Sternheim Lot C, Wickham Miriam I, Danner Unna N, Maddox Todd W, Filoteo Vincent J, Shott Megan E, Frank Guido K W
Department of Clinical Psychology, Universiteit Utrecht, Heidelberglaan 1, 3508, TC, Utrecht, The Netherlands.
, Utrecht, The Netherlands.
J Eat Disord. 2021 Jun 29;9(1):77. doi: 10.1186/s40337-021-00431-7.
Cognitive disturbances such as impairments in learning are thought to play a role in adult Anorexia Nervosa (AN). It is remains unclear to what extent these disturbances result from starvation of the brain, or relate to an abnormal premorbid cognitive profile. This study investigates learning processes in adolescents with AN, hypothesizing that implicit learning is intact, as found previously in explicit learning tasks. Secondly, we hypothesized that anxiety and depression symptoms, inherent to AN, are associated to learning processes in AN.
In total 46 adolescents diagnosed with AN and 44 control participants were administered an implicit category learning task in which they were asked to categorize simple perceptual stimuli (Gabor patches) based on a linear integration (i.e., an implicit task) of orientation and spatial frequency of the stimulus. A subgroup of adolescents (n = 38) also completed a task assessing explicit learning.
Model-based analyses indicated that adolescents with AN performed significantly more accurately compared to their healthy peers regardless of whether they used the optimal strategy or not. Depression and anxiety did not relate to learning performance in the AN group.
Overall, our findings of augmented implicit and explicit learning in adolescents with AN corroborate recent studies that suggested higher stimulus-response learning during prediction error paradigms. Learning disturbances in adult AN may then be at least partly due to long-term malnourishment, highlighting the importance of early recognition and refeeding in treatments for AN.
认知障碍，如学习能力受损，被认为在成人神经性厌食症（AN）中起作用。目前尚不清楚这些障碍在多大程度上是由大脑饥饿导致的，或者与病前异常的认知特征有关。本研究调查了青少年神经性厌食症患者的学习过程，假设内隐学习是完整的，这与之前在明确学习任务中的发现一致。其次，我们假设神经性厌食症所固有的焦虑和抑郁症状与神经性厌食症的学习过程有关。
总共46名被诊断为神经性厌食症的青少年和44名对照参与者接受了一项内隐类别学习任务，要求他们根据刺激的方向和空间频率的线性整合（即一项内隐任务）对简单的感知刺激（加博尔斑）进行分类。一部分青少年（n = 38）还完成了一项评估明确学习的任务。
基于模型的分析表明，无论是否使用最佳策略，患有神经性厌食症的青少年的表现都比健康同龄人更准确。抑郁和焦虑与神经性厌食症组的学习表现无关。
总体而言，我们在青少年神经性厌食症患者中发现增强的内隐和外显学习，这证实了最近的研究，即在预测误差范式中存在更高的刺激 - 反应学习。成人神经性厌食症中的学习障碍可能至少部分归因于长期营养不良，这突出了早期识别和重新喂养在神经性厌食症治疗中的重要性。
