An experimental investigation into the use of eye-contact in social interactions in women in the acute and recovered stages of anorexia nervosa

Int J Eat Disord. 2018 Dec 22. doi: 10.1002/eat.22993. Online ahead of print.

Abstract

Objective: People with anorexia nervosa (AN) report significant difficulties in social functioning and a growing literature is beginning to explain some of the differences in social skills that might underlie the social challenges experienced by patients. One vital area of social functioning that has been largely neglected to date is how eye-contact is used in the context of social stimuli and in social situations.

Methods: This cross-sectional, experimental study used eye-tracking to measure the frequency and duration of eye-contact made with the eye region of interest (ROI) of (1) static social stimuli (man and woman Ekman faces displaying basic emotions); (2) moving social stimuli (a video of two actors conversing); and (3) during a real-life social interaction in 75 women (25 with AN, 25 recovered from AN, and 25 non-AN controls; mean age = 27.18, SD = 6.19).

Results: Participants showed greater eye-contact during a real-life social interaction than when viewing static social stimuli. Those with AN made contact with the eye ROI of the static and moving social stimuli and during a real-life social interaction significantly less often and for significantly less time than non-AN controls. Those recovered from AN showed greater eye-contact than the acute group but significantly less eye-contact with the eye ROI across the static and moving social stimuli and during the real-life social interaction than non-AN controls.

Discussion: These findings contribute new knowledge regarding the types of social skills that people with AN may need additional support with to allow them to make greater use of social support in their recovery.

Keywords: anorexia nervosa; eating disorders; eye tracking; eye-contact; eye-gaze; social skills.