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Differential motivational responses to food and pleasurable cues in anorexia and bulimia nervosa: a startle reflex paradigm.

Abstract：

BACKGROUND:Abnormal perceptions of food and shape underpin the cognitive behavioural model of eating disorders (EDs). The aim of this study was to investigate motivational processing of disorder-specific and standard emotional cues in anorexia (AN) and bulimia nervosa (BN) using startle eyeblink modulation (SEM). SEM was used because it is sensitive to motivational states of approach (appetitive response) and withdrawal (aversive response), which are independent of conscious intentional control. METHOD:Acoustically elicited SEM and subjective anxiety ratings were measured in 30 female patients with an ED (n=15 AN, n=15 BN) and 30 female control subjects while they viewed ED-relevant stimuli (food, female bodies) and standardized emotional pictures. RESULTS:BN subjects showed an appetitive response (startle inhibition) to food relative to neutral cues that differed significantly from AN subjects. By contrast, self-reports indicated significantly increased anxiety related to food cues across both ED groups. To female body picture (relative to neutral) cues, no significant between-group differences were found for SEM. ED subjects unexpectedly showed an aversive response (startle potentiation) to positive cues, in contrast to controls, who showed the established startle attenuation. CONCLUSIONS:These preliminary results suggest that BN patients demonstrated an exaggerated appetitive response to food but not to standardized positive cues, whereas SEM in AN patients points to a generalized failure to activate the appetitive motivational system. Differences in motivational salience to food cues are in line with distinctions between AN and BN in eating behaviour and food consumption and support differential treatment requirements.

journal_name

Psychol Med

journal_title

Psychological medicine

authors

Friederich HC,Kumari V,Uher R,Riga M,Schmidt U,Campbell IC,Herzog W,Treasure J

doi

10.1017/S0033291706008129

subject

Has Abstract

pub_date

2006-09-01 00:00:00

pages

1327-35

issue

eissn

0033-2917

issn

1469-8978

pii

S0033291706008129

journal_volume

pub_type

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Differential motivational responses to food and pleasurable cues in anorexia and bulimia nervosa: a startle reflex paradigm.