Pavlovian‐to‐instrumental transfer in Anorexia Nervosa: A pilot study on conditioned learning and instrumental responding to low‐ and high‐calorie food stimuli

Abstract

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. AbstractAnorexia Nervosa is characterized by persistent restraint eating despite severe negative consequences and often a chronic course of the disease. Recent theoretical models suggest that abnormalities in reward processing and incentive salience of disorder-compatible stimuli as observed in addictive behaviours contribute to the development and maintenance of Anorexia Nervosa. The aim of the present study was to investigate the process of the acquisition of food-related conditioned responses and the influence of conditioned low-calorie and high-calorie food stimuli on instrumental responding for different foods. A Pavlovian-to-instrumental transfer paradigm and questionnaires on eating disorder psychopathology (EDE-Q, EDI-2) were administered to patients with Anorexia Nervosa (n = 39) and healthy controls (n = 41).Results indicated that patients with Anorexia Nervosa showed deficits of the acquisition of knowledge of the experimental contingencies. Nevertheless, in patients with Anorexia Nervosa and healthy controls instrumental responding for low-and highcalorie food rewards was affected by stimuli conditioned to these rewards; no group differences were observed. Importantly, in Anorexia Nervosa, instrumental responding for low-calorie food increased with increasing severity of eating disorder psychopathology suggesting weight-loss directed behaviour. Future studies are warranted to enhance our understanding of deficits of reward-associated learning and to replicate and extend findings with regard to the impact of conditioned stimuli on instrumental responding. At present, our findings suggest that cognitive treatment interventions might be warranted that challenge dysfunctional beliefs about weight loss. K E Y W O R D S appetitive conditioning, eating disorders, goal-directed behaviour, instrumental responding, PIT effect | 1795 VOGEL Et aL.

Exposure to the thin beauty ideal: Are there subliminal priming effects?

“…For example, Brooks et al (2012) found that subliminally presented food stimuli compromised cognitive performance of patients with AN compared to healthy controls in an N‐back‐task, while Boehm et al (2018) did not observe significant differences in brain activation between patients with AN and healthy controls after subliminal presentation of food stimuli. In an own study on habitual responding in AN (Vogel et al, 2020), we administered a Pavlovian‐to‐Instrumental‐Transfer‐Paradigm with low‐ and high caloric food stimuli and found that behavioral responding of women with AN was more in line with goal‐directed than stimulus driven habitual behavior. However, an affective priming paradigm might be more appropriate to investigate rapid, automatic processes and future studies in this direction might contribute to our understanding of subliminal priming effects of food‐ and body‐related stimuli in the development and maintenance of eating and weight disorders.…”

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“…Intriguingly, not only high-calorie food can acquire incentive-sensitization, low-calorie food or physical activities could also do and trigger wanting , which has been suggested to be the underlying mechanism of AN [55, 56]. Vogel et al [57] tested this hypothesis in patients with AN and HCs with a sPIT paradigm that offered high- and low-calorie food outcomes. Although participants increased in their responses for both high- and low-calorie food when the corresponding stimuli were presented, this effect was not different between AN and HC groups.…”

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“…disorders (Genauck et al, 2020), anorexia nervosa (Vogel et al, 2019) and obesity (Lehner et al, 2017;Meemken & Horstmann, 2019;Watson et al, 2014).…”