Format

Send to

Choose Destination
Biol Psychiatry Cogn Neurosci Neuroimaging. 2019 May 13. pii: S2451-9022(19)30110-7. doi: 10.1016/j.bpsc.2019.05.001. [Epub ahead of print]

Insensitivity to Losses: A Core Feature in Patients With Anorexia Nervosa?

Author information

1
Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
2
Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands; Altrecht Eating Disorders Rintveld, Zeist, The Netherlands.
3
Altrecht Eating Disorders Rintveld, Zeist, The Netherlands.
4
Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands.
5
Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands; Altrecht Eating Disorders Rintveld, Zeist, The Netherlands; Institute of Physiology and Neuroscience, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. Electronic address: r.a.h.adan@umcutrecht.nl.

Abstract

BACKGROUND:

Patients with anorexia nervosa (AN) demonstrate aberrations in choice behavior, including impairments in laboratory measures of decision making. Although a wealth of studies suggest that these aberrations arise from alterations in value processing, it remains unclear by which core component of value processing this is mediated.

METHODS:

We fit trial-by-trial data of patients with AN (n = 60 first cohort, n = 216 second cohort) and healthy control participants (n = 55) performing the Iowa Gambling Task to a computational model based on prospect utility theory. We determined, per participant, the best-fit model parameters and compared these between the groups.

RESULTS:

Analyses revealed a decreased estimate of model parameter λ in patients with AN, indicative of an attenuation of loss-aversive behavior in the Iowa Gambling Task. In comparison, measures of reward sensitivity, value-based learning, and exploration versus exploitation were unaltered in patients with AN. A measurement in a second independent cohort replicated the finding that loss aversion, typically observed in healthy individuals, is reduced in patients with AN.

CONCLUSIONS:

We show that patients with AN, in contrast to healthy control participants, demonstrate reduced loss-aversive behavior. This finding provides important fundamental insights into the decision-making capacity of patients with AN, suggesting alterations in the mechanisms involved in value processing related to negative feedback.

KEYWORDS:

Anorexia nervosa; Computational modeling; Decision making; Eating disorders; Iowa Gambling Task; Value

PMID:
31262707
DOI:
10.1016/j.bpsc.2019.05.001

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center