The Link Between Negative Emotions and Eating Disorder Behaviour in Patients with Anorexia Nervosa

Espeset, Ester M. S.; Gulliksen, Kjersti S.; Nordbø, Ragnfrid H. S.; Skårderud, Finn; Holte, Arne

doi:10.1002/erv.2183

Cited by 119 publications

(138 citation statements)

References 46 publications

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“…Furthermore, previous literature suggests that, in individuals with AN, eating may induce dysphoria while dietary restriction decreases anxiety (Kaye et al, 2009). Thus, CR is seen as a form of emotional regulation in AN (Espeset et al, 2012;Wildes et al, 2010). Treatment of the underlying anxiety as a central component to AN has gained increasing interest clinically.…”

Section: Discussionmentioning

confidence: 99%

Caloric Restriction Enhances Fear Extinction Learning in Mice

Riddle

McKenna

Yoon

et al. 2013

Neuropsychopharmacol

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Fear extinction learning, the ability to reassess a learned cue of danger as safe when it no longer predicts aversive events, is often dysregulated in anxiety disorders. Selective serotonin reuptake inhibitors (SSRI's) enhance neural plasticity and their ability to enhance fear extinction learning may explain their anxiolytic properties. Caloric restriction (CR) has SSRI-like effects on neural plasticity and anxiety-related behavior. We implemented CR in mice to determine its effects on conditioned-fear responses. Wild type and serotonin transporter (SERT) knockout mice underwent CR for 7 days leading to significant weight loss. Mice were then tested for cued fear learning and anxiety-related behavior. CR markedly enhanced fear extinction learning and its retention in adolescent female mice, and adults of both sexes. These effects of CR were absent in SERT knockout mice. Moreover, CR phenocopied behavioral and molecular effects of chronic fluoxetine, but there was no additive effect of CR in fluoxetine-treated mice. These results demonstrate that CR enhances fear extinction learning through a SERT-dependent mechanism. These results may have implications for eating disorders such as anorexia nervosa (AN), in which there is a high prevalence of anxiety before the onset of dietary restriction and support proposals that in AN, CR is a motivated effort to control dysregulated fear responses and elevated anxiety.

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Section: Discussionmentioning

confidence: 99%

Caloric Restriction Enhances Fear Extinction Learning in Mice

Riddle

McKenna

Yoon

et al. 2013

Neuropsychopharmacol

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“…Moreover, although experiencing similar levels of negative feelings as controls, patients with AN may tend to avoid negative affect, or may try to regulate it engaging in behaviours such as restrictive eating, purging, and body checking (Corstorphine, 2006;Skårderud & Fonagy, 2011;Schmidt & Treasure, 2006;Espeset et al, 2012). Therefore, an incongruence between expression of negative emotion and inner experience is likely to take place, and patients may inhibit the expression of negative feelings according to the belief that these would have aversive consequences, damage relationships and create or increase conflict (Davies, Swan, Schmidt, Tchanturia, 2012;Ioannou & Fox 2009).…”

Section: Feit and Tasitmentioning

confidence: 99%

Alexithymia, empathy, emotion identification and social inference in anorexia nervosa: A case-control study

et al. 2016

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Alexithymia, difficulties in facial emotion recognition, poor socio-relational skills are typical of Anorexia Nervosa (AN). We assessed patients with AN and healthy controls (HCs) with mixed stimuli: questionnaires (Toronto Alexithymia Scale-TAS, Interpersonal Reactivity Index-IRI), photographs (Facial Emotion Identification Test-FEIT) and dynamic images (The Awareness of Social Inference Test-TASIT). TAS and IRI Personal Distress (PD) were higher in AN than HCs.Few or no differences emerged at the FEIT and TASIT, respectively. Despite higher levels of alexithymia, patients with AN seem to properly acknowledge others' emotions while being inhibited in the expression of their own.

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“…It is also pertinent to notice that Espeset et al 34 , in their qualitative study with women with anorexia nervosa, considered that negative feelings associated with eating may be not only the consequence but also the cause of anorexic behaviors. For example, sadness and fear were managed through restrictive eating.…”

Section: Discussionmentioning

confidence: 99%