Cue reactivity towards bodies in anorexia nervosa – common and differential effects in adolescents and adults

Horndasch, Stefanie; Kratz, Oliver; Doren, Jessica Van; Graap, Holmer; Kramer, Rebecca K.; Moll, Gunther H.; Heinrich, Hartmut

doi:10.1017/s0033291717001994

Cited by 18 publications

(18 citation statements)

References 49 publications

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“…The observation that all adolescents displayed biased attention toward foods in early and late attention phases corroborates previous research demonstrating increased attention approach toward foods in adolescents with AN (Neimeijer, Roefs, & de Jong, ) and non‐clinical groups (Werthmann, Jansen, Vreugdenhil, et al, ; Werthmann et al, ). The finding that cognitive processes for disorder‐relevant cues are less disturbed in adolescents versus adults with AN is also in line with previous research showing differential patterns of cognitive biases in adults versus adolescents with AN (Horndasch, Kratz, et al, ; Horndasch, Roesch, et al, ). Potentially this finding is good news, suggesting that cognitive processes may still be malleable in early phases of illness (Gama et al, ; Moylan et al, ; Treasure, Stein, & Maguire, ).…”

Section: Discussionsupporting

confidence: 90%

“…Functional neuroimaging studies reported significant differences in neural processing of food and affective stimuli (Horndasch, Roesch, et al, ) and also in neural processing of body image stimuli (Fladung, Schulze, Schöll, Bauer, & Grön, ) in adolescents compared to adults in AN. Similarly, differences in late positive potentials (LPP) as measured during event‐related electroencephalography, emerged between adolescents and adults with AN when viewing pictures of bodies (Horndasch, Kratz, et al, ). Taken together these findings suggest that AN behaviors may be much more malleable during the early stages of illness.…”

Section: Introductionmentioning

confidence: 99%

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Same, same but different: Attention bias for food cues in adults and adolescents with anorexia nervosa

Werthmann

Simic

Konstantellou

et al. 2019

Intl J Eating Disorders

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Objective: Attention processing for food may be biased in people with Anorexia Nervosa (AN). However, previous studies have had inconsistent results. This is likely to be due to indirect assessment of attention, which does not inform on the underlying attention processes, and/or the heterogeneity of participants across studies, testing either adults or adolescents with AN, that is, people at very different developmental and illness stages.Method: Eye-tracking was employed as a direct assessment of attention during a visual probe task with food versus non-food pictures. Attention bias for food was measured in 39 adults and 34 adolescents with AN and in 53 adults and 31 adolescents without AN.Results: All participants had a direction bias for food, specifically for high-calorie food.However, adults with AN subsequently avoided maintaining attention on food versus non-food cues, compared to adults without AN. Adolescents with or without AN demonstrated increased attention maintenance on food versus non-food cues, and, contrary to our hypothesis, did not differ in their attention bias for food cues. Accordingly, adults with AN differed significantly from adolescents with AN in attention maintenance for food cues: while adolescents with AN showed significantly increased attention maintenance on food stimuli, adults avoided maintaining attention on food cues.Discussion: Adults with AN may apply attention strategies to facilitate restrictive eating. This strategy is absent in adolescents with AN. This difference in food-related attention bias between adolescents and adults with AN suggests that attention biases develop over time as the illness progresses. K E Y W O R D Sanorexia nervosa, attention bias, eye-tracking, food, visual probe

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Same, same but different: Attention bias for food cues in adults and adolescents with anorexia nervosa

Werthmann

Simic

Konstantellou

et al. 2019

Intl J Eating Disorders

View full text Add to dashboard Cite

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“…Individuals with AN demonstrate elevated skin conductance, decreased eye blink startle, and increased electroencephalogram late positive potential in response to underweight stimuli (Clarke, Ramoz, Fladung, & Gorwood, ; Horndasch et al, ; O'Hara et al, ), indicating greater salience and PA responding. This altered dopaminergic functioning and reward response is corroborated by a study showing increased eye blink startle in response to thinness images following dopamine depletion (O'Hara et al, ).…”

Section: Current Evidencementioning

confidence: 99%

The posited effect of positive affect in anorexia nervosa: Advocating for a forgotten piece of a puzzling disease

Coniglio

Christensen

Haynos

et al. 2019

Intl J Eating Disorders

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Anorexia nervosa (AN) is a complex and life‐threatening eating disorder. Current models of AN onset and maintenance have largely focused on the role of negative affect, while fewer models have described the role of positive affect (PA). Given that these theoretical models have informed current treatment approaches, and that treatment remains minimally effective for adults with AN, we advocate that targeting PA is one avenue for advancing maintenance models and by extension, treatment. We specifically propose that AN may arise and be chronically and pervasively maintained as a function of dysregulated PA in response to weight loss and weight loss behaviors (e.g., restriction, excessive exercise), to a degree that is not accounted for in existing models of AN. We present evidence from multiple domains, including biological, behavioral, and self‐report, supporting the hypothesis that PA dysregulation in AN contributes to the maintenance of the disorder. We conclude with several specific avenues for treatment development research as well as a call for future work elucidating the biological correlates of PA.

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“…While some results suggest that hypoactivation in motivational brain regions is also evident in recAN [8], others suggest altered responses in brain regions associated with motivation and cognitive control present during the acute phase of AN (acAN) do not persist into recovery [9]. In addition to the large literature focused on reward-related processing associated with body perception [10][11][12][13][14] applying positive social stimuli is a potentially informative means of studying a nondisorder specific, but nonetheless for general mental health highly relevant stimulus domain. However, there is a scarcity of research regarding neural responses to social reward in AN.…”

Section: Introductionmentioning

confidence: 99%

Aberrant neural representation of food stimuli in women with acute anorexia nervosa predicts treatment outcome and is improved in weight restored individuals

et al. 2021

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Anorexia nervosa (AN) has been associated with altered reward processing. We recently reported greater neural response in secondary visual areas when processing visual food stimuli in acutely underweight AN patients (acAN). In order to examine whether the observed alterations are indicative of acute undernutrition or a potential trait marker of AN, we set out to assess neural responses in acAN and in individuals weight-recovered from AN (recAN). FMRI data were collected from a total of 126 female volunteers, 35 acAN, 33 recAN, and 58 age-matched healthy controls (HC) while they viewed streams of food, social and neutral stimuli. A standard general linear model (GLM) was used to interrogate neural responses to the different stimuli in recAN vs. age-matched HC. Moreover, within-subject multivoxel pattern analyses (MVPA) in the two matched samples (acAN/HC and recAN/HC) were used to estimate neural representation of food vs. neutral, and social vs. neutral stimuli. A multiple regression analysis was conducted to test associations between the accuracy of the neural representation and treatment outcome. The GLM revealed no group differences between recAN and HC. The MVPAs showed greater classification accuracy of food stimuli in the posterior fusiform gyrus in acAN but not recAN. Classification accuracy was associated with better treatment outcome. Our findings suggest that the neural representation of food stimuli is altered in secondary visual areas in acAN and normalizes with weight recovery. Possibly this altered representation reflects attentional engagement motivating food intake, which may promote the recovery process.

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Cue reactivity towards bodies in anorexia nervosa – common and differential effects in adolescents and adults

Cited by 18 publications

References 49 publications

Same, same but different: Attention bias for food cues in adults and adolescents with anorexia nervosa

Same, same but different: Attention bias for food cues in adults and adolescents with anorexia nervosa

The posited effect of positive affect in anorexia nervosa: Advocating for a forgotten piece of a puzzling disease

Aberrant neural representation of food stimuli in women with acute anorexia nervosa predicts treatment outcome and is improved in weight restored individuals

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