Background ED

Question 1

eating disorders =

Answer 1

mental disorders that involve disturbed attitudes towards weight, body shape, and eating. Eating disorders are difficult to treat, and consequences can be serious and even fatal sometimes. Problems include serious physical problems but also feelings of guilt, shame, depression, and loneliness.

Question 2

health problems due to anorexia nervosa

Answer 2

exhaustion, low body temperature, problems with the heart and blood vessels, stomach and intestinal complaints, hormonal inconsistencies causing an absence of menstruation

Question 3

overlap between AN & addiction

Answer 3

• Compulsiveness: compulsive (habitual) eating and sporting behaviors despite negative (health) consequences.
• Functional impairment: impairment in social and occupational areas.
• Withdrawal: negative symptoms (panic, anxiety) when the behavior is not performed, which seems similar to withdrawal in substance addiction.
• Tolerance: an increasing need to lose more weight, which seems similar to tolerance in substance addiction.

Question 4

is food restriction in AN habitual of goal directed?

Answer 4

Food restriction (and other weight-related behaviors) in AN can begin as a goal-directed action aimed at losing weight. However, the more this behavior is repeated, the greater the chance that it will continue as a habit.

Question 5

reinforcement processes that can reinforce maladaptive weight-related behaviours in AN (this reinforcement can make the habits compulsive)

Answer 5

• positive reinforcement: weight loss and experiences of being in control, increased reward sensitivity due to starvation
• negative reinforcement: avoidance of weight gain and consumption of energy-rich foods.
• accelerated habit formation: starvation can lead to stress, which leads to accelerated habit formation
• perfectionism: patients have a tendency towards perfectionism, which makes them apply rigid repetition of dieting and exercising according to strict rules. this can reinforce the stimulus-response associations and result in fast and efficient habit formation

Question 6

executive control impairments in AN, en hoe meet je dit

Answer 6

• set shifting (reduced cognitive flexibility: wisconsin card sorting task)
• decision making (Iowa gambling task)

Question 7

wisconsin card sorting test WCST

Answer 7

• measure cognitive flexibility
• participants need to match cards, without being told how to match them. They are given feedback on whether the match is correct or incorrect after each match. The card sorting rule is changed regularly and unannounced (set shifting).

Question 8

iowa gambling task

Answer 8

• measure decision making
• a task that involves decision making on the basis of positive vs. negative consequences. Participants choose cards from 4 virtual decks and are told that each time they can win or lose some game money. They have to discover which decks are advantageous (in the long-term) and which are not:
• Advantageous: 2 decks that give small gains (€50) but also small occasional penalties (€50).
• Disadvantageous: 2 decks that give large gains (€100) but even larger penalties (€250).

Question 9

wat komt NIET overeen tussen AN en SUD

Answer 9

delay discounting: In contrast with substance abusing patients who show increased delay discounting, AN patients often have a stronger focus on delayed gratification and long-term goals.

Question 10

waar staat het neurowetenschappelijke onderzoek nu over gewoontes in AN?

Answer 10

There is no strong neuroscientific basis that shows an imbalance towards reliance on habits in AN.

Studies do show hyperactivity in the caudate (important for goal-directed control), but this would point to a shift to goal-directed control. More research is needed.

Question 11

schema in schrift zetten van goal directed control towards habitual control

Answer 11

echt doen nog