Abstract
BackgroundDecision-making is reported to be impaired in anorexia nervosa (AN) and bulimia nervosa (BN), but the influence of mood status, pathophysiological eating, and weight concerns on the performance of decision-making ability between AN and BN is still unclear. The aims of this study were to investigate differential impairments in the decision-making process between AN, BN, and healthy controls (HC), and secondly, to explore the role of mood status, such as anxiety, depression, pathological eating, and weight concerns, in decision-making ability.MethodsPatients suffering from AN (n = 22), BN (n = 36) and age-matched HC (n = 51) were assessed for their decision-making abilities using the Iowa Gambling Task (IGT). Self-reported questionnaires including the Eating Disorder Examination Questionnaire (EDE-Q), the Bulimia Investigatory Test, Edinburgh (BITE), the Eating Disorders Inventory, the Maudsley Obsessive-Compulsive Inventory measuring obsessive-compulsive traits, the Hospital Anxiety and Depression Scale, and the Toronto Alexithymia Scale were used to assess pathological eating concerns and attitude to feelings.ResultsSignificant differences in IGT performance were observed between BN and HC. Significant negative correlation was found between IGT performance and the BITE symptom subscale in AN. In BN, there was a negative correlation between the EDE-Q weight concerns subscale and IGT performance. It was also found that increased anxiety, depression, and eating/weight concerns predicted poorer decision-making.ConclusionDifferent patterns of association between pathological eating concerns/behaviors and performances in decision-making ability were found between AN, BN, and HC. Anxiety, depressive mood status, and eating/weight concerns were related to decision-making ability.
Highlights
Decision-making is reported to be impaired in anorexia nervosa (AN) and bulimia nervosa (BN), but the influence of mood status, pathophysiological eating, and weight concerns on the performance of decision-making ability between AN and BN is still unclear
Significant differences were obtained for body mass index (BMI) and clinical self-report measures (TAS-20, Eating Disorder Examination Questionnaire (EDE-Q), Hospital Anxiety and Depression Scale (HADS), BITE, Maudsley Obsessive-Compulsive Inventory (MOCI), and Eating Disorders Inventory-2 (EDI-2))
Post hoc t tests revealed that AN and/or BN differed from healthy controls (HC) for most of the dimensional assessments, while no significant differences were found with respect to the overall questionnaires between AN and BN
Summary
Decision-making is reported to be impaired in anorexia nervosa (AN) and bulimia nervosa (BN), but the influence of mood status, pathophysiological eating, and weight concerns on the performance of decision-making ability between AN and BN is still unclear. Decision-making is affected by the combination of emotional representations, sensitivity to immediate reward and long-term outcome according to the somatic marker hypothesis (SMH) [3,4,5]. Multiple cognitive functions such as attention, memory, learning [6,7], risk-taking, and obsessive-compulsive traits [8] have been suggested as being involved in performances in decision-making [9,10]. It is unclear whether the AN and BN groups have different deficits in emotional skills during decision-making
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