Heightened self-reported punishment sensitivity, but no differential attention to cues signaling punishment or reward in anorexia nervosa

Abstract

This study examined whether adolescents with anorexia nervosa (AN) are more sensitive to punishment and less sensitive to reward than a non-eating disorder comparison group. Both self-report and performance measures were used to index reward and punishment sensitivity. Participants were adolescents with AN (n = 69) and an individually matched comparison group with healthy weight (n = 69). They completed the Behavioral Inhibition Scale/Behavioral Activation Scale and the Sensitivity to Punishment and Sensitivity to Reward Questionnaire to index self-reported reward and punishment sensitivity, and performed the Spatial Orientation Task to index attention to cues signaling reward and punishment. There was extremely strong evidence (BF 10 > 100), that adolescents with AN reported higher sensitivity to punishment than adolescents without an eating disorder. However, adolescents with AN did not differ from the comparison group on self-reported reward sensitivity, and attention to cues signaling reward or punishment. Adolescents with AN clearly show heightened punishment sensitivity, yet this was not paralleled by a heightened proneness to detect signals of punishment. An important next step would be to examine whether punishment sensitivity is a reliable risk factor for the development or maintenance of AN.

Are Sensitivity to Punishment, Sensitivity to Reward and Effortful Control Transdiagnostic Mechanisms Underlying the Eating Disorder/Obesity Spectrum?

“…When comparing different ED subtypes, most studies did not find significant differences among AN-R, AN-BP, or BN patients [8,25,29,30]. Two studies [23,27] showed that AN-R patients scored significantly higher on sensitivity to punishment than AN-BP or ED-PB (AN-BP + BN) patients, whereas other studies found the opposite [24] or no significant differences [31].…”

“…and punishment, whereas the SPSRQ items often include specific situational triggers related to punishment and reward (e.g., "Do you often meet people that you find physically attractive?"). Patients with EDs (AN-R, AN-BP, or BN) typically report significantly higher scores on punishment sensitivity (BIS/SP) compared to healthy controls [8,[23][24][25][26][27][28][29]. When comparing different ED subtypes, most studies did not find significant differences among AN-R, AN-BP, or BN patients [8,25,29,30].…”

Visual attention to food cues and the course of anorexia nervosa

“…This study was approved by the medical ethical committee of the University Medical Center in Groningen, the Netherlands (NL.51694042.14). The current study is part of a larger project on characteristics that might play a role in disordered eating behavior, and data of the baseline measure of this group have already been reported (Jonker et al, 2019;Jonker, Glashouwer, Hoekzema, Ostafin, & de Jong, 2020). The ARDPEI was the third performance measure during both baseline and follow-up.…”

Why Dieters Succeed or Fail: The Relationship Between Reward and Punishment Sensitivity and Restrained Eating and Dieting Success

“…Thus, a positive as well as a negative relationship between RS and food restriction have been suggested. In line with this, studies have failed to find consistent evidence for differential RS in adolescents and young adults with anorexia nervosa (Harrison et al, 2010;Matton et al, 2017a;Jonker et al, 2020), and in adolescents and adults with obesity (Davis and Fox, 2008;Jonker et al, 2016b). Furthermore studies on the relationship between RS and restrained eating show a mixed pattern (Ahern et al, 2010;Stapleton and Whitehead, 2014;Jonker et al, 2016a;Walther and Hilbert, 2016;Matton et al, 2017b).…”

“…High punishment sensitive (PS) individuals might be more sensitive to the punishing consequences of overeating such as becoming fat, and might therefore be more likely to engage in attempts to restrict their food intake to prevent undesirable outcomes ( Jappe et al, 2011 ). Indeed higher PS has been found to relate to a stronger fear of becoming fat and more concern for dieting ( Dalley, 2016 ), and PS was found to be higher in individuals with anorexia nervosa who are characterized by extreme food restriction ( Harrison et al, 2010 ; Jonker et al, 2020 ). Furthermore, positive associations have been found between PS and restrained eating as measured with the Dutch Eating Behavior Questionnaire (DEBQ; van Strien et al, 1986 ) and as measured with the Restraint Scale ( Herman and Polivy, 1975 ) in both adolescents and young adults ( Ahern et al, 2010 ; Matton et al, 2013 ; Jonker et al, 2016a ; Matton et al, 2017b ).…”