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

Published online by Cambridge University Press:  12 January 2015

F. Ritschel ,
J. A. King ,
D. Geisler ,
L. Flohr ,
F. Neidel ,
I. Boehm ,
M. Seidel ,
J. Zwipp ,
S. Ripke  and
M. N. Smolka
...Show all authors
F. Ritschel
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
J. A. King
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
D. Geisler
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
L. Flohr
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
F. Neidel
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
I. Boehm
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
M. Seidel
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
J. Zwipp
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
S. Ripke
Affiliation:
Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
M. N. Smolka
Affiliation:
Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
V. Roessner
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
S. Ehrlich*
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
*
*Address for correspondence: S. Ehrlich, M.D., Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Dresden University of Technology, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307 Dresden, Germany. (Email: [email protected])
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Abstract

Background.

Patients with anorexia nervosa (AN) are characterized by a very low body weight but readily give up immediate rewards (food) for long-term goals (slim figure), which might indicate an unusual level of self-control. This everyday clinical observation may be quantifiable in the framework of the anticipation-discounting dilemma.

Method.

Using a cross-sectional design, this study compared the capacity to delay reward in 34 patients suffering from acute AN (acAN), 33 weight-recovered AN patients (recAN) and 54 healthy controls. We also used a longitudinal study to reassess 21 acAN patients after short-term weight restoration. A validated intertemporal choice task and a hyperbolic model were used to estimate temporal discounting rates.

Results.

Confirming the validity of the task used, decreased delay discounting was associated with age and low self-reported impulsivity. However, no group differences in key measures of temporal discounting of monetary rewards were found.

Conclusions.

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.

Keywords

Anorexia nervosadelay discountingimpulsivityintertemporal choiceself-controlweight-recovered anorexia nervosa
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 6 , April 2015 , pp. 1229 - 1239
Copyright
Copyright © Cambridge University Press 2015 

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