Temporal delay discounting in acutely ill and weight-recovered patients with anorexia nervosa

Abstract

Increased cognitive control, which has been suggested as a key characteristic of AN, does not seem to extend the capacity to wait for delayed monetary rewards. Differences between our study and the only previous study reporting decreased delay discounting in adult AN patients may be explained by the different age range and chronicity of acute patients, but the fact that weight recovery was not associated with changes in discount rates suggests that discounting behavior is not a trait marker in AN. Future studies using paradigms with disorder-specific stimuli may help to clarify the role of delay discounting in AN.

Temporal discounting across three psychiatric disorders: Anorexia nervosa, obsessive compulsive disorder, and social anxiety disorder

“…At the other extreme, two studies of AN (Decker, Figner, & Steinglass, 2015; Steinglass et al, 2012) and one of obsessive–compulsive personality disorder (OCPD) (Pinto et al, 2014) reported a tendency for these individuals to discount significantly less than healthy peers. While findings in AN have not been entirely consistent (King et al, 2016; Ritschel et al, 2015), these studies suggest that a propensity to choose larger-later rewards can also be associated with pathology. Clinically, individuals with AN appear to be forgoing an immediate reward (food) in favor of the potential for delayed reward (weight loss).…”

The relationship between perfectionism and discounting measures

“…However, the eating disorder scale used classified at-risk participants did not discriminate between AN, bulimia, and BED (Scherr et al, 2010). While binge eating is sometimes a component of AN, the relationship between AN and impulsivity has only been examined in a few studies, with mixed results (Boone et al, 2014;Ritschel et al, 2015;Slof-Op't Landt et al, 2016;Steinglass et al, 2012). To better understand whether clinical levels of perfectionism is related to impulsivity, the current study focused on individuals who showed perfectionism scores relatively equivalent to those from clinical samples (Bastiani et al, 1995;Halmi et al, 2000;Patterson, 2008;Sassaroli et al, 2008).…”

Altered Medial Frontal Feedback Learning Signals in Anorexia Nervosa

“…The current evidence of altered decision-making in response to negative 248 feedback is in line with notion of altered reinforcement learning in AN (1)(2)(3)(4)(5)8) and, considered in 249 light of similar recent findings (13), is suggestive of a particular sensitivity to punishment. Decision-250 making may be intact, however, in paradigms that don't include negative feedback, at least in 251 adolescents (19,59). Nonetheless, these findings were made in predominately restrictive AN and 252 future studies are needed to clarify potential subtype differences in reward and punishment 253 sensitivity (10,11).…”