A reward-centred model of anorexia nervosa: a focussed narrative review of the neurological and psychophysiological literature

Neuroscience and Biobehavioral Reviews
Caitlin B O'HaraU Schmidt

Abstract

This focussed narrative review examines neurobiological and psychophysiological evidence supporting a role for altered reward processes in the development and maintenance of anorexia nervosa (AN). In AN, there does not appear to be a generalised inability to experience reward. Rather, data suggest that a reluctance to gain weight leads to an aversive appraisal of food- and taste-related stimuli. As a result, cues compatible with this aberrant mode of thinking become rewarding for the individual. Evidence also suggests that attribution of motivational salience to such cues promotes anorectic behaviours. These findings are consistent with models in which interactions between cognition and reward are important in eliciting the anorectic "habit". A model is proposed which is consistent with elements of other theoretical frameworks, but differs in that its emphasis is towards neural overlaps between AN and addiction. It is consistent with AN being a reward-based learned behaviour in which aberrant cognitions related to eating and shape alter functioning of central reward systems. It proposes that the primary neural problem responsible for the development, maintenance, and treatment resistance is centred in the striatal reward system...Continue Reading

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Citations

Nov 6, 2015·European Eating Disorders Review : the Journal of the Eating Disorders Association·Jessica McClellandUlrike Schmidt
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Dec 18, 2019·European Eating Disorders Review : the Journal of the Eating Disorders Association·Emilia KotPalmiero Monteleone
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Aug 18, 2017·Current Opinion in Psychiatry·Bethan DaltonUlrike Schmidt
Dec 17, 2019·The International Journal of Eating Disorders·Katrin E GielKathrin Schag

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