Delay Discounting of Reward and Impulsivity in Eating Disorders: From Anorexia Nervosa to Binge Eating Disorder

Abstract

Evidence points to eating disorder patients displaying altered rates of delay discounting (one's degree of preference for immediate rewards over larger delayed rewards). Anorexia nervosa (AN) patients are believed to have an increased capacity to delay reward, which reflects their ability to override the drive to eat. Contrarily, binge eating disorder (BED) patients are associated with a reduced predisposition to delay gratification. Here, we investigated monetary delay discounting and impulsivity in 80 adult women with EDs (56 AN and 24 BED), diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, and 80 healthy controls. AN-restrictive (AN-R) subtype patients showed less steep discounting rates than BED and AN-bingeing/purging subtype patients. Compared with healthy controls and AN-R patients, BED and AN-bingeing/purging patients presented higher delay discounting and positive and negative urgency levels. Our findings suggest that restriction in AN-R patients is associated with disproportionate self-control, whereas bingeing behaviours could be more driven by emotional states and impulsivity traits. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

How are early maladaptive schemas and DSM‐5 personality traits associated with the severity of binge eating?

“…BED-obese also displayed an insufficient self-control schema. In fact, others (Caroleo et al, 2018;Steward et al, 2017) had already reported high impulsivity leading to severe problems with emotional regulation (Agüera et al, 2019;Zeeck et al, 2011).…”

Dimensions of Impulsivity in Gambling Disorder

“…K values can range from 0 (selection of the delayed reward option for all items, or no discounting) to 0.25 (selection of the immediate reward option for all items, or always discounting). According to many studies using the delay discounting task (also termed the Monetary Choice Questionnaire) 22,60 , the distributions of k values were normalized using square root transformation.…”

Network analysis of specific psychopathology and psychiatric symptoms in patients with anorexia nervosa

“…Also, characterizing the relationship between ED-specific symptoms and psychiatric symptoms in diagnostic subgroups within AN may provide a clinically useful picture on the pattern and strength of the network sustaining symptoms themselves. Restricting-type AN and bulimic-purgative-type AN differ on neuropsychological (Steward et al, 2017) and psychopathological profile (Dell'Osso et al, 2018), and such differences have clinical impact (Kastner et al, 2018). Although recently ineffectiveness and interoceptive awareness as measured by EDI-2 have been shown to be central nodes (Olatunji, Levinson, & Calebs, 2018), no study to the best of our knowledge has assessed a network including psychiatric symptoms in patients with EDs to date.…”