title: Testing the disgust conditioning theory of food-avoidance in adolescents with recent onset anorexia nervosa.
abstract: Anorexia nervosa is characterized by chronic food avoidance that is resistant to change. Disgust conditioning offers one potential unexplored mechanism for explaining this behavioral disturbance because of its specific role in facilitating food avoidance in adaptive situations. A food based reversal learning paradigm was used to study response flexibility in 14 adolescent females with restricting subtype anorexia nervosa (AN-R) and 15 healthy control (HC) participants. Expectancy ratings were coded as a behavioral measure of flexibility and electromyography recordings from the levator labii (disgust), zygomaticus major (pleasure), and corrugator (general negative affect) provided psychophysiological measures of emotion. Response inflexibility was higher for participants with AN-R, as evidenced by lower extinction and updated expectancy ratings during reversal. EMG responses to food stimuli were predictive of both extinction and new learning. Among AN-R patients, disgust specific responses to food were associated with impaired extinction, as were elevated pleasure responses to the cued absence of food. Disgust conditioning appears to influence food learning in acutely ill patients with AN-R and may be maintained by counter-regulatory acquisition of a pleasure response to food avoidance and an aversive response to food presence. Developing strategies to target disgust may improve existing interventions for patients with AN.
authors.affiliation: Departmant of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: tom.hildebrandt@mssm.edu.
authors.forename: Tom
authors.initials: T
authors.lastname: Hildebrandt
authors.affiliation: Departmant of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Grotzinger
authors.affiliation: Departmant of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Marianne
authors.initials: M
authors.lastname: Reddan
authors.affiliation: Departmant of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Greif
authors.affiliation: Department of Neuroscience, Yale University, New Haven, CT, USA.
authors.forename: Ifat
authors.initials: I
authors.lastname: Levy
authors.affiliation: Departmant of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Wayne
authors.initials: W
authors.lastname: Goodman
authors.affiliation: Departmant of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Daniela
authors.initials: D
authors.lastname: Schiller
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology / Q000523:psychology*; D000856:Anorexia Nervosa / Q000503:physiopathology / Q000523:psychology*; D001362:Avoidance Learning / Q000502:physiology*; D016022:Case-Control Studies; D002648:Child; D003213:Conditioning, Psychological / Q000502:physiology*; D004576:Electromyography; D004644:Emotions / Q000502:physiology; D005108:Extinction, Psychological / Q000502:physiology; D005152:Facial Muscles / Q000502:physiology; D005260:Female; D005502:Food; D006801:Humans; D012193:Reversal Learning / Q000502:physiology*; D055815:Young Adult
keywords: Anorexia nervosa; Electromyography; Emotion; Food learning; Reversal learning