Differential impairments underlying decision making in anorexia nervosa and bulimia nervosa: A cognitive modeling analysis

Chan, WS; Ahn, Woo Young; Bates, John E.; Busemeyer, Jerome R.; Guillaume, Sébastien; Redgrave, Graham W.; Danner, Unna N.; Courtet, Philippe

doi:10.1002/eat.22223

Cited by 73 publications

(119 citation statements)

References 33 publications

(59 reference statements)

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“…While previous laboratory investigations (14,15) were relatively limited in 243 their ability to isolate specific alterations, a recent cognitive modelling study of IGT performance 244 found a "recency bias" in AN captured by a learning/memory parameter (58). Although the model 245 did not uncover a group difference in a feedback sensitivity parameter, the finding that patients 246 tended to base their decisions on recent experience is commensurate with our finding of increased 247 learning rate in AN.…”

Section: Imaging Data 187supporting

confidence: 70%

“…Fourth, the group 302 difference in self-reported HA was not significant in the present study, presumably because of lack of 303 statistical power (SM 2.1), and the expected correlation between HA and learning rate after 304 punishment was not found (SM 2.3). Therefore, alternative explanations of increased learning rate in 305 AN inlcuding impaired memory (58) and uncertainty regarding present beliefs are also plausible. 306…”

Section: Imaging Data 187mentioning

confidence: 99%

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Altered Medial Frontal Feedback Learning Signals in Anorexia Nervosa

Bernardoni

Geisler

King

et al. 2018

Biological Psychiatry

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Section: Imaging Data 187supporting

confidence: 70%

Section: Imaging Data 187mentioning

confidence: 99%

Altered Medial Frontal Feedback Learning Signals in Anorexia Nervosa

Bernardoni

Geisler

King

et al. 2018

Biological Psychiatry

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“…The use of such models allows one to decompose behavioral performance on the task into distinct cognitive, motivational, and response processes, thereby providing a fine-grained analysis of the underlying decision-making processes and characterizing more precisely the decision-making deficits of different clinical groups. This approach yields quantifiable parameter estimates of such processes, which have been successfully mapped in various clinical populations including cocaine users, cannabis users, alcohol users, individuals with Asperger's disease, Huntington's disease, schizophrenia, and bipolar disorder (for a review, see Yechiam et al, 2005), as well as in eating disorders (Chan et al, 2014) and patients with HIV (Vassileva et al, 2013). Studies applying this approach show that although behavioral performance may be similar across different clinical groups, the cognitive processes that underlie these behavioral profiles may vary across groups in clinically meaningful ways.…”

Section: Introductionmentioning

confidence: 99%

Decision-making in stimulant and opiate addicts in protracted abstinence: evidence from computational modeling with pure users

Vasilev²,

et al. 2014

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Substance dependent individuals (SDI) often exhibit decision-making deficits; however, it remains unclear whether the nature of the underlying decision-making processes is the same in users of different classes of drugs and whether these deficits persist after discontinuation of drug use. We used computational modeling to address these questions in a unique sample of relatively “pure” amphetamine-dependent (N = 38) and heroin-dependent individuals (N = 43) who were currently in protracted abstinence, and in 48 healthy controls (HC). A Bayesian model comparison technique, a simulation method, and parameter recovery tests were used to compare three cognitive models: (1) Prospect Valence Learning with decay reinforcement learning rule (PVL-DecayRI), (2) PVL with delta learning rule (PVL-Delta), and (3) Value-Plus-Perseverance (VPP) model based on Win-Stay-Lose-Switch (WSLS) strategy. The model comparison results indicated that the VPP model, a hybrid model of reinforcement learning (RL) and a heuristic strategy of perseverance had the best post-hoc model fit, but the two PVL models showed better simulation and parameter recovery performance. Computational modeling results suggested that overall all three groups relied more on RL than on a WSLS strategy. Heroin users displayed reduced loss aversion relative to HC across all three models, which suggests that their decision-making deficits are longstanding (or pre-existing) and may be driven by reduced sensitivity to loss. In contrast, amphetamine users showed comparable cognitive functions to HC with the VPP model, whereas the second best-fitting model with relatively good simulation performance (PVL-DecayRI) revealed increased reward sensitivity relative to HC. These results suggest that some decision-making deficits persist in protracted abstinence and may be mediated by different mechanisms in opiate and stimulant users.

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“…Consistent with this idea, the majority of studies examining decision-making in AN using the IGT have documented worse performance in AN compared to healthy participants (e.g., Abbate-Daga et al, 2011; Cavedini et al, 2004; Cavedini et al, 2006; Danner et al, 2012, Garrido & Subirá, 2013; Tchanturia et al, 2007). This has led to models in which poor decision-making may contribute to the development and maintenance of symptoms in AN (Brogan et al, 2010; Cavedini et al, 2004; Chan et al, 2014). …”

Section: Introductionmentioning

confidence: 99%

Longitudinal examination of decision-making performance in anorexia nervosa: Before and after weight restoration

Bodell

Keel

Brumm

et al. 2014

Journal of Psychiatric Research

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Background This study aimed to extend previous work on decision-making deficits in anorexia nervosa (AN) by using a longitudinal design to examine decision-making before and after weight restoration. Methods Participants were 22 women with AN and 20 healthy comparison participants who completed the Iowa Gambling Task (IGT). Decision-making was assessed both before and after weight restoration in a subset of 14 AN patients. Self-report and interview assessments were used to measure psychological correlates of decision-making performance including depression, anxiety, and eating disorder symptoms, and magnetic resonance imaging (MRI) scans were conducted to explore associations between brain volume in the orbitofrontal cortex (OFC) and decision-making in individuals with AN. Results Currently ill AN patients performed worse on the IGT compared to the control group. Although decision-making performance did not improve significantly with weight restoration in the full AN sample, AN patients who were poor performers at baseline did improve task performance with weight-restoration. When actively ill, lower body mass index (BMI) and decreased left medial OFC volume were significantly associated with worse IGT performance, and these associations were no longer significant after weight restoration. Conclusions Findings suggest that decision-making deficits in AN in the acute phase of illness are associated with low weight and decreased left medial OFC volume, but increases in brain volume and BMI may not have been sufficient to improve decision-making in all patients. Findings contribute to a model for understanding how some patients may sustain self-starvation, and future work should examine whether decision-making deficits predict relapse.

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Differential impairments underlying decision making in anorexia nervosa and bulimia nervosa: A cognitive modeling analysis

Abstract: This study identified differential impairments underlying IGT performance in AN and BN. Findings suggest that impaired decision making in AN might involve impaired memory functions. Impaired decision making in BN might involve altered reward and punishment sensitivity.

Cited by 73 publications

References 33 publications

Altered Medial Frontal Feedback Learning Signals in Anorexia Nervosa

Altered Medial Frontal Feedback Learning Signals in Anorexia Nervosa

Decision-making in stimulant and opiate addicts in protracted abstinence: evidence from computational modeling with pure users

Longitudinal examination of decision-making performance in anorexia nervosa: Before and after weight restoration

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