Cognitive biases in response to visual body-related stimuli in eating disorders: study protocol for a systematic review and meta-analysis

BACKGROUND: Biased processing of body-related information may be linked to the development and maintenance of eating disorders (ED). The objective of this systematic review will be to examine the occurrence and the extent of cognitive biases in response to visual body-related stimuli in individuals with ED and individuals with an increased risk to develop ED. METHODS: Studies will be identified by searching MEDLINE and PsycINFO. We will include observational and experimental studies that examine the association between cognitive biases (information processing biases) in response to visual body-related stimuli and eating-related pathology in clinical and non-clinical adult samples. In addition to database searches, citation tracking will be used. Two reviewers will first screen titles and abstracts independently and will then review full texts for eligibility. Data extraction will be done independently by two reviewers. Conflicts at all levels of screening and extraction will be resolved through discussion. Studies will be included if they 1) assess cognitive biases (i.e., attentional biases, memory biases, judgment biases, response biases, and interpretation biases) in response to visual body-related stimuli (i.e., pictures or photographs of a human body or a human body shape), 2) if they report associations between biases and eating-related pathology, 3) if study participants are at least 16 years or older, and 4) if no priming task was administered prior to the assessment. Descriptive data of studies will also be collected. Risk of bias assessment will be undertaken by two independent reviewers. Data will be analyzed using random-effects meta-analysis. DISCUSSION: This systematic review will synthesize the evidence for cognitive bias in response to visual body-related stimuli in individuals with ED and individuals with an increased risk of developing an ED. The findings may help to better understand information processing in eating-related psychopathology. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015019165