Self-Perception and Social Rewards in Atypical Anorexia Nervosa

项目摘要 进食障碍（艾德）是一种严重的精神疾病，几乎没有循证治疗和机械治疗。 了解疾病和康复背后的神经回路损伤。该项目有助于 通过比较涉及自我和自我的神经回路， 知觉和社会奖励在以前未研究的临床队列，非典型神经性厌食症（AAN），以一个 精神健康的队列，已经失去了类似的体重量（WLC）。典型的神经性厌食症（AN）， 对于研究和临床护理的目的，定义为营养不良的身体状态（BMI < 18.5）， 影响体重恢复的行为，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中定义为符合AN的所有标准，但体重不足; 由于严重的限制性饮食行为， 由于他们的艾德认知的严重性，他们的心理社会功能受到破坏。临床上，AAN是 与类似于更高水平的心理困扰和对饮食和身体的扭曲有关- 图为典型的AN。这个探索性的试点项目将评估是否类似的神经行为问题，在自我， 在AAN的大脑中观察到感知和社会奖励，扩展了现有的R 01 检查AN和神经性贪食症（BN）中的这些回路。另外，精神健康的减肥 队列（WLC）将经历显著的体重减轻（最高体重的10-20%），但不支持 病理性艾德认知偏见;与AAN相比，该队列允许分离以下因素的影响： 体重减轻对大脑功能的影响来自于调节身体关注的神经心理过程。总之， 这项探索性的初步研究评估了一种未充分研究的诊断AAN的神经生物学回路，并提供了 必要的数据，以填补目前的空白，在我们的知识的影响，体重和艾德认知对神经 功能以及临床症状。这些数据是朝着更机械的理解迈出的一步 ED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.