Mahr Fauzia, Bunce Scott C, Meyer Roger E, Halmi Katherine A
Psychiatry and Behavioral Health and Pediatrics, Penn State College of Medicine, Hershey, USA.
Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, USA.
Cureus. 2022 Jul 26;14(7):e27304. doi: 10.7759/cureus.27304. eCollection 2022 Jul.
Individuals with anorexia nervosa (AN), restricting type demonstrate unique emotional responses to hedonically positive stimuli beyond eating disorder (ED)-related stimuli. The goal of this study was to evaluate differences in responses to five types of emotionally positive stimuli among acutely ill anorexia nervosa (IAN), restricting type patients, weight-recovered anorexia patients (WRAN), and healthy controls (HCs) using affect modulated startle response (AMSR) as an objective measure.
A total of 28 participants were recruited (n=28). Fourteen participants were recruited as IAN using the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) criteria, seven were WRAN, and seven were HC females. All participants were female and aged between 8 and 18 years. The participants viewed images depicting negative, neutral, standardized, and non-eating disorder (ED)-related positive stimuli. Additionally, four categories of ED-related stimuli (high-calorie food, body image, success, and parent-child relationships) were presented to all participants during a standard AMSR paradigm.
No significant between-group differences were found for any of the four ED stimulus categories; all groups showed an inhibited startle response to the four ED-related categories. In contrast, IAN and WRAN showed reduced hedonic responses to standardized positive stimuli relative to HC-replicating previous results. Reduced hedonic response to the standardized (non-ED) positive stimuli was highly correlated with self-reported social anxiety, low self-esteem, body dissatisfaction, asceticism, interpersonal problems, and ineffectiveness.
AN patients had a reduced hedonic response to some non-ED-related positive stimuli, which correlated with several anxiety-related traits. In contrast, their early automatic responses to high-calorie food, normal weight models, images of success, and positive parent-child relationships did not differ from HC, suggesting these stimuli are either being evaluated as highly interesting or hedonically positive.
神经性厌食症（AN）限制型患者对享乐主义积极刺激表现出独特的情绪反应，这种反应超出了饮食失调（ED）相关刺激的范畴。本研究的目的是使用情感调节惊跳反应（AMSR）作为客观测量指标，评估急性病神经性厌食症（IAN）限制型患者、体重恢复的厌食症患者（WRAN）和健康对照者（HCs）对五种类型的情感积极刺激的反应差异。
共招募了28名参与者（n = 28）。根据《精神疾病诊断与统计手册》第五版（DSM-V）标准招募了14名IAN参与者，7名是WRAN，7名是HC女性。所有参与者均为女性，年龄在8至18岁之间。参与者观看描绘负面、中性、标准化和非饮食失调（ED）相关积极刺激的图像。此外，在标准的AMSR范式中，向所有参与者呈现四类ED相关刺激（高热量食物、身体形象、成功和亲子关系）。
在四类ED刺激类别中，未发现组间有显著差异；所有组对四类ED相关类别均表现出惊跳反应抑制。相比之下，IAN和WRAN相对于HC对标准化积极刺激的享乐反应降低，重复了先前的结果。对标准化（非ED）积极刺激的享乐反应降低与自我报告的社交焦虑、低自尊、身体不满、禁欲主义、人际问题和无效性高度相关。
AN患者对一些非ED相关的积极刺激的享乐反应降低，这与几种焦虑相关特质相关。相比之下，他们对高热量食物、正常体重模型、成功图像和积极亲子关系的早期自动反应与HC没有差异，表明这些刺激要么被评估为非常有趣，要么在享乐主义上是积极的。
