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reward dysfunction
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Plan for RCD essayTitle
Introduction:
What are eating disorders?
Summary of neurobiology
Reward dysfunction heavily implicated amongst other factors
In this essay we will…….
Neurobiology:
- Dopamine and brain regions paragraphs
Reward dysfunction:
Although Reward dysfunction is implicated in EDs there are other factors
Impulsivity
Habit formation
Cognitive control
Stress reactivity
interoceptive awareness and alexithymia
Increased harm avoidance and perfectionism
Conclusion
PY3RCD Notes for exam:
What do we know about the neurobiology of eating disorders and
is it all about reward?
Introduction:
Eating disorders (EDs) are characterised by disordered eating patterns. Two common types of
eating disorders are anorexia nervosa (AN) and bulimia nervosa (BN). Eating disorders cause
a considerable amount of distress, and can lead to physical implications. Anorexia nervosa is
the most fatal psychiatric illness. (BEAT, 2017). Through assessing reward dysfunction in
eating disorders, we can identify the neurological processes which are implicated in these
disorders, which will enable us to develop more effective treatment plans.
https://www.cell.com/trends/neurosciences/fulltext/S0166-2236(13)00006-4?
_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii
%2FS0166223613000064%3Fshowall%3Dtrue
AN high rates of mortality
, REWARD DYSFUNCTION:
Harrison et al, (2010) conducted a review into reward and punishment in eating disorders.
They looked at 25 studies, and the participants in the studies had AN and BN, restrictive AN
(RAN), binge/purge type AN (BPAN) and recovered AN. They were mostly between 20-30
years old. A range of measures was used (BIS/BAS, TPQ and TCI) to obtain self-report data,
and the questionnaires measure different constructs of reward. Most studies used an
experimental eating disorder group and a control group, with no psychiatric illness. Harrison
et al, (2010) found that people with AN were less sensitive to rewarding stimuli than healthy
controls. Whereas, people with either mixed type AN and BN or BN only, had higher
novelty-seeking behaviour, and were more stimulated by reward. Harrison et al, (2010) stated
that the data from the questionnaires could act as a very reliable way to understand BN. The
BIS/BAS assesses reward sensitivity and TCI/TPQ measures impulsivity responding. Thus,
showing the underlying pattern which is displayed in BN, the motivation to binge which has
temporarily rewarding and pleasurable affects. As well as the impulsive act of binging on
food.
Limitations:
• Most studies featured a higher number of participants in the control groups.
• The study relied on self-report measures to obtain their data, however, the results may have
been impacted by socially desirable responding
However, due to socially desirable responding (SDR) this may impact on the data, as some
participants may respond inaccurately.
• A small number of studies including recovered patient groups. The review fails on
identifying if reward sensitivity is a cause of EDs of a neurological 'scar' from the illness.
Wieringa et al, (2015) investigated the brain response to reward in participants with AN
during hunger and satiated states. Hunger tends to enhance reward in the brain. However in
people with AN they appear to lack the motivation to eat when hungry. Therefore, by
assessing reward, this may increase the understanding of the underlying mechanisms present
in those with AN. 23 women in remission from AN and 17 women in the control group
completed a delayed discounting monetary task. Whilst in an fMRI scanner. The findings
suggest that participants in the control group had increased activation in neural reward
circuitry when hungry, and increased activation in neural cognitive control circuitry, when
satiated. However, the brain response did not differ during hunger and satiated states in the
AN group. This suggests that people with AN may have a reduced motivational response to
reward and a raised cognitive control ability. This could explain why people with AN are able
to resist food for a long period of time, because they are both less able to experience the
pleasurable effects of reward (food) and have an elevated ability to 'control' themselves.
There is also evidence of altered brain and neurotransmitter function in participants with AN.
Limitations:
• Small sample size was obtained, meaning that generalising these findings to the population,
should be made with caution.
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