Reward Dependence and Harm Avoidance among Patients with Binge‐Purge Type Eating Disorders

Gat-Lazer, Sigal; Geva, Ronny; Gur, Eitan; Stein, Daniel

doi:10.1002/erv.2505

Cited by 9 publications

(3 citation statements)

References 40 publications

(41 reference statements)

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“…In our sample, FA was not associated with the expected factors that are typically correlated with FA. This might be due to the ED sample heterogeneity and to the existence of associations between these factors and certain types of EDs, as found in the literature [77][78][79][80][81][82][83], displaying comorbidity and personality traits shared between FA and ED.…”

Section: Resultsmentioning

confidence: 95%

Food Addiction among Female Patients Seeking Treatment for an Eating Disorder: Prevalence and Associated Factors

et al. 2020

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The concept of “food addiction” (FA) has aroused much focus because of evidence for similarities between overeating and substance use disorders (SUDs). However, few studies have explored this concept among the broad spectrum of eating disorders (ED), especially in anorexia nervosa (AN). This study aimed to assess FA prevalence in ED female patients and to determine its associated factors. We recruited a total of 195 adult women with EDs from an ED treatment center. The prevalence of FA diagnosis (Yale Food Addiction Scale) in the whole ED sample was 83.6%; AN restrictive type (AN-R), 61.5%; AN binge-eating/purging type (AN-BP), 87.9%; bulimia nervosa (BN), 97.6%; and binge-eating disorder (BED), 93.3%. The most frequently met criteria of FA were “clinically significant impairment or distress in relation to food”, “craving” and “persistent desire or repeated unsuccessful attempts to cut down”. An FA diagnosis was independently associated with three variables: presence of recurrent episodes of binge eating, ED severity, and lower interoceptive awareness. In showing an overlap between ED and FA, this study allows for considering EDs, and AN-R in particular, from an “addictive point of view”, and thus for designing therapeutic management that draws from those proposed for addictive disorders.

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Section: Resultsmentioning

confidence: 95%

Food Addiction among Female Patients Seeking Treatment for an Eating Disorder: Prevalence and Associated Factors

et al. 2020

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“…However, it is unclear what drives these patients to abuse such large amounts of stimulant laxatives and whether psychological distress contributes to their feelings of constipation. Cloninger [15] originally proposed a biosocial model of personality which stressed three dimensions of temperament: Harm Avoidance (HA), the tendency to react strongly to anxiety-or disgust-provoking stimuli, thereby over-estimating the risk of getting hurt; Reward Dependence (RD), the tendency to respond strongly to social rewards in order to increase the chance of future rewards and/or prevent punishment, as well as the ability to more easily form emotional attachments; and Novelty Seeking (NS), the propensity to respond emotionally to novel stimuli, acting with increased excitability and impulsivity [15,16]. Harm Avoidance and Reward Dependence tend to be high in those with binge-eating and purging behaviors [16][17][18][19], and high Novelty Seeking has also been found to be a significant risk factor for the development of addictions and use of risky behaviors, as well as binge-eating and purging behaviors [20][21][22].…”

Section: Introductionmentioning

confidence: 99%

“…Sensitivity to Reward (SR), a dimension characterized by a drive to increase pleasurable experience, and Sensitivity to Punishment (SP), a dimension characterized by a desire to avoid negative consequences, are components of Reward Dependence that are thought to represent stable personality traits [23]. Research regarding Sensitivity to Punishment and Sensitivity to Reward in the eating disorder population has resulted in mixed findings in those engaging in binge-purge behaviors [6,16,[24][25][26], although they have not been specifically examined in people abusing laxatives [16,[25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study

et al. 2021

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Background Stimulant laxative abuse as a purging behavior can be profound in those with eating disorders. However, the psychopathology leading to stimulant laxative abuse is poorly understood. Furthermore, the medical impact of stimulant laxative abuse has not been studied in this population. Methods Six individuals abusing stimulant laxatives underwent a barium enema to assess for evidence of the cathartic colon syndrome and 29 individuals engaging in any purging behaviors completed the Tri-dimensional Personality Questionnaire-Short Form, Sensitivity to Punishment/Sensitivity to Reward Questionnaire-Short Form, Beck Depression Inventory, and the State Trait Anxiety Inventory questionnaires. Results Three of the six patients completing the barium enema had the radiographic findings consistent with cathartic colon. Individuals engaging in laxative abuse showed higher Novelty Seeking compared to those engaging in other forms of purging, and those engaging in any form of purging behavior showed greater Sensitivity to Punishment compared to Sensitivity to Reward. There was also the presence of greater Harm Avoidance than Reward Dependence in this population. Conclusion There may be different psychopathology that contributes to the abuse of stimulant laxatives than that associated with other forms of purging. Regardless of the driving factor, further research is warranted to discover best therapeutic interventions given the potential to develop the cathartic colon syndrome with ongoing use of stimulant laxatives. Plain English Summary Cathartic colon is a condition whereby the colon, or lower intestine, is converted into an inert tube incapable of propagating fecal matter. It is thought to develop due to over-use of stimulant laxatives. However, it is unclear if this condition truly exists and whether it contributes to the constipation experienced by individuals with eating disorders who have extensive past histories of abusing laxatives. It is also unclear if laxative abuse presents with different medical complications than other forms of purging. The purpose of this study is to determine whether radiographic evidence of cathartic colon can be found in eating disorder patients abusing stimulant laxatives, whether there are different medical complications with laxative abuse versus other forms of purging, and to examine the psychological composition of individuals who engage in severe laxative abuse. Specifically, the authors investigated the interrelationship between Harm Avoidance and Reward Dependence, with emphasis on gaining a better understanding of Reward Dependence by examining both Sensitivity to Reward and Sensitivity to Punishment in patients who engage in severe laxative abuse. Our findings suggest that stimulant laxative abuse may cause the development of cathartic colon changes and that there may be unique psychopathology that contributes to the abuse of stimulant laxatives. Given the higher Novelty Seeking personality-dimension in those abusing laxatives, it is possible that this purging behavior may be considered addiction-like in nature, which would have distinct treatment implications.

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Reinforcement sensitivity and bulimia symptoms: the role of emotion regulation

et al. 2021

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Reward Dependence and Harm Avoidance among Patients with Binge‐Purge Type Eating Disorders

Abstract: Combination of lower TPQ-HA, lower SPSRQ-SP, and greater risk-taking inclination may maintain disordered eating in patients with B/P EDs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Cited by 9 publications

References 40 publications

Food Addiction among Female Patients Seeking Treatment for an Eating Disorder: Prevalence and Associated Factors

Food Addiction among Female Patients Seeking Treatment for an Eating Disorder: Prevalence and Associated Factors

Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study

Reinforcement sensitivity and bulimia symptoms: the role of emotion regulation

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