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Brooks SJ, Dahl K, Dudley-Jones R, Schiöth HB. A neuroinflammatory compulsivity model of anorexia nervosa (NICAN). Neurosci Biobehav Rev 2024; 159:105580. [PMID: 38417395 DOI: 10.1016/j.neubiorev.2024.105580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/31/2024] [Accepted: 02/09/2024] [Indexed: 03/01/2024]
Affiliation(s)
- S J Brooks
- Department of Surgical Sciences, Uppsala University, Sweden; School of Psychology, Liverpool John Moores University, UK; Neuroscience Research Laboratory (NeuRL), Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa.
| | - K Dahl
- Department of Surgical Sciences, Uppsala University, Sweden
| | - R Dudley-Jones
- School of Psychology, Liverpool John Moores University, UK
| | - H B Schiöth
- Department of Surgical Sciences, Uppsala University, Sweden
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2
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Forester G, Johnson JS, Reilly EE, Lloyd EC, Johnson E, Schaefer LM. Back to the future: Progressing memory research in eating disorders. Int J Eat Disord 2023; 56:2032-2048. [PMID: 37594119 PMCID: PMC10843822 DOI: 10.1002/eat.24045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/17/2023] [Accepted: 08/02/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE Human behaviors, thoughts, and emotions are guided by memories of the past. Thus, there can be little doubt that memory plays a fundamental role in the behaviors (e.g., binging), thoughts (e.g., body-image concerns), and emotions (e.g., guilt) that characterize eating disorders (EDs). Although a growing body of research has begun to investigate the role of memory in EDs, this literature is limited in numerous ways and has yet to be integrated into an overarching framework. METHODS In the present article, we provide an operational framework for characterizing different domains of memory, briefly review existing ED memory research within this framework, and highlight crucial gaps in the literature. RESULTS We distinguish between three domains of memory-episodic, procedural, and working-which differ based on functional attributes and underlying neural systems. Most recent ED memory research has focused on procedural memory broadly defined (e.g., reinforcement learning), and findings within all three memory domains are highly mixed. Further, few studies have attempted to assess these different domains simultaneously, though most behavior is achieved through coordination and competition between memory systems. We, therefore, offer recommendations for how to move ED research forward within each domain of memory and how to study the interactions between memory systems, using illustrative examples from other areas of basic and clinical research. DISCUSSION A stronger and more integrated understanding of the mechanisms that connect memory of past experiences to present ED behavior may yield more comprehensive theoretical models of EDs that guide novel treatment approaches. PUBLIC SIGNIFICANCE Memories of previous eating-related experiences may contribute to the onset and maintenance of eating disorders (EDs). However, research on the role of memory in EDs is limited, and distinct domains of ED memory research are rarely connected. We, therefore, offer a framework for organizing, progressing, and integrating ED memory research, to provide a better foundation for improving ED treatment and intervention going forward.
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Affiliation(s)
- Glen Forester
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Jeffrey S. Johnson
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- Department of Psychology, North Dakota State University, Fargo, North Dakota, USA
| | - Erin E. Reilly
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - E. Caitlin Lloyd
- Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Emily Johnson
- Department of Psychology, North Dakota State University, Fargo, North Dakota, USA
| | - Lauren M. Schaefer
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
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3
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Mestermann S, Stonawski V, Böhm L, Kratz O, Moll GH, Horndasch S. A 10-Year-Old Girl's Dysfunctional 'Self-Help' in ADHD: Suppression of Hyperkinetic Symptoms via Self-Induced Weight Loss in the Context of Anorexia Nervosa-A Case Report. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1509. [PMID: 37761470 PMCID: PMC10528357 DOI: 10.3390/children10091509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
Anorexia Nervosa (AN) and Attention Deficit Hyperactivity Disorder (ADHD) are frequent mental disorders in child and adolescent psychiatry. Comorbidity of these disorders is, however, rare among minors. Thus, little is known about their mutual impact on illness development as well as diagnostic and therapeutic influencing factors. We report the case of a 10-year old girl with AN and massive underweight. At the age of 5, ADHD had been diagnosed. Application of ADHD-specific medication had been refused by her caregiver. As of 3rd grade, hyperkinetic symptoms were significantly reduced, which was later linked to beginning AN-induced weight loss. At inpatient admission, no clinically relevant ADHD-related symptoms were present. Accompanying weight gain, rather 'sudden' appearance of attention difficulties, motoric hyperactivity and impulsivity were reported, widely impairing our patient's schoolwork and further daily life. Methylphenidate medication showed good clinical response and tolerability. We hypothesize that the former massive underweight had suppressed ADHD-specific behaviour. AN with significant weight loss could possibly mask hyperkinetic symptoms in children. Thus, sufficient clinical diagnostics and intense monitoring during ED treatment are required. Physicians and therapists should be sensitized for interactions in the joint occurrence of these mental disorders among minors.
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Affiliation(s)
- Stefan Mestermann
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany (S.H.)
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Pappaianni E, Barona M, Doucet GE, Clark C, Frangou S, Micali N. Neurocognitive Endophenotypes for Eating Disorders: A Preliminary High-Risk Family Study. Brain Sci 2023; 13:brainsci13010099. [PMID: 36672080 PMCID: PMC9856317 DOI: 10.3390/brainsci13010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
Eating disorders (EDs) are psychiatric disorders with a neurobiological basis. ED-specific neuropsychological and brain characteristics have been identified, but often in individuals in the acute phase or recovered from EDs, precluding an understanding of whether they are correlates and scars of EDs vs. predisposing factors. Although familial high-risk (FHR) studies are available across other disorders, this study design has not been used in EDs. We carried out the first FMH study in EDs, investigating healthy offspring of women with EDs and controls. We preliminarily aimed to investigate ED-related neurocognitive and brain markers that could point to predisposing factors for ED. Sixteen girls at FHR for EDs and twenty control girls (age range: 8−15), completed neuropsychological tests assessing executive functions. Girls also underwent a resting-state fMRI scan to quantify functional connectivity (FC) within resting-state networks. Girls at FHR for EDs performed worse on a cognitive flexibility task compared with controls (F = 5.53, p = 0.02). Moreover, they showed different FC compared with controls in several resting-state networks (p < 0.05 FDR-corrected). Differences identified in cognitive flexibility and in FC are in line with those identified in individuals with EDs, strongly pointing to a role as potential endophenotypes of EDs.
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Affiliation(s)
- Edoardo Pappaianni
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Center Ballerup, 2750 Ballerup, Denmark
| | - Manuela Barona
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Gaelle E. Doucet
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE 68010, USA
| | - Christopher Clark
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Nadia Micali
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Center Ballerup, 2750 Ballerup, Denmark
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
- Correspondence:
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Phonological working memory is adversely affected in adults with anorexia nervosa: a systematic literature review. Eat Weight Disord 2022; 27:1931-1952. [PMID: 35133643 PMCID: PMC9287223 DOI: 10.1007/s40519-022-01370-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/18/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Cognitive restraint has potentiating and deleterious effects on working memory (WM) in anorexia nervosa (AN). Conflicting evidence may be due to heterogeneity of tasks examining different WM components (e.g., verbal/auditory versus visuospatial), and differences in adolescent versus adult AN. Additionally, differential cognitive profiles of restricting versus binge/purging subtypes, comorbid psychiatric disorders and psychotropic medication use may confound findings. METHODS To address these conflicts, 25 studies, published between 2016 and 2021, investigating WM in children, adolescents and adults with AN were systematically reviewed using PRISMA guidelines. RESULTS In 71% of WM tasks, no difference in performance between AN patients and age-matched controls was reported, while 29% of WM tasks showed worse performance. Adults with AN displayed deficits in 44% of the verbal/auditory tasks, while performance remained unaffected in 86% of visuospatial tasks. CONCLUSION Examining age groups and WM subsystems separately revealed novel findings of differentially affected WM components in AN. Comorbidities and psychotropic medications were common among AN participants and should be regarded as critical confounding factors for WM measures. Future studies examining different components of WM, acknowledging these confounding factors, may reveal specific deficits in AN to aid treatment improvement strategies. LEVEL OF EVIDENCE I, systematic review.
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Dai W, Zhou H, Møller A, Wei P, Hu K, Feng K, Han J, Li Q, Liu X. Patients with Methamphetamine Use Disorder Show Highly Utilized Proactive Inhibitory Control and Intact Reactive Inhibitory Control with Long-Term Abstinence. Brain Sci 2022; 12:brainsci12080974. [PMID: 35892415 PMCID: PMC9394348 DOI: 10.3390/brainsci12080974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 12/10/2022] Open
Abstract
Methamphetamine use disorder (MUD) is a chronic brain disorder that involves frequent failures of inhibitory control and relapses into methamphetamine intake. However, it remains unclear whether the impairment of inhibitory control in MUD is proactive, reactive or both. To address this issue, the current study used the conditional stop-signal task to assess proactive and reactive inhibitory control in 35 MUD patients with long-term abstinence and 35 matched healthy controls. The results showed that MUD patients with long-term abstinence had greater preparation costs than healthy controls, but did not differ in performance, implying a less efficient utilization of proactive inhibitory control. In contrast, MUD patients exhibited intact reactive inhibitory control; reactive but not proactive inhibitory control was associated with high sensation seeking in MUD patients with long-term abstinence. These findings suggest that proactive and reactive inhibitory control may be two different important endophenotypes of addiction in MUD patients with long-term abstinence. The current study provides new insight into the uses of proactive and reactive inhibitory control to effectively evaluate and precisely treat MUD patients with long-term abstinence.
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Affiliation(s)
- Weine Dai
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China; (W.D.); (H.Z.)
- Sino-Danish College, University of Chinese Academy of Sciences, Beijing 101408, China
- Department of Nuclear Medicine and PET Center, Institute of Clinical Medicine, Aarhus University and University Hospital, 8200 Aarhus N, Denmark;
- Sino-Danish Center for Education and Research, Beijing 101408, China
| | - Hui Zhou
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China; (W.D.); (H.Z.)
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Arne Møller
- Department of Nuclear Medicine and PET Center, Institute of Clinical Medicine, Aarhus University and University Hospital, 8200 Aarhus N, Denmark;
| | - Ping Wei
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100048, China;
| | - Kesong Hu
- Department of Psychology, Lake Superior State University, Sault St. Marie, MI 49783, USA;
| | - Kezhuang Feng
- Hebei Female Drug Rehabilitation Center, Shijiazhuang 050000, China; (K.F.); (J.H.)
| | - Jie Han
- Hebei Female Drug Rehabilitation Center, Shijiazhuang 050000, China; (K.F.); (J.H.)
| | - Qi Li
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100048, China;
- Correspondence: (Q.L.); (X.L.)
| | - Xun Liu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China; (W.D.); (H.Z.)
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China
- Correspondence: (Q.L.); (X.L.)
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Thomas KS, Birch RE, Jones CRG, Vanderwert RE. Neural Correlates of Executive Functioning in Anorexia Nervosa and Obsessive-Compulsive Disorder. Front Hum Neurosci 2022; 16:841633. [PMID: 35693540 PMCID: PMC9179647 DOI: 10.3389/fnhum.2022.841633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) are commonly reported to co-occur and present with overlapping symptomatology. Executive functioning difficulties have been implicated in both mental health conditions. However, studies directly comparing these functions in AN and OCD are extremely limited. This review provides a synthesis of behavioral and neuroimaging research examining executive functioning in AN and OCD to bridge this gap in knowledge. We outline the similarities and differences in behavioral and neuroimaging findings between AN and OCD, focusing on set shifting, working memory, response inhibition, and response monitoring. This review aims to facilitate understanding of transdiagnostic correlates of executive functioning and highlights important considerations for future research. We also discuss the importance of examining both behavioral and neural markers when studying transdiagnostic correlates of executive functions.
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Affiliation(s)
- Kai S. Thomas
- School of Psychology, Cardiff University, Cardiff, United Kingdom
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | | | - Catherine R. G. Jones
- School of Psychology, Cardiff University, Cardiff, United Kingdom
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Ross E. Vanderwert
- School of Psychology, Cardiff University, Cardiff, United Kingdom
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, United Kingdom
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom
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8
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Luo R, Silenzio VMB, Huang Y, Chen X, Luo D. The Changes and the Predictors of Suicidal Ideation Among HIV-positive Sexual Minority Men: A Five-year Longitudinal Study from China. AIDS Behav 2022; 26:339-349. [PMID: 34331609 PMCID: PMC8813835 DOI: 10.1007/s10461-021-03387-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2021] [Indexed: 02/05/2023]
Abstract
This study aimed to explore whether there were differences in suicidal ideation at different time points among sexual minority men (SMM) within five years of HIV diagnosis, and to investigate the influence of time and psychosocial variables on suicidal ideation. This was a five-year follow-up study focusing on the suicidal ideation among HIV-positive SMM who were recruited when they were newly diagnosed with HIV. Suicidal ideation and psychosocial characteristics including depression, anxiety, HIV-related stress, and social support were assessed within one month, the first year, and the fifth year after HIV diagnosis. A total of 197 SMM newly diagnosed with HIV completed three-time point surveys in this study. The prevalence of suicidal ideation was 27.4%, 15.7%, and 23.9% at one month, the first year, and the fifth year after HIV diagnosis, respectively. The risk of suicidal ideation was lower in the first year than baseline, but there was no significant difference between the fifth year and baseline. Emotional stress and objective support independently predicted suicidal ideation and they had interactions with time. The suicidal ideation of SMM newly diagnosed with HIV decreased in the first year and then increased in the fifth year, not showing a sustained decline trend in a longer trajectory of HIV diagnosis. Stress management, especially long-term stress assessment and management with a focus on emotional stress should be incorporated into HIV health care in an appropriate manner. In addition, social support should also be continuously provided to this vulnerable population.
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Affiliation(s)
- Rui Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, Hunan 410078 People’s Republic of China
| | - Vincent M. B. Silenzio
- Department of Urban-Global Public Health, Rutgers School of Public Health, Rutgers University, Newark, NJ USA
| | - Yunxiang Huang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan People’s Republic of China
| | - Xi Chen
- Hunan Provincial Center for Disease Prevention and Control, Changsha, Hunan People’s Republic of China
| | - Dan Luo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, Hunan 410078 People’s Republic of China
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A Multi-Faceted Evaluation of Impulsivity Traits and Early Maladaptive Schemas in Patients with Anorexia Nervosa. J Clin Med 2021; 10:jcm10245895. [PMID: 34945191 PMCID: PMC8703582 DOI: 10.3390/jcm10245895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 12/12/2022] Open
Abstract
(1) Background: patients with Anorexia Nervosa (AN) are classified either as restrictive (ANr) or binge/purge (ANbp) according to the absence or presence of impulsive eating and compensatory behaviors. The aim of the present study was to assess the levels of impulsivity in both AN subtypes and to explore whether individual differences in impulsivity may be explained by differences in the presence of early maladaptive schemas. (2) Methods: the sample group included 122 patients with ANr, 112 patients with ANbp, and 131 healthy women (HW). All of these participants completed the UPPS-P scale for an assessment of impulsive behaviors and the Young Schema Questionnaire (YSQ-S3) for an assessment of early maladaptive schemas. (3) Results: the patients with ANbp displayed higher levels of impulsivity compared with the patients with ANr and HW. Patients with AN, especially the restrictive subtype, also reported higher levels of early maladaptive schemas than HW, and regression analyses revealed that specific maladaptive schemas partially explain the variability in impulsivity in both patients and HW. (4) Conclusions: it appears that maladaptive beliefs developed during childhood or adolescence may predict the development of impulsivity, a personality trait usually associated with maladaptive behaviors, and appears to be prevalent among ANbp patients. The clinical effects of this, as well as directions for future study, are also discussed in this paper.
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Sanchez-Castañeda C, Luis-Ruiz S, Ramon-Krauel M, Lerin C, Sanchez C, Miró N, Martínez S, Garolera M, Jurado MA. Executive Function Training in Childhood Obesity: Food Choice, Quality of Life, and Brain Connectivity (TOuCH): A Randomized Control Trial Protocol. Front Pediatr 2021; 9:551869. [PMID: 33718294 PMCID: PMC7943482 DOI: 10.3389/fped.2021.551869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 01/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Individuals with obesity are known to present cognitive deficits, especially in executive functions. Executive functions play an important role in health and success throughout the whole life and have been related to food decision-making and to the ability to maintain energy balance. It is possible to improve executive functions through targeted training. This would involve brain plasticity changes that could be studied through connectivity MRI. The general hypothesis of this study is that executive functions training in children with obesity can improve food choices and produce cognitive and neuroimaging changes (structural and functional connectivity), as well as improve emotional state and quality of life. Methods: Randomized controlled double-blind trial with 12-month follow-up. Thirty children with obesity will be randomly allocated into "executive training" (Cognifit with adaptive difficulty + Cogmed) or "control task" group (Cognifit without adaptive difficulty). Both groups will attend 30-45 min of individual gamified training (Cogmed and/or Cognifit systems) by iPad, five times per week during 6 weeks. Cogmed and Cognifit software are commercially available from Pearson and Cognifit, respectively. Participants will receive an iPad with both apps installed for a 6-week use. Participants will also receive counseling diet information via presentations sent to the iPad and will wear a Fitbit Flex 2 tracker to monitor daily activity and sleep patterns. Main outcomes will be cognitive, emotional, food decision, and quality-of-life measures, as well as neuroimaging measures. Participants are evaluated at baseline (T0), after treatment (T1), and 12 months since baseline (T2). Discussion: Longitudinal study with active control group and 3 time points: baseline, immediately after treatment, and 1 year after baseline. Threefold treatment: executive function training, psychoeducation, and feedback on activity/sleep tracking. We will evaluate the transfer effects of the intervention, including emotional and functional outcomes, as well as the effects on neural plasticity by connectivity MRI. Trial registration: This project has been registered in ClinicalTrials.gov (trial registration number NCT03615274), August 3, 2018.
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Affiliation(s)
- Cristina Sanchez-Castañeda
- Department of Clinical Psychology and Psychobiology, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Sandra Luis-Ruiz
- Department of Clinical Psychology and Psychobiology, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Marta Ramon-Krauel
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain.,Endocrinology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carles Lerin
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain.,Endocrinology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Consuelo Sanchez
- Paediatric Endocrinology Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Núria Miró
- Diabetes Education Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Sònia Martínez
- Pharmacy and Nutrition Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Maite Garolera
- Neuropsychology Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Maria Angeles Jurado
- Department of Clinical Psychology and Psychobiology, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Barcelona, Spain
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Controlling the laxative abuse of anorexia nervosa patients with the Serigaya Methamphetamine Relapse Prevention Program workbook: a case report. Biopsychosoc Med 2019; 13:23. [PMID: 31660062 PMCID: PMC6807258 DOI: 10.1186/s13030-019-0166-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 10/02/2019] [Indexed: 02/04/2023] Open
Abstract
Background There is no consensus on effective treatment for laxative abuse in patients with eating disorders. Here, we report the case of a patient with laxative abuse who showed some improvement through an intervention based on the Matrix model. Case presentation A woman diagnosed with anorexia nervosa-binge eating/purging type (AN-BP) steadfastly denied laxative abuse and would not admit to suffering from an eating disorder. This led to low motivation for undergoing conventional psychotherapy, psychoeducation, and cognitive behavioral therapy. These were ineffective and followed by repeated cycles of hospitalization and discharge. The patient’s general condition, as depicted by her laboratory and clinical parameters, deteriorated due to the medical complications resulting from laxative abuse. Focusing on laxative abuse, we considered an intervention for drug addiction. Because the patient could maintain a diet diary and acknowledged laxative abuse as a drug addiction, we introduced the Serigaya Methamphetamine Relapse Prevention Program (SMARPP) workbook as a self-administered treatment. The patient meticulously completed the treatment and experienced a gradual improvement in laxative abuse. She has not been re-hospitalized in 4 years, currently performs household chores, and demonstrates improved social function. Conclusions In patients with AN-BP, the SMARPP workbook may be effective in treating laxative abuse.
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12
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Bartholdy S, O'Daly OG, Campbell IC, Banaschewski T, Barker G, Bokde ALW, Bromberg U, Büchel C, Quinlan EB, Desrivières S, Flor H, Frouin V, Garavan H, Gowland P, Heinz A, Ittermann B, Martinot JL, Paillère Martinot ML, Nees F, Orfanos DP, Poustka L, Hohmann S, Fröhner JH, Smolka MN, Walter H, Whelan R, Schumann G, Schmidt U, Artiges E, Schneider S, Bach C, Paus T, Barbot A, Gareth Barker, Bokde A, Vetter N, Büchel C, Cattrell A, Constant P, Gowland P, Crombag H, Czech K, Dalley J, Decideur B, Spranger T, Ripley T, Heym N, Flor H, Sommer W, Fuchs B, Gallinat J, Spanagel R, Kaviani M, Heinrichs B, Andreas Heinz, Subramaniam N, Jia T, Ihlenfeld A, Ireland J, Ittermann B, Conrod P, Banaschewski T, Jones J, Klaassen A, Lalanne C, Lanzerath D, Lawrence C, Lemaitre H, Desrivieres S, Mallik C, Karl Mann, Mar A, Martinez-Medina L, Jean-Luc Martinot, Mennigen E, Mesquita de Carvahlo F, Schwartz Y, Bruehl R, Müller K, Nees F, Nymberg C, Lathrop M, Trevor Robbins, Pausova Z, Jani Pentilla, Biondo F, Jean-Baptiste Poline, Hohmann S, Poustka L, Millenet S, Michael Smolka, Fröhner J, Struve M, Steve Williams, Hübner T, Bromberg U, Aydin S, Rogers J, Romanowski A, Schmäl C, Schmidt D, Ripke S, Arroyo M, Schubert F, Pena-Oliver Y, Fauth-Bühler M, Mignon X, Whelan R, Speiser C, Fadai T, Dai Stephens, Ströhle A, Paillere ML, Strache N, Theobald D, Jurk S, Vulser H, Miranda R, Yacubian J, Frouin V, Genauck A, Parchetka C, Gemmeke I, Kruschwitz J, Weiß K, Walter H, Feng J, Papadopoulos D, Filippi I, Ing A, Ruggeri B, Xu B, Macare C, Chu C, Hanratty E, Burke Quinlan E, Robert G, Schumann G, Yu T, Ziesch V, Stedman A. Neural Correlates of Failed Inhibitory Control as an Early Marker of Disordered Eating in Adolescents. Biol Psychiatry 2019; 85:956-965. [PMID: 31122340 DOI: 10.1016/j.biopsych.2019.01.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 01/23/2019] [Accepted: 01/24/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Binge eating and other forms of disordered eating behavior (DEB) are associated with failed inhibitory control. This study investigated the neural correlates of failed inhibitory control as a potential biomarker for DEB. METHODS The study used prospective longitudinal data from the European IMAGEN study adolescent cohort. Participants completed baseline assessments (questionnaires and a brain scan [functional magnetic resonance imaging]) at 14 years of age and a follow-up assessment (questionnaires) at 16 years of age. Self-reported binge eating and/or purging were used to indicate presence of DEB. Neural correlates of failed inhibition were assessed using the stop signal task. Participants were categorized as healthy control subjects (reported no DEB at both time points), maintainers (reported DEB at both time points), recoverers (reported DEB at baseline only), and developers (reported DEB at follow-up only). Forty-three individuals per group with complete scanning data were matched on gender, age, puberty, and intelligence (N = 172). RESULTS At baseline, despite similar task performance, incorrectly responding to stop signals (failed inhibitory control) was associated with greater recruitment of the medial prefrontal cortex and anterior cingulate cortex in the developers compared with healthy control subjects and recoverers. CONCLUSIONS Greater recruitment of the medial prefrontal and anterior cingulate regions during failed inhibition accords with abnormal evaluation of errors contributing to DEB development. As this precedes symptom onset and is evident despite normal task performance, neural responses during failed inhibition may be a useful biomarker of vulnerability for DEB. This study highlights the potential value of prospective neuroimaging studies for identifying markers of illness before the emergence of behavior changes.
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Affiliation(s)
- Savani Bartholdy
- Section of Eating Disorders, Department of Psychological Medicine, London, United Kingdom.
| | - Owen G O'Daly
- Centre for Neuroimaging Sciences, London, United Kingdom
| | - Iain C Campbell
- Section of Eating Disorders, Department of Psychological Medicine, London, United Kingdom
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Gareth Barker
- Centre for Neuroimaging Sciences, London, United Kingdom
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Uli Bromberg
- University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Erin Burke Quinlan
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sylvane Desrivières
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Vincent Frouin
- Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette, Paris, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, Vermont
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Ittermann
- Physikalisch-Technische Bundesanstalt, Braunschweig, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 "Neuroimaging & Psychiatry," University Paris Sud - Paris Saclay, University Paris Descartes, Paris, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 "Neuroimaging & Psychiatry," University Paris Sud - Paris Saclay, University Paris Descartes, Paris, France; Department of Adolescent Psychopathology and Medicine, Maison de Solenn, Cochin Hospital, Public Assistance Hospitals of Paris, Paris, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dimitri Papadopoulos Orfanos
- Neurospin, Commissariat à l'énergie atomique et aux énergies alternatives, Université Paris-Saclay, Gif-sur-Yvette, Paris, France
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany; Clinic for Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Gunter Schumann
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, London, United Kingdom; South London & Maudsley National Health Service Foundation Trust, London, United Kingdom
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13
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Rubenis AJ, Fitzpatrick RE, Lubman DI, Verdejo‐Garcia A. Working memory predicts methamphetamine hair concentration over the course of treatment: moderating effect of impulsivity and implications for dual-systems model. Addict Biol 2019; 24:145-153. [PMID: 29114992 DOI: 10.1111/adb.12575] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/22/2017] [Accepted: 10/03/2017] [Indexed: 01/08/2023]
Abstract
High impulsivity and poor executive function are characteristic of methamphetamine use disorder. High arousal in the impulsive system has been proposed to compromise the executive system's regulating ability (i.e. the dual-systems model). While interaction between these variables may partly explain poor treatment outcomes associated with methamphetamine use disorder, previous research has tended to examine each factor separately. We investigated whether high impulsivity (measured with an impulsive choice task) and poor executive function (measured with a working memory task) predict methamphetamine use (determined by hair sample) in the 6 weeks following treatment commencement. We also investigated whether impulsive choice moderates the relationship between working memory and methamphetamine use. One hundred and eight individuals with methamphetamine use disorder (75 percent male) were tested within 3 weeks of commencing treatment; 80 (74 percent) were followed up 6 weeks following baseline testing. Cognitive measures significantly predicted drug use after controlling for nuisance variables. Working memory was a significant predictor, while impulsive choice was not. The interaction model included working memory as a predictor and impulsive choice as a moderator. This model was significant, as was the interaction term. Working memory significantly predicted levels of methamphetamine use in early treatment, and impulsive choice moderated this relationship. Those with working memory deficits are particularly vulnerable to using greater amounts of methamphetamine. As working memory increased methamphetamine use decreased among individuals with low/medium delay discounting. Pre-treatment cognitive testing may identify patients at high risk, while remediation of working memory function may be a treatment target for reducing methamphetamine use.
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Affiliation(s)
- Adam J. Rubenis
- Monash Institute of Cognitive and Clinical Neurosciences Monash University Clayton VIC 3800 Australia
| | - Rebecca E. Fitzpatrick
- Monash Institute of Cognitive and Clinical Neurosciences Monash University Clayton VIC 3800 Australia
| | - Dan I. Lubman
- Turning Point Eastern Health Fitzroy VIC 3065 Australia
- Eastern Health Clinical School Monash University Fitzroy VIC 3065 Australia
| | - Antonio Verdejo‐Garcia
- Monash Institute of Cognitive and Clinical Neurosciences Monash University Clayton VIC 3800 Australia
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14
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Smith KE, Mason TB, Johnson JS, Lavender JM, Wonderlich SA. A systematic review of reviews of neurocognitive functioning in eating disorders: The state-of-the-literature and future directions. Int J Eat Disord 2018; 51:798-821. [PMID: 30102781 PMCID: PMC6594106 DOI: 10.1002/eat.22929] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 06/11/2018] [Accepted: 06/13/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE In recent years there has been increasing clinical and empirical interest in neurocognitive functioning in eating disorders (EDs), which has resulted in numerous quantitative and qualitative reviews. However, there has yet to be a comprehensive synthesis or critical review of this literature to identify future directions to advance the field in this area. Therefore the aim of this systematic review of systematic reviews was to (a) characterize the existing literature on neurocognitive functioning in EDs based on recent reviews (i.e., published since 2010), (b) describe related limitations, and (c) suggest avenues for future research to address gaps in the current literature. METHOD Electronic databases were queried for reviews of neurocognitive domains (i.e., inhibitory control, decision-making, central coherence, set-shifting, working memory, and attention bias) in EDs, which identified 28 systematic and meta-analytic reviews. RESULTS Broadly, the literature indicates deficits across these neurocognitive domains in EDs, though heterogeneity was noted in the magnitude of these effects, which varied to some extent across ED subtypes, sample characteristics, and methodological approaches. DISCUSSION While these reviews have generally suggested varying patterns of neurocognitive deficits across EDs, there remain critical limitations regarding the methodological quality of these studies (e.g., the lack of prospective designs, consideration of confounding influences, or examination of interrelationships between neurocognitive domains and relationships between neurocognition and other relevant behavioral constructs). Specifically, we outline 10 key areas that are imperative to address in future research in this area in order to move our field forward.
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Affiliation(s)
- Kathryn E Smith
- Center for Bio-Behavioral Research, Sanford Research, South Fargo, ND
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, North Dakota
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Jeffrey S Johnson
- Center for Bio-Behavioral Research, Sanford Research, South Fargo, ND
- Department of Psychology, North Dakota State University, North Dakota
| | - Jason M Lavender
- Department of Psychiatry, University of California, San Diego, California
| | - Stephen A Wonderlich
- Center for Bio-Behavioral Research, Sanford Research, South Fargo, ND
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, North Dakota
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15
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Cavalera C, Pepe A, Zurloni V, Diana B, Realdon O, Todisco P, Castelnuovo G, Molinari E, Pagnini F. Negative social emotions and cognition: Shame, guilt and working memory impairments. Acta Psychol (Amst) 2018; 188:9-15. [PMID: 29800767 DOI: 10.1016/j.actpsy.2018.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 03/09/2018] [Accepted: 05/13/2018] [Indexed: 12/13/2022] Open
Abstract
Negative emotions can have an impact on a variety of cognitive domains, including Working Memory (WM). The present work investigated whether shame and guilt modulate WM performance in a dual-task test both in a non-clinical and a clinical population. In Experiment 1, 76 non-clinical participants performed a dual-task before and after being randomly assigned to shame, guilt or neutral inductions elicited by the writing of autobiographical past experiences. Shame and guilt elicitations were related to impaired WM performances. In Experiment 2, 65 clinical inpatients with eating disorders were assigned to the same procedure. The negative relationship of self-conscious emotions and WM was confirmed. Taken together these results suggest that shame and guilt are related to impairments of WM in both clinical and non-clinical participants.
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16
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Abstract
PURPOSE OF REVIEW The present review organises the recent literature on the role of memory in eating behaviours and provides an overview of the current evidence relating to the associations between memory and weight gain. RECENT FINDINGS Research over the last few years has highlighted working memory as an important cognitive process that underpins many aspects of appetite control. Recent work on episodic memory and appetite has replicated work showing that manipulating memory for recent eating affects later consumption and extended this work to examine associations between individual differences in memory and eating behaviours. Poorer episodic memory ability is related to a reduced sensitivity to internal states of hunger and satiety and a tendency towards uncontrolled eating. There is also recent evidence to suggest that working memory and episodic memory impairments are related to weight gain and high BMI. Working memory and episodic memory are core cognitive processes that are critical for food-related decision-making, and disruption to these processes contributes to problems with appetite control and weight gain, which suggests that weight loss programmes might be improved by the addition of cognitive training.
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Affiliation(s)
- Suzanne Higgs
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Maartje S Spetter
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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17
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Brooks SJ, Lochner C, Shoptaw S, Stein DJ. Using the research domain criteria (RDoC) to conceptualize impulsivity and compulsivity in relation to addiction. PROGRESS IN BRAIN RESEARCH 2017; 235:177-218. [PMID: 29054288 DOI: 10.1016/bs.pbr.2017.08.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nomenclature for mental disorder was updated in 2013 with the publication of the fifth edition of the Diagnostic and Statistical Manual (DSM-5). In DSM-5, substance use disorders are framed as more dimensional. First, the distinction between abuse and dependence is replaced by substance use. Second, the addictions section now covers both substances and behavioral addictions. This contemporary move toward dimensionality and transdiagnosis in the addictions and other disorders embrace accumulating cognitive-affective neurobiological evidence that is reflected in the United States' National Institutes of Health Research Domain Criteria (NIH RDoC). The RDoC calls for the further development of transdiagnostic approaches to psychopathy and includes five domains to improve research. Additionally, the RDoC suggests that these domains can be measured in terms of specific units of analysis. In line with these suggestions, recent publications have stimulated updated neurobiological conceptualizations of two transdiagnostic concepts, namely impulsivity and compulsivity and their interactions that are applicable to addictive disorders. However, there has not yet been a review to examine the constructs of impulsivity and compulsivity in relation to addiction in light of the research-oriented RDoC. By doing so it may become clearer as to whether impulsivity and compulsivity function antagonistically, complementarily or in some other way at the behavioral, cognitive, and neural level and how this relationship underpins addiction. Thus, here we consider research into impulsivity and compulsivity in light of the transdiagnostic RDoC to help better understand these concepts and their application to evidence-based clinical intervention for addiction.
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Affiliation(s)
- Samantha J Brooks
- University of Cape Town, Cape Town, South Africa; Uppsala University, Uppsala, Sweden.
| | - Christine Lochner
- US/UCT MRC Unit on Anxiety & Stress Disorders, University of Stellenbosch, Stellenbosch, South Africa
| | - Steve Shoptaw
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Dan J Stein
- US/UCT MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa
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18
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Brooks SJ, Funk SG, Young SY, Schiöth HB. The Role of Working Memory for Cognitive Control in Anorexia Nervosa versus Substance Use Disorder. Front Psychol 2017; 8:1651. [PMID: 29018381 PMCID: PMC5615794 DOI: 10.3389/fpsyg.2017.01651] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 09/07/2017] [Indexed: 01/20/2023] Open
Abstract
Prefrontal cortex executive functions, such as working memory (WM) interact with limbic processes to foster impulse control. Such an interaction is referred to in a growing body of publications by terms such as cognitive control, cognitive inhibition, affect regulation, self-regulation, top-down control, and cognitive–emotion interaction. The rising trend of research into cognitive control of impulsivity, using various related terms reflects the importance of research into impulse control, as failure to employ cognitions optimally may eventually result in mental disorder. Against this background, we take a novel approach using an impulse control spectrum model – where anorexia nervosa (AN) and substance use disorder (SUD) are at opposite extremes – to examine the role of WM for cognitive control. With this aim, we first summarize WM processes in the healthy brain in order to frame a systematic review of the neuropsychological, neural and genetic findings of AN and SUD. In our systematic review of WM/cognitive control, we found n = 15 studies of AN with a total of n = 582 AN and n = 365 HC participants; and n = 93 studies of SUD with n = 9106 SUD and n = 3028 HC participants. In particular, we consider how WM load/capacity may support the neural process of excessive epistemic foraging (cognitive sampling of the environment to test predictions about the world) in AN that reduces distraction from salient stimuli. We also consider the link between WM and cognitive control in people with SUD who are prone to ‘jumping to conclusions’ and reduced epistemic foraging. Finally, in light of our review, we consider WM training as a novel research tool and an adjunct to enhance treatment that improves cognitive control of impulsivity.
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Affiliation(s)
- Samantha J Brooks
- Functional Pharmacology, Department of Neuroscience, Uppsala UniversityUppsala, Sweden.,Department of Psychiatry and Mental Health, University of Cape TownCape Town, South Africa
| | - Sabina G Funk
- Department of Psychiatry and Mental Health, University of Cape TownCape Town, South Africa
| | - Susanne Y Young
- Department of Psychiatry, Stellenbosch UniversityBellville, South Africa
| | - Helgi B Schiöth
- Functional Pharmacology, Department of Neuroscience, Uppsala UniversityUppsala, Sweden
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19
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Bartholdy S, Rennalls SJ, Jacques C, Danby H, Campbell IC, Schmidt U, O’Daly OG. Proactive and reactive inhibitory control in eating disorders. Psychiatry Res 2017; 255:432-440. [PMID: 28672226 PMCID: PMC5555256 DOI: 10.1016/j.psychres.2017.06.073] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 04/10/2017] [Accepted: 06/21/2017] [Indexed: 02/01/2023]
Abstract
Altered inhibitory control has been implicated in the development and maintenance of eating disorders (ED), however it is unclear how different types of inhibitory control are affected across the EDs. We explored whether individuals with bulimia nervosa (BN), binge eating disorder (BED) and anorexia nervosa (AN) differed from healthy individuals (HC) on two types of motor inhibitory control: proactive inhibition (related to the preparation/initiation of a response) and reactive inhibition (withholding a response in reaction to a signal). Ninety-four women (28 AN, 27 BN, 11 BED, 28 HC) completed two neuropsychological tasks (a cued reaction time task and a stop signal task), and questionnaires assessing clinical variables, mood, anxiety, and inhibitory control. Self-reported inhibitory control was poorer in women with BN compared to the HC and AN groups, but greater in women with AN compared to all other groups. However, no group differences in reactive inhibition were observed. Proactive inhibition was augmented in women with AN compared to HC, and this was related to self-reported intolerance of uncertainty. The findings suggest that proactive inhibition may be a relevant target for behavioural interventions for AN, and call for further research into the relationship between intolerance of uncertainty and proactive inhibition.
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Affiliation(s)
- Savani Bartholdy
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
| | - Samantha J. Rennalls
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Claire Jacques
- Department of Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Hollie Danby
- Department of Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Iain C. Campbell
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Owen G. O’Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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20
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Neural correlates of altered feedback learning in women recovered from anorexia nervosa. Sci Rep 2017; 7:5421. [PMID: 28710363 PMCID: PMC5511172 DOI: 10.1038/s41598-017-04761-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 05/19/2017] [Indexed: 12/19/2022] Open
Abstract
Anorexia nervosa (AN) is associated with exaggerated self-control and altered reward-based decision making, but the underlying neural mechanisms are poorly understood. Consistent with the notion of excessive cognitive control, we recently found increased dorsal anterior cingulate cortex (dACC) activation in acutely ill patients (acAN) on lose-shift trials in a probabilistic reversal learning (PRL) task. However, undernutrition may modulate brain function. In attempt to disentangle trait from state factors, the current fMRI study investigated cognitive control in recovered patients (recAN). Thirty-one recAN and 31 healthy controls (HC) completed a PRL task during fMRI. Based on previous findings, we focused on hemodynamic responses during lose-shift behaviour and conducted supplementary functional connectivity analysis. RecAN showed elevated lose-shift behaviour relative to HC. On the neural level, recAN showed normal dACC responses, but increased activation in fronto-parietal control regions. A trend for increased coupling between frontal and parietal regions of interest was also evident in recAN. The current findings in recAN differ from those in our previous study in acAN. While aberrant dACC response to negative feedback may be a correlate of the underweight state in acAN, impaired behavioural adaptation and elevated activation of cognitive control regions in recAN is suggestive of altered neural efficiency.
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21
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Leppanen J, Cardi V, Paloyelis Y, Simmons A, Tchanturia K, Treasure J. FMRI Study of Neural Responses to Implicit Infant Emotion in Anorexia Nervosa. Front Psychol 2017; 8:780. [PMID: 28567026 PMCID: PMC5434152 DOI: 10.3389/fpsyg.2017.00780] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/26/2017] [Indexed: 12/29/2022] Open
Abstract
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.
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Affiliation(s)
- Jenni Leppanen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK
| | - Valentina Cardi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK
| | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK
| | - Andy Simmons
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK.,Department of Psychology, Ilia State UniversityTbilisi, Georgia
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College LondonLondon, UK
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22
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Brooks SJ, Wiemerslage L, Burch KH, Maiorana SA, Cocolas E, Schiöth HB, Kamaloodien K, Stein DJ. The impact of cognitive training in substance use disorder: the effect of working memory training on impulse control in methamphetamine users. Psychopharmacology (Berl) 2017; 234:1911-1921. [PMID: 28324119 PMCID: PMC5486910 DOI: 10.1007/s00213-017-4597-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 03/11/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Impulsivity is a vulnerability trait for poor self-regulation in substance use disorder (SUD). Working memory (WM) training improves impulsivity and self-regulation in psychiatric disorders. Here we test WM training in methamphetamine use disorder (MUD). METHODS There are 15 MUD patients receiving inpatient treatment as usual (TAU) and 20 who additionally completed WM cognitive training (CT) and 25 healthy controls (HC). MANCOVA repeated measures analyses examined changes in impulsivity and self-regulation at baseline and after 4 weeks. RESULTS Post hoc t tests confirmed that at baseline, feelings of self-control were significantly lower in the MUD (t = 2.001, p = 0.05) and depression was higher (t = 4.980, p = 0.001), as was BIS total impulsivity (t = 5.370, p = 0.001) compared to the HC group. Total self-regulation score was higher in HC than MUD patients (t = 5.370, p = 0.001). CT had a 35% learning rate (R 2 = 0.3523, p < 0.05). Compared to follow-up TAU, follow-up CT group had higher self-reported mood scores (t = 2.784, p = 0.01) and higher compared to CT baseline (t = 2.386, p = 0.036). Feelings of self-control were higher in CT than TAU at follow-up (t = 2.736, p = 0.012) and also compared to CT baseline (t = 3.390, p = 0.006), lack of planning significantly improved in CT between baseline and follow-up (t = 2.219, p = 0.048), as did total impulsivity scores (t = 2.085, p = 0.048). Measures of self-regulation were improved in the CT group compared to TAU at follow-up, in total score (t = 2.442, p = 0.038), receiving score (t = 2.314, p = 0.029) and searching score (t = 2.362, p = 0.027). Implementing self-regulation was higher in the CT group compared to TAU (t = 2.373, p = 0.026). CONCLUSIONS WM training may improve control of impulsivity and self-regulation in people with MUD.
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Affiliation(s)
- Samantha J. Brooks
- 0000 0004 0635 1506grid.413335.3UCT Department of Psychiatry and Mental Health, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, South Africa ,0000 0004 1936 9457grid.8993.bDepartment of Neuroscience, Uppsala University, Uppsala, Sweden
| | - L Wiemerslage
- 0000 0004 1936 9457grid.8993.bDepartment of Neuroscience, Uppsala University, Uppsala, Sweden
| | - KH Burch
- 0000 0004 0635 1506grid.413335.3UCT Department of Psychiatry and Mental Health, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, South Africa ,0000 0004 1936 8868grid.4563.4Department of Neuroscience, University of Nottingham, Nottingham, UK
| | - SA Maiorana
- 0000 0004 0635 1506grid.413335.3UCT Department of Psychiatry and Mental Health, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, South Africa ,UCT Department of Psychology, Cape Town, South Africa
| | - E Cocolas
- 0000 0004 0635 1506grid.413335.3UCT Department of Psychiatry and Mental Health, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, South Africa
| | - HB Schiöth
- 0000 0004 1936 9457grid.8993.bDepartment of Neuroscience, Uppsala University, Uppsala, Sweden
| | - K Kamaloodien
- 0000 0001 2156 8226grid.8974.2Department of Psychology, University of the Western Cape, Cape Town, South Africa
| | - DJ Stein
- 0000 0004 0635 1506grid.413335.3UCT Department of Psychiatry and Mental Health, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, South Africa ,MRC Unit on Anxiety and Stress Disorders, Cape Town, South Africa
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Terhoeven V, Kallen U, Ingenerf K, Aschenbrenner S, Weisbrod M, Herzog W, Brockmeyer T, Friederich HC, Nikendei C. Meaningful Memory in Acute Anorexia Nervosa Patients-Comparing Recall, Learning, and Recognition of Semantically Related and Semantically Unrelated Word Stimuli. EUROPEAN EATING DISORDERS REVIEW 2016; 25:89-97. [PMID: 28032373 DOI: 10.1002/erv.2496] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 10/17/2016] [Accepted: 11/14/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE It is unclear whether observed memory impairment in anorexia nervosa (AN) depends on the semantic structure (categorized words) of material to be encoded. We aimed to investigate the processing of semantically related information in AN. METHOD Memory performance was assessed in a recall, learning, and recognition test in 27 adult women with AN (19 restricting, 8 binge-eating/purging subtype; average disease duration: 9.32 years) and 30 healthy controls using an extended version of the Rey Auditory Verbal Learning Test, applying semantically related and unrelated word stimuli. RESULTS Short-term memory (immediate recall, learning), regardless of semantics of the words, was significantly worse in AN patients, whereas long-term memory (delayed recall, recognition) did not differ between AN patients and controls. DISCUSSION Semantics of stimuli do not have a better effect on memory recall in AN compared to CO. Impaired short-term versus long-term memory is discussed in relation to dysfunctional working memory in AN. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Valentin Terhoeven
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Ursula Kallen
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.,Department of Psychiatry and Psychotherapy Bethel, Evangelisches Krankenhaus Bielefeld, Bielefeld, Germany
| | - Katrin Ingenerf
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of General Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Matthias Weisbrod
- Department of General Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.,Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
| | - Wolfgang Herzog
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Timo Brockmeyer
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Christoph Nikendei
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Gaudio S, Wiemerslage L, Brooks SJ, Schiöth HB. A systematic review of resting-state functional-MRI studies in anorexia nervosa: Evidence for functional connectivity impairment in cognitive control and visuospatial and body-signal integration. Neurosci Biobehav Rev 2016; 71:578-589. [DOI: 10.1016/j.neubiorev.2016.09.032] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 08/11/2016] [Accepted: 09/30/2016] [Indexed: 10/20/2022]
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Bartholdy S, Campbell IC, Schmidt U, O’Daly OG. Proactive inhibition: An element of inhibitory control in eating disorders. Neurosci Biobehav Rev 2016; 71:1-6. [DOI: 10.1016/j.neubiorev.2016.08.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 07/19/2016] [Accepted: 08/05/2016] [Indexed: 12/01/2022]
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Brooks S, Burch K, Maiorana S, Cocolas E, Schioth H, Nilsson E, Kamaloodien K, Stein D. Psychological intervention with working memory training increases basal ganglia volume: A VBM study of inpatient treatment for methamphetamine use. Neuroimage Clin 2016; 12:478-91. [PMID: 27625988 PMCID: PMC5011179 DOI: 10.1016/j.nicl.2016.08.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 08/15/2016] [Accepted: 08/22/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND Protracted methamphetamine (MA) use is associated with decreased control over drug craving and altered brain volume in the frontostriatal network. However, the nature of volumetric changes following a course of psychological intervention for MA use is not yet known. METHODS 66 males (41 MA patients, 25 healthy controls, HC) between the ages of 18-50 were recruited, the MA patients from new admissions to an in-patient drug rehabilitation centre and the HC via public advertisement, both in Cape Town, South Africa. 17 MA patients received 4 weeks of treatment as usual (TAU), and 24 MA patients completed TAU plus daily 30-minute cognitive training (CT) using an N-back working memory task. Magnetic resonance imaging (MRI) at baseline and 4-week follow-up was acquired and voxel-based morphometry (VBM) was used for analysis. RESULTS TAU was associated with larger bilateral striatum (caudate/putamen) volume, whereas CT was associated with more widespread increases of the bilateral basal ganglia (incorporating the amygdala and hippocampus) and reduced bilateral cerebellum volume coinciding with improvements in impulsivity scores. CONCLUSIONS While psychological intervention is associated with larger volume in mesolimbic reward regions, the utilisation of additional working memory training as an adjunct to treatment may further normalize frontostriatal structure and function.
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Affiliation(s)
- S.J. Brooks
- Department of Psychiatry and Mental Health, Groote Schuur Hospital and University of Cape Town, MRC Unit on Anxiety and Stress Disorders, South Africa
| | - K.H. Burch
- Department of Psychiatry and Mental Health, Groote Schuur Hospital and University of Cape Town, MRC Unit on Anxiety and Stress Disorders, South Africa
- Department of Neuroscience, University of Nottingham, UK
| | - S.A. Maiorana
- Department of Psychology, University of Cape Town, South Africa
| | - E. Cocolas
- Department of Psychiatry and Mental Health, Groote Schuur Hospital and University of Cape Town, MRC Unit on Anxiety and Stress Disorders, South Africa
| | - H.B. Schioth
- Department of Neuroscience, Uppsala University, Sweden
| | - E.K. Nilsson
- Department of Neuroscience, Uppsala University, Sweden
| | - K. Kamaloodien
- Department of Psychology, University of the Western Cape, Bellville, Cape Town, South Africa
| | - D.J. Stein
- Department of Psychiatry and Mental Health, Groote Schuur Hospital and University of Cape Town, MRC Unit on Anxiety and Stress Disorders, South Africa
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