Decision-making impulsivity in disordered eating: outcomes from a discounting task

Dissociable frontostriatal white matter connectivity underlies reward and motor impulsivity

Dysfunction of cognitive control often leads to impulsive decision-making in clinical and healthy populations. Some research suggests that a generalized cognitive control mechanism underlies the ability to modulate various types of impulsive behavior, while other evidence suggests different forms of impulsivity are dissociable, and rely on distinct neural circuitry. Past research consistently implicates several brain regions, such as the striatum and portions of the prefrontal cortex, in impulsive behavior. However the ventral and dorsal striatum are distinct in regards to function and connectivity. Nascent evidence points to the importance of frontostriatal white matter connectivity in impulsivity, yet it remains unclear whether particular tracts relate to different control behaviors. Here we used probabilistic tractography of diffusion imaging data to relate ventral and dorsal frontostriatal connectivity to reward and motor impulsivity measures. We found a double dissociation such that individual differences in white matter connectivity between the ventral striatum and the ventromedial prefrontal cortex and dorsolateral prefrontal cortex was associated with reward impulsivity, as measured by delay discounting, whereas connectivity between dorsal striatum and supplementary motor area was associated with motor impulsivity, but not vice versa. Our findings suggest that (a) structural connectivity can is associated with a large amount of behavioral variation; (b) different types of impulsivity are driven by dissociable frontostriatal neural circuitry.

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

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.

Understanding the relationships between body esteem, risk for anorexia nervosa, and domain-dependent decision-making impulsivity in a college sample

Impulsivity has been suggested to interact with low body esteem to elevate risk for anorexia nervosa. Discounting tasks are unique tools for examining impulsivity. Female college students (N=139) at varying levels of body esteem and risk for anorexia nervosa responded to discounting scenarios depicting opportunities to lose/gain weight and to worsen/improve complexion. Multiple regression analyses were used to examine the relationships between impulsivity and risk for anorexia nervosa and body esteem in four disorder-relevant decision-making contexts. Results indicated that lower decision-making impulsivity predicted lower body esteem levels when the outcome of the task was framed as an opportunity to lose weight. It is suggested that greater self-control regarding weight-loss in women with low body esteem may be problematic, placing them at higher risk for eating- and weight-related problems. Results reiterate the need for continued attention to fostering healthy body esteem and weight-control patterns in women on college campuses.