Affective Responses in Different Stages of Anorexia Nervosa: Results from a Startle‐reflex Paradigm

Abstract

We observed diverging subjective and psychophysiological reactions in different stages of AN. Psychophysiological methods can help to attain a more comprehensive understanding of biological alterations in the long-term course of AN. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Blunted emotion‐modulated startle reflex in anorexia nervosa

“…If this finding can be replicated in a larger sample, this would support the notion that reduced weight attenuates anxiety in AN (Kaye, ; Kaye et al, ). This finding is in line with and extends the previous finding by Erdur et al () who found a general flattening in emotion‐modulated startle response in acute and chronic but not in recovered patients with AN.…”

“…The findings of a blunted emotional reactivity to fear‐related material in AN are in line with previous findings of reduced amygdala activity in response to fear‐eliciting stimuli (Leppanen et al, ). Furthermore, the findings of the present study extend and differentiate previous findings of a lack of emotion‐modulation of the startle response to pleasant stimuli (Friederich et al, ) and a general lack of emotion‐modulation of startle response to both pleasant and unpleasant stimuli in AN (Erdur et al, ; Friederich et al, ), by showing a specifically reduced startle response to fear‐eliciting stimuli in a larger sample of patients with AN. The present finding is, however, in contrast to a previous study in adolescent patients with AN (Reichel et al, ) which did not find a blunted emotion‐modulation of startle response to negative emotional stimuli.…”

“…One study that used pictures with generally pleasant, neutral, and unpleasant emotional content found no differences in startle responses between adolescent patients with AN and healthy controls (Reichel et al, 2014). In contrast, two other studies using the exact same stimuli in adult patients with AN found either a lack of emotion-modulation of startle responses toward pleasant stimuli (Friederich et al, 2006) or a general lack of emotion-modulation in startle responses to both pleasant and unpleasant pictures in AN (Erdur et al, 2017). Interestingly, the authors of the latter study found no such lack of emotion-modulation in women who had recovered from AN, suggesting that emotional reactivity in AN is moderated by weight status.…”

“…Research on emotion-modulated startle response in AN has primarily focused on the processing of disorder-specific stimuli such as food or body image cues (Erdur, Weber, Zimmermann-Viehoff, Rose, & Deter, 2017;Friederich et al, 2006;Reichel et al, 2014;Soussignan, Jiang, Rigaud, Royet, & Schaal, 2010). Findings regarding startle response to general (i.e., not disorder-specific) emotional material in AN is inconsistent.…”

Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

“…2013;Shott et al, 2016;Tchanturia et al, 2012;Wagner et al, 2006;Yackobovitch-Gavan et al, 2009). However, in contrast, in a few studies, patients improved in psychological distress, depression, and anxiety, not differing significantly from healthy controls(Oldershaw et al, 2012;Harney, Fitzsimmons-Craft, Maldonado, & Bardone-Cone, 2014;Bernardoni et al, 2016;Bentz et al, 2017;Erdur, Weber, Zimmermann-Viehoff, Rose, & Deter, 2017) specifically when considered fully recovered(Harney et al, 2014).…”