Abstract
Dysfunctional social reward and social attention are present in a variety of neuropsychiatric disorders including autism, schizophrenia, and social anxiety. Here we show that similar social reward and attention dysfunction are present in anorexia nervosa (AN), a disorder defined by avoidance of food and extreme weight loss. We measured the implicit reward value of social stimuli for female participants with (n = 11) and without (n = 11) AN using an econometric choice task and also tracked gaze patterns during free viewing of images of female faces and bodies. As predicted, the reward value of viewing bodies varied inversely with observed body weight for women with anorexia but not control women, in contrast with their explicit ratings of attractiveness. Surprisingly, women with AN, unlike control women, did not find female faces rewarding and avoided looking at both the face and eyes – independent of observed body weight. These findings suggest comorbid dysfunction in the neural circuits mediating gustatory and social reward in anorexia nervosa.
Highlights
Eating is a profoundly social experience for humans, and the amount one eats at a meal is modulated by the identity and number of mealtime companions (de Castro and Brewer, 1992; Young et al, 2009)
We found that control and Anorexia nervosa (AN)-WR participants did not differ in their explicit ratings of attractiveness [repeated measures ANOVA, F(1,21) = 1.5, p = 0.238], and that both groups discriminated between the high- and low-attractiveness face image groups in their ratings [F(1, 21) = 313.0, p < 0.001; Figure 1]
Overall AN-WR and control females were remarkably similar in their explicit ratings of attractiveness and showed similar bias in relating attractiveness to body weight
Summary
Eating is a profoundly social experience for humans, and the amount one eats at a meal is modulated by the identity and number of mealtime companions (de Castro and Brewer, 1992; Young et al, 2009). A growing body of clinical evidence suggests that individuals with AN demonstrate impairments in interpersonal behavior as well (Zucker et al, 2007). We hypothesized that these interpersonal impairments are rooted in a fundamental difference in the ways in which individuals with AN process social rewards. Disruptions in social reward processing may comprise part of an endophenotype of AN, analogous to the deficits in social reward and cognition in individuals with autism spectrum disorders (ASD) (Zucker et al, 2007; Rastam, 2008), as well as schizophrenia and social anxiety. Children with autism exhibit more feeding related problems than typically developing children, including restricted food preferences and a significantly higher rate of food refusal (Schreck et al, 2004)
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