Anne Roefs

• Maastricht University

Measuring subjective experiences in Ecological Momentary Assessment (EMA) studies has become a popular approach. A design choice in such studies is the response scale of the survey questions. Typically, researchers choose between a Likert scale and a visual analog scale (VAS). However, there is little guidance on this choice. We conducted a between...

Ecological momentary assessment (EMA) collects real-time data in daily life, enhancing ecological validity and reducing recall bias. An EMA questionnaire that measures symptoms and transdiagnostic factors was recently developed with network modeling purposes. This study examines this EMA protocol’s (a) subjective experience (e.g., burden, item clar...

The network perspective of psychopathology proposes that mental disorders arise from dynamic interactions between psychopathology-relevant variables. This study explored the robustness, generalizability, and heterogeneity of dynamic networks of psychopathology using Ecological Momentary Assessment data of 173 participants. Robustness - i.e., how pr...

Objectives The network approach to psychopathology posits that mental disorders emerge from dynamic interactions among psychopathology‐relevant variables. Ecological Momentary Assessment (EMA) is frequently used to assess these variables in daily life. Considering the transdiagnostic nature of the network approach to psychopathology, this study des...

Measuring subjective experiences in Ecological Momentary Assessment (EMA) studies has become a popular research design. A key design choice in such studies is the response scale of the survey questions. Typically, researchers choose between a Likert scale and a visual analog scale (VAS). However, there is little guidance on this choice. We conducte...

Measuring subjective experiences in Ecological Momentary Assessment (EMA) studies has become a popular approach. A design choice in such studies is the response scale of the survey questions. Typically, researchers choose between a Likert scale and a visual analog scale (VAS). However, there is little guidance on this choice. We conducted a between...

BACKGROUND Consuming too much food or drink with high levels of saturated fats, salt or sugar can be harmful for health. Many snack foods fall into this category (HFSS snacks). However, the palatability of these snacks means that people can sometimes struggle to reduce their intake. Machine learning algorithms could help by predicting the likely oc...

Background Consuming high amounts of foods or beverages with high levels of saturated fats, salt, or sugar (HFSS) can be harmful for health. Many snacks fall into this category (HFSS snacks). However, the palatability of these snacks means that people can sometimes struggle to reduce their intake. Machine learning algorithms could help in predictin...

Using ultra-high field (7 Tesla) functional MRI (fMRI), we conducted the first in-vivo functional neuroimaging study of the normal human brainstem specifically designed to examine neural signals in the Nucleus Tractus Solitarius (NTS) in response to all basic taste stimuli. NTS represents the first relay station along the mammalian taste processing...

Background: In today's obesogenic environment high-caloric palatable foods are omnipresent, making it hard for many to reach and maintain a healthy body weight. This study investigates the effects of a health versus hedonic mindset on daily-life snacking behaviour. The hypothesis is that a health mindset leads to reduced snacking behaviour compare...

The network perspective to psychopathology posits that mental disorders emerge from the dynamic interactions of elements such as emotions, cognitions, behaviors and symptoms. Investigating such interactions requires studying how they unfold over time, and there is agreement that such studies should go beyond single disorder. Of the many challenges...

Background The present study is the first step of a 3-year European project in which a tailored smartphone application will be developed and tested as a potential tool in the personalized treatment of children and adolescents with overweight. Methods In this study, 10 focus groups (n = 48 participants) were conducted in Belgium, The Netherlands an...

In the field of psychopathology, Ecological Momentary Assessment (EMA) methodological advancements have offered new opportunities to collect time-intensive, repeated and intra-individual measurements. This way, a large amount of data has become available, providing the means for further exploring mental disorders. Consequently, advanced machine lea...

Brain responses to food are thought to reflect food's rewarding value and to fluctuate with dietary restraint. We propose that brain responses to food are dynamic and depend on attentional focus. Food pictures (high-caloric/low-caloric, palatable/unpalatable) were presented during fMRI-scanning, while attentional focus (hedonic/health/neutral) was...

In the field of psychopathology, Ecological Momentary Assessment (EMA) methodological advancements have offered new opportunities to collect time-intensive, repeated and intra-individual measurements. This way, a large amount of data has become available, providing the means for further exploring mental disorders. Consequently, advanced machine lea...

Evidence for attention bias (AB) for food in restrained eaters is inconsistent. A person's mindset related to food - that is, whether someone focuses on the hedonic or health aspects of food - might be an overlooked influence on AB for food, possibly explaining the inconsistency in the literature. Fluctuations between a hedonic versus a health mind...

Obesity reached pandemic proportions and weight-loss treatments are mostly ineffective. The level of brain activity in the reward circuitry is proposed to be proportionate to the reward value of food stimuli, and stronger in people with obesity. However, empirical evidence is inconsistent. This may be due to the double-sided nature of high caloric...

Brain responses to food are thought to reflect food’s rewarding value. We propose that brain responses to food are more dynamic and hypothesize that brain responses to food depend on attentional focus. Food pictures (high-caloric/low-caloric, palatable/unpalatable) were presented during fMRI-scanning, while attentional focus (hedonic/health/neutral...

Background: The present study is the first step of a 3-year European project in which a tailored smartphone application will be developed and tested as a potential tool in the personalized treatment of children and adolescents with overweight. Methods: In this study, 10 focus groups (n = 48 participants) were conducted in Belgium, The Netherlands a...

Previous research on EMA data of mental disorders was mainly focused on multivariate regression-based approaches modeling each individual separately. This paper goes a step further towards exploring the use of non-linear interpretable machine learning (ML) models in classification problems. ML models can enhance the ability to accurately predict th...

The core ideas of a 10-year research program ‘New Science of Mental Disorders’ are outlined. This research program moves away from the disorder-based ‘one-model-fits-all’ approach to treating mental disorders, and adopts the network approach to psychopathology as its foundation of research. Its core assumption is that dynamically interacting sympto...

Obesity is a worldwide pandemic and theories propose that attentional bias (AB) for food triggers craving and overeating, especially for people with obesity. However, empirical evidence is inconsistent, which may be due to methodological diversity and the double-sided nature of high-caloric palatable foods. That is, these foods simultaneously have...

A person can alternate between food-related mindsets, which in turn may depend on one's emotional state or situation. Being in a certain mindset can influence food-related thoughts, but interestingly it might also affect eating-related physiological responses. The current study investigates the influence of an induced ‘loss of control’ mindset as c...

Previous research on EMA data of mental disorders was mainly focused on multivariate regression-based approaches modeling each individual separately. This paper goes a step further towards exploring the use of non-linear interpretable machine learning (ML) models in classification problems. ML models can enhance the ability to accurately predict th...

Research has shown repeatedly that overweight and obesity are associated with more fluctuations in attentional bias (AB), as reflected in trial-level bias scores (TL-BS). More specifically, people with a high BMI more frequently alternate their attention towards and away from food over time. The current study proposed and tested a model on the mech...

It is often believed that attentional bias (AB) for food is a stable trait of certain groups, like restrained eaters. However, empirical evidence from this domain is inconsistent. High-calorie foods are double-faceted, as they are both a source of reward and of weight/health concern. Their meaning might depend on the food-related context (i.e., foc...

Background People with overweight have stronger reactivity (e.g., subjective craving) to food cues than lean people, and this reactivity is positively associated with food intake. Cue reactivity is a learned response that can be reduced with food cue exposure therapy.Objectives It was hypothesized that participants after food cue exposure therapy w...

Calorie-reduced diets to combat obesity do work, but they only work when one sticks to the diet and the - relatively small - weight loss usually is short-lived. It is argued that calorie-reduced diets should converge with enduring lifestyle changes: the diet is just the start of a lifelong new eating pattern. Getting people to change their lifestyl...

Objective: Although the effectiveness of interpersonal psychotherapy (IPT) and cognitive therapy (CT) for major depression has been established, little is known about how and for whom they work and how they compare in the long term. The latter is especially relevant for IPT because research on its long-term effects has been limited. This overview...

Research investigating neural responses to visual food stimuli has produced inconsistent results. Crucially, high-caloric palatable foods have a double-sided nature - they are often craved but are also considered unhealthy - which may have contributed to the inconsistency in the literature. Taking this double-sided nature into account in the curren...

Hoewel de effectiviteit van cognitieve therapie (CT) en interpersoonlijke psychotherapie (IPT) voor depressie overtuigend is aangetoond, is er weinig bekend over hoe, hoelang, en voor wie ze werken. In dit artikel wordt een overzicht gegeven van resultaten van een grote gerandomiseerde behandelstudie naar de (differentiële) effecten en werkingsmech...

Background: The present study examined food cravings in daily life by comparing overweight and normal-weight participants right before eating events and at non-eating moments. It was hypothesised that overweight participants would have (i) more frequent, (ii) stronger and (iii) a greater variety of high-caloric palatable food cravings, and also wo...

The current study examined the relationships among dynamics of attentional bias for food, executive control and adjusted BMI% among children. 106 Dutch (8-12 years old, 56.60% female) and 99 Chinese children (9-13 years old, 44.44% female) participated in the study. All participants first completed a self-report hunger questionnaire, and then the f...

Background and objectives: Anorexia Nervosa (AN) patients are characterized by an excessive restriction of their food-intake. Prior research using an Affective Simon Task (AST) with food as a task-irrelevant feature, provided evidence for the view that AN patients' ability to refrain from food is facilitated by reduced automatic approach tendencie...

This study assessed internal reliability and test-retest reliability of attention bias scores for food derived from the dot probe task. A visual dot probe task with food and non-food pictures (presented for 3000 ms) was administered to 53 healthy women on two occasions. Attention bias scores for food were calculated based on manual response latenci...

In dit artikel wordt het standaard medische model van eetstoornissen kritisch beschouwd en een veelbelovend alternatief geïntroduceerd: de netwerkbenadering van eetstoornissen. De centrale assumptie in de netwerkbenadering is – in tegenstelling tot het medische model – dat symptomen geen inwisselbare indicatoren van de onderliggende oorzaak zijn, m...

Background and objectives: Learning models of overeating predict that exposure therapy is effective in reducing food cue reactivity and overeating. This pilot study tested an eight-session exposure therapy aimed at inhibitory learning vs. an active control condition aimed at lifestyle improvement for obesity (treatment-as-usual). Main outcomes are...

Background: Although the effectiveness of cognitive therapy (ct) and interpersonal psychotherapy (ipt) for depression has been well established, little is known about how, how long and for whom they work. AIM: To summarize findings from a large rct to the (differential) effects and mechanisms of change of ct/ipt for depression. METHOD: 182 adult d...

Purpose of review: The dominant view in the literature is that increased neural reactivity to high-caloric palatable foods in the mesocorticolimbic system is a stable-specific characteristic of obese people. In this review, we argue that this viewpoint may not be justified, and we propose that the neural response to food stimuli is dynamic, and in...

Objective: This study tested the role of habituation of eating desires and violation of overeating expectancies during food cue exposure in obese women. Method: 52 obese females were randomised into a two-session exposure condition aimed at habituation, a two-session exposure condition aimed at expectancy violation, or a no-treatment control con...

Background and objectives: This study tested whether two sessions of food cue exposure therapy reduced eating in the absence of hunger (EAH), specified for exposed and non-exposed food, in overweight and obese adolescents, and whether habituation of food cue reactivity and reduced CS-US expectancies predicted a decrease in EAH. Methods: 41 overw...

The texture of food can be a reason why children reject it: It matters if food is crispy, slimy, smooth or has pips and bits in it. In general, mere exposure is the best method to increase acceptance of food: becoming more familiar with a food by repeated exposure increases liking for it. However, exposure to texture can be difficult, as children c...

The rise of internet and mobile technologies (such as smartphones) provide a harness of data and an opportunity to learn about peoples' states, behavior, and context in regard to several application areas such as health. Eating behavior is an area that can benefit from the development of effective e-coaching applications which utilize psychological...

Full-text view-only version of the paper can be accessed here:: http://rdcu.be/ut5k With this set of papers, we hope to contribute significantlyto a scientific approach to e-coaching for healthy lifestyles.We sincerely believe such a scientific approach is needed inthis growing field, as part of the identification and validationof valuable compone...

The present study was designed to test the hypothesis that anorexia nervosa (AN) patients are relatively insensitive to the attentional capture of visual food stimuli. Attentional avoidance of food might help AN patients to prevent more elaborate processing of food stimuli and the subsequent generation of craving, which might enable AN patients to...

Objective: Although restrained eaters are motivated to control their weight by dieting, they are often unsuccessful in these attempts. Dual process models emphasize the importance of differentiating between controlled and automatic tendencies to approach food. This study investigated the hypothesis that heightened automatic approach tendencies in r...

High-sugar/high-fat foods are related to binge-eating behaviour and especially people with low inhibitory control may encounter elevated difficulties to resist their intake. Incentive sensitization to food-related cues might lead to increased motivated attention towards these stimuli and to cue-induced craving. To investigate the combined influence...

In this paper a framework for warning people when they are at risk of unhealthy eating is presented. Data is collected trough a mobile application called " ThinkSlim " which was developed for the purpose of studying eating behavior using Ecological Momentary Assessment (EMA) principles. Data is converted in order to allow early prediction of health...

Objectives: The purpose of this article is to critically evaluate the following claims derived from contemporary theoretical models of attentional bias (AB) for food- and drug-related stimuli: (a) AB is a characteristic feature of obesity and addiction, (b) AB predicts future behavior, (c) AB exerts a causal influence on consummatory behavior, and...

Ecological Momentary Assessment (EMA) data is organized in multiple levels (per-subject, per-day, etc.) and this particular structure should be taken into account in machine learning algorithms used in EMA like decision trees and its variants. We propose a new algorithm called BBT (standing for Bagged Boosted Trees) that is enhanced by a over/under...

Attention bias for food could be a cognitive pathway to overeating in obesity and restrained eating. Yet, empirical evidence for individual differences (e.g., in restrained eating and body mass index) in attention bias for food is mixed. We tested experimentally if temporarily induced health versus palatability mindsets influenced attention bias fo...

Long-term weight loss maintenance is difficult to achieve. Effectiveness of obesity interventions could be increased by providing extended treatment, and by focusing on person-environment interactions. Ecological Momentary Intervention (EMI) can account for these two factors by allowing an indefinite extension of a treatment protocol in everyday li...

Background: In rodents, the striatal dopamine (DA) system and the (hypo)thalamic serotonin (5-HT) system are involved in the regulation of feeding behavior. In lean humans, little is known about the relationship between these brain neurotransmitter systems and feeding. We studied the relationship between striatal DA transporters (DAT) and dienceph...

Ecological Momentary Assessment (EMA) techniques have been blooming during the last years due to the emergence of smart devices (like PDAs and smartphones) that allow the collection of repeated assessments of several measures (predictors) that affect a target variable. Eating behavior studies can benefit from EMA techniques by analysing almost real...

Change your lifestyle: decrease your energy intake and increase your energy expenditure, is what obesity experts tell people who need to lose weight. Though the advice might be correct, it appears to be extremely difficult to change one’s lifestyle. Unhealthy habits usually are ingrained and hard to change, especially for people with an “obese cogn...

We report results from three experimental studies that investigated the independence of approach and avoidance motivational orientations for alcohol, both of which operate within controlled and automatic cognitive processes. In order to prime their approach or avoidance motivational orientations, participants watched brief videos, the content of wh...

Obesity prevalence among children is high and knowledge on cognitive factors that contribute to children's reactivity to the "obesogenic" food environment could help to design effective treatment and prevention campaigns. Empirical studies in adults suggest that attention bias for food could be a risk factor for overeating. Accordingly, the current...

Background Children's picky eating behaviour has been linked both to being overweight and underweight. However, the role of parenting practices in this relationship has rarely been investigated. The present study aimed to clarify the direction of the association between picky eating and weight status and to examine the moderating role of food paren...

Objective The aim of the present study was to investigate the role of automatic approach/avoidance tendencies for food in Anorexia Nervosa (AN). We used a longitudinal approach and tested whether a reduction in eating disorder symptoms is associated with enhanced approach tendencies toward food and whether approach tendencies toward food at baselin...

Background: Although both cognitive therapy (CT) and interpersonal psychotherapy (IPT) have been shown to be effective treatments for major depressive disorder (MDD), it is not clear yet whether one therapy outperforms the other with regard to severity and course of the disorder. This study examined the clinical effectiveness of CT v. IPT in a larg...

Objective: Overeating and obesity are associated with impulsivity. In studies among patients with a substance use disorder, impulsivity was found to be associated with substance-related attentional bias. This study examined whether obesity, impulsivity and food craving are associated with an attentional bias for high-calorie food. Methods: Obese...

Living in an ‘obesogenic’ environment poses a serious challenge for weight maintenance. However, many people are able to maintain a healthy weight indicating that not everybody is equally susceptible to the temptations of this food environment. The way in which someone perceives and reacts to food cues, that is, cognitive processes, could underlie...

Background: Picky or fussy eating is common in early childhood and associated with a decreased preference for a variety of foods. The aim of the current study was to test experimentally which sensory food feature influences food acceptance, which, in turn is an indication for fussy eating, in young children (32 - 48 months). Another aim was to eva...

Background Emotional eating is associated with overeating and the development of obesity. Yet, empirical evidence for individual (trait) differences in emotional eating and cognitive mechanisms that contribute to eating during sad mood remain equivocal. Aim The aim of this study was to test if attention bias for food moderates the effect of self-r...

Emotional eaters are often presumed to eat in response to negative emotions, while positive emotions have been largely neglected. The current study induced a positive, negative, or neutral mood in a student sample and subsequently measured food intake. In addition, the relation between caloric intake and mood improvement was assessed. It was expect...

The present study tested the impact of experimentally manipulated perceived availability of chocolate on attention for chocolate stimuli, momentary (state) craving for chocolate and consumption of chocolate in healthy weight female students. It was hypothesized that eating forbiddance would be related to attentional avoidance (thus diminished atten...

Emotional eaters are often presumed to eat in response to negative emotions, while positive emotions have been largely neglected. The current study induced a positive, negative, or neutral mood in a student sample and subsequently measured food intake. In addition, the relation between caloric intake and mood improvement was assessed. It was expect...

Cue reactivity and craving can be influenced by cue exposure with response prevention (CERP). This study investigated the neural correlates of CERP using functional magnetic resonance imaging, while participants smelled chocolate (17 participants) or a control object (17 participants). CERP was interrupted by 7 scanning sequences measuring the brai...

Although restrained eaters try to limit their food intake, they often fail and indulge in exactly those foods that they want to avoid. A possible explanation is a temporal attentional bias for food cues. It could be that for these people food stimuli are processed relatively efficiently and require less attentional resources to enter awareness. Onc...

In general, a high level of dieting motivation is associated with successful weight loss. However, this may not be equally true for everyone. The goal of the current longitudinal study was to test the interactive effect of dieting motivation and depressive symptoms on weight change in a sample of 142 participants (M age = 46.7; 112 females). Height...

For many years, emotional eating has been measured by means of self-report questionnaires, which retrospectively measure eating in response to (mainly negative) emotions. However, some researchers suggest that these questionnaires may not be the best way to assess emotional eating, as people are generally not very good at recalling their emotions,...

According to theoretical models biased attention for food cues is related to craving and food (over)consumption. In three studies we assessed attention biases towards food cues by eye-movement recordings. Results indicated that overweight/obese individuals show a distinctive pattern of attentional bias for food that was associated with craving: Ove...

In a previous study, restrained eaters showed stronger implicit preferences for high-caloric food compared to unrestrained eaters. Caloric density and palatability are however almost always intertwined, and it was never tested whether this high-calorie food preference of restrained eaters follows from the energy density or the palatability of high-...

Objective: The present research tested whether an evaluative conditioning intervention makes thin-ideal models less enviable as standards for appearance-based social comparisons (Study 1), and increases body satisfaction (Study 2). Design: Female participants were randomly assigned to intervention versus control conditions in both studies (ns = 66...

Background Sensory-specific satiety (SSS) refers to a decrease in sensory pleasure derived from a specific food or drink with its consumption relative to the consumer's liking for the unconsumed foods and drinks. This satiety does not require any post-ingestive feedback, and yet it is an important factor in determining meal intake. SSS has not been...

The premise of cognitive therapy is that one can overcome the irresistible temptation of highly palatable foods by actively restructuring the way one thinks about food. Testing this idea, participants in the present study were instructed to passively view foods, up-regulate food palatability thoughts, apply cognitive reappraisal (e.g., thinking abo...