Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study

Background Stimulant laxative abuse as a purging behavior can be profound in those with eating disorders. However, the psychopathology leading to stimulant laxative abuse is poorly understood. Furthermore, the medical impact of stimulant laxative abuse has not been studied in this population. Methods Six individuals abusing stimulant laxatives underwent a barium enema to assess for evidence of the cathartic colon syndrome and 29 individuals engaging in any purging behaviors completed the Tri-dimensional Personality Questionnaire-Short Form, Sensitivity to Punishment/Sensitivity to Reward Questionnaire-Short Form, Beck Depression Inventory, and the State Trait Anxiety Inventory questionnaires. Results Three of the six patients completing the barium enema had the radiographic findings consistent with cathartic colon. Individuals engaging in laxative abuse showed higher Novelty Seeking compared to those engaging in other forms of purging, and those engaging in any form of purging behavior showed greater Sensitivity to Punishment compared to Sensitivity to Reward. There was also the presence of greater Harm Avoidance than Reward Dependence in this population. Conclusion There may be different psychopathology that contributes to the abuse of stimulant laxatives than that associated with other forms of purging. Regardless of the driving factor, further research is warranted to discover best therapeutic interventions given the potential to develop the cathartic colon syndrome with ongoing use of stimulant laxatives. Plain English Summary Cathartic colon is a condition whereby the colon, or lower intestine, is converted into an inert tube incapable of propagating fecal matter. It is thought to develop due to over-use of stimulant laxatives. However, it is unclear if this condition truly exists and whether it contributes to the constipation experienced by individuals with eating disorders who have extensive past histories of abusing laxatives. It is also unclear if laxative abuse presents with different medical complications than other forms of purging. The purpose of this study is to determine whether radiographic evidence of cathartic colon can be found in eating disorder patients abusing stimulant laxatives, whether there are different medical complications with laxative abuse versus other forms of purging, and to examine the psychological composition of individuals who engage in severe laxative abuse. Specifically, the authors investigated the interrelationship between Harm Avoidance and Reward Dependence, with emphasis on gaining a better understanding of Reward Dependence by examining both Sensitivity to Reward and Sensitivity to Punishment in patients who engage in severe laxative abuse. Our findings suggest that stimulant laxative abuse may cause the development of cathartic colon changes and that there may be unique psychopathology that contributes to the abuse of stimulant laxatives. Given the higher Novelty Seeking personality-dimension in those abusing laxatives, it is possible that this purging behavior may be considered addiction-like in nature, which would have distinct treatment implications.

Are Sensitivity to Punishment, Sensitivity to Reward and Effortful Control Transdiagnostic Mechanisms Underlying the Eating Disorder/Obesity Spectrum?

Although it has been postulated that eating disorders (EDs) and obesity form part of a broad spectrum of eating- and weight-related disorders, this has not yet been tested empirically. In the present study, we investigated interindividual differences in sensitivity to punishment, sensitivity to reward, and effortful control along the ED/obesity spectrum in women. We used data on 286 patients with eating disorders (44.6% AN-R, 24.12% AN-BP, and 31.82% BN), 126 healthy controls, and 640 Class II/III obese bariatric patients (32.81% Class II and 67.19% Class III) with and without binge eating. Participants completed the behavioral inhibition and behavioral activation scales, as well as the effortful control scale, to assess sensitivity to punishment and reward and effortful control. Results showed that patients with EDs scored significantly higher on punishment sensitivity (anxiety) compared to healthy controls and Class II/III obese patients; the different groups did not differ significantly on reward sensitivity. Patients with binge eating or compensatory behaviors scored significantly lower on effortful control than patients without binge eating. Differences in temperamental profiles along the ED/obesity spectrum appear continuous and gradual rather than categorical. This implies that it may be meaningful to include emotion regulation and impulse regulation training in the treatment of both EDs and obesity.

Sensorimotor feedback loops are selectively sensitive to reward

While it is well established that motivational factors such as earning more money for performing well improve motor performance, how the motor system implements this improvement remains unclear. For instance, feedback-based control, which uses sensory feedback from the body to correct for errors in movement, improves with greater reward. But feedback control encompasses many feedback loops with diverse characteristics such as the brain regions involved and their response time. Which specific loops drive these performance improvements with reward is unknown, even though their diversity makes it unlikely that they are contributing uniformly. This lack of mechanistic insight leads to practical limitations in applications using reward, such as clinical rehabilitation, athletic coaching, and brain-inspired robotics. We systematically tested the effect of reward on the latency (how long for a corrective response to arise?) and gain (how large is the corrective response?) of eight distinct sensorimotor feedback loops in humans. Only the feedback responses known to rely on prefrontal associative cortices showed sensitivity to reward, while feedback responses that relied mainly on premotor and sensorimotor cortex did not show sensitivity to reward. Our results may have implications regarding feedback control performance in pathologies showing a cognitive decline, or on athletic coaching. For instance, coaching methodologies that rely on reinforcement or "reward shaping" may need to specifically target aspects of movement that rely on reward-sensitive feedback responses.

Long-Term Profiles of Bullying Victims and Aggressors: A Retrospective Study

Bullying is a widespread and worrying phenomenon, related to many different personal, behavioral, and social variables which can modulate it and its outcomes, also in the long term. These relationships are usually studied in children and adolescents, but less often in adults who have suffered or perpetrated bullying in the past. The present work explored the long-term characteristics of bullying victims and aggressors using a retrospective design. A sample of 138 adults of different ages completed an on-line protocol that included measures of bullying and victimization, substance use, sensitivity to reward and punishment, social skills, antisocial behavior, emotional regulation strategies, depression, anxiety, stress, self-esteem, and risk of suicide. The sample was divided into three groups (victims, aggressors, and controls) based on their responses to bullying-related questions. A set of Multiple Analyses of Variance with group as a fixed factor was carried out for each dependent variable. Victims and aggressors did not significantly differ in their self-reported substance consumption. Victims showed higher global depression, anxiety and stress in the past than aggressors (M = 34.66, SD = 11.74; aggressors: M = 19.70, SD = 16.53), higher emotional lack of control (M = 23.97, SD = 10.62; controls: M = 17.11, SD = 7.95) and rejection (M = 21.72, SD = 7.24; controls: M = 16.33, SD = 5.67), lower self-esteem (M = 27.72, SD = 6.70; controls: M = 31.60, SD = 6.60), and a larger frequency of suicidal thoughts (in the past) than controls. Aggressors showed higher sensitivity to reward (M = 12.03, SD = 3.66; controls: M = 8.42, SD = 3.92), larger communicational and relational skills (M = 22.10, SD = 7.20; controls: M = 17.96, SD = 7.16), and lower emotional sensitivity (M = 14.80, SD = 4.10; controls: M = 16.76, SD = 2.21). Accordingly, the logistic regression analysis identified sensitivity to reward and low psychological adjustment as the main predictors of the aggressor and victim profiles, respectively. The present results are discussed considering the extant literature on bullying and may help to improve prevention programs for this relevant social scourge.

Comparison of the Effectiveness of Motivational Manipulation and Neurofeedback Methods on Sensitivity to Reward, Delay Discounting and Impulsivity in Children with Attention Deficit / Hyperactivity Disorder

Purpose; The aim of this study was to comparison of the effectiveness of two methods of motivational manipulation and neurofeedback on sensitivity to reward, delay discounting and impulsivity in children with attention deficit / hyperactivity disorder. Methods; The present study was an experimental study with pre-test, post-test, follow-up and control group. The study population consisted of children aged 7 to 12 years with ADHD. Available sampling method was used for sampling in this study. Sample size was selected based on the purpose and method of research (in experimental research, the sample size of at least 30 people in each group is recommended) 90 people. In this study, neurofeedback and motivational manipulation were performed on the intervention group as an intervention, each session was performed for 12 sessions and each session was performed for 45 minutes. Balloon risk test and delay discounting test were used to collect data in pre-test, post-test and follow-up stages and the data were analyzed using MANCOVA statistical method in SPSS-23. Results; By controlling the effects of pretest on posttest, the difference between the groups in the posttest was statistically significant between the variables of impulsivity and delay at the level of P <0.01 and between the variables of reward sensitivity at the level of P <0.05. The results also showed that neurofeedback method (M = 4.66) had a greater effect on reward processing than motivational manipulation method (M = 2.31) compared to the control group, which was significant at the level of P <0.01. But the difference between the mean of motivational manipulation (M = 2.31) in comparison with the control group was not significant. Conclusion; Voluntary activation of dopaminergic regions of the brain by neurofeedback and motivational manipulation leads to endogenous dopamine control in these structures, leading to successful regulation or inhibitory control and reduced cravings, which reduces impulsivity, delay discounting, and sensitivity to reward.

The Comparison of Sensitivity to Reward and Punishment, Response Inhibition and Sustained Attention in Children with ADHD and SCT: Distinct Contribution of ADHD and SCT to Attention Problems Based on Cold and Hot Executive Circuits

Objectives: Recent studies have identified a disorder called Sluggish Cognitive Tempo (SCT) that has similarities with attention deficit / hyperactivity disorder (ADHD) in attention problems and often mistakenly labeled as ADHD. Attention problems also cause malfunctions in executive functions, often involving the hot circuit and the cold circuit. The purpose of this study was to compare the sensitivity to reward and punishment, response inhibition and sustained attention in children with ADHD and SCT. Methods: The design of the present study was in the frame of Casual Comparative. Participants comprised 100 boys (50 ADHD and 50 SCT) from elem entary schools in Tabriz in 1398-1399 academic years, which were selected through a screening method using the Child Behavior Rating Scale (SNAP-IV) and the SCT scale. Then, balloon analogue risk task (BART) was used to measure the sensitivity to reward and punishment and the continuous performance test was used to measure response inhibition and sustained attention. For data analysis Manova and SPSS 20 were used. Results: The results showed that children with ADHD had higher scores in sensitivity to reward and children with SCT had higher scores in sensitivity to punishment. Moreover, children with ADHD have deficits in response inhibition and children with SCT have deficits in sustained attention (P<0.0001). Conclusion: Based on the research Background and the findings of this study, it seems that children with SCT have deficits in hot executive circuit and children with ADHD have trouble in cold executive circuit.

Sex differences in neural responses to reward and the influences of individual reward and punishment sensitivity

Background Men and women show differences in sensitivity to reward and punishment, which may impact behavior in health and disease. However, the neural bases of these sex differences remain under-investigated. Here, by combining functional magnetic resonance imaging (fMRI) and a variant of the Monetary Incentive Delay Task (MIDT), we examined sex differences in the neural responses to wins and losses and how individual reward and punishment sensitivity modulates these regional activities. Methods Thirty-sex men and 27 women participated in the fMRI study. We assessed sensitivity to punishment (SP) and sensitivity to reward (SR) with the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ). In the MIDT, participants pressed a button to collect reward ($1, 1¢, or nil), with the reaction time window titrated across trials so participants achieved a success rate of approximately 67%. We processed the Imaging data with published routines and evaluated the results with a corrected threshold. Results Women showed higher SP score than men and men showed higher SR score than women. Men relative to women showed higher response to the receipt of dollar or cent reward in bilateral orbitofrontal and visual cortex. Men as compared to women also showed higher response to dollar loss in bilateral orbitofrontal cortex. Further, in whole-brain regressions, women relative to men demonstrated more significant modulation by SP in the neural responses to wins and larger wins, and the sex differences were confirmed by slope tests. Conclusions Together, men showed higher SR and neural sensitivity to both wins, large or small, and losses than women. Individual differences in SP were associated with diminished neural responses to wins and larger wins in women only. These findings highlight how men and women may differ in reward-related brain activations in the MIDT and add to the imaging literature of sex differences in cognitive and affective functions.

Predictors of positive and negative risk-taking in adolescents and young adults: Similarities and differences

Although the risk-taking can potentially result in positive and negative outcomes, most of the researchers focused on its negative, not positive manifestations. Recently, Duell and Steinberg proposed a framework that clarifies the features of positive risk-taking. Research comparing positive and negative risk-taking increased and new measures have been developed. The presented study was designed to examine how the construct of positive risk-taking differs or overlaps with its opposite, negative risk-taking, and whether both are predicted by the same or different factors. Two hundred fifty eight (258) adolescents and young adults (aged 16-29) participated in the study. We tested self-reported sensitivity to reward and punishment, self-control, tolerance to ambiguity, trait anxiety, and gender as possible predictors of positive and negative risk-taking. We also referred both types of risk-taking to domain-specific risk-taking. We found that positive risk-taking is driven by sensitivity to reward and tolerance to ambiguity, and occurs especially in the social domain. Negative risk-taking is driven by gender, sensitivity to reward and (low) sensitivity to punishment, and occurs in all domains except social. Results indicate that positive risk-taking is chosen for exploration and personal growth by people who look for rewards in the social world and is done in a socially accepted way. Negative risk-taking is chosen by people who are not discouraged by severe negative effects and look for rewards outside existing norms.