On bells, saliva, and abdominal pain or discomfort: Early aversive visceral conditioning and vulnerability for anorexia nervosa.

The International Journal of Eating Disorders
Nancy L Zucker, Cynthia M Bulik

Abstract

Gastrointestinal (GI) symptoms are common in anorexia nervosa (AN), can predate illness onset, complicate renourishment, and persist after recovery. We explore how, through processes of aversive visceral conditioning, early GI pain and discomfort may increase vulnerability to AN in some individuals. Processes include enhanced preoccupation with the gut resulting from aversive visceral memories and disruptions in the typical acquisition of self-attunement when children learn to map and interpret interoceptive sensations and develop adaptive actions. We question whether a fear of weight gain, in some cases, may be an epiphenomenon of the recapitulation of actual or perceived GI symptoms that is especially relevant during puberty, especially in girls. This conceptualization has immediate clinical implications and offers ideas for future research. We propose that GI discomfort associated with renourishment may reignite prior aversive visceral experiences. We encourage development of a formulation that organizes the individual's current experience of the body with respect to these prior aversive experiences. Our conceptualization underscores the importance of assessment of GI experiences in individuals with AN; the examination of di...Continue Reading

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Citations

Jan 7, 2021·Current Psychiatry Reports·Lisa M AndersonErin E Reilly
Jan 16, 2021·The International Journal of Eating Disorders·Tiffany A BrownChristina E Wierenga
Apr 10, 2021·The International Journal of Eating Disorders·Kara L KerrAmanda Sheffield Morris
Apr 23, 2021·The International Journal of Eating Disorders·Helen Burton MurrayJennifer J Thomas
May 21, 2021·The International Journal of Eating Disorders·Jennifer E WildesMeredith Kells
May 25, 2021·The International Journal of Eating Disorders·Guido K W FrankHelen Burton Murray
Jun 2, 2021·The International Journal of Eating Disorders·Corey R RoosCheri A Levinson
Jun 3, 2021·Children·Lindsay T IvesNancy L Zucker
Sep 19, 2021·The International Journal of Eating Disorders·Leslie Sim, Carol B Peterson

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Anorexia Nervosa

Anorexia nervosa (AN) is a psychiatric condition characterized by severe weight loss and secondary problems associated with malnutrition. Here is the latest research on AN.