The Functional Significance of Shyness in Anorexia Nervosa

Winecoff, Amy A.; Ngo, Lawrence; Moskovich, Ashley A.; Merwin, Rhonda M.; Zucker, Nancy

doi:10.1002/erv.2363

Cited by 6 publications

(6 citation statements)

References 30 publications

(32 reference statements)

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“…Neural responses to social rewards may depend, at least in part, on social proficiency. AN has been associated with lower scores on measures of empathy [55], impoverished social networks [56], reduced intimate secure attachments [57], and self-perceptions of impaired social skills [58]. Reduced striatal activation to bodies in AN-WR could reflect reduced sensitivity to rewarding properties of social images, explained by a lack of experience with some of the positive traits of relationships (e.g., bestowing and receiving warmth and comfort).…”

Section: Discussionmentioning

confidence: 99%

Neurobiology of social reward valuation in adults with a history of anorexia nervosa

et al. 2018

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ObjectiveAnorexia nervosa (AN) is a disorder characterized by atypical patterns of reward valuation (e.g. positive valuation of hunger). Atypical reward processing may extend into social domains. If so, such findings would be of prognostic significance as impaired social functioning predicts worse outcome. We explore neural circuits implicated in social reward processing in individuals with a history of AN who are weight-restored relative to controls and examine the effects of illness course on the experience of social value.Method20 weight-restored individuals with a history of AN (AN-WR) and 24 healthy control (HC) participants were assessed using fMRI tasks that tapped social reward: smiling faces and full human figures that varied in attractiveness and weight.ResultsAN-WR differed from HC in attractiveness ratings by weight (negatively correlated in AN-WR). While there were no significant differences when viewing smiling faces, viewing full figures resulted in decreased activation in regions implicated in reward valuation (the right caudate) for AN-WR and this region was negatively correlated with a sustained course of the disorder. Exploratory whole brain analyses revealed reduced activation in regions associated with social reward, self-referential processing, and cognitive reappraisal (e.g., medial prefrontal cortex, striatum, and nucleus accumbens) with sustained disorder course.DiscussionThe rewarding value of full body images decreases with a sustained disorder course. This may reflect an extension of atypical reward processing documented in AN-WR, perhaps as a function of starvation dampening visceral motivational signals; the deployment of cognitive strategies that lessen the experience of reward; and/or the nature of the stimuli themselves as provocative of eating disorder symptoms (e.g., thin bodies). These findings did not extend to smiling face stimuli. Advances in technology (e.g., virtual avatars, text messaging) may provide novel means to build relationships, including therapeutic relationships, to support improved social connections without threats to symptom provocation.

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Section: Discussionmentioning

confidence: 99%

Neurobiology of social reward valuation in adults with a history of anorexia nervosa

et al. 2018

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“…It is known that AN is highly comorbid with social phobia (Swinbourne et al, 2012), and there is preliminary evidence that shyness may influence social skills in AN (Winecoff et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Facial expression of positive emotions in individuals with eating disorders

Dapelo

Hart

Hale

et al. 2015

Psychiatry Research

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first and second authors contributed equally to this publication  AN showed Duchenne smiles for shorter durations than BN and HC participants. AN participants' Duchenne smiles were less intense than those of BN and HC. Reduced Duchenne smile was related to low BMI, and use of medication. Results provide further evidence of difficulties in emotion processing in AN. AbstractA large body of research has associated Eating Disorders with difficulties in socioemotional functioning and it has been argued that they may serve to maintain the illness. This study aimed to explore facial expressions of positive emotions in individuals with Anorexia Nervosa (AN) and Bulimia Nervosa (BN) compared to healthy controls (HC), through an examination of the Duchenne smile (DS), which has been associated with feelings of enjoyment, amusement and happiness . Sixty participants (AN=20; BN=20; HC=20) were videotaped while watching a humorous film clip. The duration and intensity of DS were subsequently analysed using the Facial Action Coding System (FACS) (Ekman and Friesen, 2003). Participants with AN displayed DS for shorter durations than BN and HC participants, and their DS had lower intensity. In the clinical groups, lower duration and intensity of DS were associated with lower BMI, and use of psychotropic medication.The study is the first to explore DS in people with eating disorders, providing further evidence of difficulties in the socio-emotional domain in people with AN.

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“…For example, before illness onset, individuals with AN report more social difficulties, fewer childhood friends, and engage in more solitary activities than healthy controls (HCs) [3][4][5][6]. During the illness, a variety of difficulties are seen, including high social anxiety, poorer social skills and social problem-solving abilities, loss of interest in social activities, and reduced social networks [7][8][9][10][11][12][13][14]. Given that interpersonal difficulties are associated with poorer outcomes in those with AN [15][16][17], it is important to understand potential underlying socio-cognitive mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Emotion Recognition Abilities in Adults with Anorexia Nervosa are Associated with Autistic Traits

Kerr-Gaffney

Mason

Jones

et al. 2020

JCM

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Difficulties in socio-emotional functioning are proposed to contribute to the development and maintenance of anorexia nervosa (AN). This study aimed to examine emotion recognition abilities in individuals in the acute and recovered stages of AN compared to healthy controls (HCs). A second aim was to examine whether attention to faces and comorbid psychopathology predicted emotion recognition abilities. The films expressions task was administered to 148 participants (46 AN, 51 recovered AN, 51 HC) to assess emotion recognition, during which attention to faces was recorded using eye-tracking. Comorbid psychopathology was assessed using self-report questionnaires and the Autism Diagnostic Observation Schedule–2nd edition (ADOS-2). No significant differences in emotion recognition abilities or attention to faces were found between groups. However, individuals with a lifetime history of AN who scored above the clinical cut-off on the ADOS-2 displayed poorer emotion recognition performance than those scoring below cut-off and HCs. ADOS-2 scores significantly predicted emotion recognition abilities while controlling for group membership and intelligence. Difficulties in emotion recognition appear to be associated with high autism spectrum disorder (ASD) traits, rather than a feature of AN. Whether individuals with AN and high ASD traits may require different treatment strategies or adaptations is a question for future research.

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The Functional Significance of Shyness in Anorexia Nervosa

Cited by 6 publications

References 30 publications

Neurobiology of social reward valuation in adults with a history of anorexia nervosa

Neurobiology of social reward valuation in adults with a history of anorexia nervosa

Facial expression of positive emotions in individuals with eating disorders

Emotion Recognition Abilities in Adults with Anorexia Nervosa are Associated with Autistic Traits

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