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Altered learning from positive feedback in adolescents with anorexia nervosa

Published online by Cambridge University Press:  18 September 2024

Blair Uniacke Open the ORCID record for Blair Uniacke [Opens in a new window] ,
Wouter van den Bos ,
Joseph Wonderlich ,
Jessica Ojeda ,
Jonathan Posner ,
Joanna E. Steinglass  and
Karin Foerde
Blair Uniacke*
Affiliation:
Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
Wouter van den Bos
Affiliation:
Department of Psychology – Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands Max Planck Institute for Human Development, Center for Adaptive Rationality, Berlin, Germany
Joseph Wonderlich
Affiliation:
Sanford Center for Biobehavioral Research, Sanford Health, Fargo, ND, USA
Jessica Ojeda
Affiliation:
Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
Jonathan Posner
Affiliation:
Department of Psychiatry, Duke University, Durham, NC, USA
Joanna E. Steinglass
Affiliation:
Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA
Karin Foerde
Affiliation:
Department of Psychology – Brain & Cognition, University of Amsterdam, Amsterdam, Netherlands
*
Corresponding author: Blair Uniacke; Email: blair.uniacke@nyspi.columbia.edu
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Abstract

Objective:

Anorexia nervosa (AN) is characterized by severe restriction of calorie intake, which persists despite serious medical and psychological sequelae of starvation. Several prior studies have identified impaired feedback learning among individuals with AN, but whether it reflects a disturbance in learning from positive feedback (i.e., reward), negative feedback (i.e., punishment), or both, and the extent to which this impairment is related to severity and duration of illness, has not been clarified.

Method:

Participants were female adolescents with AN (n = 76) and healthy teen volunteers (HC; n = 38) between the ages of 12–18 years who completed a probabilistic reinforcement learning task. A Bayesian reinforcement learning model was used to calculate separate learning rates for positive and negative feedback. Exploratory analyses examined associations between feedback learning and duration of illness, eating disorder severity, and self/parent reports of reward and punishment sensitivity.

Results:

Adolescents with AN had a significantly lower rate of learning from positive feedback relative to HC. Patients and HC did not differ in learning from negative feedback or on overall task performance measures. Feedback learning parameters were not significantly associated with duration of illness, eating disorder severity, or questionnaire-based reports of reward and punishment sensitivity.

Conclusion:

Adolescents with AN showed a circumscribed deficit in learning from reward that was not associated with duration of illness or reported sensitivity to reward or punishment. Subsequent longitudinal research should explore whether differences in learning from positive feedback relate to course of illness in youth with AN.

Keywords

Adolescent developmentanorexia nervosacognitiondecision-makingeating disordersreward
Type
Research Article
Information
Journal of the International Neuropsychological Society , First View , pp. 1 - 9
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of International Neuropsychological Society

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