Neurobiology of social reward valuation in adults with a history of anorexia nervosa

Abstract

ObjectiveAnorexia nervosa (AN) is a disorder characterized by atypical patterns of reward valuation (e.g. positive valuation of hunger). Atypical reward processing may extend into social domains. If so, such findings would be of prognostic significance as impaired social functioning predicts worse outcome. We explore neural circuits implicated in social reward processing in individuals with a history of AN who are weight-restored relative to controls and examine the effects of illness course on the experience of social value.Method20 weight-restored individuals with a history of AN (AN-WR) and 24 healthy control (HC) participants were assessed using fMRI tasks that tapped social reward: smiling faces and full human figures that varied in attractiveness and weight.ResultsAN-WR differed from HC in attractiveness ratings by weight (negatively correlated in AN-WR). While there were no significant differences when viewing smiling faces, viewing full figures resulted in decreased activation in regions implicated in reward valuation (the right caudate) for AN-WR and this region was negatively correlated with a sustained course of the disorder. Exploratory whole brain analyses revealed reduced activation in regions associated with social reward, self-referential processing, and cognitive reappraisal (e.g., medial prefrontal cortex, striatum, and nucleus accumbens) with sustained disorder course.DiscussionThe rewarding value of full body images decreases with a sustained disorder course. This may reflect an extension of atypical reward processing documented in AN-WR, perhaps as a function of starvation dampening visceral motivational signals; the deployment of cognitive strategies that lessen the experience of reward; and/or the nature of the stimuli themselves as provocative of eating disorder symptoms (e.g., thin bodies). These findings did not extend to smiling face stimuli. Advances in technology (e.g., virtual avatars, text messaging) may provide novel means to build relationships, including therapeutic relationships, to support improved social connections without threats to symptom provocation.

Exploring the Eating Disorder Examination Questionnaire, Clinical Impairment Assessment, and Autism Quotient to Identify Eating Disorder Vulnerability: A Cluster Analysis

“…Historical research shows that females, Caucasian females in particular, are at a much greater risk for developing an eating disorder than any other group [4,5,7,13]. Researchers have also been able to identify brain abnormalities in those diagnosed with AN while using functional magnetic resonance imaging (fMRI) and other technologies [1,2]. It has been concluded using fMRI scans that participants with a previous eating disorder diagnosis had reduced activation in the part of the brain responsible for social reward processing [2,14].…”

“…Researchers have also been able to identify brain abnormalities in those diagnosed with AN while using functional magnetic resonance imaging (fMRI) and other technologies [1,2]. It has been concluded using fMRI scans that participants with a previous eating disorder diagnosis had reduced activation in the part of the brain responsible for social reward processing [2,14]. Additionally, Sweitzer and colleagues [2] found that the longer the person had an eating disorder, the greater decrease in brain activation.…”

“…It has been concluded using fMRI scans that participants with a previous eating disorder diagnosis had reduced activation in the part of the brain responsible for social reward processing [2,14]. Additionally, Sweitzer and colleagues [2] found that the longer the person had an eating disorder, the greater decrease in brain activation. Other researchers hypothesize that eating disorders may be caused by neurochemical and hormonal imbalances, specifically in serotonin and dopamine levels, due to their relationship with reward experience [7,[15][16][17][18][19]].…”

“…The dataset that was used in this analysis was originally produced in 2018 by Dr. Maggie Sweitzer, Dr. Nancy Zucker, and Savannah Erwin from the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine. They used a Qualtrics survey to collect the data, Excel to clean the data, and SPSS for their analysis [2]. Researchers also calculated the total scores and subscale scores for the following, which will be discussed later in more depth: EDE-Q global score, CIA global score, and Autism Quotient (AQ) total score.…”

“…Currently, an eating disorder can be categorized into one of six subtypes: pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa (AN), bulimia nervosa, and binge-eating disorder [1]. The data that were used in this analysis specifically focused on individuals with a previous diagnosis of AN [2].…”