4. Discussion
anxiety, food-specific disgust, eating disorders, eating disorder
This explorative study assessed correlations between food-specific trait and state disgust, eating disorder psychopathology (EDE-Q global and BMI), and food interaction measures (eye gaze and touch) in people with AN. We collected food disgust sensitivity (trait disgust) and eating disorder psychopathology data at baseline before participants were randomly assigned to the different virtual kitchen scenarios in which food interaction measures were obtained. Participants were then asked to rate their disgust reactions (state disgust) to high-calorie foods. The correlations involving variables collected during or after the VR paradigm were examined for each scenario rather than the whole sample. There are two main findings in the present study. The first finding is that food-specific trait and state disgust were significantly and positively associated with eating disorder symptom severity. The second finding is that inconsistent correlations between food disgust sensitivity and food-related eye gaze in different virtual kitchen scenarios were observed.The first finding of an association between trait and state disgust with eating disorder psychopathology can be interpreted as an association of eating disorder severity with food-specific disgust. This is in line with a recent systematic review and meta-analysis that found that the levels of generic disgust sensitivity, self-disgust sensitivity, and momentary disgust to food images were significantly higher in people with eating disorders than in healthy controls [In addition, food-specific state disgust correlated with eating disorder severity in the three different virtual kitchen scenarios. However, there was no difference among the scenarios regarding the question of “How disgusted do you feel now about eating high-calorie or palatable foods (e.g., pizza, chocolate, crisps)?” This indicates that there is no post-exposure effect on disgust ratings. However, this question is not suitable for investigating the impact of the kitchen scenarios comprehensively on the food-specific state of disgust. In addition, the experimental paradigm was primarily designed to test whether induced social support or positive mood would enhance the impact of virtual food exposure on food-related anxiety in people with AN [Our second finding suggests that correlations between food disgust sensitivity and food-related eye gaze differed across the three virtual kitchen scenarios. A positive correlation between food disgust sensitivity and food-related eye gaze was observed for people with AN in the virtual kitchen plus pet scenario. Interestingly, this relationship was non-existent in the other two conditions. The variations between the conditions might partially explain the discrepancies in the results. Specifically, participants in the virtual kitchen plus avatar condition had a higher BMI and lower illness duration in comparison with those in the virtual kitchen plus pet condition. Lower BMI and longer duration of eating disorder diagnosis have previously been associated with non-response to treatment [