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Blanchette-Sarrasin A, Saj A. [Effects of non-invasive neuromodulation on the cognitive profile of people with anorexia nervosa: A scoping review]. L'ENCEPHALE 2024; 50:339-347. [PMID: 38087685 DOI: 10.1016/j.encep.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/13/2023] [Accepted: 11/02/2023] [Indexed: 05/31/2024]
Abstract
BACKGROUND The use of non-invasive neuromodulation is emerging in the treatment of anorexia nervosa. Despite promising results, further research is needed to improve our understanding of these techniques and to adapt interventions to this population. As anorexia nervosa is associated with several cognitive difficulties and cerebral anomalies, the aim of the present study was to summarize the available data on the effects of non-invasive neuromodulation on the neuropsychological profile of people with anorexia nervosa. METHOD A scoping review was conducted by searching in PsycINFO, PubMed and CINAHL databases to systematically identify relevant studies published between 1994 and 2023 on the treatment of anorexia nervosa with repetitive transcranial magnetic stimulation, transcranial direct current stimulation or neurofeedback electroencephalogram. RESULTS Seventeen articles were included, including 12 on repetitive transcranial magnetic stimulation, four on transcranial direct current stimulation and one on neurofeedback electroencephalogram. Of these, only three studies included a neuropsychological measure to assess the impact of neuromodulation on participants' cognitive functions. CONCLUSIONS Including detailed neuropsychological measures in clinical trials of non-invasive neuromodulation is highly recommended and appears essential to improve our understanding of these techniques and optimize their efficacy in the treatment of anorexia nervosa.
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Affiliation(s)
| | - Arnaud Saj
- Département de psychologie, Université de Montréal, Montréal, Québec, H3T 1J4, Canada; Centre de recherche interdisciplinaire en réadaptation (CRIR), Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC J4K 5G4, Canada; Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Université de Montréal, Montréal, Québec, Canada; Laboratory for Behavioral Neurology and Imaging of Cognition, Neuroscience Department, University of Geneva, 1211 Geneva, Suisse; Département des neurosciences cliniques, Université de Genève, 1205 Genève, Suisse
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2
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Haynos AF, Anderson LM, Askew AJ, Liu C, Venables K, Craske MG, Peterson CB. A randomized, controlled pilot study of positive affect treatment adapted for anorexia nervosa. Int J Eat Disord 2024; 57:1253-1259. [PMID: 37811810 PMCID: PMC11001784 DOI: 10.1002/eat.24071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/09/2023] [Accepted: 09/23/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Novel treatments for adults with anorexia nervosa (AN) are sorely needed. Although psychological interventions have been developed for AN, none have been identified as superior to one another or nonspecific treatments. Common comorbidities (e.g., mood and anxiety disorders) are rarely targeted in AN treatments, possibly impairing long-term clinical improvement. AN is associated with reward processing dysfunctions paralleling those identified in affective disorders; however, few treatments directly target these processes. METHOD We adapted Positive Affect Treatment, a neuroscience-informed behavioral treatment developed for affective disorders, to the treatment of AN (PAT-AN). Adults with AN (N = 20) were randomized to 20 weeks of PAT-AN or waitlist to investigate the feasibility, acceptability, preliminary efficacy, and target engagement (on reward mechanisms) of PAT-AN. RESULTS PAT-AN demonstrated strong retention (100%) and acceptability ratings (M = 5.67-5.95 on a 7-point scale). BMI (p = .006) and eating disorder symptoms (p < .001) improved over PAT-AN sessions. The PAT-AN group showed medium to large pre-to-post-treatment improvements in BMI, eating disorder symptoms and impairment, depressive and anxiety symptoms, and some reward indices (ds = .56-.87); changes were largely sustained at 3-month follow-up. Waitlist showed negligible changes (ds < .20) on nearly all measures. DISCUSSION PAT-AN holds promise as an innovative treatment with capability to simultaneously improve eating disorder symptoms, affective symptoms, and underlying reward mechanisms. Findings should be interpreted cautiously due to small sample size and permitted concurrent enrollment in other treatments. Future, larger-scale research is warranted to establish the efficacy of PAT-AN. PUBLIC SIGNIFICANCE This study provided a preliminary evaluation of Positive Affect Treatment for anorexia nervosa (PAT-AN), a novel, neuroscience-informed treatment aimed at increasing rewarding life experiences outside of one's eating disorder. Initial results suggest that PAT-AN is considered acceptable and may alleviate eating disorder, depressive, and anxiety symptoms. Therefore, this study presents promising data on a treatment that may hold potential for improving the lives of individuals with this disorder.
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Affiliation(s)
- Ann F. Haynos
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Lisa M. Anderson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Autumn J. Askew
- San Diego State University/University of California, San Diego, San Diego, CA
| | - Chassidie Liu
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Kira Venables
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Michelle G. Craske
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Carol B. Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
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3
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Camacho-Barcia L, Giel KE, Jiménez-Murcia S, Álvarez Pitti J, Micali N, Lucas I, Miranda-Olivos R, Munguia L, Tena-Sempere M, Zipfel S, Fernández-Aranda F. Eating disorders and obesity: bridging clinical, neurobiological, and therapeutic perspectives. Trends Mol Med 2024; 30:361-379. [PMID: 38485648 DOI: 10.1016/j.molmed.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 04/13/2024]
Abstract
Eating disorders (EDs) and obesity are complex health conditions sharing various risk and maintenance factors, intensified in cases of comorbidity. This review explores the similarities and connections between these conditions, examining different facets from a multidisciplinary perspective, among them comorbidities, metabolic and psychological factors, neurobiological aspects, and management and therapy implications. We aim to investigate the common characteristics and complexities of weight and EDs and explore their interrelationships in individuals who experience both. The rising prevalence of EDs in people with obesity necessitates integrated approaches to study this comorbidity and to identify and analyze both common and distinct features of these conditions. This review may offer new opportunities for simultaneous prevention and management approaches, as well as future lines of research.
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Affiliation(s)
- Lucia Camacho-Barcia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany; Centre of Excellence for Eating Disorders (KOMET), University of Tübingen, Tübingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Julio Álvarez Pitti
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain; Innovation in Paediatrics and Technologies-iPEDITEC- research group, Research Foundation, Consorcio Hospital General, University of Valencia, Valencia, Spain
| | - Nadia Micali
- Eating Disorders Research Unit, Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark; Great Ormond Street Institute of Child Health, University College London, London, UK; Institute of Biological Psychiatry, Psychiatric Center Sct. Hans, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Ignacio Lucas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Romina Miranda-Olivos
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucero Munguia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Tena-Sempere
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain
| | - Stephan Zipfel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany; Centre of Excellence for Eating Disorders (KOMET), University of Tübingen, Tübingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Schuman I, Wang J, Ballard IC, Lapate RC. Waiting for it: Anorexia Risk, Future Orientation, and Intertemporal Discounting. RESEARCH SQUARE 2024:rs.3.rs-4002723. [PMID: 38585785 PMCID: PMC10996782 DOI: 10.21203/rs.3.rs-4002723/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Anorexia Nervosa is a severe eating disorder characterized by food restriction in service of a future goal: thinness and weight loss. Prior work suggests abnormal intertemporal decision-making in anorexia, with more farsighted decisions observed in patients with acute anorexia. Prospective future thinking in daily life, or temporal orientation, promotes more farsighted delay discounting. However, whether temporal orientation is altered in anorexia, and underlies reduced delay discounting in this population, remains unclear. Further, because changes in delay discounting could reflect cognitive effects of an acute clinical state, it is important to determine whether reduced delay discounting is observed in subclinical, at-risk samples. We measured delay discounting behavior and temporal orientation in a large sample of never-diagnosed individuals at risk of anorexia nervosa. We found that farsighted delay discounting was associated with elevated risk for anorexia nervosa. Anorexia nervosa risk was also associated with increased future-oriented cognition. Future-oriented cognition mediated the difference in delay-discounting behavior between high and low-risk groups. These results were unrelated to subjective time perception and were independent of mood and anxiety symptomatology. These findings establish future-oriented cognition as a cognitive mechanism underlying altered intertemporal decision-making in individuals at risk of developing anorexia nervosa.
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Affiliation(s)
- Isabel Schuman
- Department of Psychological & Brain Sciences, University of California, Santa Barbara
| | - Jingyi Wang
- Department of Psychological & Brain Sciences, University of California, Santa Barbara
| | - Ian C Ballard
- Department of Psychology, University of California, Riverside
| | - Regina C Lapate
- Department of Psychological & Brain Sciences, University of California, Santa Barbara
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5
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Berebbi S, Naftalovich H, Weinbach N, Kalanthroff E. Fostering positive attitudes toward food in individuals with restrained eating: the impact of flexible food-related inhibition. J Eat Disord 2024; 12:41. [PMID: 38509611 PMCID: PMC10956199 DOI: 10.1186/s40337-024-00995-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
Individuals exhibiting restrained eating behaviors demonstrate increased inhibitory control when exposed to food-related stimuli, indicating the presence of an automatic food-inhibition association. Existing literature proposes that this association contributes to the devaluation of food within this population. Efforts to disrupt this association by promoting the complete elimination of the inhibition of food responses have resulted in increased food consumption but have also led to heightened food-related anxiety in individuals with restrained eating behaviors. In the current investigation, we investigated whether a novel flexible food response/inhibition computerized task could yield favorable changes in attitudes toward food in individuals with restrained eating. We randomly assigned 78 females who engage in restrained eating to one of three training groups. In the flexible response/inhibition group, participants were instructed to equally inhibit or respond to food stimuli. In the response group, participants consistently responded to food stimuli, while in the inhibition group, participants consistently inhibited their response to food cues. Implicit attitudes toward food were assessed both before and after the manipulation. To examine the stability of the effect of the training, participants also engaged in a seemingly unrelated bogus taste test. Our results revealed that only the flexible response/inhibition group demonstrated a significant improvement in positive attitudes toward high-calorie foods after eating, while there were no observable changes in negative attitudes among the other two groups. These findings suggest that promoting a balance between the responding and inhibiting responses to food stimuli can increase positive attitudes toward food amongst individuals with restrained eating.
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Affiliation(s)
- Shir Berebbi
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Hadar Naftalovich
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Noam Weinbach
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Eyal Kalanthroff
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Psychiatry, Columbia University Medical Center, New York, USA
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6
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Hill L. Temperament impact on eating disorder symptoms and habit formation: a novel model to inform treatment. J Eat Disord 2024; 12:40. [PMID: 38504375 PMCID: PMC10953227 DOI: 10.1186/s40337-024-00998-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/14/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Temperament has long been described as the biological dimension of personality. Due to advancing brain-imaging technology, our understanding of temperament has deepened and transformed over the last 25 years. Temperament combines genetic, neurobiological and trait research. Temperament has been included peripherally in some eating disorder (ED) treatment approaches but has been ignored by most. Temperament fills a fundamental treatment gap by clarifying who is more vulnerable to develop ED and why some individuals are susceptible to specific ED symptoms while others are not. In addition, temperament targets possible treatment solutions. MAIN TEXT There is a need for a novel model that incorporates and explores the role of temperament in ED treatment intervention. This paper is a metaphoric temperament model to inform treatment intervention. It describes how temperament traits influences new decisions which impact new behavioural responses. In turn, it neurobiologically tracks how and why the brain efficiently transforms new decisions into new habits. This model integrates both temperament and habit research to explore (a) what temperament is; (b) how new decisions develop into habits neurobiologically; (c) that the brain wires destructive symptoms into habits in the same way that it wires healthy/productive behaviours into habits; (d) traits that trigger ED symptoms are the same traits that influence productive behaviours; and in regard to treatment implications (e) when treatment structure and intervention target client temperaments, the potential for new healthy "trait-syntonic" habits could develop. CONCLUSIONS This paper introduces a metaphoric model that synthesizes and integrates temperament neurobiological and trait findings with ED symptoms, habits, and client trait-based solutions. The model synthesizes and integrates different research domains to establish a brain-based foundation to inform treatment intervention. The model targets clients' temperament traits as central collections of innate self-expressions that could be utilized as tools to redirect client trait-syntonic ED responses into trait-syntonic productive outcomes. The brain bases of temperament and habit formation serve as a biological foundation for ED treatment intervention.
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Affiliation(s)
- Laura Hill
- Department of Psychiatry, University of California, San Diego, CA, USA.
- Adjunct Associate Clinical Professor of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA.
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7
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Hjerresen TS, Bentz M, Nejad AB, Raffin E, Andersen KW, Hulme OJ, Siebner HR, Plessen KJ. Performing well but not appreciating it - A trait feature of anorexia nervosa. JCPP ADVANCES 2024; 4:e12194. [PMID: 38486955 PMCID: PMC10933629 DOI: 10.1002/jcv2.12194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/28/2023] [Indexed: 03/17/2024] Open
Abstract
Background Despite advances in the etiology of anorexia nervosa (AN), a large subgroup of individuals does not profit optimally from treatment. Perfectionism has been found to be a risk factor predicting the onset, severity, and duration of AN episodes. To date, perfectionism has been studied predominantly by the use of self-report questionnaires, a useful approach that may, however, be impacted by demand characteristics, or other distortions of introspective or metacognitive access. Methods Here we circumvent these problems via a behavioral paradigm in which participants perform a modified Go/NoGo task, whilst self-evaluating their performance. We compared a group of 33 adolescent females during their first episode of AN (age = 16.0) with 29 female controls (age = 16.2), and 23 adolescent girls recovered from AN (age = 18.3) with 23 female controls (age = 18.5). The controls were closely matched by intelligence quotient and age to the two clinical groups. Results First-episode AN and control participants performed equally well on the task (reaction time and errors of commission), whereas the recovered group displayed significantly faster reaction times but incurred the same error rate. Despite performing at least as good as and predominantly better than control groups, both clinical groups evaluated their performances more negatively than controls. Conclusion We offer a novel behavioral method for measuring perfectionism independent of self-report, and we provide tentative evidence that this behavioral manifestation of perfectionism is evident during first-episode AN and persists even after recovery.
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Affiliation(s)
- Tine Schuppli Hjerresen
- Child and Adolescent Mental Health CenterCopenhagen University Hospital ‐ Mental Health Services CPHCopenhagenDenmark
- Danish Research Centre for Magnetic ResonanceCentre for Functional and Diagnostic Imaging and ResearchCopenhagen University Hospital ‐ Amager and HvidovreCopenhagenDenmark
- Department of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Mette Bentz
- Child and Adolescent Mental Health CenterCopenhagen University Hospital ‐ Mental Health Services CPHCopenhagenDenmark
| | | | - Estelle Raffin
- Danish Research Centre for Magnetic ResonanceCentre for Functional and Diagnostic Imaging and ResearchCopenhagen University Hospital ‐ Amager and HvidovreCopenhagenDenmark
- Defitech Chair of Clinical NeuroengineeringNeuro‐X Institute and Brain Mind Institute (BMI)Swiss Federal Institute of Technology (EPFL)GenevaSwitzerland
| | - Kasper Winther Andersen
- Danish Research Centre for Magnetic ResonanceCentre for Functional and Diagnostic Imaging and ResearchCopenhagen University Hospital ‐ Amager and HvidovreCopenhagenDenmark
| | - Oliver James Hulme
- Danish Research Centre for Magnetic ResonanceCentre for Functional and Diagnostic Imaging and ResearchCopenhagen University Hospital ‐ Amager and HvidovreCopenhagenDenmark
- London Mathematical LaboratoryLondonUK
- Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic ResonanceCentre for Functional and Diagnostic Imaging and ResearchCopenhagen University Hospital ‐ Amager and HvidovreCopenhagenDenmark
- Department of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Department of NeurologyCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
| | - Kerstin Jessica Plessen
- Child and Adolescent Mental Health CenterCopenhagen University Hospital ‐ Mental Health Services CPHCopenhagenDenmark
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryUniversity Hospital LausanneLausanneSwitzerland
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Brown CS, Devine S, Otto AR, Bischoff-Grethe A, Wierenga CE. Greater reliance on model-free learning in adolescent anorexia nervosa: An examination of dual-system reinforcement learning. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.31.24302097. [PMID: 38352608 PMCID: PMC10863009 DOI: 10.1101/2024.01.31.24302097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Alterations in learning and decision-making systems are thought to contribute to core features of anorexia nervosa (AN), a psychiatric disorder characterized by persistent dietary restriction and weight loss. Instrumental learning theory identifies a dual-system of habit and goal-directed decision-making, linked to model-free and model-based reinforcement learning algorithms. Difficulty arbitrating between these systems, resulting in an over-reliance on one strategy over the other, has been implicated in compulsivity and extreme goal pursuit, both of which are observed in AN. Characterizing alterations in model-free and model-based systems, and their neural correlates, in AN may clarify mechanisms contributing to symptom heterogeneity (e.g., binge/purge symptoms). This study tested whether adolescents with restricting AN (AN-R; n = 36) and binge/purge AN (AN-BP; n = 20) differentially utilized model-based and model-free learning systems compared to a healthy control group (HC; n = 28) during a Markov two-step decision-making task under conditions of reward and punishment. Associations between model-free and model-based learning and resting-state functional connectivity between neural regions of interest, including orbitofrontal cortex (OFC), nucleus accumbens (NAcc), putamen, and sensory motor cortex (SMC) were examined. AN-R showed higher utilization of model-free learning compared to HC for reward, but attenuated model-free and model-based learning for punishment. In AN-R only, higher model-based learning was associated with stronger OFC-to-left NAcc functional connectivity, regions linked to goal-directed behavior. Greater utilization of model-free learning for reward in AN-R may differentiate this group, particularly during adolescence, and facilitate dietary restriction by prioritizing habitual control in rewarding contexts.
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Affiliation(s)
- Carina S. Brown
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology
- Department of Psychiatry, University of California, San Diego
| | | | | | | | - Christina E. Wierenga
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology
- Department of Psychiatry, University of California, San Diego
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9
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Li Z, Tong G, Wang Y, Ruan H, Zheng Z, Cheng J, Wang Z. Task fMRI studies investigating inhibitory control in patients with obsessive-compulsive disorder and eating disorders: A comparative meta-analysis. World J Biol Psychiatry 2024; 25:26-42. [PMID: 37640027 DOI: 10.1080/15622975.2023.2251057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/04/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) and eating disorders (EDs) share similarities in terms of clinical characteristics and deficits in inhibitory control. OBJECTIVE To investigate whether inhibitory control could serve as a common behavioural phenotype between OCD and EDs and whether it might be underpinned by shared and/or distinct neural signatures. METHOD We performed a quantitative meta-analysis of brain function abnormalities during the inhibitory control task-based functional Magnetic Resonance Imaging (fMRI) scan across patients with OCD and EDs using seed-based d mapping (SDM). RESULTS The meta-analysis included sixteen OCD fMRI studies and ten EDs fMRI studies. And findings revealed that patients with OCD showed hypoactivation relative to healthy controls and patients with EDs in the anterior cingulate cortex, while compared to healthy controls and patients with OCD, patients with EDs showed hypoactivation in the right insula. CONCLUSIONS Patients with OCD and EDs are inclined to exhibit impaired inhibitory control, which may be attributed to different abnormal patterns of neural activation.
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Affiliation(s)
- Zheqin Li
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Geya Tong
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Wang
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hanyang Ruan
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zifeng Zheng
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiayue Cheng
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhen Wang
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
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10
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Wang J, Tang L, Wang M, Wu G, Li W, Wang Y, Wang X, Wang H, Yang Z, Li Z, Chen Q, Zhang P, Wang Z. Fronto-temporal dysfunction in appetitive regulation of bulimia nervosa with affective disorders: A regional homogeneity and remote connectivity pattern analysis. J Affect Disord 2023; 340:280-289. [PMID: 37553018 DOI: 10.1016/j.jad.2023.08.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/03/2023] [Accepted: 08/04/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE The aim of this study was to assess brain functional alterations in BN patients with affective disorders and their association with maladaptive eating behaviors. METHODS A total of 42 BN patients with affective disorders (anxiety and depression) and 47 healthy controls (HCs) were enrolled in this study. The resting-state fMRI data were analyzed for functional changes as indicated by regional homogeneity based on Kendall's coefficient of concordance (KCC-ReHo) and seed-based functional connectivity (FC). A principal component analysis (PCA) model was used to identify the commonalities within the behavioral questionnaires from the BN group. RESULTS Patients in the BN group showed decreased ReHo in the bilateral middle frontal gyrus (MFG) and right supramarginal gyrus (SMG). Additionally, the BN group showed increased FC between the left MFG and the right inferior temporal gyrus (ITG); decreased FC between the right MFG and the bilateral insula and the left middle temporal gyrus (MTG); and decreased FC between the right SMG and the left superior temporal gyrus (STG) and right inferior frontal gyrus (IFG). In the FC-behavior association analysis, the second principal component (PC2) was negatively correlated with FC between the left MFG and the right ITG. CONCLUSION Based on a brain functional analysis (ReHo and FC), this study revealed significant aberrant changes in the frontal-temporal regions of BN patients with affective disorders. These regions, which serve as fronto-temporal circuitry, are associated with restraint and emotional eating behaviors. Our findings shed new light on the neural mechanisms underlying the condition.
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Affiliation(s)
- Jiani Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lirong Tang
- Beijing Anding Hospital, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Miao Wang
- Chinese Institute for Brain Research, Beijing, China
| | - Guowei Wu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Weihua Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yiling Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xuemei Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Hao Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhanjiang Li
- Beijing Anding Hospital, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Peng Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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11
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Bernardoni F, King JA, Hellerhoff I, Schoemann M, Seidel M, Geisler D, Boehm I, Pauligk S, Doose A, Steding J, Gramatke K, Roessner V, Scherbaum S, Ehrlich S. Mouse-cursor trajectories reveal reduced contextual influence on decision conflict during delay discounting in anorexia nervosa. Int J Eat Disord 2023; 56:1898-1908. [PMID: 37415568 DOI: 10.1002/eat.24019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/05/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE The capacity of individuals with anorexia nervosa (AN) to forgo immediate food rewards in their long-term pursuit of thinness is thought to reflect elevated self-control and/or abnormal reward sensitivity. Prior research attempted to capture an increased tendency to delay gratification in AN using delay-discounting tasks that assess how rapidly the subjective value of rewards decreases as a function of time until receipt. However, significant effects were mostly subtle or absent. Here, we tested whether the process leading to such decisions might be altered in AN. METHOD We recorded mouse-cursor movement trajectories leading to the final choice in a computerized delay-discounting task (238 trials) in 55 acutely underweight females with AN and pairwise age-matched female healthy controls (HC). We tested for group differences in deviations from a direct choice path, a measure of conflict strength in decision making, and whether group moderated the effect of several predictors of conflict strength (e.g., choice difficulty, consistency). We also explored reaction times and changes in trajectory directions (X-flips). RESULTS No group differences in delay-discounting parameters or movement trajectories were detected. However, the effect of the aforementioned predictors on deviations (and to a lesser extent reaction times) was reduced in AN. DISCUSSION These findings suggest that while delay discounting and conflict strength in decision making are generally unaltered in AN, conflict strength was more stable across different decisions in the disorder. This might enable individuals with AN to pursue (maladaptive) long-term body-weight goals, because particularly conflicting choices may not be experienced as such. PUBLIC SIGNIFICANCE The deviations from a direct path of mouse-cursor movements during a computerized delay-discounting task varied less in people with anorexia nervosa. Assuming such deviations measure decision conflict, we speculate that this increased stability might help people with anorexia nervosa achieve their long-term weight goals, as for them the struggle with the decision to eat high-calorie meals when hungry will be milder, so they would be more likely to skip them.
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Affiliation(s)
- Fabio Bernardoni
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Joseph A King
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Inger Hellerhoff
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Martin Schoemann
- Department of Psychology, Faculty of Natural sciences, TU Dresden, Dresden, Germany
| | - Maria Seidel
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Daniel Geisler
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Ilka Boehm
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Sophie Pauligk
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Arne Doose
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Julius Steding
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Katrin Gramatke
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Dresden, Germany
| | - Stefan Scherbaum
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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12
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Schaefer LM, Forester G, Dvorak RD, Steinglass J, Wonderlich SA. Integrating aspects of affect, reward, and cognition to develop more comprehensive models of binge-eating pathology. Int J Eat Disord 2023; 56:1502-1510. [PMID: 37084184 PMCID: PMC10681362 DOI: 10.1002/eat.23971] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/28/2023] [Accepted: 04/13/2023] [Indexed: 04/22/2023]
Abstract
Reward-related processes are an increasing focus of eating disorders research. Although evidence suggests that numerous distinct reward processes may contribute to eating pathology (e.g., reward learning and delay discounting), existing etiological models of reward dysfunction tend to focus on only a limited number of reward processes, and frequently lack specificity when identifying the individual reward processes hypothesized to contribute to dysregulated eating behavior. Moreover, existing theories have been limited in their integration of reward-related processes with other demonstrated risk and maintenance factors for eating disorders (e.g., affect and cognition), potentially contributing to underdeveloped models of eating pathology. In this article, we highlight five distinct reward processes with theorized or demonstrated relevance to eating disorders involving binge-eating, followed by a review of two well-established risk/maintenance factors for binge-eating pathology. We then introduce two novel models of binge eating onset and maintenance that integrate these factors (i.e., the Affect, Reward, Cognition models), and discuss methods for testing each of the models in future research. Ultimately, we hope that the proposed models provide a springboard for the continued evolution of more precise and comprehensive theories of reward dysfunction in the eating disorders, as well as the development of novel intervention approaches. PUBLIC SIGNIFICANCE STATEMENT: Eating disorders are associated with abnormalities in multiple domains of reward functioning. However, models of reward dysfunction within the eating disorders have not been well-integrated with prominent models of affect and cognition. This article presents two novel models of onset and maintenance for binge-eating pathology, which attempt to integrate observed reward abnormalities with other affective and cognitive processes implicated in binge-type eating disorders.
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Affiliation(s)
- Lauren M. Schaefer
- Center for Biobehavioral Research, Sanford Research, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, North Dakota, USA
| | - Glen Forester
- Center for Biobehavioral Research, Sanford Research, North Dakota, USA
| | - Robert D. Dvorak
- Center for Biobehavioral Research, Sanford Research, North Dakota, USA
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Joanna Steinglass
- Department of Psychiatry, Columbia University Medical Center, New York, USA
- Department of Psychiatry, New York State Psychiatric Institute, New York, USA
| | - Stephen A. Wonderlich
- Center for Biobehavioral Research, Sanford Research, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, North Dakota, USA
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13
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de Moraes CEF, Donnelly B, Appolinario JC, Hay P. Obtaining long-term recovery: advances in optimizing treatment outcomes in patients with binge-eating disorder. Expert Rev Neurother 2023; 23:1097-1111. [PMID: 37916419 DOI: 10.1080/14737175.2023.2273392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Binge-eating disorder (BED) is a complex and disabling eating disorder (ED) associated with considerable burden and impairments in quality of life and physical/mental health. It has been recognized as a formal ED category since 2013, however BED is still underdetected and undertreated. AREAS COVERED This review summarizes the advances in the understanding of the pathophysiology of BED as well as the evidence on the efficacy of the existing treatments. The authors searched Scopus, PubMed, ClinicalTrials.Gov, and ANZCTR with terms including 'assessment' OR 'treatment' OR 'diagnosis' OR 'mechanisms' AND 'binge eating' OR 'binge-eating disorder' for manuscripts published between January 2013 and April 2023. EXPERT OPINION Most of the trials on treatments of BED have been in people of high weight with weight loss as an outcome. Nevertheless, less is known about the treatment of this condition in people with body mass index (BMI) within the normal range where weight stabilization may be a more appropriate goal. Moreover, there is a need for an enhanced appreciation of the role of combination treatment to improve overall outcomes. Also, there are important opportunities for future research in understanding the mechanisms of action and effectiveness of BED treatments.
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Affiliation(s)
- Carlos Eduardo Ferreira de Moraes
- Obesity and Eating Disorders Group (GOTA), Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Brooke Donnelly
- Clinical Psychology Unit, School of Psychology, University of Sydney, Camperdown, Australia
| | - Jose Carlos Appolinario
- Obesity and Eating Disorders Group (GOTA), Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Mental Health Services, South West Sydney Local Health District (SWSLHD), Campbelltown, Australia
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14
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Murray SB, Alba C, Duval CJ, Nagata JM, Cabeen RP, Lee DJ, Toga AW, Siegel SJ, Jann K. Aberrant functional connectivity between reward and inhibitory control networks in pre-adolescent binge eating disorder. Psychol Med 2023; 53:3869-3878. [PMID: 35301976 DOI: 10.1017/s0033291722000514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Behavioral features of binge eating disorder (BED) suggest abnormalities in reward and inhibitory control. Studies of adult populations suggest functional abnormalities in reward and inhibitory control networks. Despite behavioral markers often developing in children, the neurobiology of pediatric BED remains unstudied. METHODS 58 pre-adolescent children (aged 9-10-years) with BED (mBMI = 25.05; s.d. = 5.40) and 66 age, BMI and developmentally matched control children (mBMI = 25.78; s.d. = 0.33) were extracted from the 3.0 baseline (Year 0) release of the Adolescent Brain Cognitive Development (ABCD) Study. We investigated group differences in resting-state functional MRI functional connectivity (FC) within and between reward and inhibitory control networks. A seed-based approach was employed to assess nodes in the reward [orbitofrontal cortex (OFC), nucleus accumbens, amygdala] and inhibitory control [dorsolateral prefrontal cortex, anterior cingulate cortex (ACC)] networks via hypothesis-driven seed-to-seed analyses, and secondary seed-to-voxel analyses. RESULTS Findings revealed reduced FC between the dlPFC and amygdala, and between the ACC and OFC in pre-adolescent children with BED, relative to controls. These findings indicating aberrant connectivity between nodes of inhibitory control and reward networks were corroborated by the whole-brain FC analyses. CONCLUSIONS Early-onset BED may be characterized by diffuse abnormalities in the functional synergy between reward and cognitive control networks, without perturbations within reward and inhibitory control networks, respectively. The decreased capacity to regulate a reward-driven pursuit of hedonic foods, which is characteristic of BED, may in part, rest on this dysconnectivity between reward and inhibitory control networks.
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Affiliation(s)
- Stuart B Murray
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Celina Alba
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Christina J Duval
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Ryan P Cabeen
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Darrin J Lee
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- Department of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Arthur W Toga
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Steven J Siegel
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Kay Jann
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
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15
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Via E, Contreras-Rodríguez O. Binge-Eating Precursors in Children and Adolescents: Neurodevelopment, and the Potential Contribution of Ultra-Processed Foods. Nutrients 2023; 15:2994. [PMID: 37447320 DOI: 10.3390/nu15132994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Binge-eating disorder (BED) is a highly prevalent disorder. Subthreshold BED conditions (sBED) are even more frequent in youth, but their significance regarding BED etiology and long-term prognosis is unclear. A better understanding of brain findings associated with BED and sBED, in the context of critical periods for neurodevelopment, is relevant to answer such questions. The present narrative review starts from the knowledge of the development of emotional self-regulation in youth, and the brain circuits supporting emotion-regulation and eating behaviour. Next, neuroimaging studies with sBED and BED samples will be reviewed, and their brain-circuitry overlap will be examined. Deficits in inhibition control systems are observed to precede, and hyperactivity of reward regions to characterize, sBED, with overlapping findings in BED. The imbalance between reward/inhibition systems, and the implication of interoception/homeostatic processing brain systems should be further examined. Recent knowledge of the potential impact that the high consumption of ultra-processed foods in paediatric samples may have on these sBED/BED-associated brain systems is then discussed. There is a need to identify, early on, those sBED individuals at risk of developing BED at neurodevelopmental stages when there is a great possibility of prevention. However, more neuroimaging studies with sBED/BED pediatric samples are needed.
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Affiliation(s)
- Esther Via
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Spain
| | - Oren Contreras-Rodríguez
- Medical Imaging, Girona Biomedical Research Institute (IdIBGi), Parc Hospitalari Martí i Julià-Edifici M2, Salt, 17190 Girona, Spain
- Health Institute Carlos III (ISCIII) and CIBERSAM, 28029 Madrid, Spain
- Department of Psychiatry and Legal Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
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16
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Eddy KT, Plessow F, Breithaupt L, Becker KR, Slattery M, Mancuso CJ, Izquierdo AM, Van De Water AL, Kahn DL, Dreier MJ, Ebrahimi S, Deckersbach T, Thomas JJ, Holsen LM, Misra M, Lawson EA. Neural activation of regions involved in food reward and cognitive control in young females with anorexia nervosa and atypical anorexia nervosa versus healthy controls. Transl Psychiatry 2023; 13:220. [PMID: 37353543 DOI: 10.1038/s41398-023-02494-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 05/20/2023] [Accepted: 05/26/2023] [Indexed: 06/25/2023] Open
Abstract
Anorexia nervosa (AN) and atypical AN (AtypAN) are complex neurobiological illnesses that typically onset in adolescence with an often treatment-refractory and chronic illness trajectory. Aberrant eating behaviors in this population have been linked to abnormalities in food reward and cognitive control, but prior studies have not examined respective contributions of clinical characteristics and metabolic state. Research is needed to identify specific disruptions and inform novel intervention targets to improve outcomes. Fifty-nine females with AN (n = 34) or AtypAN (n = 25), ages 10-22 years, all ≤90% expected body weight, and 34 age-matched healthy controls (HC) completed a well-established neuroimaging food cue paradigm fasting and after a standardized meal, and we used ANCOVA models to investigate main and interaction effects of Group and Appetitive State on blood oxygenation level-dependent (BOLD) activation for the contrast of exposure to high-calorie food images minus objects. We found main effects of Group with greater BOLD activation in the dorsal anterior cingulate cortex (dACC), dorsolateral prefrontal cortex (DLPFC), hippocampus, caudate, and putamen for AN/AtypAN versus HC groups, and in the three-group model including AN, AtypAN, and HC (sub-)groups, where differences were primarily driven by greater activation in the AtypAN subgroup versus HC group. We found a main effect of Appetitive State with increased premeal BOLD activation in the hypothalamus, amygdala, nucleus accumbens, and caudate for models that included AN/AtypAN and HC groups, and in BOLD activation in the nucleus accumbens for the model that included AN, AtypAN, and HC (sub-)groups. There were no interaction effects of Group with Appetitive State for any of the models. Our findings demonstrate robust feeding-state independent group effects reflecting greater neural activation of specific regions typically associated with reward and cognitive control processing across AN and AtypAN relative to healthy individuals in this food cue paradigm. Differential activation of specific brain regions in response to the passive viewing of high-calorie food images may underlie restrictive eating behavior in this clinical population.
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Affiliation(s)
- Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Franziska Plessow
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lauren Breithaupt
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kendra R Becker
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Meghan Slattery
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Avery L Van De Water
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
- Division of Women's Health, Department of Medicine, and Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Danielle L Kahn
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Melissa J Dreier
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Seda Ebrahimi
- Cambridge Eating Disorders Center, Cambridge, MA, USA
| | - Thilo Deckersbach
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- University of Applied Sciences, Diploma Hochschule, Bad Sooden-Allendorf, Germany
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Laura M Holsen
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Women's Health, Department of Medicine, and Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Madhusmita Misra
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Pediatric Endocrinology, Mass General for Children, Boston, MA, USA
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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17
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Sullivan M, Fernandez-Aranda F, Camacho-Barcia L, Harkin A, Macrì S, Mora-Maltas B, Jiménez-Murcia S, O'Leary A, Ottomana AM, Presta M, Slattery D, Scholtz S, Glennon JC. Insulin and Disorders of Behavioural Flexibility. Neurosci Biobehav Rev 2023; 150:105169. [PMID: 37059405 DOI: 10.1016/j.neubiorev.2023.105169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 04/16/2023]
Abstract
Behavioural inflexibility is a symptom of neuropsychiatric and neurodegenerative disorders such as Obsessive-Compulsive Disorder, Autism Spectrum Disorder and Alzheimer's Disease, encompassing the maintenance of a behaviour even when no longer appropriate. Recent evidence suggests that insulin signalling has roles apart from its regulation of peripheral metabolism and mediates behaviourally-relevant central nervous system (CNS) functions including behavioural flexibility. Indeed, insulin resistance is reported to generate anxious, perseverative phenotypes in animal models, with the Type 2 diabetes medication metformin proving to be beneficial for disorders including Alzheimer's Disease. Structural and functional neuroimaging studies of Type 2 diabetes patients have highlighted aberrant connectivity in regions governing salience detection, attention, inhibition and memory. As currently available therapeutic strategies feature high rates of resistance, there is an urgent need to better understand the complex aetiology of behaviour and develop improved therapeutics. In this review, we explore the circuitry underlying behavioural flexibility, changes in Type 2 diabetes, the role of insulin in CNS outcomes and mechanisms of insulin involvement across disorders of behavioural inflexibility.
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Affiliation(s)
- Mairéad Sullivan
- Conway Institute of Biomedical and Biomolecular Research, School of Medicine, University College Dublin, Dublin, Ireland.
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Lucía Camacho-Barcia
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Andrew Harkin
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Ireland
| | - Simone Macrì
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Bernat Mora-Maltas
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Aet O'Leary
- University Hospital Frankfurt, Frankfurt, Germany
| | - Angela Maria Ottomana
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, 00161 Rome, Italy; Neuroscience Unit, Department of Medicine, University of Parma, 43100 Parma, Italy
| | - Martina Presta
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, 00161 Rome, Italy; Department of Physiology and Pharmacology, Sapienza University of Rome, 00185 Rome, Italy
| | | | | | - Jeffrey C Glennon
- Conway Institute of Biomedical and Biomolecular Research, School of Medicine, University College Dublin, Dublin, Ireland
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18
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López-Villatoro JM, Shimano R, Prittwitz C, De la Torre A, Diaz-Marsá M, Carrasco JL. Predictive value of the feeling of emptiness in suicidal behaviour of emotionally unstable disorders. Clin Psychol Psychother 2023; 30:112-118. [PMID: 36028788 DOI: 10.1002/cpp.2781] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE This study investigates the feeling of emptiness in patients with borderline personality disorder (BPD) and patients with eating disorder (ED) and its relationship with suicidal behaviour and childhood traumatic events. METHODOLOGY One hundred three BPD patients and 107 ED patients were assessed with the Feeling of Emptiness Scale (FES) and the Traumatic Experiences Questionnaire (TQ). Suicidal behaviour was assessed with a specific interview for frequency and intensity of suicidal behaviour. RESULTS Significant differences were found between the different factors of the FES between BPD patients and ED patients. A significant relationship was observed between Factors 1 and 4 of the FES and suicidal behaviour scores in both groups. Traumatic experiences were more strongly related to Factors 1, 2 and 4 in BPD patients. CONCLUSIONS BPD patients and ED patients show similar scores in the global construct of feeling of emptiness. However, results suggest some qualitatively difference between the nature of feeling of emptiness in BPD and in ED. As expected, suicidal behaviour is most frequently in BPD patients, and is significantly associated with Factors 1 and 4 of the FES in both groups. Therefore, feeling of emptiness could be a predictor of suicidal behaviours in patients with emotional and behavioural instability.
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Affiliation(s)
| | - Rita Shimano
- Department of Psychiatry and Medical Psychology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Clara Prittwitz
- Sanitary Research Institute, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Alejandro De la Torre
- Department of Psychiatry and Medical Psychology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Hospital Gregorio Marañón, Madrid, Spain
| | - Marina Diaz-Marsá
- Department of Psychiatry and Medical Psychology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Hospital Gregorio Marañón, Madrid, Spain
| | - José Luis Carrasco
- Department of Psychiatry and Medical Psychology, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Hospital Gregorio Marañón, Madrid, Spain
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19
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Bianco V, Veniero D, D'Acunto A, Koch G, Picazio S. Challenging inhibitory control with high- and low-calorie food: A behavioural and TMS study. Front Nutr 2023; 10:1016017. [PMID: 36908918 PMCID: PMC9992824 DOI: 10.3389/fnut.2023.1016017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/27/2023] [Indexed: 02/24/2023] Open
Abstract
Most people are often tempted by their impulses to "indulge" in high-calorie food, even if this behaviour is not consistent with their goal to control weight in the long term and might not be healthy. The outcome of this conflict is strongly dependent on inhibitory control. It has already been reported that individuals with weaker inhibitory control consume more high-calorie food, are more often unsuccessful dieters, overweight or obese compared to people with more effective inhibitory control. In the present study, we aimed at investigating inhibitory control in the context of human eating behaviour. A sample of 20 healthy normal-weight adults performed a 50% probability visual affective Go/NoGo task involving food (high- and low-calorie) and non-food images as stimuli. Single-pulse transcranial magnetic stimulation (TMS) was administered over the right primary motor cortex (M1) either 300 ms after image presentation to measure corticospinal excitability during the different stimulus categories or 300 ms after the appearance of a fixation point, as a control stimulation condition. The experimental session consisted of a food target and a non-food target block. Behavioural outcomes showed a natural implicit inclination towards high-calorie food in that participants were faster and more accurate compared to the other categories. This advantage was selectively deleted by TMS, which slowed down reaction times. MEPs did not differ according to the stimulus category, but, as expected, were bigger for Go compared to NoGo trials. Participants judged high-calorie food also as more appetising than low-calorie food images. Overall, our results point to a differential modulation when targeting inhibitory control, in favour of the more palatable food category (high-calorie). Present data suggest that the activity of the motor system is modulated by food nutritional value, being more engaged by appetising food. Future work should explore to what extent these processes are affected in patients with eating disorders and should aim to better characterise the related dynamics of cortical connectivity within the motor network.
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Affiliation(s)
- Valentina Bianco
- Laboratory of Experimental Neuropsychophysiology, Santa Lucia Foundation IRCCS, Rome, Italy.,Laboratory of Cognitive Neuroscience, Department of Languages and Literatures, Communication, Education and Society, University of Udine, Udine, Italy
| | - Domenica Veniero
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Alessia D'Acunto
- Laboratory of Experimental Neuropsychophysiology, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Giacomo Koch
- Laboratory of Experimental Neuropsychophysiology, Santa Lucia Foundation IRCCS, Rome, Italy.,Human Physiology Section, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Silvia Picazio
- Laboratory of Experimental Neuropsychophysiology, Santa Lucia Foundation IRCCS, Rome, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy
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20
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Portingale J, Eddy S, Fuller-Tyszkiewicz M, Liu S, Giles S, Krug I. Tonight, I'm disordered eating: The effects of food delivery app use, loneliness, and mood on daily body dissatisfaction and disordered eating urges. Appetite 2023; 180:106310. [PMID: 36122621 DOI: 10.1016/j.appet.2022.106310] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 08/03/2022] [Accepted: 09/10/2022] [Indexed: 12/15/2022]
Abstract
With the recent proliferation of food delivery applications ('apps'; FDAs), accessing a meal is more convenient and immediate than ever. However, these apps may foster dysregulated eating behaviours, including maladaptive eating to cope with negative emotional states. Using ecological momentary assessment (EMA), the current study assessed whether FDA use at baseline predicted levels of EMA-assessed disordered eating urges and body dissatisfaction, whether negative mood and loneliness impacted disordered eating urges and body dissatisfaction at the state level, and whether the latter relationships were moderated by FDA usage frequency. Participants (N = 483; 78.7% women; 20.1% men; 1.2% other) completed a baseline questionnaire and were characterised as current FDA users (49.3%) or non-users (50.7%). Participants then completed a smartphone-facilitated investigation into their experiences of loneliness, negative mood, body dissatisfaction, and disordered eating urges, six times per day for 7-days. Across the entire sample, current FDA users at baseline reported greater EMA-assessed urges to overeat. At the state level, loneliness and negative mood predicted greater body dissatisfaction, with the latter also predicting greater urges for restrictive eating and overeating. Among current FDA users at baseline, at the state level, loneliness predicted greater body dissatisfaction, and negative mood predicted greater body dissatisfaction and urges for overeating. No moderating effects were observed for baseline FDA usage frequency. These results elucidate FDA use and daily experiences of loneliness and negative mood as factors elevating eating disorder (ED)-related risk. Further extensions of this research with nuanced measures of state FDA use are required.
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Affiliation(s)
- Jade Portingale
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.
| | - Sarah Eddy
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, VIC, Australia; Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
| | - Shanshan Liu
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Sarah Giles
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
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21
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Kozak S, Dezachyo O, Stanford W, Bar-Haim Y, Censor N, Dayan E. Elevated integration within the reward network underlies vulnerability to distress. Cereb Cortex 2022; 33:5797-5807. [PMID: 36453462 DOI: 10.1093/cercor/bhac460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 12/05/2022] Open
Abstract
Abstract
Distress tolerance (DT), the capability to persist under negative circumstances, underlies a range of psychopathologies. It has been proposed that DT may originate from the activity and connectivity in diverse neural networks integrated by the reward system. To test this hypothesis, we examined the link between DT and integration and segregation in the reward network as derived from resting-state functional connectivity data. DT was measured in 147 participants from a large community sample using the Behavioral Indicator of Resiliency to Distress task. Prior to DT evaluation, participants underwent a resting-state functional magnetic resonance imaging scan. For each participant, we constructed a whole-brain functional connectivity network and calculated the degree of reward network integration and segregation based on the extent to which reward network nodes showed functional connections within and outside their network. We found that distress-intolerant participants demonstrated heightened reward network integration relative to the distress-tolerant participants. In addition, these differences in integration were higher relative to the rest of the brain and, more specifically, the somatomotor network, which has been implicated in impulsive behavior. These findings support the notion that increased integration in large-scale brain networks may constitute a risk for distress intolerance and its psychopathological correlates.
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Affiliation(s)
- Stas Kozak
- School of Psychological Sciences, Tel Aviv University , Tel Aviv 6997801 , Israel
| | - Or Dezachyo
- School of Psychological Sciences, Tel Aviv University , Tel Aviv 6997801 , Israel
- Sagol School of Neuroscience, Tel Aviv University , Tel Aviv 6997801 , Israel
| | - William Stanford
- Biological & Biomedical Sciences Program, University of North Carolina at Chapel Hill , Chapel Hill, NC 27599 , United States
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University , Tel Aviv 6997801 , Israel
- Sagol School of Neuroscience, Tel Aviv University , Tel Aviv 6997801 , Israel
| | - Nitzan Censor
- School of Psychological Sciences, Tel Aviv University , Tel Aviv 6997801 , Israel
- Sagol School of Neuroscience, Tel Aviv University , Tel Aviv 6997801 , Israel
| | - Eran Dayan
- Department of Radiology and Biomedical Research Imaging Center, University of North Carolina at Chapel Hill , Chapel Hill, NC 27599 , United States
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22
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Dolan SC, Reilly EE, Brown TA, Shott ME, Frank GKW. Anticipatory and consummatory pleasure in eating disorders. J Eat Disord 2022; 10:161. [PMID: 36371268 PMCID: PMC9652864 DOI: 10.1186/s40337-022-00692-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recent research suggests that anhedonia, or the inability to experience pleasure, is elevated in individuals with eating disorders (EDs). However, past literature has only studied anhedonia in EDs as a unidimensional construct rather than separately examining anticipatory (i.e., prediction of pleasure for a future event) and consummatory (i.e., enjoyment of a present event) pleasure. Given that these subcomponents of pleasure have distinct neurobiological correlates, studying pleasure as a multifaceted construct may yield important insights into the underlying mechanisms of binge eating or food restriction. METHODS A sample of 124 women with anorexia nervosa, bulimia nervosa, or other specified feeding or eating disorder and 84 control women (CW) completed self-report measures of anticipatory pleasure, consummatory pleasure, ED symptoms, depression, harm avoidance, and anxiety. RESULTS Individuals with EDs endorsed significantly lower anticipatory pleasure than CW, but there were no significant group differences in consummatory pleasure. Further, there were no significant differences in self-reported pleasure among ED diagnostic groups. Within the ED sample, anticipatory pleasure but not consummatory pleasure was positively related to binge eating frequency and significantly negatively correlated with cognitive ED symptoms, state and trait anxiety, and harm avoidance. Both anticipatory and consummatory pleasure was negatively associated with depression. CONCLUSION The results of the current study suggest that lower pleasure across the ED spectrum may be due to deficits in anticipatory, but not consummatory, pleasure. Future research should continue to explore the behavioral, affective, and neural correlates of anticipatory pleasure in EDs to characterize better how it relates to the onset and maintenance of binge eating and other eating disorder pathology.
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Affiliation(s)
- Sarah C Dolan
- Department of Psychology, Hofstra University, Hempstead, USA
| | - Erin E Reilly
- Department of Psychology, Hofstra University, Hempstead, USA.,Department of Psychiatry, University of California, San Francisco, USA
| | | | - Megan E Shott
- Department of Psychiatry, University of California San Diego, 4510 Executive Drive, San Diego, CA, 92121, USA
| | - Guido K W Frank
- Department of Psychiatry, University of California San Diego, 4510 Executive Drive, San Diego, CA, 92121, USA.
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23
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Forester G, Schaefer LM, Dodd DR, Johnson JS. The potential application of event-related potentials to enhance research on reward processes in eating disorders. Int J Eat Disord 2022; 55:1484-1495. [PMID: 36214253 PMCID: PMC9633412 DOI: 10.1002/eat.23821] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/05/2022] [Accepted: 09/21/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Reward-related processes have been posited as key mechanisms underlying the onset and persistence of eating disorders, prompting a growing body of research in this area. Existing studies have primarily utilized self-report, behavioral, and functional magnetic resonance imaging measures to interrogate reward among individuals with eating disorders. However, limitations inherent in each of these methods (e.g., poor temporal resolution) may obscure distinct neurocognitive reward processes, potentially contributing to underdeveloped models of reward dysfunction within eating disorders. The temporal precision of event-related potentials (ERPs), derived from electroencephalography, may thus offer a powerful complementary tool for elucidating the neurocognitive underpinnings of reward. Indeed, a considerable amount of research in other domains of psychopathology (e.g., depression, substance use disorders), as well as studies investigating food reward among non-clinical samples, highlights the utility of ERPs for probing reward processes. However, no study to date has utilized ERPs to directly examine reward functioning in eating disorders. METHODS In this paper, we review evidence underscoring the clinical utility of ERP measures of reward, as well as a variety of reward-related tasks that can be used to elicit specific ERP components with demonstrated relevance to reward processing. We then consider the ways in which these tasks/components may be used to help answer a variety of open questions within the eating disorders literature on reward. RESULTS/DISCUSSION Given the promise of ERP measures of reward to the field of eating disorders, we ultimately hope to spur and guide research in this currently neglected area. PUBLIC SIGNIFICANCE Abnormalities in reward functioning appear to contribute to eating disorders. Event-related potentials (ERPs) offer temporally precise measures of neurocognitive reward processing and thus may be important tools for understanding the relationship between reward and disordered eating. However, research in this area is currently lacking. This paper attempts to facilitate the use of ERPs to study reward among individuals with eating disorders by reviewing the relevant theories and methods.
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Affiliation(s)
| | - Lauren M. Schaefer
- Center for Biobehavioral Research, Sanford Research
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences
| | | | - Jeffrey S. Johnson
- Center for Biobehavioral Research, Sanford Research
- Department of Psychology, North Dakota State University
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24
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Neural correlates associated with processing food stimuli in anorexia nervosa and bulimia nervosa: an activation likelihood estimation meta-analysis of fMRI studies. Eat Weight Disord 2022; 27:2309-2320. [PMID: 35304713 PMCID: PMC9556419 DOI: 10.1007/s40519-022-01390-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 03/02/2022] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Various neurobiological models have utilised symptom categories to explore the underlying neural correlates in both anorexia nervosa (AN) and bulimia nervosa (BN). The aim of this research was to investigate the brain activity patterns associated with viewing food stimuli in anorexia nervosa and bulimia nervosa. METHODS Electronic databases including PsycInfo and PubMed were systematically searched from data base inception until 1st of December 2020, identifying 14 suitable functional magnetic resonance imaging studies (fMRI), involving 470 participants. ALE meta-analysis was used to statistically analyse the overlap of activation foci from different fMRI studies in response to visual food stimuli. RESULTS Comparing patients with AN with healthy control (HC), we detected hypoactivation in brain areas related to reward processing (i.e., amygdala and lentiform nucleus), and interoceptive processing (i.e., insula). In addition, patients with AN showed hyperactivations in cognitive control areas (i.e., prefrontal and anterior cingulate cortex). In contrast, patients with BN exhibited hyperactivations in brain areas related to reward processing (i.e., lentiform nucleus), and interoceptive processing (i.e., insula). Furthermore, patients with BN showed hypoactivations in brain regions associated with cognitive control (i.e., prefrontal and anterior cingulate cortex). CONCLUSIONS Our study shows differing neural endotypes of the two types of eating disorders, that underpin their behavioural phenotypes. While exploratory in nature, these findings might be relevant for guiding new emerging therapies, including invasive and non-invasive neuromodulation techniques in treatment of eating disorders. LEVEL OF EVIDENCE Level I, meta-analysis.
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25
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Cavicchioli M, Sarzetto A, Erzegovesi S, Ogliari A. Is Repetitive Transcranial Magnetic Stimulation (RTMS) a Promising Therapeutic Intervention for Eating Disorders and Obesity? Clinical Considerations Based on a Meta-Analytic Review. CLINICAL NEUROPSYCHIATRY 2022; 19:314-327. [PMID: 36340277 PMCID: PMC9597650 DOI: 10.36131/cnfioritieditore20220507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective Repetitive Transcranial Magnetic Stimulation (rTMS) has been introduced to treat eating disorders (EDs), especially Anorexia, Bulimia Nervosa (AN and BN) and other EDs not otherwise specified (NOS). Provisional rTMS single-case studies and clinical trials have been carried out for the treatment of binge eating disorder (BED) and obesity. However, it is still unclear whether and to what extent rTMS might be considered an effective intervention for these conditions. Method This meta-analysis includes 15 independent studies examining the clinical effects of rTMS among different EDs and obesity (N = 402 patients). Several primary and secondary treatment outcomes have been considered. Cohen's d was used as an effect size measure. The analyses estimate heterogeneity across findings, sources of variability and publication bias together with an assessment of the quality of the studies. Results The analyses show that rTMS induced large improvements in body mass index (BMI) among obese individuals. Null clinical effects have been detected for primary outcomes (i.e., BMI, binge eating and compensatory behaviors; urge to binge and to eat; severity of EDs symptoms) among individuals with AN, BN and other EDs-NOS. rTMS shows moderate therapeutic effects on the affective functioning (i.e., negative affectivity, depressive and anxious symptoms) of individuals with EDs. rTMS should be considered a promising intervention for the treatment of obesity. Conclusions This evidence might provisionally support the hypothesis on the implementation of rTMS for BED. Furthermore, rTMS could be included as an ancillary intervention for the other EDs, especially considering secondary treatment outcomes. Future controlled trials are needed to clarify the clinical effects of rTMS for EDs.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
| | - Alessandro Sarzetto
- Department of Medicine, University “Vita-Salute San Raffaele”, Milan, Italy Unit of Psychiatry, San Raffaele-Turro Hospital, Milan, Italy
| | - Stefano Erzegovesi
- Department of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy Unit of Psychiatry, San Raffaele-Turro Hospital, Milan, Italy
| | - Anna Ogliari
- Child in Mind Lab, University “Vita-Salute San Raffaele”, Milan, Italy
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26
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Phonological working memory is adversely affected in adults with anorexia nervosa: a systematic literature review. Eat Weight Disord 2022; 27:1931-1952. [PMID: 35133643 PMCID: PMC9287223 DOI: 10.1007/s40519-022-01370-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/18/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Cognitive restraint has potentiating and deleterious effects on working memory (WM) in anorexia nervosa (AN). Conflicting evidence may be due to heterogeneity of tasks examining different WM components (e.g., verbal/auditory versus visuospatial), and differences in adolescent versus adult AN. Additionally, differential cognitive profiles of restricting versus binge/purging subtypes, comorbid psychiatric disorders and psychotropic medication use may confound findings. METHODS To address these conflicts, 25 studies, published between 2016 and 2021, investigating WM in children, adolescents and adults with AN were systematically reviewed using PRISMA guidelines. RESULTS In 71% of WM tasks, no difference in performance between AN patients and age-matched controls was reported, while 29% of WM tasks showed worse performance. Adults with AN displayed deficits in 44% of the verbal/auditory tasks, while performance remained unaffected in 86% of visuospatial tasks. CONCLUSION Examining age groups and WM subsystems separately revealed novel findings of differentially affected WM components in AN. Comorbidities and psychotropic medications were common among AN participants and should be regarded as critical confounding factors for WM measures. Future studies examining different components of WM, acknowledging these confounding factors, may reveal specific deficits in AN to aid treatment improvement strategies. LEVEL OF EVIDENCE I, systematic review.
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27
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Mahr F, Bunce SC, Meyer RE, Halmi KA. Affect Modulated Startle Response in Anorexia Nervosa, Restricting Type: Implications for Theory and Practice. Cureus 2022; 14:e27304. [PMID: 36039238 PMCID: PMC9403399 DOI: 10.7759/cureus.27304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2022] [Indexed: 11/29/2022] Open
Abstract
Objective: Individuals with anorexia nervosa (AN), restricting type demonstrate unique emotional responses to hedonically positive stimuli beyond eating disorder (ED)-related stimuli. The goal of this study was to evaluate differences in responses to five types of emotionally positive stimuli among acutely ill anorexia nervosa (IAN), restricting type patients, weight-recovered anorexia patients (WRAN), and healthy controls (HCs) using affect modulated startle response (AMSR) as an objective measure. Method: A total of 28 participants were recruited (n=28). Fourteen participants were recruited as IAN using the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) criteria, seven were WRAN, and seven were HC females. All participants were female and aged between 8 and 18 years. The participants viewed images depicting negative, neutral, standardized, and non-eating disorder (ED)-related positive stimuli. Additionally, four categories of ED-related stimuli (high-calorie food, body image, success, and parent-child relationships) were presented to all participants during a standard AMSR paradigm. Results: No significant between-group differences were found for any of the four ED stimulus categories; all groups showed an inhibited startle response to the four ED-related categories. In contrast, IAN and WRAN showed reduced hedonic responses to standardized positive stimuli relative to HC-replicating previous results. Reduced hedonic response to the standardized (non-ED) positive stimuli was highly correlated with self-reported social anxiety, low self-esteem, body dissatisfaction, asceticism, interpersonal problems, and ineffectiveness. Conclusion: AN patients had a reduced hedonic response to some non-ED-related positive stimuli, which correlated with several anxiety-related traits. In contrast, their early automatic responses to high-calorie food, normal weight models, images of success, and positive parent-child relationships did not differ from HC, suggesting these stimuli are either being evaluated as highly interesting or hedonically positive.
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28
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Donnelly B, Foroughi N, Williams M, Touyz S, Madden S, Kohn M, Clark S, Sachdev P, Peduto A, Caterson I, Russell J, Hay P. Neural Response to Low Energy and High Energy Foods in Bulimia Nervosa and Binge Eating Disorder: A Functional MRI Study. Front Psychol 2022; 13:687849. [PMID: 35529565 PMCID: PMC9070301 DOI: 10.3389/fpsyg.2022.687849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 02/24/2022] [Indexed: 11/22/2022] Open
Abstract
Objective Bulimia nervosa (BN) and binge eating disorder (BED) are eating disorders (EDs) characterized by recurrent binge eating (BE) episodes. Overlap exists between ED diagnostic groups, with BE episodes presenting one clinical feature that occurs transdiagnostically. Neuroimaging of the responses of those with BN and BED to disorder-specific stimuli, such as food, is not extensively investigated. Furthermore, to our knowledge, there have been no previous published studies examining the neural response of individuals currently experiencing binge eating, to low energy foods. Our objective was to examine the neural responses to both low energy and high energy food images in three emotive categories (disgust; fear; and happy) in BN and BED participants. Methods Nineteen females with BN (n = 14) or BED (n = 5), comprising the binge eating group (BEG; N = 19), and 19 age-matched healthy control (HC)’s completed thorough clinical assessment prior to functional MRI (fMRI). Neural response to low energy and high energy foods and non-food images was compared between groups using whole-brain exploratory analyses, from which six regions of interest (ROI) were then selected: frontal, occipital, temporal, and parietal lobes; insula and cingulate. Results In response to low energy food images, the BEG demonstrated differential neural responses to all three low energy foods categories (disgust; fear; and happy) compared to HCs. Correlational analyses found a significant association between frequency of binge episodes and diminished temporal lobe and greater occipital lobe response. In response to high energy food images, compared to HC’s, the BEG demonstrated significantly decreased neural activity in response to all high energy food images. The HC’s had significantly greater neural activity in the limbic system, occipital lobe, temporal lobe, frontal lobe, and limbic system in response to high energy food images. Conclusion Results in the low energy food condition indicate that binge frequency may be related to increased aberrant neural responding. Furthermore, differences were found between groups in all ROI’s except the insula. The neural response seen in the BEG to disgust food images may indicate disengagement with this particular stimuli. In the high energy food condition, results demonstrate that neural activity in BN and BED patients may decrease in response to high energy foods, suggesting disengagement with foods that may be more consistent with those consumed during a binge eating episode.
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Affiliation(s)
- Brooke Donnelly
- Clinical Psychology Unit, School of Psychology, University of Sydney, Camperdown, NSW, Australia.,Peter Beumont Tertiary Eating Disorder Service, Department of Psychiatry, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Nasim Foroughi
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Mark Williams
- Department of Cognitive Science, Macquarie University, Ryde, NSW, Australia
| | - Stephen Touyz
- Clinical Psychology Unit, School of Psychology, University of Sydney, Camperdown, NSW, Australia.,InsideOut Institute, University of Sydney, Camperdown, NSW, Australia
| | - Sloane Madden
- Department of Psychological Medicine, Sydney Children's Hospital Network, Westmead Campus, Westmead, NSW, Australia.,Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Michael Kohn
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.,Department of Paediatrics and Child Health, Sydney Children's Hospital Network, Westmead Campus, Westmead, NSW, Australia.,Adolescent and Young Adult Medicine Unit, Sydney Children's Hospital Network, Westmead Campus, Westmead, NSW, Australia.,Centre for Research Into Adolescents' Health, Westmead Research Foundation, Westmead, NSW, Australia
| | - Simon Clark
- Adolescent and Young Adult Medicine Unit, Sydney Children's Hospital Network, Westmead Campus, Westmead, NSW, Australia.,Centre for Research Into Adolescents' Health, Westmead Research Foundation, Westmead, NSW, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Anthony Peduto
- Department of Radiology, Westmead Hospital, Westmead, NSW, Australia.,Discipline of Medical Imaging, Charles Perkins Centre, Boden Institute, University of Sydney, Camperdown, NSW, Australia
| | - Ian Caterson
- Discipline of Medical Imaging, Charles Perkins Centre, Boden Institute, University of Sydney, Camperdown, NSW, Australia
| | - Janice Russell
- Peter Beumont Tertiary Eating Disorder Service, Department of Psychiatry, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.,InsideOut Institute, University of Sydney, Camperdown, NSW, Australia.,Discipline of Medical Imaging, Charles Perkins Centre, Boden Institute, University of Sydney, Camperdown, NSW, Australia
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia.,School of Medicine, Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
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29
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Jonker NC, Glashouwer KA, de Jong PJ. Punishment sensitivity and the persistence of anorexia nervosa: High punishment sensitivity is related to a less favorable course of anorexia nervosa. Int J Eat Disord 2022; 55:697-702. [PMID: 35347752 PMCID: PMC9313888 DOI: 10.1002/eat.23707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Cross-sectional research provides robust evidence that individuals with anorexia nervosa (AN) report higher punishment sensitivity (PS) than individuals without an eating disorder (ED). High PS might interfere with treatment motivation and the ability to learn from experience. The current study took a longitudinal approach to test predictions that follow from the proposed relevance of PS as a factor in the persistence of AN symptoms. More specifically we tested (1) if higher PS at the start of treatment was related to less improvement in ED symptoms after one year, and (2) if a decrease in ED symptoms was associated with a concurrent decrease in PS. METHOD Participants were 69 adolescents with a diagnosis of AN at the start of treatment of whom 62 participated again one year later. ED symptom severity and PS were assessed at both time points. RESULTS Findings showed that (1) higher PS at the start of treatment was related to less improvement in ED symptoms, and (2) an improvement in ED symptoms was related to a decrease in PS. DISCUSSION These findings are consistent with the proposed relevance of PS in the persistence of AN and suggest that it might be beneficial to address high PS in treatment. PUBLIC SIGNIFICANCE Consistent with the view that punishment sensitivity (PS) is related to the persistence of anorexia nervosa, high PS at the start of treatment was related to less improvement in eating disorder symptoms in patients with anorexia nervosa. Furthermore, an improvement in eating disorder symptoms was associated with a concurrent decrease in PS, suggesting that PS can be subject to change and may be a relevant target for treatment.
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Affiliation(s)
- Nienke C. Jonker
- Department of Clinical Psychology and Experimental PsychopathologyUniversity of GroningenGroningenThe Netherlands
| | - Klaske A. Glashouwer
- Department of Clinical Psychology and Experimental PsychopathologyUniversity of GroningenGroningenThe Netherlands,Department of Eating DisordersAccare Child and Adolescents PsychiatryGroningenThe Netherlands
| | - Peter J. de Jong
- Department of Clinical Psychology and Experimental PsychopathologyUniversity of GroningenGroningenThe Netherlands
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Wang JN, Tang LR, Li WH, Zhang XY, Shao X, Wu PP, Yang ZM, Wu GW, Chen Q, Wang Z, Zhang P, Li ZJ, Wang Z. Regional Neural Activity Abnormalities and Whole-Brain Functional Connectivity Reorganization in Bulimia Nervosa: Evidence From Resting-State fMRI. Front Neurosci 2022; 16:858717. [PMID: 35573287 PMCID: PMC9100949 DOI: 10.3389/fnins.2022.858717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
The management of eating behavior in bulimia nervosa (BN) patients is a complex process, and BN involves activity in multiple brain regions that integrate internal and external functional information. This functional information integration occurs in brain regions involved in reward, cognition, attention, memory, emotion, smell, taste, vision and so on. Although it has been reported that resting-state brain activity in BN patients is different from that of healthy controls, the neural mechanisms remain unclear and need to be further explored. The fractional amplitude of low-frequency fluctuation (fALFF) analyses are an important data-driven method that can measure the relative contribution of low-frequency fluctuations within a specific frequency band to the whole detectable frequency range. The fALFF is well suited to reveal the strength of interregional cooperation at the single-voxel level to investigate local neuronal activity power. FC is a brain network analysis method based on the level of correlated dynamics between time series, which establishes the connection between two spatial regions of interest (ROIs) with the assistance of linear temporal correlation. Based on the psychological characteristics of patients with BN and the abnormal brain functional activities revealed by previous neuroimaging studies, in this study, we investigated alterations in regional neural activity by applying fALFF analysis and whole-brain functional connectivity (FC) in patients with BN in the resting state and to explore correlations between brain activities and eating behavior. We found that the left insula and bilateral inferior parietal lobule (IPL), as key nodes in the reorganized resting-state neural network, had altered FC with other brain regions associated with reward, emotion, cognition, memory, smell/taste, and vision-related functional processing, which may have influenced restrained eating behavior. These results could provide a further theoretical basis and potential effective targets for neuropsychological treatment in patients with BN.
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Affiliation(s)
- Jia-ni Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Li-rong Tang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Wei-hua Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xin-yu Zhang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Xiao Shao
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Ping-ping Wu
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Ze-mei Yang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Guo-wei Wu
- Chinese Institute for Brain Research, Beijing, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zheng Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Peng Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- *Correspondence: Zhenchang Wang,
| | - Zhan-jiang Li
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
- *Correspondence: Zhenchang Wang,
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- *Correspondence: Zhenchang Wang,
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Murray SB, Duval CJ, Balkchyan AA, Cabeen RP, Nagata JM, Toga AW, Siegel SJ, Jann K. Regional gray matter abnormalities in pre-adolescent binge eating disorder: A voxel-based morphometry study. Psychiatry Res 2022; 310:114473. [PMID: 35220054 DOI: 10.1016/j.psychres.2022.114473] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 02/02/2022] [Accepted: 02/19/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Binge eating disorder (BED) is a pernicious psychiatric disorder which is linked with an array of multisystemic organ morbidity, broad psychiatric morbidity, and obesity. Despite behavioral markers often developing in early childhood, the neurobiological markers of early-onset BED remain understudied, and developmental pathophysiology remains poorly understood. METHODS 71 preadolescent children (aged 9-10-years) with BED and 74 age, BMI and developmentally matched control children were extracted from the 3.0 baseline (Year 0) release of the Adolescent Brain Cognitive Development (ABCD) Study. We investigated group differences in gray matter density (GMD) via voxel-based morphometry (VBM). We additionally performed region of interest analyses, assessing the association between GMD in nodes of the reward (orbitofrontal cortex; OFC) and inhibitory control (dorsolateral prefrontal cortex; dlPFC) networks, and parent-reported behavioral inhibition and approach tendencies. RESULTS Diffuse elevations in cortical GMD were noted in those with BED, which spanned prefrontal, parietal, and temporal regions. No areas of reduced GMD were noted in those with BED. No alterations in subcortical GMD were noted. Brain-behavioral associations suggest a distinct and negative relationship between GMD in the OFC and dlPFC, respectively, and self-reported markers of hedonic behavioral approach tendencies. CONCLUSIONS Early-onset BED may be characterized by diffuse morphological abnormalities in gray matter density, suggesting alterations in cortical architecture which may reflect decreased synaptic pruning and arborization, or decreased myelinated fibers and therefore inter-regional afferents.
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Affiliation(s)
- Stuart B Murray
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States; Translational Research in Eating Disorders Program, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States.
| | - Christina J Duval
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States; Translational Research in Eating Disorders Program, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Ane A Balkchyan
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States; Translational Research in Eating Disorders Program, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Ryan P Cabeen
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Arthur W Toga
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Steven J Siegel
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Kay Jann
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
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32
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Rodgers RF, Fischer LE, Laveway K, Laws K, Bui E. Fear of fatness and desire for thinness as distinct experiences: A qualitative exploration. Int J Eat Disord 2022; 55:530-540. [PMID: 35150010 DOI: 10.1002/eat.23689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The pursuit of thinness and fear of gaining weight have been found to play an important role in eating disorder symptomatology. While these dimensions have typically been considered conjointly, emerging evidence suggests they may be distinct dimensions. The aim of this study was to explore the subjective experiences of fear of fatness and drive for thinness in young women with body image concerns. METHOD Young women endorsing weight concerns (N = 29, mean age = 20.86, SD = 2.70 years) were interviewed and asked to describe an experience of fear of fat and drive for thinness, respectively. RESULTS Qualitative analysis was conducted and identified four themes: (1) precipitating events; (2) physiological, emotional, cognitive, and proprioceptive experiences; (3) coping strategies; and (4) sociocultural influences. While similarities emerged, the experiences of fear of fatness, and of drive for thinness also evidenced clear differences situating the former in the context of fear-based avoidance patterns, and the latter in approach-based reward models. DISCUSSION These findings provide additional support for the usefulness of considering fear of fat and drive for thinness as distinct constructs. Further research examining the contributions of each of these constructs to eating pathology is warranted.
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Affiliation(s)
- Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA.,Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France
| | - Laura E Fischer
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Katherine Laveway
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Kristen Laws
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Eric Bui
- Department of Psychiatry, Caen University Hospital & Caen University, Caen, France.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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Molina-Ruiz RM, Looi JCL, Walterfang M, García-Saiz T, Wilkes FA, Liu LL, Velakoulis D, Perera JLC, Diaz-Marsa M. Striatal volumes as potential biomarkers in Eating Disorders: A pilot study. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:65-73. [PMID: 35840286 DOI: 10.1016/j.rpsmen.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 01/20/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Differences in bulimic and impulsive behaviours in Eating Disorders (ED) have been associated with cortico-striatal circuit dysfunction at a neurobiological level. We sought to investigate neo-striatal volume as a biomarker in ED subgroups as well as the possible relationship with trauma history. MATERIAL AND METHODS We studied 24 female patients: Anorexia Nervosa AN (n=8), Bulimia Nervosa BN (n=9), comorbid ED with borderline personality disorder (EDc; n=7), and a group of Healthy Controls (n=19). Binge eating behaviours and impulsivity scales were used to characterize our sample as well as Trauma Questionnaires and Magnetic resonance imaging (MRI) volumetric manual measurements of caudate and putamen nuclei (striatum). RESULTS Our preliminary results showed a significantly larger left putaminal volume in AN compared to the other three groups [C (p=0.008), BN (p<.001) and EDc (p=.001)] and a smaller right putaminal volume in EDc compared to controls (p=.045) and AN (p=.039). Some negative correlations were found between bilateral putaminal volumes and self-reported general and early traumatization scores. CONCLUSION This pilot study suggested that striatal volumes might differentiate AN from BN and EDc at a neurobiological level with implications for treatment strategies. Larger scale studies should be carried out that allow replication of these data.
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Affiliation(s)
- Rosa M Molina-Ruiz
- Complutense University Medical School, Hospital Clínico San Carlos, Madrid, Spain.
| | - Jeffrey C L Looi
- Research Centre for Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra. Hospital, Canberra, Australia
| | - Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital; Melbourne Neuropsychiatry Centre, University of Melbourne and Northwestern Mental Health, Melbourne, Australia
| | | | - Fiona A Wilkes
- Research Centre for Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra. Hospital, Canberra, Australia
| | - Lena L Liu
- Research Centre for Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra. Hospital, Canberra, Australia
| | - Dennis Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital; Melbourne Neuropsychiatry Centre, University of Melbourne and Northwestern Mental Health, Melbourne, Australia
| | | | - Marina Diaz-Marsa
- Complutense University Medical School, Hospital Clínico San Carlos, Madrid, Spain
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34
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de los Remedios Moreno-Frías M, Solís-Ortiz S. Dietary intake of micro- and macronutrients is associated with deficits in executive functioning in young women with high adiposity. Nutrition 2022; 101:111691. [DOI: 10.1016/j.nut.2022.111691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/11/2022] [Accepted: 04/05/2022] [Indexed: 11/26/2022]
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Mottarlini F, Targa G, Bottan G, Tarenzi B, Fumagalli F, Caffino L. Cortical reorganization of the glutamate synapse in the activity-based anorexia rat model: impact on cognition. J Neurochem 2022; 161:350-365. [PMID: 35257377 PMCID: PMC9313878 DOI: 10.1111/jnc.15605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 12/01/2022]
Abstract
Patients suffering from anorexia nervosa (AN) display altered neural activity, morphological, and functional connectivity in the fronto‐striatal circuit. In addition, hypoglutamatergic transmission and aberrant excitability of the medial prefrontal cortex (mPFC) observed in AN patients might underpin cognitive deficits that fuel the vicious cycle of dieting behavior. To provide a molecular mechanism, we employed the activity‐based anorexia (ABA) rat model, which combines the two hallmarks of AN (i.e., caloric restriction and intense physical exercise), to evaluate structural remodeling together with alterations in the glutamatergic signaling in the mPFC and their impact on temporal memory, as measured by the temporal order object recognition (TOOR) test. Our data indicate that the combination of caloric restriction and intense physical exercise altered the homeostasis of the glutamate synapse and reduced spine density in the mPFC. These events, paralleled by an impairment in recency discrimination in the TOOR test, are associated with the ABA endophenotype. Of note, after a 7‐day recovery period, body weight was recovered and the mPFC structure normalized but ABA rats still exhibited reduced post‐synaptic stability of AMPA and NMDA glutamate receptors associated with cognitive dysfunction. Taken together, these data suggest that the combination of reduced food intake and hyperactivity affects the homeostasis of the excitatory synapse in the mPFC contributing to maintain the aberrant behaviors observed in AN patients. Our findings, by identifying novel potential targets of AN, may contribute to more effectively direct the therapeutic interventions to ameliorate, at least, the cognitive effects of this psychopathology.
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Affiliation(s)
- Francesca Mottarlini
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
| | - Giorgia Targa
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
| | - Giorgia Bottan
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
| | - Benedetta Tarenzi
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
| | - Fabio Fumagalli
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
| | - Lucia Caffino
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Via Balzaretti 9, 20133, Milano, Italy
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Dolan SC, Brown TA, Wierenga CE, Kaye WH, Reilly EE. Changes in anhedonia over the course of eating disorder treatment. Int J Eat Disord 2022; 55:399-405. [PMID: 34997637 DOI: 10.1002/eat.23673] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Anhedonia, a transdiagnostic symptom referring to the loss of ability to experience pleasure, is heightened across eating disorder (ED) diagnoses. This study aimed to assess whether anhedonia changes during ED treatment and explore how changes in anhedonia relate to treatment outcome. METHOD Adults and adolescents in a partial hospitalization program for EDs (N = 499) completed the Eating Disorders Examination Questionnaire (EDE-Q) and the anhedonia subscale of the Beck Depression Inventory (BDI) at admission and discharge. RESULTS Anhedonia scores significantly decreased from admission to discharge. Anhedonia at admission was also significantly different across ED diagnostic groups. To examine how study variables related to discharge EDE-Q scores, a hierarchical linear regression was conducted with demographic, diagnostic, and medication variables in the first step, anhedonia and EDE-Q scores at admission added to the second step, and anhedonia at discharge added to the final step. Greater anhedonia at discharge was related to higher EDE-Q scores at discharge. DISCUSSION Our findings suggest that anhedonia changes significantly over the course of intensive treatment and changes in anhedonia relate to ED symptoms at discharge. Future research is needed to determine whether specifically targeting anhedonia in ED treatment may influence treatment outcomes. PUBLIC SIGNIFICANCE The findings from this study suggest that anhedonia may decrease during eating disorder (ED) treatment, and greater anhedonia may relate to elevated ED symptoms. These results provide support for the continued study of anhedonia in ED samples and indicate that anhedonia should be explored as a potential target for novel ED treatments.
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Affiliation(s)
- Sarah C Dolan
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Tiffany A Brown
- Eating Disorders Research and Treatment Program, Department of Psychiatry, University of California, San Diego Health, California, USA
| | - Christina E Wierenga
- Eating Disorders Research and Treatment Program, Department of Psychiatry, University of California, San Diego Health, California, USA
| | - Walter H Kaye
- Eating Disorders Research and Treatment Program, Department of Psychiatry, University of California, San Diego Health, California, USA
| | - Erin E Reilly
- Department of Psychology, Hofstra University, Hempstead, New York, USA.,Department of Psychiatry, University of California, San Francisco, California, USA
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37
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Dolan SC, Khindri R, Franko DL, Thomas JJ, Reilly EE, Eddy KT. Anhedonia in eating disorders: A meta-analysis and systematic review. Int J Eat Disord 2022; 55:161-175. [PMID: 34811779 DOI: 10.1002/eat.23645] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/11/2021] [Accepted: 11/11/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Anhedonia, or loss of pleasure, is related to deficits in reward processing across a variety of psychiatric disorders. In light of research suggesting abnormal reward processing in eating disorders (EDs), the study of anhedonia in EDs may yield important insights into the role of reward in eating pathology. This meta-analysis and review aimed to provide both a quantitative and qualitative synthesis of the existing literature on this topic. METHOD We conducted this research (or these meta-analyses) according to PRISMA guidelines. We searched four databases for both peer-reviewed and unpublished literature, and included studies only if a self-report or clinical interview measure of anhedonia was administered to a sample with an ED diagnosis. RESULTS We included 21 studies in the systematic review, and 10 studies in two meta-analyses that compared anhedonia between ED and control samples (n = 9 studies) and within different ED diagnoses (n = 5 studies). Meta-analyses revealed that anhedonia was significantly higher in ED groups compared to healthy controls, but there was no significant difference in anhedonia between ED diagnostic groups. A qualitative review of the literature also suggested that anhedonia may be correlated with increased ED symptom severity. DISCUSSION Findings indicated that anhedonia is elevated in EDs and may be a relevant treatment target. Future research should examine how self-reported anhedonia may correlate with components of reward processing in EDs in order to improve theoretical models as well as targeted interventions.
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Affiliation(s)
- Sarah C Dolan
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Ruchika Khindri
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Debra L Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Erin E Reilly
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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38
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Pellegrini RA, Finzi S, Veglia F, Di Fini G. Narrative and Bodily Identity in Eating Disorders: Toward an Integrated Theoretical-Clinical Approach. Front Psychol 2021; 12:785004. [PMID: 34975677 PMCID: PMC8714898 DOI: 10.3389/fpsyg.2021.785004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/16/2021] [Indexed: 11/22/2022] Open
Abstract
Eating disorders (EDs) can be viewed as “embodied acts” that help to cope with internal and external demands that are perceived as overwhelming. The maintenance of EDs affects the entire identity of the person; the lack of a defined; or valid sense of self is expressed in terms of both physical body and personal identity. According to attachment theory, primary relationships characterized by insecurity, traumatic experiences, poor mirroring, and emotional attunement lead to the development of dysfunctional regulatory strategies. Although the literature shows an association between attachment style or states of mind, trauma, behavioral strategies, and various EDs, the debate is still ongoing and the results are still conflicting. Therefore, we believe it is important to examine and treat EDs by understanding which narrative trajectory intercepts distress in relation to narrative and embodied self-concept. Drawing on clinical observation and a narrative review of the literature, we focus on the construction and organization of bodily and narrative identity. Because bodily representations are the primary tools for generating meaning, organizing experience, and shaping social identity from the earliest stages of life, we focus on the role that bodily interactions and sensorimotor and proprioceptive patterns have played in the development of EDs. We consider the role that lack of attunement, insecure attachment, and relational trauma play in mentalizing, affecting self-representation and emotion regulation strategies. The paper also considers a semantic mode of trauma in EDs that involves a top-down pathway through beliefs and narratives about oneself based on lack of amiability, on devaluation, and on humiliation memories. Finally, we would like to highlight the proposal of an integrated model with multiple access model to psychotherapy that takes into account the complexity of ED patients in whom aspects related to dysregulation, body image disintegration, and post-traumatic symptoms are associated with a suffering sense of self and a retraumatizing narrative.
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Affiliation(s)
| | - Sarah Finzi
- Centro Clinico Crocetta, Scuola di Specializzazione in Psicoterapia Cognitiva, Turin, Italy
- Department of Psychology, University of Turin, Turin, Italy
- *Correspondence: Sarah Finzi,
| | - Fabio Veglia
- Centro Clinico Crocetta, Scuola di Specializzazione in Psicoterapia Cognitiva, Turin, Italy
- Department of Psychology, University of Turin, Turin, Italy
| | - Giulia Di Fini
- Centro Clinico Crocetta, Scuola di Specializzazione in Psicoterapia Cognitiva, Turin, Italy
- Department of Psychology, University of Turin, Turin, Italy
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Devoe DJ, Dimitropoulos G, Anderson A, Bahji A, Flanagan J, Soumbasis A, Patten SB, Lange T, Paslakis G. The prevalence of substance use disorders and substance use in anorexia nervosa: a systematic review and meta-analysis. J Eat Disord 2021; 9:161. [PMID: 34895358 PMCID: PMC8666057 DOI: 10.1186/s40337-021-00516-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/25/2021] [Indexed: 12/24/2022] Open
Abstract
AIM Individuals with anorexia nervosa (AN) often present with substance use and substance use disorders (SUDs). However, the prevalence of substance use and SUDs in AN has not been studied in-depth, especially the differences in the prevalence of SUDs between AN types [e.g., AN-R (restrictive type) and AN-BP (binge-eating/purge type]. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of SUDs and substance use in AN samples. METHOD Systematic database searches of the peer-reviewed literature were conducted in the following online databases: MEDLINE, PsycINFO, Embase, and CINAHL from inception to January 2021. We restricted review eligibility to peer-reviewed research studies reporting the prevalence for either SUDs or substance use in individuals with AN. Random-effects meta-analyses using Freeman-Tukey double arcsine transformations were performed on eligible studies to estimate pooled proportions and 95% confidence intervals (CIs). RESULTS Fifty-two studies met the inclusion criteria, including 14,695 individuals identified as having AN (mean age: 22.82 years). Random pooled estimates showed that substance use disorders had a 16% prevalence in those with AN (AN-BP = 18% vs. AN-R = 7%). Drug abuse/dependence disorders had a prevalence of 7% in AN (AN-BP = 9% vs. AN-R = 5%). In studies that looked at specific abuse/dependence disorders, there was a 10% prevalence of alcohol abuse/dependence in AN (AN-BP = 15% vs. AN-R = 3%) and a 6% prevalence of cannabis abuse/dependence (AN-BP = 4% vs. AN-R = 0%). In addition, in terms of substance use, there was a 37% prevalence for caffeine use, 29% prevalence for alcohol use, 25% for tobacco use, and 14% for cannabis use in individuals with AN. CONCLUSION This is the most comprehensive meta-analysis on the comorbid prevalence of SUDs and substance use in persons with AN, with an overall pooled prevalence of 16%. Comorbid SUDs, including drugs, alcohol, and cannabis, were all more common in AN-BP compared to AN-R throughout. Therefore, clinicians should be aware of the high prevalence of SUD comorbidity and substance use in individuals with AN. Finally, clinicians should consider screening for SUDs and integrating treatments that target SUDs in individuals with AN. Individuals with anorexia nervosa (AN) may also present with substance use or have a substance use disorder (SUDs). Thus, we conducted a systematic review and meta-analysis to determine the prevalence of substance use and substance use disorders in individuals with AN. We examined published studies that reported the prevalence of either substance use or SUDs in individuals with AN. We found that substance use disorders had a 16% prevalence and that drug abuse/dependence disorders had a prevalence of 7% in those with AN. These rates were much higher in individuals with binge-eating/purging type compared to the restrictive AN. However, many specific substance use disorders and substance use types were low in individuals with AN. Nonetheless, clinicians should be aware of the high prevalence of SUD comorbidity and substance use in individuals with AN.
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Affiliation(s)
- Daniel J Devoe
- Department of Psychiatry, Cumming School of Medicine, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - Gina Dimitropoulos
- Department of Psychiatry, Cumming School of Medicine, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
- Faculty of Social Work, University of Calgary, Calgary, Canada
| | - Alida Anderson
- Department of Psychiatry, Cumming School of Medicine, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Anees Bahji
- Department of Psychiatry, Cumming School of Medicine, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Jordyn Flanagan
- Department of Psychiatry, Cumming School of Medicine, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Andrea Soumbasis
- Department of Psychiatry, Cumming School of Medicine, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Scott B Patten
- Department of Psychiatry, Cumming School of Medicine, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Tom Lange
- Department of Psychiatry, Cumming School of Medicine, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Georgios Paslakis
- Ruhr-University Bochum, University Clinic for Psychosomatic Medicine and Psychotherapy, Campus East-Westphalia, Lübbecke, Germany
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Miranda-Olivos R, Testa G, Lucas I, Sánchez I, Sánchez-González J, Granero R, Jiménez-Murcia S, Fernández-Aranda F. Clinical factors predicting impaired executive functions in eating disorders: The role of illness duration. J Psychiatr Res 2021; 144:87-95. [PMID: 34601380 DOI: 10.1016/j.jpsychires.2021.09.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/08/2021] [Accepted: 09/22/2021] [Indexed: 01/30/2023]
Abstract
Poor performance in executive functions is observed in individuals with eating disorders (EDs). These impairments have usually been associated with the presence of comorbid psychopathology or with higher severity of EDs. However, few studies have explored the interaction between illness duration and deficits in executive functions. The present study investigates the association between ED duration and performance in decision-making, inhibitory control, and cognitive flexibility in the anorexia nervosa restrictive subtype (AN-R), bulimic/purging subtype (AN-BP), and binge spectrum disorders (BSDs) (namely, bulimia nervosa and binge eating disorder) among 116 women with EDs compared with 123 women healthy controls (HCs). Using cumulative survival analysis, we estimated the risk of deficits related to illness duration. Predictors of executive dysfunctions were assessed by regression analysis, including as potential predictors illness duration, severity of general psychopathology, and ED symptomatology. Results showed poor decision-making and cognitive flexibility in participants with EDs compared with HCs. ED duration was associated with poor inhibitory control in the AN-BP group and poor cognitive flexibility in the BSD group. The illness duration increased the risk of presenting early deficits in executive function. In decision-making and inhibitory control, the AN-R group showed the earliest deficits, whereas in cognitive flexibility it was the BSD group. ED duration predicted impaired cognitive flexibility in the BSD group and impaired inhibitory control in the AN-BP group, whereas the severity of general psychopathological symptoms was a predictor of impaired cognitive flexibility in individuals with AN-R. These results highlight the relevance of illness duration in executive dysfunctions in EDs.
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Affiliation(s)
- Romina Miranda-Olivos
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Giulia Testa
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Ignacio Lucas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Isabel Sánchez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Jessica Sánchez-González
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Claes L, Kiekens G, Boekaerts E, Depestele L, Dierckx E, Gijbels S, Schoevaerts K, Luyckx K. Are Sensitivity to Punishment, Sensitivity to Reward and Effortful Control Transdiagnostic Mechanisms Underlying the Eating Disorder/Obesity Spectrum? Nutrients 2021; 13:nu13103327. [PMID: 34684327 PMCID: PMC8541040 DOI: 10.3390/nu13103327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 11/16/2022] Open
Abstract
Although it has been postulated that eating disorders (EDs) and obesity form part of a broad spectrum of eating- and weight-related disorders, this has not yet been tested empirically. In the present study, we investigated interindividual differences in sensitivity to punishment, sensitivity to reward, and effortful control along the ED/obesity spectrum in women. We used data on 286 patients with eating disorders (44.6% AN-R, 24.12% AN-BP, and 31.82% BN), 126 healthy controls, and 640 Class II/III obese bariatric patients (32.81% Class II and 67.19% Class III) with and without binge eating. Participants completed the behavioral inhibition and behavioral activation scales, as well as the effortful control scale, to assess sensitivity to punishment and reward and effortful control. Results showed that patients with EDs scored significantly higher on punishment sensitivity (anxiety) compared to healthy controls and Class II/III obese patients; the different groups did not differ significantly on reward sensitivity. Patients with binge eating or compensatory behaviors scored significantly lower on effortful control than patients without binge eating. Differences in temperamental profiles along the ED/obesity spectrum appear continuous and gradual rather than categorical. This implies that it may be meaningful to include emotion regulation and impulse regulation training in the treatment of both EDs and obesity.
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Affiliation(s)
- Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium; (G.K.); (K.L.)
- Faculty of Medicine and Health Sciences, University Antwerp, 2000 Antwerp, Belgium
- Correspondence: ; Tel.: +32-16-32-61-33
| | - Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium; (G.K.); (K.L.)
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
| | - Els Boekaerts
- Obesity Centre Hasselt, Jessa Hospital, 3500 Hasselt, Belgium; (E.B.); (S.G.)
| | - Lies Depestele
- Psychiatric Hospital Alexianen Zorggroep Tienen, 3300 Tienen, Belgium; (L.D.); (E.D.); (K.S.)
| | - Eva Dierckx
- Psychiatric Hospital Alexianen Zorggroep Tienen, 3300 Tienen, Belgium; (L.D.); (E.D.); (K.S.)
- Department of Clinical Psychology, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Sylvia Gijbels
- Obesity Centre Hasselt, Jessa Hospital, 3500 Hasselt, Belgium; (E.B.); (S.G.)
| | - Katrien Schoevaerts
- Psychiatric Hospital Alexianen Zorggroep Tienen, 3300 Tienen, Belgium; (L.D.); (E.D.); (K.S.)
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium; (G.K.); (K.L.)
- UNIBS, University of the Free State, Bloemfontein 9300, South Africa
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42
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Kogel AK, Herpertz S, Steins-Loeber S, Diers M. Disorder specific rewarding stimuli in anorexia nervosa. Int J Eat Disord 2021; 54:1477-1485. [PMID: 33955563 DOI: 10.1002/eat.23526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To enhance our understanding of reward stimuli in anorexia nervosa (AN) and to provide a basis for future research on reward processes, disorder specific reward stimuli as well as primary and secondary reinforcers were investigated. METHOD We developed a set of pictures with "disorder specific reward" stimuli, with the six subcategories "sport," "losing weight," "healthy food," "discipline," "thin bodies," "appreciation of others," and evaluated reward ratings of these "disorder specific reward" stimuli as well as "erotic," "high caloric," and "neutral" stimuli in 25 patients with AN and 25 participants in the comparison group (CG). RESULTS We found a significant main effect for picture category and a significant interaction. The reward ratings were higher in patients with AN compared with CG for the "disorder specific reward" stimuli. In the reward subcategories, patients with AN had higher reward ratings compared with CG in all categories except of healthy food. The "disorder specific reward" stimuli of the categories "sport," "losing weight," and "healthy food" showed higher reward ratings compared with the categories "discipline," "thin bodies," and "appreciation of others" in patients with AN. DISCUSSION The previously used category "thin bodies" used to investigate the reward system might be less effective compared with stimuli from the categories "sport," "losing weight," and "healthy food."
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Affiliation(s)
- Ann-Kathrin Kogel
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Martin Diers
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
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Haynos AF, Wang SB, LeMay-Russell S, Lavender JM, Pearson CM, Mathis KJ, Peterson CB, Crow SJ. An empirical taxonomy of reward response patterns in a transdiagnostic eating disorder sample. Eat Behav 2021; 42:101531. [PMID: 34126343 PMCID: PMC8380651 DOI: 10.1016/j.eatbeh.2021.101531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/14/2021] [Accepted: 05/19/2021] [Indexed: 11/26/2022]
Abstract
Reward response patterns may contribute to risk and maintenance of eating disorders (EDs), and there may be clinically meaningful heterogeneity in behavioral responses to different actual and anticipated rewards across ED diagnoses. We used an empirical approach to classify individuals with EDs based on self-reported tendencies for responding to reward-related stimuli. Latent profile analysis was conducted in a transdiagnostic ED sample (N = 104) using Temperament and Character Inventory (Cloninger et al., 1993) subscales to categorize participants on reward responses of behavioral activation towards immediate, hedonic rewards (Novelty Seeking subscale), persistence towards long-term rewards (Persistence subscale), and maintenance by social rewards (Reward Dependence subscale) rewards. Two profiles were identified: (1) Behavioral Activation group (elevated Novelty Seeking; n = 62); and (b) Behavioral Persistence group (elevated Persistence; n = 42). Generalized linear models comparing profiles showed that frequency of these reward response profiles did not differ in probable AN, BN, or OSFED groups; however, individuals with probable BED more often demonstrated the Behavioral Activation profile (p = .041). These profiles exhibited comparable ED severity, but different presentations. Across probable ED diagnoses, the Behavioral Activation group reported greater binge eating (p = .006, d = 0.32) and had higher BMIs (p = .001, d = 0.57); the Behavioral Persistence group endorsed greater driven exercise (p = .042, d = 0.33). Categorization by activation to novel, immediate rewards versus persistence towards long-term rewards was associated with different symptoms across diagnoses, potentially supporting the role of specific reward response profiles in ED phenomenology.
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Affiliation(s)
- Ann F. Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | | | - Sarah LeMay-Russell
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda MD
| | - Jason M. Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD,Metis Foundation; San Antonio, TX
| | - Carolyn M. Pearson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Karen J. Mathis
- College of Nursing, University of Rhode Island, Providence, RI
| | - Carol B. Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Scott J. Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN,The Emily Program, Minneapolis, MN, USA
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Haynos AF, Anderson LM, Askew AJ, Craske MG, Peterson CB. Adapting a neuroscience-informed intervention to alter reward mechanisms of anorexia nervosa: a novel direction for future research. J Eat Disord 2021; 9:63. [PMID: 34039415 PMCID: PMC8152047 DOI: 10.1186/s40337-021-00417-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/04/2021] [Indexed: 01/16/2023] Open
Abstract
Accumulating psychobiological data implicate reward disturbances in the persistence of anorexia nervosa (AN). Evidence suggests that individuals with AN demonstrate decision-making deficits similar to those with mood and anxiety disorders that cause them to under-respond to many conventionally rewarding experiences (e.g., eating, interacting socially). In contrast, unlike individuals with other psychiatric disorders, individuals with AN simultaneously over-respond to rewards associated with eating-disorder behaviors (e.g., restrictive eating, exercising). This pattern of reward processing likely perpetuates eating-disorder symptoms, as the rewards derived from eating-disorder behaviors provide temporary relief from the anhedonia associated with limited responsivity to other rewards. Positive Affect Treatment (PAT) is a cognitive-behavioral intervention designed to target reward deficits that contribute to anhedonia in mood and anxiety disorders, including problems with reward anticipation, experiencing, and learning. PAT has been found to promote reward responsivity and clinical improvement in mood and anxiety disorders. This manuscript will: (1) present empirical evidence supporting the promise of PAT as an intervention for AN; (2) highlight nuances in the maintaining processes of AN that necessitate adaptations of PAT for this population; and (3) suggest future directions in research on PAT and other reward-based treatments that aim to enhance clinical outcomes for AN.
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Affiliation(s)
- Ann F Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, 2450 Riverside Ave., Minneapolis, MN, 55454, USA.
| | - Lisa M Anderson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, 2450 Riverside Ave., Minneapolis, MN, 55454, USA
| | - Autumn J Askew
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, 2450 Riverside Ave., Minneapolis, MN, 55454, USA
| | - Michelle G Craske
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, 2450 Riverside Ave., Minneapolis, MN, 55454, USA
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45
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Jonker NC, Bennik EC, de Jong PJ. Why Dieters Succeed or Fail: The Relationship Between Reward and Punishment Sensitivity and Restrained Eating and Dieting Success. Front Psychol 2021; 12:636432. [PMID: 34054646 PMCID: PMC8155680 DOI: 10.3389/fpsyg.2021.636432] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/15/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The current study set out to improve our understanding of the characteristics of individuals who are motivated to restrict their food intake yet who nevertheless fail to do so. We examined whether punishment sensitivity (PS) was related to restrained eating, and reward sensitivity (RS) to perceived dieting success. Additionally, it was examined whether executive control (EC) moderates the association between RS and perceived dieting success. METHODS Female student participants (N = 290, aged 17-29, BMI between 18.5 and 38.0) completed questionnaires on restrained eating, perceived dieting success, RS and PS, and carried out a behavioral task to index EC. RESULTS PS was indeed positively related to restrained eating. RS was positively related to perceived dieting success, yet, EC did not moderate this association. CONCLUSION The current study adds to the evidence that PS is related to individuals' motivation to restrict their food intake. Furthermore, it shows support for the suggestion that RS may facilitate food restriction.
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Affiliation(s)
- Nienke C. Jonker
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
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Chen X, Gao X, Qin J, Wang C, Xiao M, Tian Y, Luo YJ, Qiu J, Feng T, He Q, Lei X, Chen H. Resting-state functional network connectivity underlying eating disorder symptoms in healthy young adults. NEUROIMAGE-CLINICAL 2021; 30:102671. [PMID: 33892431 PMCID: PMC8082688 DOI: 10.1016/j.nicl.2021.102671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/25/2021] [Accepted: 04/08/2021] [Indexed: 12/12/2022]
Abstract
This study examined the resting-state functional network connectivity underlying eating disorder symptoms in a large sample of healthy young adults (n = 693). Individuals with higher levels of eating disorder symptoms displayed weaker intra-network connectivity of the executive control network and basal ganglia network, as well as weaker inter-network connectivity in the three examined networks (i.e., the executive control network, basal ganglia network, and default mode network). The findings suggest that these neural circuits may play a key role in symptoms of disordered eating in healthy adults. They further reveal that the less efficient information exchange within and between intrinsic networks associated with self-referential thinking, inhibitory control, and reward sensitivity are strongly related to eating disorder symptoms.
Previous neuroimaging research of eating disorders such as anorexia nervosa and bulimia nervosa has mainly focused on clinical patients, indicating the crucial role of intrinsic connectivity networks involved in aberrant behavioral control (i.e., executive control network), reward reactivity (i.e., basal ganglia network), and excessive self-focused and body-focused ruminations (i.e., default mode network) in the onset and maintenance of eating disturbances. However, examinations of large-scale resting-state networks that support the role of cognitive control, reward sensitivity, and self-directed thinking in disordered eating have rarely involved non-clinical samples from the general population. This study, involving a total of 693 healthy young adults (68.69% females; mean age, 18.37 years), investigated these issues by using pre-defined functional regions of interest from the executive control network, basal ganglia network, default mode network, and a seed-based region of interest-to-region of interest approach. After statistically controlling for differences in age, sex, body mass index, and head motion, we observed significant associations of higher levels of eating disorder symptoms, especially bulimia-type eating (i.e., binge eating and a combination of binge eating and compensatory behaviors, such as purging via self-induced vomiting or laxative use, and compulsive exercise), with weaker intra-network and inter-network functional synchrony. These results remained significant after excluding underweight, overweight, and obese participants. These findings suggest that these neural circuits may play a key role in the symptoms of disordered eating in healthy adults. They further reveal that the less efficient information exchange within and between intrinsic networks associated with self-referential thinking, inhibitory control, and reward sensitivity are strongly related to eating disorder symptoms.
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Affiliation(s)
- Ximei Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xiao Gao
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Jingmin Qin
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Chuan Wang
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Mingyue Xiao
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Yun Tian
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
| | - Yi-Jun Luo
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Southwest University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality at Beijing Normal University, Chongqing, China
| | - Tingyong Feng
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Chongqing, China
| | - Qinghua He
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Southwest University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality at Beijing Normal University, Chongqing, China
| | - Xu Lei
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China; Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Chongqing, China.
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Williams-Kerver GA, Steffen KJ, Smith KE, Cao L, Crosby RD, Engel SG. Negative Affect and Loss of Control Eating Among Bariatric Surgery Patients: an Ecological Momentary Assessment Pilot Investigation. Obes Surg 2021; 30:2382-2387. [PMID: 32125646 DOI: 10.1007/s11695-020-04503-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Research shows that loss of control (LOC) eating impacts weight outcomes following bariatric surgery, but mechanisms explaining the development and/or maintenance of post-surgical LOC eating remain unclear. Ecological momentary assessment (EMA) research among eating disorder populations has demonstrated prospective relationships between negative affect (NA) and LOC eating; however, this momentary effect has not been examined among bariatric surgery patients. Thus, this study used EMA data to examine momentary relationships between NA and LOC eating among pre- and post-bariatric surgery patients. METHODS Fourteen pre- and 17 post-RYGB patients completed 2 weeks of EMA data collection. Participants responded to seven signals daily wherein they rated their mood and severity of LOC eating. RESULTS Higher momentary NA predicted more severe LOC eating for all participants. Group had a moderating effect, demonstrating that the association between NA and LOC eating was stronger among the post-surgery group. Percent total body weight loss (%TBWL) had a moderating effect within the post-surgery group, demonstrating that the relationship between NA and LOC eating was stronger for those who experienced less weight loss. Finally, between-subjects analyses revealed that, for individuals with lower %TBWL, lower overall NA and higher overall positive affect (PA) were related to greater LOC eating. CONCLUSIONS This research demonstrates that affect influences the effect of LOC eating on weight loss following bariatric surgery. While further work is needed to extend these preliminary findings, this research suggests that affective experience might become an important target in the assessment and treatment of LOC eating among bariatric patients.
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Affiliation(s)
- Gail A Williams-Kerver
- Sanford Center for Bio-behavioral Research, 120 South 8th St., PO Box 2010, Fargo, ND, 58122, USA.
| | - Kristine J Steffen
- Sanford Center for Bio-behavioral Research, 120 South 8th St., PO Box 2010, Fargo, ND, 58122, USA.,Department of Pharmaceutical Sciences, North Dakota State University, PO Box 6050, Fargo, ND, 58108-6050, USA
| | - Kathryn E Smith
- Sanford Center for Bio-behavioral Research, 120 South 8th St., PO Box 2010, Fargo, ND, 58122, USA.,Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar Street #2200, Los Angeles, CA, 90033, USA
| | - Li Cao
- Sanford Center for Bio-behavioral Research, 120 South 8th St., PO Box 2010, Fargo, ND, 58122, USA
| | - Ross D Crosby
- Sanford Center for Bio-behavioral Research, 120 South 8th St., PO Box 2010, Fargo, ND, 58122, USA
| | - Scott G Engel
- Sanford Center for Bio-behavioral Research, 120 South 8th St., PO Box 2010, Fargo, ND, 58122, USA
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Bergner L, Himmerich H, Kirkby KC, Steinberg H. Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803-2017. Front Psychiatry 2021; 11:504157. [PMID: 33519534 PMCID: PMC7840701 DOI: 10.3389/fpsyt.2020.504157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 11/25/2020] [Indexed: 12/13/2022] Open
Abstract
The most common eating disorders (EDs) according to DSM-5 are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). These disorders have received increasing attention in psychiatry due to rising prevalence and high morbidity and mortality. The diagnostic category "anorexia nervosa," introduced by Ernest-Charles Lasègue and William Gull in 1873, first appears a century later in a German textbook of psychiatry, authored by Gerd Huber in 1974. However, disordered eating behavior has been described and discussed in German psychiatric textbooks throughout the past 200 years. We reviewed content regarding eating disorder diagnoses but also descriptions of disordered eating behavior in general. As material, we carefully selected eighteen German-language textbooks of psychiatry across the period 1803-2017. Previously, in German psychiatry, disordered eating behaviors were seen as symptoms of depressive disorders, bipolar disorder or schizophrenia, or as manifestations of historical diagnoses no longer used by the majority of psychiatrists such as neurasthenia, hypochondria and hysteria. Interestingly, 19th and early 20th century psychiatrists like Kraepelin, Bumke, Hoff, Bleuler, and Jaspers reported symptom clusters such as food refusal and vomiting under these outdated diagnostic categories, whereas nowadays they are listed as core criteria for specific eating disorder subtypes. A wide range of medical conditions such as endocrinopathies, intestinal or brain lesions were also cited as causes of abnormal food intake and body weight. An additional consideration in the delayed adoption of eating disorder diagnoses in German psychiatry is that people with EDs are commonly treated in the specialty discipline of psychosomatic medicine, introduced in Germany after World War II, rather than in psychiatry. Viewed from today's perspective, the classification of disorders associated with disordered eating is continuously evolving. Major depressive disorder, schizophrenia and physical diseases have been enduringly associated with abnormal eating behavior and are listed as important differential diagnoses of EDs in DSM-5. Moreover, there are overlaps regarding the neurobiological basis and psychological and psychopharmacological therapies applied to all of these disorders.
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Affiliation(s)
- Lukas Bergner
- Archiv für Leipziger Psychiatriegeschichte, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig, Leipzig, Germany
| | - Hubertus Himmerich
- Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Kenneth C. Kirkby
- Department of Psychiatry, University of Tasmania, Hobart, TAS, Australia
| | - Holger Steinberg
- Archiv für Leipziger Psychiatriegeschichte, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig, Leipzig, Germany
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Reward Learning Through the Lens of RDoC: a Review of Theory, Assessment, and Empirical Findings in the Eating Disorders. Curr Psychiatry Rep 2021; 23:2. [PMID: 33386514 DOI: 10.1007/s11920-020-01213-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW Reward-related processes may represent important transdiagnostic factors underlying eating pathology. Using the NIMH Research Domain Criteria as a guide, the current article reviews theories, behavioral and self-report assessments, and empirical findings related to reward learning in the eating disorders. RECENT FINDINGS Data from behavioral tasks suggest deficits in reinforcement learning, which may become more pronounced with increasing disorder severity and duration. Self-report data strongly implicate positive eating and thinness/restriction expectancies (an element of reward prediction error) in the onset and maintenance of eating pathology. Finally, self-report measures of habit strength demonstrate relationships with eating pathology and illness duration; however, behavioral task data do not support relationships between eating pathology and a propensity towards general habit development. Existing studies are limited, but provide preliminary support for the presence of abnormal reward learning in eating disorders. Continued research is needed to address identified gaps in the literature.
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Wonderlich JA, Bershad M, Steinglass JE. Exploring Neural Mechanisms Related to Cognitive Control, Reward, and Affect in Eating Disorders: A Narrative Review of FMRI Studies. Neuropsychiatr Dis Treat 2021; 17:2053-2062. [PMID: 34188475 PMCID: PMC8232881 DOI: 10.2147/ndt.s282554] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/04/2021] [Indexed: 12/23/2022] Open
Abstract
Studies using functional magnetic resonance imaging (fMRI) have contributed to our understanding of possible neural abnormalities among individuals with eating disorders. Many of these studies have focused on three domains: 1) cognitive control, 2) reward processing, and 3) affective processing. This review attempts to summarize the recent fMRI findings across these domains among the most well-characterized eating disorders: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Though the literature is a bit murky, a few major themes have emerged. Cognitive control systems are affected among individuals across eating disorder diagnoses, but effects seem least pronounced in AN. Specifically, individuals with all eating disorders appear to show decreased prefrontal activation during cognitive control, but there is less evidence in AN linking decreased prefrontal activation with behavior. There is some evidence that the reinforcing value of food is reduced in AN, but individuals with BN and BED show hyperactivation to rewarding food-related stimuli, suggesting the reinforcing value of food may be enhanced. However, more complex reward processing paradigms show that individuals with BN and BED exhibit hypoactivation to reward anticipation and provide mixed results with regards to reward receipt. There are fewer neuroimaging findings related to affective processing, yet behavioral findings suggest affective processing is important in understanding eating disorders. Though the extant literature is complicated, these studies represent a foundation from which to build and provide insight into potential neurobiological mechanisms that may contribute to the pathophysiology of eating disorders.
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Affiliation(s)
- Joseph A Wonderlich
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.,Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Mariya Bershad
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.,Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Joanna E Steinglass
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.,Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
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