The influence of oxytocin on risk‐taking in the balloon analogue risk task among women with bulimia nervosa and binge eating disorder

Abstract

| INTRODUC TI ONRecurrent loss-of-control binge eating characterises the DSM-5 eating disorders bulimia nervosa (BN) and binge eating disorder (BED). 1 Binge eating behaviour is associated with significant distress, guilt and shame, 1-3 and detracts from the overall quality of life of the affected individuals. 4 Furthermore, populations with recurrent binge eating behaviour, including those with BN and BED, have been found to exhibit heightened levels of risk-taking behaviour, as indicated by the high comorbidity of BN and BED with substance abuse disorders and self-harm behaviour. 5,6 The role of impulsivity in binge eating behaviour has been well-studied, and has been proposed to account for higher levels of risk-taking behaviour in populations with recurrent binge AbstractPrevious theoretical models of bulimia nervosa (BN) and binge eating disorder (BED) have implicated cross-domain risk-taking behaviour as a significant maintenance factor in both disorders. The present study aimed to test this hypothesis by administering the Balloon Analogue Risk Task (BART) to 25 women with BN or BED and 27 healthy comparison women without a history of an eating disorder. Furthermore, we tested the effect of a divided dose of 64 IU of oxytocin on risk-taking behaviour in the BART. Contrary to our hypothesis, women with BN or BED did not exhibit baseline differences in performance on the BART in the placebo condition (t = 1.42, df = 50, P = 0.161, d = 0.39). Oxytocin did not have a main effect on performance in the BART (F = 0.01, df = 1, P = .907, η 2 partial < 0.001); however, there was an interaction, such that participants in the BN/BED participant group, compared to the healthy comparison group, demonstrated safer behaviour on the BART in the oxytocin condition, but not in the placebo condition (F = 4.29, df = 1, P = 0.044, η 2 partial = 0.082). These findings cast doubt on the common assumption that individuals with BN and BED exhibit greater risk-taking behaviour in all domains and add to the evidence that oxytocin plays a functional role in modulating behaviours that entail trade-offs between reward approach and risk in humans. We recommend that future dose-response studies investigate the effect of oxytocin on reward approach behaviour further in women with recurrent binge eating behaviour, as well as the clinical significance of this effect. K E Y W O R D Sbinge eating disorder, bulimia nervosa, oxytocin, risk-taking

Highlighting psychological pain avoidance and decision‐making bias as key predictors of suicide attempt in major depressive disorder—A novel investigative approach using machine learning

“…The Balloon Analogue Risk Task (BART) was demonstrated to mimic uncertainty‐associated tension and exhilaration by requiring participants to make dynamic decisions under the condition of uncertain outcomes (Schonberg et al, 2011). The BART has been shown to have very good ecological validity and high test–retest reliability in both clinical and general population samples (Buelow & Cayton, 2020; Fernie et al, 2010; Lejuez et al, 2002; Leslie et al, 2019; X. Li et al, 2020). Early studies of decision‐making in patients with depression, especially in adolescent or elderly patients, have often interpreted suicidal behavior largely from the perspective of developmental cognitive neuroscience (Bridge et al, 2012; Clark et al, 2011).…”

Intranasal Oxytocin Modulates Decision-Making Depending on Outcome Predictability—A Randomized Within-Subject Controlled Trial in Healthy Males

“…Adding to the literature, we were able to disentangle OT effects depending on situational ambiguity and risk load. Another recent study [ 25 ] in patients with eating disorders found that after intranasal administration of OT, patients with eating disorders—compared to healthy participants—displayed less risky behavior in the Balloon Analogue Risk Task, which can be classified as a risk-taking task with unknown but, to a certain degree, learning-dependent probabilities [ 46 ]. This result does not concur with our findings of increased risk-taking in situations with high ambiguity.…”

“…One study in healthy participants reported reduced risk-taking after intranasal OT administration in a task assessing risk under known outcome probabilities (high outcome predictability/low ambiguity) [ 24 ]. Another recent study in patients with eating disorders and healthy participants found that after intranasal administration of OT, patients with an eating disorder—compared to healthy participants—displayed safer behavior in the Balloon Analogue Risk Task, a computerized risk-taking task that does not provide risk probabilities (low outcome predictability/high ambiguity) [ 25 ].…”

OXTR DNA methylation differentiates men on the obesity spectrum with and without binge eating disorder

“…As the anorexigenic effects of OXT might partly be communicated by influencing reward-related brain circuits and inhibitory control networks [ 10 , 31 ], it will be important for future studies to investigate interactions of OXT function and dimensions of impulsivity versus cognitive control to understand the underlying mechanisms especially in the spectrum of under controlled eating behavior and along the obesity spectrum. Two recent studies suggest that there might be a specific and positive influence of OXT administration on inhibitory control in men on the obesity spectrum [ 31 ] and in women characterized by impulsive eating behavior [ 44 ]. This might also translate to food intake, but a recent study in women with BED could not find any effects of a single dose of OXT on eating behavior [ 45 ].…”

“…Furthermore, effects of intranasal OXT administration on OXTR DNA methylation should be addressed in order to gain insight into potential mechanisms underlying the observed differential OXTR DNA methylation in male patients with BED. Previous studies using intranasal OXT administration have been performed partly in male and female samples, and some of them have demonstrated effects on inhibitory control [ 31 , 44 ]. The investigation of putative interactions of intranasal OXTR administration with different epigenetic profiles would be an interesting next step and may inform tailored interventions.…”