer shorter interpersonal distance with underweight social stimuli and larger interpersonal distance with overweight ones and show increased physiological response to both of them. Patients with AN show a bias towards morphological rather than emotional cues when processing information to optimise social interaction.