Clinical and Neurophysiological Correlates of Emotion and Food Craving Regulation in Patients with Anorexia Nervosa

Abstract

Background: Difficulties in emotion regulation and craving regulation have been linked to eating symptomatology in patients with anorexia nervosa (AN), contributing to the maintenance of their eating disorder. Methods: To investigate clinical and electrophysiological correlates of these processes, 20 patients with AN and 20 healthy controls (HC) completed a computerized task during EEG recording, where they were instructed to down-regulate negative emotions or food craving. Participants also completed self-report measures of emotional regulation and food addiction. The P300 and Late Positive Potential (LPP) ERPs were analysed. Results: LPP amplitudes were significantly smaller during down-regulation of food craving among both groups. Independent of task condition, individuals with AN showed smaller P300 amplitudes compared to HC. Among HC, the self-reported use of re-appraisal strategies positively correlated with LPP amplitudes during emotional regulation task, while suppressive strategies negatively correlated with LPP amplitudes. The AN group, in comparison to the HC group, exhibited greater food addiction, greater use of maladaptive strategies, and emotional dysregulation. Conclusions: Despite the enhanced self-reported psychopathology among AN, both groups indicated neurophysiological evidence of food craving regulation as evidenced by blunted LPP amplitudes in the relevant task condition. Further research is required to delineate the mechanisms associated with reduced overall P300 amplitudes among individuals with AN.

Food Addiction among Female Patients Seeking Treatment for an Eating Disorder: Prevalence and Associated Factors

“…Indeed, people with AN-R seem not to be addicted to food but quite the opposite, i.e., addicted to food deprivation, and they show real determination instead of losing control. In their recent paper, Mallorquí-Bagué et al (2020) concluded that patients with AN exhibited a successful down-regulation of food craving, despite the presence of food addiction symptomatology [63]. In the present study, we found a prevalence of FA in patients with AN-R that was far more substantial than in nonclinical samples (0 to 25%) [11].…”

Null hypothesis significance tests, a misleading approach to scientific knowledge: Some implications for eating disorders research

“…Hypothesis testing studies analyze the empirical evidence obtained in a specific sample with different purposes: (a) to identify risk factors and underlying mechanisms that enable a better understanding of the etiology and the phenotypes of disorders [e.g. the study by Mallorquí‐Bagué and colleagues aiming at investigating clinical and electrophysiological correlates of emotion regulation and craving regulation in anorexia nervosa (AN) (Mallorquí‐Bagué et al, 2020)]; (b) to assess the therapeutic efficacy of treatments [such as the study by Fernández‐Aranda and colleagues analyzing the benefits of a serious video game (SVG) as a complementary program to enhance the general functioning of patients with BN (Fernandez‐Aranda et al, 2015)]; and (c) to find out the evolution over time of different disorders and their possible correlated factors [such as the work by Svedlund and colleagues, which assessed whether the efficiency of a medium‐term intervention in women with ED may be due to attention deficit hyperactivity disorder symptoms (Svedlund, Norring, Ginsberg, & von Hausswolff‐Juhlin, 2018), or the randomized clinical trial (RCT) by Loeb et al aimed at assessing the efficacy of family‐based treatment for paediatric obesity (FBT‐PO), when compared with nutrition education counselling for weight management (Loeb et al, 2019), or the study by Giombini and colleagues analyzing the benefits of using individual cognitive remediation therapy in inpatient setting with Anorexia nervosa (Giombini et al, 2018).…”

Advances in Eating Disorders

“…To address this important health issue, the current Special Issue collected 21 articles examining the most recent and relevant scientific findings regarding advances in ED. The published articles comprised three reviews and 18 research articles focusing on different aspects, such as genetic [ 7 ] and epigenetic factors [ 8 ], biomarkers [ 9 ], comorbidity [ 10 , 11 , 12 , 13 , 14 ], clinical phenotypes [ 15 , 16 ], neurocognition [ 12 , 17 , 18 , 19 , 20 , 21 ], treatment predictors [ 22 ], and treatment models and therapeutic targets [ 19 , 23 , 24 , 25 , 26 , 27 ]. Altogether, these studies may provide increased knowledge about the pathogenesis, the risk factors, the maintenance factors, and the most appropriate treatments tools for ED.…”

“…This collection also includes a set of studies that analyze the role of implicit–explicit emotion in patients with ED and their families, supporting the important role of the emotion recognition [ 13 , 14 ], the expressed emotion [ 27 ] or the emotion regulation strategies [ 12 , 17 ] in the development and maintenance of these disorders.…”

“…The majority of research of this Special Issue focuses on neurosciences and EDs. There are several studies examining and reviewing a variety of relevant topics such as neuropsychology (especially executive functions) [ 12 , 17 ], structural alterations of the brain [ 18 ], neurometabolic alterations [ 20 ], neuroimaging studies, and the use and efficacy of invasive and non-invasive brain stimulation techniques [ 19 , 21 ]. Specifically, Mallorquí-Bagué et al [ 17 ] used electrophysiological techniques to explore emotion regulation and food craving regulation in patients with AN.…”