Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA.
J Psychiatr Res. 2024 Jul;175:29-33. doi: 10.1016/j.jpsychires.2024.04.042. Epub 2024 Apr 23.
Dysfunctions in reward and/or habit formation have been proposed as factors contributing individually to the maintenance of restrictive eating and nonsuicidal self-injury (NSSI). However, despite the high comorbidity between these behaviors, the associations between reward and habit formation in their co-occurrence remains unclear. This study examined self-reported reward responsivity and habit strength among individuals with co-occurring restrictive eating and NSSI (Comorbid group; n = 108) and those with one behavior only (One-behavior group; n = 113). Hierarchical logistic regression analyses assessed the association between reward and habit features and the co-occurrence of restrictive eating and NSSI, accounting for the effects of impulsivity (a characteristic commonly considered to underlie co-occurring disordered eating and NSSI). Partial correlations examined the relationships between these features and the severity of eating disorder and NSSI symptoms, also controlling for impulsivity. Lower reward responsivity was associated with the co-occurrence of restrictive eating and NSSI, even after accounting for impulsivity (p = 0.017). In exploratory analyses, this relationship was no longer significant after accounting for self-reported depression. No significant associations were found regarding habit formation and restrictive eating and NSSI co-occurrence. Lower reward responsivity was linked to increased NSSI frequency and versatility in both groups and associated with severity of eating pathology in the Comorbid group (ps < 0.05). Our findings suggest that blunted reward responsivity may relate to the co-occurrence of restrictive eating, NSSI, and depressive symptoms, as well as the severity of restrictive eating and NSSI. Reward disturbances may serve as a crucial target in the treatment of multiple self-destructive behaviors.
奖赏和/或习惯形成功能障碍被认为是导致限制饮食和非自杀性自我伤害（NSSI）持续存在的因素。然而，尽管这些行为存在高度共病性，但它们在共病时的奖赏和习惯形成之间的关联仍不清楚。本研究调查了同时存在限制饮食和 NSSI 的个体（共病组；n=108）和仅存在一种行为的个体（单一行为组；n=113）的自我报告奖赏反应性和习惯强度。分层逻辑回归分析评估了奖赏和习惯特征与限制饮食和 NSSI 共病之间的关联，同时考虑了冲动性的影响（冲动性通常被认为是导致共病性饮食障碍和 NSSI 的原因）。偏相关分析考察了这些特征与饮食障碍和 NSSI 症状严重程度之间的关系，同时也控制了冲动性。即使在考虑了冲动性之后，较低的奖赏反应性与限制饮食和 NSSI 的共病相关（p=0.017）。在探索性分析中，在考虑了自我报告的抑郁后，这种关系不再显著。关于习惯形成和限制饮食与 NSSI 共病，没有发现显著的关联。较低的奖赏反应性与两组 NSSI 频率和多样性的增加有关，并且与共病组饮食病理学的严重程度有关（p<0.05）。我们的研究结果表明，奖赏反应迟钝可能与限制饮食、NSSI 和抑郁症状的共病以及限制饮食和 NSSI 的严重程度有关。奖赏障碍可能是治疗多种自我伤害行为的关键靶点。
