Emotional reactivity to binge food and erotic cues in women with bulimia nervosa symptoms Hernández Rivero, Isabel María Miccoli, Laura Fernández-Santaella Santiago, Carmen Bulimia nervosa Binge food cues Erotic cues Psychophysiology Valence Startle reflex This work was supported by the MECD [grant numbers FPU16/01200], 'Doctoral College "Imaging the Mind" (FWF; W1233-B)', a grant from Junta de Andalucia, Spain [Grant Code P12.SEJ.391], and a grant from the Spanish Ministry of Economy and Competitiveness/MINECO (Grant Code: PSI2013-43777-P). Background: Studies on food cue reactivity have documented that altered responses to high-calorie food are associated with bulimic symptomatology, however, alterations in sexual motivations and behaviors are also associated clinical features in this population, which justify their inclusion as a research target. Here, we study responses to erotic cues—alongside food, neutral and aversive cues—to gain an understanding of specificity to food versus a generalized sensitivity to primary reinforcers. Methods: We recorded peripheral psychophysiological indices –the startle reflex, zygomaticus, and corrugator responses—and self-reported emotional responses (valence, arousal, and dominance) in 75 women completing the Bulimia Test-Revised (BULIT-R). Multiple regression analysis tested whether BULIT-R symptoms were predicted by selfreported and psychophysiological responses to food versus neutral and erotic versus neutral images. Results: The results showed that individuals with higher bulimic symptoms were characterized by potentiated eye blink startle response during binge food (vs. neutral images) and more positive valence ratings during erotic (vs. neutral) cues. Conclusions: The results highlight the negative emotional reactivity of individuals with elevated bulimic symptoms toward food cues, which could be related to the risk of progression to full bulimia nervosa and thereby addressed in prevention efforts. Results also point to the potential role of reactivity to erotic content, at least on a subjective level. Theoretical models of eating disorders should widen their conceptual scope to consider reactivity to a broader spectrum of primary reinforcers, which would have implications for cue exposure-based treatments. Plain English summary: We examined appetitive and aversive cue responses in college women to investigate how bulimic symptoms relate to primary reinforcers such as food and erotic images. We recorded peripheral psychophysiological indices (the startle reflex, zygomaticus, and corrugator responses) and self-reported emotional responses (valence, arousal, and dominance) in 75 college women that were presented with the Spanish version of the Bulimia Test-Revised. The results showed that bulimic symptoms increase both psychophysiological defensiveness toward food cues and subjective pleasure toward erotic cues. The findings suggest a generalized sensitivity to primary reinforcers in the presence of bulimic symptoms, and emphasize the relevance of adopting a wider framework in research and treatment on bulimia nervosa. 2021-10-26T10:12:31Z 2021-10-26T10:12:31Z 2021-09-28 journal article Hernández-Rivero, I... [et al.]. Emotional reactivity to binge food and erotic cues in women with bulimia nervosa symptoms. J Eat Disord 9, 120 (2021). [https://doi.org/10.1186/s40337-021-00475-9] http://hdl.handle.net/10481/71112 10.1186/s40337-021-00475-9 eng http://creativecommons.org/licenses/by/3.0/es/ open access Atribución 3.0 España BMC