Anorexia nervosa as a motivated behavior: Relevance of anxiety, stress, fear and learning

Guarda, Ángela S.; Schreyer, Colleen C.; Boersma, Gretha J.; Tamashiro, Kellie L.K.; Moran, Timothy H.

doi:10.1016/j.physbeh.2015.04.007

Cited by 81 publications

(61 citation statements)

References 112 publications

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“…In the present case, there may be evidence only for simple compulsive behavior. Finally, the present study fails to account for the possibility that increased exercise frequency reflects a compensatory behavior to alleviate anxiety, which is consistent with an anxiolytic action of exercise [48], given the high co-morbidity between AN and anxiety disorders [17].…”

Section: Limitations Of the Studycontrasting

confidence: 75%

“…Recovered participants did not differ significantly from controls on any implicit affect measure [16]. The notion of AN, as a motivated behavioral disorder in which compulsiveness may contribute to the persistence of abnormal eating habits and excessive exercise behaviors, seems warranted in view of evidence implicating anxiety, stress, fear and avoidance learning factors [17,18].…”

Section: Introductionmentioning

confidence: 93%

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Emotional Well-Being in Anorexia Nervosa: Negative Affect, Sleeping Problems, Use of Mood-enhancing Drugs and Exercise Frequency

Archer¹

2015

Arch Depress Anxiety

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The purpose of this study was to ascertain emotional well-being among patients presenting ninety anorexia nervosa (AN) and healthy age-matched controls using the Positive Affect and Negative Affect Schedule and the Emotional Well-Being Scale together with background health information. The results indicated that AN patients displayed higher levels of negative affect and negative emotions, more stress and depression, greater sleeping problems, pain, and use of analgesics and mood-enhancing drugs, as well as lower levels of positive affect and positive emotions, compared to the age-matched healthy controls. Despite their negative self-report, on the variables pertaining to affect, sleep and pain, the AN patients reported a higher frequency of physical exercise. Regression analysis indicated that the AN condition, from diagnosis, was predicted from negative affect, sleeping problems, use of moodenhancing drugs and exercise frequency. Hence, suggesting that excessive exercise together with depression, anxiety, obsessive-compulsive, additive behaviors and sleep problems represent AN from a perspective of multiple comorbidities.compared with healthy volunteers, assessed on Estonian versions of the Eating Disorder Inventory-2, positive affect and negative affect (measured by the Positive Affect and Negative Affect Schedule), and Neuroticism made the largest contribution to Eating Disorder-2 subscales, with Openness to Experience and Conscientiousness (measured by the NEO Personality Inventory), predisposing individuals to eating problems [5]. It has been shown also that patients with AN inhibit expressions of both positive and negative emotions, even after controlling for neuroticism, with higher levels of hostility and neuroticism; they were less aware of their inner thoughts and feelings, "private self-consciousness", and had a heightened awareness of the thoughts and expectations of others, "public selfconsciousness", [6]. Patients presenting eating disorders often report alexithymia, an inability to identify and describe their emotions and affective status [7,8]. They show a paucity of words expressing feelings and demonstrate difficulties in identifying and distinguishing feeling of physical sensations. Alexithymia and personal distress seem to predict the vulnerability features of Anorexia Nervosa (AN) with higher levels of personal distress in the latter linked to poor selfregulation and emotional awareness [9].There is a high comorbidity between AN and anxiety and/or alexithymia disorders [10], moreover, AN patients display certain features similar to those abusing substances/exercise, through a 'narrowed' behavioral repertoire such that weight loss, food intake restriction, and excessive exercise interfere with other activities in a similar fashion to substance/exercise abuse [11]. Further, comorbidity between AN, anxiety, depression and psychoactive substance use has been described [12]. It is likely that the disorder elevates anxiety, depression with stress presenting a predisposing factor to poorer ...

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Section: Limitations Of the Studycontrasting

confidence: 75%

Section: Introductionmentioning

confidence: 93%

Emotional Well-Being in Anorexia Nervosa: Negative Affect, Sleeping Problems, Use of Mood-enhancing Drugs and Exercise Frequency

Archer¹

2015

Arch Depress Anxiety

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“…Genetic vulnerability due to multigenic effects may code for personality traits associated with AN such as: perfectionism, harm avoidance and neuroticism [17,18]. These individuals are vulnerable to environmental factors, such as the cultural tying of self-esteem to a thin body.…”

Section: Pathophysiologymentioning

confidence: 99%

“…Neuroimaging studies have shown structural and functional brain changes in patients with AN [21,22]. Deficits in dopaminergic, opioidergic and serotonergic brain functions (involved in mood, motivation, reward, impulse control and obsessional behaviour) have also been found in individuals with AN [ 17 ].…”

Section: Pathophysiologymentioning

confidence: 99%

Eating disorders in older women

et al. 2015

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Eating disorders (EDs) are disturbances that seriously endanger the physical health and often the lives of sufferers and affect their psychosocial functioning. EDs are usually thought of as problems afflicting teenagers. However, the incidence in older women has increased in recent decades. These cases may represent either late-onset disease or, more likely, a continuation of a lifelong disorder. The DSM-5 classification differentiates 4 categories of eating disorder: anorexia nervosa, bulimia nervosa, binge-eating disorders and other specified feeding and eating disorders. The weight loss and malnutrition resulting from EDs have widespread negative consequences for physical, mental and social health. The main risk factors for developing long-term consequences are the degree of weight loss and the chronicity of the illness. Most of the cardiac, neurological, pulmonary, gastric, haematological and dermatological complications of EDs are reversible with weight restoration. EDs are serious illnesses and they should never be neglected or treated only as a manifestation of the fashion for dieting or a woman's wish to achieve an imposed standard feminine figure. Additionally, EDs are associated with high risk of morbidity and mortality. The literature concerning EDs in older, postmenopausal women is very limited. The main aim of this paper is to ascertain the epidemiology and prognosis of EDs in older women, and to review their diagnosis and management.

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“…In fact it has been suggested that this need for a better integration of genetic, environmental and developmental factors applies to animal models for psychiatric disorders in general [136]. What animal models do not represent well are the cognitive-emotional aspects of AN and its ego-syntonic nature of food restriction [137]. Another caveat to keep in mind from substance use disorder treatment research is that drug development can show much promise in animals, but not all of these results can be directly translated to humans [138].…”

Section: Neurobiology Of Anmentioning

confidence: 99%

The Role of Psychotropic Medications in the Management of Anorexia Nervosa: Rationale, Evidence and Future Prospects

Frank

Shott

2016

CNS Drugs

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Anorexia nervosa is a severe psychiatric disorder without approved medication intervention. Every class of psychoactive medication has been tried to improve treatment outcome; however, randomized controlled trials have been ambiguous at best and across studies have not shown robust improvements in weight gain and recovery. Here we review the available literature on pharmacological interventions since anorexia nervosa came to greater public recognition in the 1960s. This will include a critical review of why those trials may not have been successful. We further provide a neurobiological background for the disorder and discuss how cognition, learning and emotion-regulating circuits could become treatment targets in the future. Making every effort to develop effective pharmacological treatment options for anorexia nervosa is imperative, as it continues to be a complex psychiatric disorder with high disease burden and mortality.

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Anorexia nervosa as a motivated behavior: Relevance of anxiety, stress, fear and learning

Cited by 81 publications

References 112 publications

Emotional Well-Being in Anorexia Nervosa: Negative Affect, Sleeping Problems, Use of Mood-enhancing Drugs and Exercise Frequency

Emotional Well-Being in Anorexia Nervosa: Negative Affect, Sleeping Problems, Use of Mood-enhancing Drugs and Exercise Frequency

Eating disorders in older women

The Role of Psychotropic Medications in the Management of Anorexia Nervosa: Rationale, Evidence and Future Prospects

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