title: Implicit learning on a probabilistic classification task in adults and adolescents with Bulimia Nervosa.
abstract: BACKGROUND
  Dysfunction in frontostriatal circuits likely contributes to impaired regulatory control in Bulimia Nervosa (BN), resulting in binge-eating and purging behaviors that resemble maladaptive habits. Less is known about the implicit learning processes of these circuits, which may contribute to habit formation.
  
  
  METHODS
  We compared 52 adolescent and adult females with BN to 55 healthy matched-controls during performance of a probabilistic classification learning task, one form of implicit learning. Groups were compared in accuracy and response times, using mixed-models with block, age, and diagnosis as predictors, corrected for multiple comparisons with confounds covaried.
  
  
  RESULTS
  BN participants showed differences in performance on a probabilistic classification learning task that varied by age. Adolescents with BN initially performed as accurately as healthy adolescents, but showed poorer perseverance over time. Adults with BN initially performed less accurately than healthy adults, but improved to perform equivalently. Symptom severity was associated with poorer accuracy in both adults and adolescents with BN.
  
  
  CONCLUSIONS
  Frontostriatal dysfunction may underlie abnormalities in regulatory control and probabilistic classification learning in BN, likely contributing to the dysregulation of implicitly learned, maladaptive binge-eating and purging behaviors. Such dysfunction in BN may progress with increasing age, first manifesting in poor regulatory control over behaviors and then expanding to implicit learning processes that may underlie habitual behaviors.
authors.affiliation: Division of Child and Adolescent Psychiatry in the Department of Psychiatry, New York State Psychiatric Institute and the Columbia University College of Physicians & Surgeons, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA. Electronic address: labouli@nyspi.columbia.edu.
authors.forename: Christa D
authors.initials: CD
authors.lastname: Labouliere
authors.affiliation: Division of Child and Adolescent Psychiatry in the Department of Psychiatry, New York State Psychiatric Institute and the Columbia University College of Physicians & Surgeons, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Terranova
authors.affiliation: Eating Disorders Research Unit in the Department of Psychiatry, New York State Psychiatric Institute and the Columbia University College of Physicians & Surgeons, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Joanna
authors.initials: J
authors.lastname: Steinglass
authors.affiliation: Division of Child and Adolescent Psychiatry in the Department of Psychiatry, New York State Psychiatric Institute and the Columbia University College of Physicians & Surgeons, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Marsh
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000523:psychology*; D052018:Bulimia Nervosa / Q000523:psychology*; D002648:Child; D005260:Female; D006801:Humans; D011337:Probability Learning; D011581:Psychological Tests; D011930:Reaction Time; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Bulimia Nervosa; Continuous performance task; Implicit learning; Probabilistic classification learning; Self-regulation; Weather prediction task