Self-Perception and Social Rewards in Atypical Anorexia Nervosa

项目总结 进食障碍(ED)是一种严重的精神疾病，几乎没有循证治疗和机械治疗 了解作为疾病和康复基础的神经回路损伤。该项目有助于 通过比较两个个体参与的神经回路，发展对EDS的更多维度的理解 非典型神经性厌食症(AAN)患者的知觉和社会奖赏 精神健康-体重下降幅度相似的队列(WLC)。典型的神经性厌食症， 出于研究和临床护理的目的，定义为营养不良的身体状态(BMI&lt；18.5)，并持续 干扰体重恢复的行为，通常包括对身体形象的关注。非典型 神经性厌食症(AAN)在DSM-5中被定义为满足所有标准的ANN而不是体重不足；这些 由于严格的限制饮食行为，患者的体重通常会大幅下降 由于ED认知的严重程度，他们的心理社会功能受到干扰。临床上，AAN是 与更高水平的心理痛苦和对饮食和身体的扭曲有关- 形象为典型的A。这一探索性的试点项目将评估类似的神经行为问题在自我 感知和社会奖励在AAN的大脑中观察到，扩展了现有的R01 检查AN和神经性贪食症(BN)的这些回路。此外，心理健康的减肥 队列(WLC)将经历显著的体重减轻(最高体重的10%-20%)，但不会认可 病理性ED认知关注点；与AAN相比，该队列允许分离 通过调节身体关注点的神经心理过程对大脑功能的减肥。总而言之， 这项探索性的先导性研究评估了未被充分研究的AAN诊断中的神经生物回路，并提供了 必要的数据来填补我们目前关于体重和ED认知对神经的影响的知识空白 EDS的功能和临床症状。这些数据是朝着更机械化的理解迈出的一步 急诊室的病理生理学。

PROJECT SUMMARY Eating disorders (ED) are serious mental illnesses with few evidence-based treatments and little mechanistic understanding of the neural circuit impairments that underlie both illness and recovery. This project contributes to developing a more dimensional understanding of EDs, by comparing the neural circuits involved in both self- perception and social reward in a previously unstudied clinical cohort, atypical anorexia nervosa (AAN) to a psychiatrically-healthy cohort that has lost similar amounts of body weight (WLC). Typical anorexia nervosa (AN), for the purpose of research and clinical care, is defined by a malnourished body state (BMI < 18.5) with persistent behaviors that interfere with weight restoration, and often includes preoccupations with body image. Atypical anorexia nervosa (AAN) was defined in DSM-5 as meeting all criteria for AN without being underweight; these patients have typically experienced substantial weight loss due to severe restrictive eating behaviors as well as disruptions of their psychosocial functioning due to the severity of their ED cognitions. Clinically, AAN is associated with similar to higher levels of psychological distress and distortions about both eating and body- image as typical AN. This exploratory pilot project will evaluate whether similar neurobehavioral problems in self- perception and social reward are observed in the brain in AAN, extending an existing R01 that is currently examining these circuits in both AN and bulimia nervosa (BN). In addition, the psychiatrically-healthy weight loss cohort (WLC) will have experienced significant weight loss (10-20% of highest body weight) but will not endorse pathological ED cognitive preoccupations; this cohort, in comparison to AAN, allows separation of the impact of weight loss on brain function from the neuropsychological processes that mediate body preoccupations. In sum, this exploratory pilot study evaluates neurobiological circuitry in an understudied diagnosis, AAN, and provides the necessary data to fill current gaps in our knowledge about the effects of weight and ED cognitions on neural function as well as clinical symptoms in EDs. These data are a step towards a more mechanistic understanding of the pathophysiology in EDs.