The costs of over-control in anorexia nervosa: evidence from fMRI and ecological momentary assessment.
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ABSTRACT:
SUBMITTER: Pauligk S
PROVIDER: S-EPMC8138008 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Regulation of emotions is necessary for successful attainment of short-term and long-term goals. However, over-regulation may also have its costs. In anorexia nervosa (AN), forgoing food intake despite emaciation and endocrine signals that promote eating is an example of "too much" self-control. Here we investigated whether voluntary emotion regulation in AN patients comes with associated disorder-relevant costs. Thirty-five patients with acute AN and thirty-five age-matched healthy controls (HCs) performed an established emotion regulation paradigm during functional magnetic resonance imaging after an overnight fast. The task required reducing emotions induced by positively valenced pictures via distancing. We calculated a neural regulation score from responses recorded in a reward-related brain region of interest (ventral striatum; VS) by subtracting activation measured on "positive distance" trials from that elicited under the "positive watch" (baseline) condition. Complementing the imaging data, we used ecological momentary assessment (EMA) to probe disorder-related rumination and affect six times/day for 2 weeks following the scanning session. The neural regulation score indicating reduced VS activation during emotion regulation was used as a predictor in hierarchical linear models with EMA measures as outcomes. No group differences in neural activity were found for the main contrasts of the task. However, regulation of VS activity was associated with increased body-related rumination and increased negative affect in AN, but not in HC. In line with this finding, correlational analysis with longitudinal BMI measurements revealed a link between greater VS regulation and poorer treatment outcome after 60 and 90 days. Together, these results identify a neural correlate of altered emotion regulation in AN, which seems to be detrimental to psychological well-being and may interfere with recovery.
| S-EPMC5802555 | biostudies-literature
Project description:BackgroundIndividuals with anorexia nervosa (AN) are often thought to show heightened self-control and increased ability to inhibit desires. In addition to inhibitory self-control, antecedent-focused strategies (e.g., cognitive reconstrual-the re-evaluation of tempting situations) might contribute to disorder maintenance and enable disorder-typical, maladaptive behaviors.MethodsOver a period of 14 days, 40 acutely underweight young female patients with anorexia nervosa (AN) and 40 healthy control (HC) participants reported their affect and behavior in self-control situations via ecological momentary assessment during inpatient treatment (AN) and everyday life (HC). Data were analyzed via hierarchical analyses (linear and logistic modeling).ResultsConflict strength had a significantly lower impact on self-control success in AN compared to HC. While AN and HC did not generally differ in the number or strength of self-control conflicts or in the percentage of self-control success, AN reported self-controlled behavior to be less dependent on conflict strength.ConclusionsWhile patients with AN were not generally more successful at self-control, they appeared to resolve self-control conflicts more effectively. These findings suggest that the magnitude of self-control conflicts has comparatively little impact on individuals with AN, possibly due to the use of antecedent-focused strategies. If confirmed, cognitive-behavioral therapy might focus on and help patients to exploit these alternative self-control strategies in the battle against their illness.
| S-EPMC9280923 | biostudies-literature
Project description:OBJECTIVES:Voice handicap has generally been measured at a single timepoint. Little is known about its variability from hour to hour or day to day. Voice handicap has been shown to be negatively related to voice-related perceived control in cross-sectional studies, but the within-person variability in voice-related perceived control is also unknown. We aimed to use ecological momentary assessment (EMA) to (1) assess the feasibility of EMA to examine daily voice handicap and voice-related perceived control in patients with voice disorders, (2) measure within-person variability in daily voice handicap and perceived control, and (3) characterize temporal associations (eg, correlations over time) between daily voice handicap and perceived control. METHODS:Adults with voice problems were recruited from a large public university medical center in the Midwest. They completed baseline measures, followed by twice-daily assessments, including selected items measuring voice handicap and perceived control, and then repeated the baseline measures at the final timepoint. Feasibility was assessed via completion rates. Within-person variability was measured using standard deviations. Temporal associations were characterized using simulation modeling analysis. RESULTS:EMA of voice handicap and perceived control was feasible in this patient population. Momentary voice handicap varied more than perceived control, though both were variable. Multiple patterns of temporal associations between daily voice handicap and perceived control were found. CONCLUSIONS:These findings identified important variability in (1) measures of voice handicap and perceived control and (2) their associations over time. Future EMA studies in patients with voice disorders are both feasible and warranted.
| S-EPMC6693974 | biostudies-literature
Project description:Patients with anorexia nervosa (AN) display impaired social interactions, implicated in the development and prognosis of the disorder. Importantly, social behavior is modulated by reward-based processes, and dysfunctional at-brain-level reward responses have been involved in AN neurobiological models. However, no prior evidence exists of whether these neural alterations would be equally present in social contexts. In this study, we conducted a cross-sectional social-judgment functional magnetic resonance imaging (fMRI) study of 20 restrictive-subtype AN patients and 20 matched healthy controls. Brain activity during acceptance and rejection was investigated and correlated with severity measures (Eating Disorder Inventory -EDI-2) and with personality traits of interest known to modulate social behavior (The Sensitivity to Punishment and Sensitivity to Reward Questionnaire). Patients showed hypoactivation of the dorsomedial prefrontal cortex (DMPFC) during social acceptance and hyperactivation of visual areas during social rejection. Ventral striatum activation during rejection was positively correlated in patients with clinical severity scores. During acceptance, activation of the frontal opercula-anterior insula and dorsomedial/dorsolateral prefrontal cortices was differentially associated with reward sensitivity between groups. These results suggest an abnormal motivational drive for social stimuli, and involve overlapping social cognition and reward systems leading to a disruption of adaptive responses in the processing of social reward. The specific association of reward-related regions with clinical and psychometric measures suggests the putative involvement of reward structures in the maintenance of pathological behaviors in AN.
| S-EPMC4510264 | biostudies-literature
Project description:Theoretical models and recent advances in the treatment of anorexia nervosa (AN) have increasingly focused on the role of alterations in the processing and regulation of emotions. To date, however, our understanding of these changes is still limited and reports of emotional dysregulation in AN have been based largely on self-report data, and there is a relative lack of objective experimental evidence or neurobiological data. The current functional magnetic resonance imaging (fMRI) study investigated the hemodynamic correlates of passive viewing and voluntary downregulation of negative emotions by means of the reappraisal strategy detachment in AN patients. Detachment is regarded as adaptive regulation strategy associated with a reduction in emotion-related amygdala activity and increased recruitment of prefrontal brain regions associated with cognitive control processes. Emotion regulation efficacy was assessed via behavioral arousal ratings and fMRI activation elicited by an established experimental paradigm including negative images. Participants were instructed to either simply view emotional pictures or detach themselves from feelings triggered by the stimuli. The sample consisted of 36 predominantly adolescent female AN patients and a pairwise age-matched healthy control group. Behavioral and neuroimaging data analyses indicated a reduction of arousal and amygdala activity during the regulation condition for both patients and controls. However, compared with controls, individuals with AN showed increased activation in the amygdala as well as in the right dorsolateral prefrontal cortex (dlPFC) during the passive viewing of aversive compared with neutral pictures. These results extend previous findings indicative of altered processing of salient emotional stimuli in AN, but do not point to a general deficit in the voluntary regulation of negative emotions. Increased dlPFC activation in AN during passive viewing of negative stimuli is in line with the hypothesis that the disorder may be characterized by excessive self-control. Taken together, the data seem to suggest that reappraisal via detachment may be an effective strategy to reduce negative arousal for individuals with AN.
| S-EPMC5756056 | biostudies-literature
Project description:Difficulties in social-emotional processing have been proposed to play an important role in the development and maintenance of anorexia nervosa (AN). Few studies, thus far, have investigated neural processes that underlie these difficulties, including processing emotional facial expressions. However, the majority of these studies have investigated neural responses to adult emotional display, which may be confounded by elevated sensitivity to social rank and threat in AN. Therefore, the aim of this study was to investigate the neural processes underlying implicit processing of positively and negatively valenced infant emotional display in AN. Twenty-one adult women with AN and twenty-six healthy comparison (HC) women were presented with images of positively valenced, negatively valenced, and neutral infant faces during a fMRI scan. Significant differences between the groups in positive > neutral and negative > neutral contrasts were investigated in a priori regions of interest, including the bilateral amygdala, insula, and lateral prefrontal cortex (PFC). The findings revealed that the AN participants showed relatively increased recruitment while the HC participants showed relatively reduced recruitment of the bilateral amygdala and the right dorsolateral PFC in the positive > neutral contrast. In the negative > neutral contrast, the AN group showed relatively increased recruitment of the left posterior insula while the HC groups showed relatively reduced recruitment of this region. These findings suggest that people with AN may engage in implicit prefrontal down-regulation of elevated limbic reactivity to positively social-emotional stimuli.
| S-EPMC5434152 | biostudies-literature
Project description:Anorexia nervosa (AN) is a psychiatric disorder with an estimated heritability of around 70%. Although the largest genome-wide association study meta-analysis on AN identified independent loci-conferring risk to the disorder, the molecular mechanisms underlying the genetic basis of AN remains to be elucidated. To explore AN, we ran a transcriptome profiling in peripheral blood mononuclear cells of 15 AN subjects and 15 healthy controls. We validated our mean results in a mouse model of chronic food restriction mimicking several aspects of AN. Through this exploratory study we identified 673 significantly differentially expressed genes in AN. Among these genes, we identified the Vanin-1 (Vnn1) gene that appears to play a major role in the regulation of multiple metabolic pathways. We confirmed an underexpression of Vnn1, especially in the liver, in a mouse model of chronic food restriction. These results indicate that quantitative food restriction affects Vnn1 expression, suggesting that this gene may contribute to the anorexic phenotype in the chronic food restriction mouse model as well as in patients affected by AN. We believe that this report highlights promising candidate genes and gene pathways for AN and reveals Vnn1 as a biomarker that may be used as molecular targets to predict and/or to understand AN.
2023-10-31 | GSE245978 | GEO
Project description:Response bias characterized by decreases in self-reported subjective states when measured repeatedly over short time-frames is a potential concern in social science. Recent work suggests that this initial elevation bias (IEB) is pronounced among young adult students' self-reports of affect when using ambulatory methods, but it is unclear if such bias extends broadly across samples, designs, and constructs. We examined the conditions wherein reliable and robust IEB may manifest by conducting a coordinated analysis of seven ecological momentary assessment (EMA) studies with diverse lifespan samples to test the generalizability of IEB across study designs and affective constructs (momentary negative and positive affect). Overall, evidence for substantial IEB across studies was weak. No reliable evidence emerged for IEB in negative affect, with evidence for a small magnitude IEB for positive affect when comparing initial reports with reports made 1 week later, although the latter was not evident in other comparisons and was attenuated to nonsignificance when controlling for temporal factors. The magnitude and direction of IEB varied, but in mostly nonsystematic ways, as a function of study design and affective valence. Meta-analytic summary revealed consistently low combined effect sizes (Cohen's ds ranging from -.05 to .14). We found little evidence that IEB in momentary affect is sufficiently reliable, robust, or generalizable across designs and constructs to pose broad and/or serious concerns for EMA studies. Nonetheless, we recommend systematically examining the potential for IEB across study designs and constructs to help identify the conditions/contexts where IEB may or may not manifest. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
| S-EPMC9038639 | biostudies-literature
Project description:BackgroundLoss-of-control (LOC) eating commonly develops during adolescence, and it predicts full-syndrome eating disorders and excess weight gain. Although negative emotions and emotion dysregulation are hypothesized to precede and predict LOC eating, they are rarely examined outside the self-report domain. Autonomic indices, including heart rate (HR) and heart rate variability (HRV), may provide information about stress and capacity for emotion regulation in response to stress.MethodsWe studied whether autonomic indices predict LOC eating in real-time in adolescents with LOC eating and body mass index (BMI) ⩾70th percentile. Twenty-four adolescents aged 12-18 (67% female; BMI percentile mean ± standard deviation = 92.6 ± 9.4) who reported at least twice-monthly LOC episodes wore biosensors to monitor HR, HRV, and physical activity for 1 week. They reported their degree of LOC after all eating episodes on a visual analog scale (0-100) using a smartphone.ResultsAdjusting for physical activity and time of day, higher HR and lower HRV predicted higher self-reported LOC after eating. Parsing between- and within-subjects effects, there was a significant, positive, within-subjects association between pre-meal HR and post-meal LOC rating. However, there was no significant within-subjects effect for HRV, nor were there between-subjects effects for either electrophysiologic variable.ConclusionsFindings suggest that autonomic indices may either be a marker of risk for subsequent LOC eating or contribute to LOC eating. Linking physiological markers with behavior in the natural environment can improve knowledge of illness mechanisms and provide new avenues for intervention.
| S-EPMC10336770 | biostudies-literature
Project description:Psychological resilience, the ability to adapt to adversity, is theorized to rely on intact inhibitory control (IC) mechanisms, which underlie one's ability to maintain goal-directed behavior by inhibiting prepotent responses. However, no study to date has explored daily fluctuations of IC performance in relation to resilience. Here, we examined the association between IC and mood measured daily in relation to psychological resilience in young adults in a stressful situation. Baseline resilience was obtained from 144 female and male soldiers during their basic combat training. Then, participants completed an ecological momentary assessment protocol, in which they reported their momentary mood and completed a short IC assessment twice/day for 2 weeks. A hierarchical linear modeling analysis revealed that psychological resilience moderated the relationship between momentary IC and momentary mood, such that better IC was associated with better mood only for those with higher, but not lower, self-reported psychological resilience at baseline. These results show that psychological resilience is manifested in the everyday association between IC and mood. Furthermore, they lend important support to cognitive models of resilience and may have significant contribution to our understanding of resilient behavior in real life.Trial Registration: MOH_2018-0-13_002451.
| S-EPMC10423230 | biostudies-literature