Excessive Avoidance Behaviors in Anorexia Nervosa: the Role of Reward

Bram Vervliet

Status: Unknown

Conditions: Eating Disorders; Anorexia Nervosa; Anxiety

Treatments: Behavioral: Behavioral avoidance task

Study type: Observational

Funder types: Other

Identifiers

NCT04405440

S62060

Details and patient eligibility

About

This study investigates excessive avoidance behaviors in patients with a diagnosis of Anorexia Nervosa (AN) compared to a healthy control group. The study further examines the role of reward (relief) as a putative factor in maintaining excessive avoidance behaviors in AN.

Full description

Anorexia Nervosa (AN) is a life-threatening mental disease with a disappointing treatment outcome. Fear of weight gain and diet restrictions are considered the core symptoms of AN. Although from a diagnostic perspective AN is conceptualized as an eating-related disorder connected to an extremely low Body Mass Index (BMI) and body image distortion, AN might represent a specific phenotype of anxiety disorders characterized by tenacious avoidance behaviors, especially the restrictive subtype. To date, avoidance in AN is often investigated as a general personality trait (e.g. harm avoidance) but poorly examined in its behavioral form (which is life-threatening, such as food-avoidance). Hence, the investigators will perform a systematic investigation of excessive avoidance behaviors within a laboratory setting. Within a learning perspective, the investigators will investigate excessive avoidance in a group of 30 AN patients and 30 healthy volunteers. To achieve this, a well-validated avoidance paradigm will be used. Most critically, the investigators will examine whether patients with a diagnosis of anorexia nervosa show persistent avoidance behaviors compared to a control group. Additionally, the investigators will examine if, in the anorexia group, higher subjective relief to successful omissions of negative events during avoidance learning predicts persistent (excessive) avoidance behaviors after fear extinction.

Enrollment: 100 estimated patients

Sex: All

Ages: 18 to 40 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• For the AN group, patients need to be physically strong and sufficiently emotionally stable
• For the healthy group, the investigators will recruit participants without a previous or current history of psychiatric, cardiovascular, neurological or other relevant disorder

Exclusion criteria

• For the AN group, the investigators will exclude patients who are insufficiently emotionally stable and/or physically weak to participate in the study as estimated by the treating physicians of the units on which the patients are admitted
• Insufficient verbal skills to understand the questionnaires and the computer task
• Participants who are pregnant or breastfeeding

Trial design

100 participants in 2 patient groups

Healthy controls

Description:

The healthy control group will perform a well-validated avoidance (behavioral) task and will fill in some questionnaires about eating behaviors, emotions, and feelings.

Treatment:

Behavioral: Behavioral avoidance task

Anorexia Nervosa patients

Description:

As the healthy controls, the participants of the anorexia nervosa group will perform the same behavioral task and will fill in the same questionnaires

Treatment:

Behavioral: Behavioral avoidance task