The potential application of event‐related potentials to enhance research on reward processes in eating disorders

Abstract

Objective Reward‐related processes have been posited as key mechanisms underlying the onset and persistence of eating disorders, prompting a growing body of research in this area. Existing studies have primarily utilized self‐report, behavioral, and functional magnetic resonance imaging measures to interrogate reward among individuals with eating disorders. However, limitations inherent in each of these methods (e.g., poor temporal resolution) may obscure distinct neurocognitive reward processes, potentially contributing to underdeveloped models of reward dysfunction within eating disorders. The temporal precision of event‐related potentials (ERPs), derived from electroencephalography, may thus offer a powerful complementary tool for elucidating the neurocognitive underpinnings of reward. Indeed, a considerable amount of research in other domains of psychopathology (e.g., depression, substance use disorders), as well as studies investigating food reward among non‐clinical samples, highlights the utility of ERPs for probing reward processes. However, no study to date has utilized ERPs to directly examine reward functioning in eating disorders. Methods In this paper, we review evidence underscoring the clinical utility of ERP measures of reward, as well as a variety of reward‐related tasks that can be used to elicit specific ERP components with demonstrated relevance to reward processing. We then consider the ways in which these tasks/components may be used to help answer a variety of open questions within the eating disorders literature on reward. Results/Discussion Given the promise of ERP measures of reward to the field of eating disorders, we ultimately hope to spur and guide research in this currently neglected area. Public Significance Abnormalities in reward functioning appear to contribute to eating disorders. Event‐related potentials (ERPs) offer temporally precise measures of neurocognitive reward processing and thus may be important tools for understanding the relationship between reward and disordered eating. However, research in this area is currently lacking. This paper attempts to facilitate the use of ERPs to study reward among individuals with eating disorders by reviewing the relevant theories and methods.

Integrating aspects of affect, reward, and cognition to develop more comprehensive models of binge‐eating pathology

“…In other words, this is the hedonic process of liking, or experiencing an outcome that is deemed to be positive or favorable. This reward process can be measured in a number of ways, including via neural measures or behavioral tasks (Bohon & Stice, 2011; Forester et al, 2022). However, one approach to measuring initial response to reward, which is recommended by the NIMH, is to examine changes in self‐reported affect following a given stimulus or behavior, with poststimulus improvements in affect demonstrating an initial reward response.…”

“…Note that this represents a departure from previous EMA studies of affect‐binge eating relationships, which characterized the average change in affect across the entire participant sample (Engel et al, 2013; Schaefer, Smith, et al, 2020; Smyth et al, 2007) Finally, behavioral tasks assessing reward learning, inhibitory control, and delay discounting may be adapted to examine both generalized deficits in these domains, as well as disorder‐specific deficits (e.g., through the use of food stimuli). Notably, many of these tasks can be adapted for use with fMRI or electroencephalography, offering an opportunity to assess the neurobiological underpinnings of reward and inhibitory control processes (Balodis et al, 2015; Forester et al, 2022; Kober & Boswell, 2018), and computational modeling approaches can be meaningfully applied to the behavioral or neural data to help clarify the specific processes underlying deficits or aberrations in these domains (Castagna & Crowley, 2021; Reiter et al, 2017; Wiecki & Frank, 2013; Wierenga et al, 2022).…”

“…Within the field of eating disorders, reward‐related processes have received considerable attention in recent years (Dawe & Loxton, 2004; Forester et al, 2022; Harrison et al, 2010; Haynos et al, 2020; Kober & Boswell, 2018; Schaefer & Steinglass, 2021; Steinglass & Walsh, 2006; Stojek & MacKillop, 2017; Walsh, 2013; Wierenga et al, 2014; Wonderlich et al, 2021; Wu et al, 2016) with accumulating evidence supporting an association between aberrant reward responding and eating pathology (Avena & Bocarsly, 2012; Harrison et al, 2010; Hildebrandt et al, 2018; Schaefer & Steinglass, 2021; Stojek & MacKillop, 2017; Uniacke et al, 2018; Wonderlich et al, 2021; Wu et al, 2016). Importantly, basic science research has identified numerous distinct reward‐related processes that may have differential relationships with eating disorders (Berridge & Robinson, 2016; Bodell & Racine, 2022).…”

“…Further, existing models tend to focus on individual diagnoses, rather than examining transdiagnostic symptoms as the outcome of interest. (Bohon & Stice, 2011;Forester et al, 2022). However, one approach to measuring initial response to reward, which is recommended by the NIMH, is to examine changes in self-reported affect following a given stimulus or behavior, with poststimulus improvements in affect demonstrating an initial reward response.…”