Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-12-05T02:26:01.231Z Has data issue: false hasContentIssue false

Cue reactivity towards bodies in anorexia nervosa – common and differential effects in adolescents and adults

Published online by Cambridge University Press:  24 July 2017

S. Horndasch*
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
O. Kratz
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
J. Van Doren
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
H. Graap
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen-Nuremberg, Erlangen, Germany
R. Kramer
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
G. H. Moll
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
H. Heinrich
Affiliation:
Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany Heckscher Klinikum, Munich, Germany
*
*Address for correspondence: S. Horndasch, M.D., Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Schwabachanlage 6/10, 91054 Erlangen, Germany. (Email: [email protected])

Abstract

Background

Aberrant reward mechanisms with regard to slim body shapes are discussed in patients with anorexia nervosa (AN). The aim of the present study was to examine of cue reactivity toward body shapes in AN via the late positive potential (LPP), an event-related electroencephalography (EEG) component. By including adolescents and adults, aspects of development and chronification could be studied (2 × 2 design).

Methods

Thirty-two female AN patients (19 adolescents and 13 adults) and 37 control participants (16 adolescents and 21 adults) were included. Standardized photographic stimuli showing women's bodies in underwear from five body mass index (BMI) categories (extremely underweight to extremely overweight) were presented. During picture evaluation, EEG activity was recorded (10–20 system). The LPP was measured in two time windows characterized by different topographies (450–700 ms: posterior; 1000–1300 ms: central).

Results

Regarding the posterior component, LPP amplitudes were clearly reduced in adult but not in adolescent patients; for both time windows the LPP showed differential patterns over BMI categories for patients and controls. Regarding the central component, a highly significant linear decrease from extremely underweight to extremely overweight body shapes was revealed in patients and no significant modulation in control participants.

Conclusions

Adolescent and adult patients show increased sustained attention toward extremely underweight bodies. In chronically ill patients, this bias appears to be accompanied by generally reduced automatic attention. The LPP findings provide a differentiated picture of aberrant cue reactivity which could be interpreted as motivated attention toward body shapes in AN.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Publishing: Arlington, VA.Google Scholar
Arcelus, J, Mitchell, AJ, Wales, J, Nielsen, S (2011). Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Archives of General Psychiatry 68, 724731.Google Scholar
Baluch, B, Furnham, A, Huszcza, A (1997). Perception of body shapes by anorexics and mature and teenage females. Journal of Clinical Psychology 53, 167175.Google Scholar
Beck, AT, Steer, RA, Brown, GK (1996). Beck Depression Inventory–II (BDI–II). Harcourt Assessment Inc.: San Antonio, TX.Google Scholar
Brandeis, D, van Leeuwen, TH, Rubia, K, Vitacco, D, Steger, J, Pascual-Marqui, RD, Steinhausen, HC (1998). Neuroelectric mapping reveals precursor of stop failures in children with attention deficits. Behavioral Brain Research 94, 111125.Google Scholar
Cuthbert, BN, Schupp, HT, Bradley, MM, Birbaumer, N, Lang, PJ (2000). Brain potentials in affective picture processing: covariation with autonomic arousal and affective report. Biological Psychology 52, 95111.Google Scholar
Döpfner, M, Görtz-Dorten, A, Lehmkuhl, G (2008). DISYPS II Diagnostik-System Für Psychische Störungen Nach ICD-10 und DSM-IV für Kinder und Jugendliche II. Huber: Bern.Google Scholar
Fladung, AK, Gron, G, Grammer, K, Herrnberger, B, Schilly, E, Grasteit, S, Wolf, RC, Walter, H, von Wietersheim, J (2010). A neural signature of anorexia nervosa in the ventral striatal reward system. American Journal of Psychiatry 167, 206212.Google Scholar
Fladung, AK, Schulze, UM, Scholl, F, Bauer, K, Gron, G (2013). Role of the ventral striatum in developing anorexia nervosa. Translational Psychiatry 3, e315.Google Scholar
Franken, IH, Dietvorst, RC, Hesselmans, M, Franzek, EJ, van de Wetering, BJ, Van Strien, JW (2008). Cocaine craving is associated with electrophysiological brain responses to cocaine-related stimuli. Addiction Biology 13, 386392.Google Scholar
Gable, PA, Adams, DL (2013). Nonaffective motivation modulates the sustained LPP (1,000–2,000 ms). Psychophysiology 50, 12511254.CrossRefGoogle ScholarPubMed
Gale, L, Channon, S, Larner, M, James, D (2015). Experiences of using pro-eating disorder websites: a qualitative study with service users in NHS eating disorder services. Eating and Weight Disorders 21, 427434.Google Scholar
Garner, DM (1991). Eating Disorder Inventory-2 Manual. Psychological Assessment Resources: Odessa, Florida.Google Scholar
Godier, LR, Park, RJ (2014). Compulsivity in anorexia nervosa: a transdiagnostic concept. Frontiers in Psychology 5, 778.Google Scholar
Gratton, G, Coles, MG, Donchin, E (1983). A new method for off-line removal of ocular artifact. Electroencephalography and Clinical Neurophysiology 55, 468484.CrossRefGoogle ScholarPubMed
Hajcak, G, Dunning, JP, Foti, D (2009). Motivated and controlled attention to emotion: time-course of the late positive potential. Clinical Neurophysiology 120, 505510.Google Scholar
Hajcak, G, MacNamara, A, Olvet, DM (2010). Event-related potentials, emotion, and emotion regulation: an integrative review. Developmental Neuropsychology 35, 129155.CrossRefGoogle ScholarPubMed
Hajcak, G, Nieuwenhuis, S (2006). Reappraisal modulates the electrocortical response to unpleasant pictures. Cognitive, Affective and Behavioral Neuroscience 6, 291297.Google Scholar
Hatch, A, Madden, S, Kohn, MR, Clarke, S, Touyz, S, Gordon, E, Williams, LM (2010). Emotion brain alterations in anorexia nervosa: a candidate biological marker and implications for treatment. Journal of Psychiatry and Neuroscience 35, 267274.Google Scholar
Herrmann, MJ, Weijers, HG, Wiesbeck, GA, Boning, J, Fallgatter, AJ (2001). Alcohol cue-reactivity in heavy and light social drinkers as revealed by event-related potentials. Alcohol and Alcoholism 36, 588593.CrossRefGoogle ScholarPubMed
Horndasch, S, Heinrich, H, Kratz, O, Mai, S, Graap, H, Moll, GH (2015). Perception and evaluation of women's bodies in adolescents and adults with anorexia nervosa. European Archives of Psychiatry and Clinical Neuroscience 265, 677687.Google Scholar
Horndasch, S, Heinrich, H, Kratz, O, Moll, GH (2012). The late positive potential as a marker of motivated attention to underweight bodies in girls with anorexia nervosa. Journal of Psychosomatic Research 73, 443447.CrossRefGoogle ScholarPubMed
Kaye, WH, Wierenga, CE, Bailer, UF, Simmons, AN, Bischoff-Grethe, A (2013). Nothing tastes as good as skinny feels: the neurobiology of anorexia nervosa. Trends in Neurosciences 36, 110120.Google Scholar
Keating, C (2011). Sex differences precipitating anorexia nervosa in females: the estrogen paradox and a novel framework for targeting sex-specific neurocircuits and behavior. Current Topics in Behavioral Neurosciences 8, 189207.Google Scholar
Keil, A, Bradley, MM, Hauk, O, Rockstroh, B, Elbert, T, Lang, PJ (2002). Large-scale neural correlates of affective picture processing. Psychophysiology 39, 641649.Google Scholar
Kekic, M, Boysen, E, Campbell, IC, Schmidt, U (2016). A systematic review of the clinical efficacy of transcranial direct current stimulation (tDCS) in psychiatric disorders. Journal of Psychiatric Research 74, 7086.Google Scholar
Kujawa, A, Klein, DN, Proudfit, GH (2013). Two-year stability of the late positive potential across middle childhood and adolescence. Biological Psychology 94, 290296.Google Scholar
Langeslag, SJ, van Strien, JW (2013). Up-regulation of emotional responses to reward-predicting stimuli: an ERP study. Biological Psychology 94, 228233.Google Scholar
MacNamara, A, Verges, A, Kujawa, A, Fitzgerald, KD, Monk, CS, Phan, KL (2016). Age-related changes in emotional face processing across childhood and into young adulthood: evidence from event-related potentials. Developmental Psychobiology 58, 2738.Google Scholar
Mai, S, Gramann, K, Herbert, BM, Friederich, HC, Warschburger, P, Pollatos, O (2015). Electrophysiological evidence for an attentional bias in processing body stimuli in bulimia nervosa. Biological Psychology 108, 105114.Google Scholar
McDonough, BE, Warren, CA (2001). Effects of 12-h tobacco deprivation on event-related potentials elicited by visual smoking cues. Psychopharmacology (Berl) 154, 282291.Google ScholarPubMed
Michalowski, JM, Pane-Farre, CA, Low, A, Hamm, AO (2015). Brain dynamics of visual attention during anticipation and encoding of threat- and safe-cues in spider-phobic individuals. Social Cognitive and Affective Neuroscience 10, 11771186.CrossRefGoogle ScholarPubMed
O'Hara, CB, Campbell, IC, Schmidt, U (2015). A reward-centred model of anorexia nervosa: a focussed narrative review of the neurological and psychophysiological literature. Neuroscience and Biobehavioral Reviews 52, 131152.Google Scholar
Olofsson, JK, Nordin, S, Sequeira, H, Polich, J (2008). Affective picture processing: an integrative review of ERP findings. Biological Psychology 77, 247265.Google Scholar
Park, RJ, Godier, LR, Cowdrey, FA (2014). Hungry for reward: how can neuroscience inform the development of treatment for Anorexia Nervosa? Behavior Research and Therapy 62, 4759.Google Scholar
Parvaz, MA, Moeller, SJ, Malaker, P, Sinha, R, Alia-Klein, N, Goldstein, RZ (2016). Abstinence reverses EEG-indexed attention bias between drug-related and pleasant stimuli in cocaine-addicted individuals. Journal of Psychiatry and Neurosciences 41, 150358.Google Scholar
Pollatos, O, Herbert, BM, Schandry, R, Gramann, K (2008). Impaired central processing of emotional faces in anorexia nervosa. Psychosomatic Medicine 70, 701708.Google Scholar
Price, TF, Dieckman, LW, Harmon-Jones, E (2012). Embodying approach motivation: body posture influences startle eyeblink and event-related potential responses to appetitive stimuli. Biological Psychology 90, 211217.Google Scholar
Robinson, JD, Versace, F, Engelmann, JM, Cui, Y, Slapin, A, Oum, R, Cinciripini, PM (2015). The motivational salience of cigarette-related stimuli among former, never, and current smokers. Experimental and Clinical Psychopharmacology 23, 3748.Google Scholar
Rodgers, RF, Lowy, AS, Halperin, DM, Franko, DL (2016). A meta-analysis examining the influence of pro-eating disorder websites on body image and eating pathology. European Eating Disorders Review 24, 38.Google Scholar
Sabatinelli, D, Keil, A, Frank, DW, Lang, PJ (2013). Emotional perception: correspondence of early and late event-related potentials with cortical and subcortical functional MRI. Biological Psychology 92, 513519.Google Scholar
Scheurink, AJ, Boersma, GJ, Nergardh, R, Sodersten, P (2010). Neurobiology of hyperactivity and reward: agreeable restlessness in anorexia nervosa. Physiology and Behavior 100, 490495.Google Scholar
Schneider, S, Margraf, J (2006). Diagnostisches Interview bei Psychischen Störungen. Springer: Berlin.Google Scholar
Schupp, HT, Flaisch, T, Stockburger, J, Junghofer, M (2006). Emotion and attention: event-related brain potential studies. Progress in Brain Research 156, 3151.Google Scholar
Segalowitz, SJ, Santesso, DL, Jetha, MK (2010). Electrophysiological changes during adolescence: a review. Brain and Cognition 72, 86100.Google Scholar
Seitz, J, Herpertz-Dahlmann, B, Konrad, K (2016). Brain morphological changes in adolescent and adult patients with anorexia nervosa. Journal of Neural Transmission (Vienna) 123, 949959.Google Scholar
Smink, FR, van Hoeken, D, Hoek, HW (2012). Epidemiology of eating disorders: incidence, prevalence and mortality rates. Current Psychiatry Reports 14, 406414.Google Scholar
Thompson, JK, Heinberg, LJ, Tantleff, S (1991). The physical appearance comparison scale (PACS). Behavior Therapist 14, 174.Google Scholar
Val-Laillet, D, Aarts, E, Weber, B, Ferrari, M, Quaresima, V, Stoeckel, LE, Alonso-Alonso, M, Audette, M, Malbert, CH, Stice, E (2015). Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity. Neuroimage: Clinical 8, 131.Google Scholar
Watson, KK, Werling, DM, Zucker, NL, Platt, ML (2010). Altered social reward and attention in anorexia nervosa. Frontiers in Psychology 1, 36.Google Scholar
Wolfling, K, Morsen, CP, Duven, E, Albrecht, U, Grusser, SM, Flor, H (2011). To gamble or not to gamble: at risk for craving and relapse–learned motivated attention in pathological gambling. Biological Psychology 87, 275281.Google Scholar
Zink, CF, Weinberger, DR (2010). Cracking the moody brain: the rewards of self starvation. Nature Medicine 16, 13821383.Google Scholar