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Patients with anorexia nervosa (AN) typically hold altered beliefs about their body that they struggle to update. These can vary from sensory, local beliefs about how full their stomach feels to global, prospective beliefs about how much they can trust their own body and its signals. Clinical questionnaire studies have provided ample evidence on the role of such beliefs in the onset, maintenance, and treatment of AN, yet the parameters that contribute to the formation and maintenance of such beliefs have not been identified. Here, I present a series of studies with independent samples of women at the acute AN (total N = 106) and post-acute AN state (N = 113), compared to matched healthy controls (N = 220) in which we aim to (1) assess interoceptive and exteroceptive perception and metacognitive beliefs using state-of-the-art methods and statistical approaches; (2) study how patients update these beliefs following feedback or contextual changes; (3) develop and validate a novel neurocomputational approach to determine the parameters that may influence belief formation and updating in these domains; (4) relate some of these parameters to clinical symptoms such as insight into illness and (5) translate these insights to the development and testing of the efficacy of a novel, interdisciplinary (psychophysiological) therapeutic module in a sub-clinical RCT study with 100 individuals with low interoception awareness, stratified for subclinical disordered eating.

Cosmetic surgery is ever more affordable and accessible, but carries physical and psychological risks. Yet, no study to date has directly examined risk-taking behaviour under controlled conditions, beyond self-report and in relation to cosmetic surgery attitudes. We used the Balloon Analogue Risk Task and advanced computational modelling to measure decision-making behaviour and identify the latent parameters driving behaviour associated with cosmetic surgery attitudes in women with no cosmetic surgery history ( N = 265) and a subsample of women with a cosmetic surgery history ( N = 24). Risk taking was higher in women with greater acceptance and history of cosmetic surgery. Computational modelling revealed increased risk taking in women with greater acceptance of cosmetic surgery when decisions were made with greater knowledge of loss ( risk ) and not when the likelihood of loss was unknown ( uncertainty ). When women with greater acceptance of cosmetic surgery made decisions, they also placed less emphasis on possible losses (reduced loss aversion ). Our findings suggest that women seeking cosmetic procedures may be less sensitive to losses and thus make more risky decisions. Greater emphasis should be placed on communicating potential losses rather than just the associated risks to women considering cosmetic procedures. No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Touch offers important non-verbal possibilities for socioaffective communication. Yet most digital communications lack capabilities regarding exchanging affective tactile messages (tactile emoticons). Additionally, previous studies on tactile emoticons have not capitalised on knowledge about the affective effects of certain mechanoreceptors in the human skin, e.g., the C-Tactile (CT) system. Here, we examined whether gentle manual stroking delivered in velocities known to optimally activate the CT system (defined as ‘tactile emoticons’), during lab-simulated social media communications could convey increased feelings of social support and other prosocial intentions compared to (1) either stroking touch at CT sub-optimal velocities, or (2) standard visual emoticons. Participants (N = 36) felt more social intent with CT-optimal compared to sub-optimal velocities, or visual emoticons. In a second, preregistered study (N = 52), we investigated whether combining visual emoticons with tactile emoticons, this time delivered at CT-optimal velocities by a soft robotic device, could enhance the perception of prosocial intentions and affect participants’ physiological measures (e.g., skin conductance rate) in comparison to visual emoticons alone. Visuotactile emoticons conveyed more social intent overall and in anxious participants affected physiological measures more than visual emoticons. The results suggest that emotional social media communications can be meaningfully enhanced by tactile emoticons.