1. Introduction
ambiguous social situations, eating behaviors, eating disorders, eating psychopathology, eating behavioral cognition, bulimia nervosa, eating disorder, binge eating disorder, anorexia nervosa, AN
(1) Background: the investigation of how interpersonal functioning affects eating psychopathology has been receiving increasing attention in the last decade. This study evaluates the impact of virtual social inclusion or ostracism on emotions, perceived stress, eating psychopathology, and the drive to binge or restrict in patients across the eating disorder spectrum. (2) Methods: a group of 122 adolescent and adult females with different eating disorder diagnoses were compared to 50 healthy peers with regards to their performance on, and responses to the Cyberball task, a virtual ball-tossing game. Each participant was randomly assigned to playing a social inclusion or a social exclusion block of the Cyberball task and completed self-report assessments of emotions, perceived stress and urge to restrict/binge before and after the task. (3) Results: patients with anorexia nervosa showed a more negative impact on psychological well-being evaluated with the need threat scale after the excluding block, while patients with bulimia nervosa reported more negative effects after the overincluding condition. Patients with binge eating disorder showed a reduction in specific negative emotions after the overincluding block, unlike all other participants. (4) Conclusions: findings show significant correlations between restraint thoughts in patients with bulimia nervosa and binge thoughts in patients with binge eating disorder after being exposed to the inclusion condition. Different reactions in cognitive and emotional states of patients with eating disorders after different interpersonal scenarios confirm the impact of inclusive or exclusive relationships on eating psychopathology, with specific and different responses across the eating disorder spectrum, that have been discussed, linked to their eating behavioral cognition.Despite differences in their clinical manifestations, people with eating disorders (EDs) often experience interpersonal problems and difficulties with social cognition that negatively affect their social functioning, quality of life, and daily activities [Looking at the cognitive aspects of emotional functioning, patients with anorexia nervosa (AN) demonstrate reduced emotional expression, difficulties understanding their own and others’ emotional and mental states, submissive attitudes and behaviors, and social inhibition in their relationships [The literature has shown that greater sensitivity to social rejection may lead to social difficulties, along with a more negative interpretation of ambiguous social situations [One task commonly used to assess participants’ reactions to interpersonal dynamics is the Cyberball task [Despite the finding that patients with AN experience greater sensitivity to exclusion than healthy peers, it is largely unknown whether people with a different ED diagnosis (i.e., BN or BED) would respond similarly or whether virtually induced social exclusion or overinclusion have a different impact on their emotions, stress levels, and eating attitudes. Thus, the present study seeks to extend previous findings among patients with AN by including participants with BN or BED in our assessment of the impact of virtual exclusion and overinclusion, looking at mood and eating behaviors. Our first aim was to evaluate the effects of exclusion and overinclusion in patients with an ED compared to community peers. We hypothesized that patients with different EDs would present different emotional and cognitive responses to exclusion and overinclusion. Individuals with AN may confirm their lack of response to exclusion, while individuals with BN or BED might be more sensitive to overinclusion, due to the preliminary data in the general population [