scholarly journals Learned Industriousness as a Translational Mechanism of Excess Goal Pursuit: An Example in Eating Disorders

2021 ◽  
Author(s):  
Ann Frances Haynos ◽  
Kelsey E. Hagan

Researchers have long grappled to understand the persistence of behaviors that are non-hedonic and, ostensibly, aversive. At times, such behaviors can be taken to excess in the form of psychopathology. Eating disorders characterize a prototype of psychiatric disorders in which behaviors that most people find unpleasant (e.g., restrictive eating, excessive exercise) are rigidly and repeatedly performed. The learned industriousness theory, which has roots in behavioral neuroscience, provides a theoretical account for such phenomena. Informed by humans and animal data, this theory posits that effort (intense physical or mental activity) can be conditioned to acquire secondary rewarding properties through repeatedly pairing high-effort behavior with reward. Over time, effort sensations would become less aversive and more appetitive because they signal impending reward, increasing eagerness to engage in effortful behavior. In this manuscript we: 1) review biobehavioral data supporting learned industriousness; 2) highlight evidence that this theory may account for persistence of certain eating disorder behaviors; and 3) consider clinical and research implications of this model, including the translation to other psychiatric presentations.

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ann F. Haynos ◽  
Lisa M. Anderson ◽  
Autumn J. Askew ◽  
Michelle G. Craske ◽  
Carol B. Peterson

AbstractAccumulating psychobiological data implicate reward disturbances in the persistence of anorexia nervosa (AN). Evidence suggests that individuals with AN demonstrate decision-making deficits similar to those with mood and anxiety disorders that cause them to under-respond to many conventionally rewarding experiences (e.g., eating, interacting socially). In contrast, unlike individuals with other psychiatric disorders, individuals with AN simultaneously over-respond to rewards associated with eating-disorder behaviors (e.g., restrictive eating, exercising). This pattern of reward processing likely perpetuates eating-disorder symptoms, as the rewards derived from eating-disorder behaviors provide temporary relief from the anhedonia associated with limited responsivity to other rewards. Positive Affect Treatment (PAT) is a cognitive-behavioral intervention designed to target reward deficits that contribute to anhedonia in mood and anxiety disorders, including problems with reward anticipation, experiencing, and learning. PAT has been found to promote reward responsivity and clinical improvement in mood and anxiety disorders. This manuscript will: (1) present empirical evidence supporting the promise of PAT as an intervention for AN; (2) highlight nuances in the maintaining processes of AN that necessitate adaptations of PAT for this population; and (3) suggest future directions in research on PAT and other reward-based treatments that aim to enhance clinical outcomes for AN.


Author(s):  
Chris Fairburn ◽  
Rebecca Murphy

This chapter describes the three main eating disorders (anorexia nervosa, bulimia nervosa, and binge eating disorder), together with other similar related states. It explains how they are classified and describes their clinical features, development, and course. It is noted that the eating disorders have many features in common and that people move between them over time. These two observations support adopting a transdiagnostic perspective on these conditions.


2021 ◽  
Vol 43 ◽  
pp. 101562
Author(s):  
Rachael E. Flatt ◽  
Elliott Norman ◽  
Laura M. Thornton ◽  
Ellen E. Fitzsimmons-Craft ◽  
Katherine N. Balantekin ◽  
...  

Author(s):  
Enrico Molinari

Eating disorders represent a field of investigation and intervention of considerable interest for psychology. This is an extraordinarily complex area. When working with these patients, it is crucial to consider a multifactorial etiopathogenetic framework. As anyone who has ever worked with eating disorder will know, the words “challenge” and “body image” have a particularly important role, both in research and clinical practice. appearance. Of all other Eating Disorders, Anorexia Nervosa (AN) will be presented today. Its prevalence ranges between 0,28% and 1%, with a high mortality rate and its onset is related to the presence of a multiplicity of genetic, neurobiological and psychosocial interrelated factors. One fundamental question is: what are the objectives to achieve for each specific individual who show AN symptoms? Treatment should be directed towards as many areas as possible in order to increase the chances of success and ensure the patient’s greater psychophysical well-being. A collaborative work between nutritionists, physicians, psychologists, psychiatrists, patients themselves and their families, could turn the cure into an aesthetic, ethical and political experience. The narration of their own personal experiences is an essential moment in the treatment of patients with eating disorders. Keeping in mind that the restrictive eating behavior, which is typical in AN, seems aimed at avoiding unpleasant emotion and that the real expert of the disorder is always the patient himself, it is essential to build a relationship that promotes change.


Author(s):  
Jason M. Nagata ◽  
Emilio J. Compte ◽  
Stuart B. Murray ◽  
Rebecca Schauer ◽  
Erica Pak ◽  
...  

Abstract Purpose Cisgender bisexual plus (including bisexual, pansexual, and polysexual) women and men experience unique health concerns including eating disorders. The purpose of this study was to develop community norms for eating disorder attitudes and disordered eating behaviors in cisgender bisexual plus women and men using the Eating Disorders Examination Questionnaire (EDE-Q). Methods Participants were cisgender bisexual plus women (n = 462) and men (n = 93) participants in The PRIDE Study, an existing study of sexual and gender minority people. Results Mean and standard deviation of EDE-Q scores among cisgender bisexual plus women and men, respectively, were: Global (1.75 ± 1.26, 1.56 ± 1.18), Restraint (1.34 ± 1.44, 1.42 ± 1.53), Eating Concern (0.96 ± 1.13, 0.63 ± 0.96), Weight Concern 2.27 ± 1.55, 1.89 ± 1.46), and Shape Concern 42 ± 1.62, 2.30 ± 1.57). Among cisgender bisexual plus women and men, respectively, 27.5% and 22.6% scored in the clinically significant range on the Global score. Bisexual plus women and men reported any occurrence (≥ 1/28 days) of dietary restraint (19.3%, 23.7%), objective binge episodes (11.1%, 10.8%), excessive exercise (4.5%, 5.4%), self-induced vomiting (1.7%, 0.0%), and laxative misuse (0.4%, 1.1%), respectively. A lower percentage of age-matched cisgender bisexual plus women (18–25 years) reported any occurrence of objective binge episodes, self-induced vomiting, laxative misuse, and excessive exercise than previously published in young women. Age-matched cisgender bisexual plus men (18–26 years) reported higher weight concern subscale scores than previously published in young men. Conclusions These norms should aid clinicians in applying and interpreting the EDE-Q scores of cisgender bisexual plus women and men. Level of evidence Level V: cross-sectional descriptive study


2017 ◽  
Author(s):  
Patricia Westmoreland ◽  
Phillip S Mehler

Feeding and eating disorders are defined by persistent disturbance of eating (or behaviors related to eating) with subsequent changes in consumption or absorption of nutrition that are detrimental to physical health and social functioning. The following eating disorders are described in the DSM-5: anorexia nervosa, bulimia nervosa, binge eating disorder, pica, rumination disorder, avoidant/restrictive food intake disorder (ARFID), other specified feeding or eating disorder (OSFED), and unspecified feeding or eating disorder (USFED). ARFID, OSFED, USFED, rumination disorder, and binge eating disorder are new additions to the manual and are first described in the DSM-5. The DSM-5 also provides severity specifiers—mild, moderate, severe, and extreme—for the diagnoses of bulimia nervosa and anorexia nervosa. This review describes the eating disorders enumerated in the DSM-5 and provides information regarding their genesis and course. This review contains 8 tables and 79 references Key words: avoidant/restrictive eating disorder, binge eating disorder, DSM-5, eating disorder, other specified feeding or eating disorder, pharmacotherapy, pica rumination, psychotherapy, unspecified feeding or eating disorder


2021 ◽  
Vol 68 (2) ◽  
pp. S52-S53
Author(s):  
Jessica A. Lin ◽  
Sara F. Forman ◽  
Carly Milliren ◽  
Julia Vitagliano ◽  
Rebecca Spigel ◽  
...  

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Stephanie Knatz Peck ◽  
Terra Towne ◽  
Christina E. Wierenga ◽  
Laura Hill ◽  
Ivan Eisler ◽  
...  

Abstract Background Adult eating disorder treatments are hampered by lack of access and limited efficacy. This open-trial study evaluated the acceptability and preliminary efficacy of a novel intervention for adults with eating disorders delivered to young adults and parent-supports in an intensive, multi-family format (Young Adult Temperament-Based Treatment with Supports; YA-TBT-S). Methods 38 YA-TBT-S participants (m age = 19.58; SD 2.13) with anorexia nervosa (AN)-spectrum disorders, bulimia nervosa (BN)-spectrum disorders, and avoidant/restrictive food intake disorder (ARFID) completed self-report assessments at admission, discharge, and 12-month follow-up. Assessments measured program satisfaction, eating disorder psychopathology and impairment, body mass index (BMI), and trait anxiety. Outcomes were analyzed using linear mixed effects models to examine changes in outcome variables over time. Results Treatment was rated as highly satisfactory. 53.33% were in partial or full remission at 12-month follow-up. 56% of participants received other treatment within the 12-month follow-up period, suggesting that YA-TBT-S may be an adjunctive treatment. Participants reported reductions in ED symptomatology (AN and BN), increases in BMI (AN and ARFID), and reductions in clinical impairment (AN and ARFID) at 12-month follow-up. Conclusions YA-TBT-S is a feasible and acceptable adjunctive treatment for young adults with a broad range of ED diagnoses and may be a method for involving parents in ED treatment in ways that are acceptable to both parents and YA. Further evaluation of efficacy is needed in larger samples, and to compare YA-TBT-S to other ED treatment approaches. Plain English summary Eating disorders are costly and dangerous psychiatric disorders that affect millions of individuals each year. Despite their risks and societal costs, currently available treatments are limited. This study examined the acceptability and efficacy of Young Adult, Temperament-Based Treatment with Supports (YA-TBT-S), a new treatment program for adults with eating disorders. YA-TBT-S was rated highly, and a significant portion of participants improved based on ratings collected 12 months after program participation. Those with anorexia nervosa (AN) and bulimia nervosa (BN) showed significant reductions in eating disorder pathology, and those with AN and avoidant/restrictive food intake disorder (ARFID) showed increases in BMI over time.


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