Dataset Information

Impaired Flexible Reward-Based Decision-Making in Binge Eating Disorder: Evidence from Computational Modeling and Functional Neuroimaging.

ABSTRACT: Despite its clinical relevance and the recent recognition as a diagnostic category in the DSM-5, binge eating disorder (BED) has rarely been investigated from a cognitive neuroscientific perspective targeting a more precise neurocognitive profiling of the disorder. BED patients suffer from a lack of behavioral control during recurrent binge eating episodes and thus fail to adapt their behavior in the face of negative consequences, eg, high risk for obesity. To examine impairments in flexible reward-based decision-making, we exposed BED patients (n=22) and matched healthy individuals (n=22) to a reward-guided decision-making task during functional resonance imaging (fMRI). Performing fMRI analysis informed via computational modeling of choice behavior, we were able to identify specific signatures of altered decision-making in BED. On the behavioral level, we observed impaired behavioral adaptation in BED, which was due to enhanced switching behavior, a putative deficit in striking a balance between exploration and exploitation appropriately. This was accompanied by diminished activation related to exploratory decisions in the anterior insula/ventro-lateral prefrontal cortex. Moreover, although so-called model-free reward prediction errors remained intact, representation of ventro-medial prefrontal learning signatures, incorporating inference on unchosen options, was reduced in BED, which was associated with successful decision-making in the task. On the basis of a computational psychiatry account, the presented findings contribute to defining a neurocognitive phenotype of BED.

SUBMITTER: Reiter AM

PROVIDER: S-EPMC5240187 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Impaired Flexible Reward-Based Decision-Making in Binge Eating Disorder: Evidence from Computational Modeling and Functional Neuroimaging.

Reiter Andrea M F AM Heinze Hans-Jochen HJ Schlagenhauf Florian F Deserno Lorenz L

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology 20160615 3

Despite its clinical relevance and the recent recognition as a diagnostic category in the DSM-5, binge eating disorder (BED) has rarely been investigated from a cognitive neuroscientific perspective targeting a more precise neurocognitive profiling of the disorder. BED patients suffer from a lack of behavioral control during recurrent binge eating episodes and thus fail to adapt their behavior in the face of negative consequences, eg, high risk for obesity. To examine impairments in flexible rew ...[more]

PMID: 27301429

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Project description:Transtheoretical integrative decision-making models help clinicians to use patient factors that are known to predict outcomes in order to inform individualized treatment. Patient factors with a strong evidence base include: functional impairment, social support and interpersonal functioning, complexity and comorbidity, coping style, level of resistance, and level of subjective distress. Among those with binge-eating disorder (BED), patient factors have not been extensively characterized relative to norms or other clinical samples. We used an integrative decision-making model of these six patient factor domains related to patient outcomes to characterize a sample of 424 adults seeking treatment for BED. Data were from medical charts, a demographics questionnaire, and validated psychometric scales. We then compared these data to published data from normative and other eating disorder (ED) samples. Results showed that the average patient with BED: (1) was significantly more functionally impaired compared to non-clinical norms but somewhat less impaired than other patients with ED, (2) demonstrated clinically significant problems in social support and interpersonal functioning, (3) presented with complex comorbid pathology and high levels of chronicity, (4) used a more internalizing coping style compared to the norm and other ED samples, (5) had low levels of resistance to interventions, and (6) experienced a moderately high level of subjective distress indicating good motivation for treatment. Corresponding recommendations to these findings are that the average patient with BED should be provided higher intensity treatment that is longer in duration, interpersonally focused, directive in nature, and emphasizing self-reflection and insight. Despite the nomothetic nature of the findings, clinicians are encouraged to assess these patient domains when developing an ideographic case conceptualization and to tailor precision treatment to the individual patient with BED.

Dataset Information

Impaired Flexible Reward-Based Decision-Making in Binge Eating Disorder: Evidence from Computational Modeling and Functional Neuroimaging.

Publications

Impaired Flexible Reward-Based Decision-Making in Binge Eating Disorder: Evidence from Computational Modeling and Functional Neuroimaging.

Similar Datasets

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