Constructing the subjective value of food in Anorexia Nervosa

项目摘要 神经性厌食症（AN）是一种严重的进食障碍，其死亡率是所有精神疾病中最高的 病确定新的AN干预措施的发展可修改的目标是至关重要的， 治疗达到的缓解率低于50%，并且复发是常见的。AN的一个方面可能是 导致长期结果不佳的原因是适应不良的食物选择，即，顽固而刻板的选择 低热量、低脂肪的食物。食物的选择要求个人从一个角度来构建食物的主观价值。 属性的数量。然而，尽管食物选择在AN中处于中心地位，但人们对AN患者如何选择食物知之甚少。 构建对食物的主观价值，导致适应不良的食物选择行为。总目标 本研究的目的是阐明主观食物评价的认知和神经机制 在AN。利用功能磁共振成像，眼动追踪和计算模型， 在健康个体的决策，我们提出了两个研究来检查：（1）个人与AN 联合收割机跨越属性构建食物的主观价值;（2）认知和神经机制如何 有助于评估和食物选择的差异在AN和健康对照（HC）个体之间;以及 (3)价值构建过程如何影响食物选择。研究1将研究选择， 反应时间，眼动追踪和fMRI测量，而与AN（n=75）和HC（n=75）的个人获得 执行一项新颖的多属性决策任务，在此期间，他们将根据以下属性对食品进行评级， 健康，美味，可口，然后选择2“餐”，每一个组成的三种不同的 不同类别的食物。我们假设，与HC相比，AN患者将基于他们的 对膳食选择的主观评价主要是与健康相关的属性，更多地关注健康- 相关属性。我们还假设，健康的表征在模式的BOLD活动中， AN患者的眶额皮质（OFC）与食物选择的关系比HC更密切。研究2将使用线索法 训练（CAT），这表明，仅仅是一个提示和一个动作（按下按钮）的关联， 图像导致持久的偏好变化和注意偏向，有利于线索项目。我们将联合收割机CAT 在研究1中使用了多属性选择，并为所有参与者提供了非常美味的食物。我们假设 CAT之后的注意偏向会改变AN（但不是HC）的价值构建过程， 值的美味属性，并认为健康表示模式的BOLD活动在AN OFC将 与食物选择的关系不比美味表征的关系大。这项研究是第一次努力确定 AN中主观食物评估的潜在机制，并测试价值结构是否可以改变， 使食物选择行为正常化。研究结果将为开发基于神经科学的新型 旨在改变AN的食物偏好并提高现有治疗效果的干预措施。

Project Summary Anorexia Nervosa (AN) is a serious eating disorder with a mortality rate among the highest of any psychiatric illness. Identifying modifiable targets for the development of novel AN interventions is crucial because leading treatments achieve remission rates of less than 50%, and relapse is common. One aspect of AN that likely contributes to poor long-term outcomes is maladaptive food choice, i.e., the persistent and stereotyped choice of low-calorie, low-fat foods. Food choice requires individuals to construct the subjective value of foods from a number of attributes. Yet, despite the centrality of food choice in AN, little is known about how people with AN construct the subjective values placed on foods, leading to maladaptive food-choice behavior. The overall goal of this research is to elucidate the cognitive and neural mechanisms that contribute to subjective food valuation in AN. Leveraging fMRI, eyetracking, and computational models that have advanced understanding of decision-making in healthy individuals, we propose two studies to examine: (1) how individuals with AN combine across attributes to construct subjective value for food; (2) how the cognitive and neural mechanisms that contribute to valuation and food choice differ between individuals with AN and healthy controls (HC); and (3) how the value construction process can be biased to influence food choice. Study 1 will examine choices, reaction times, eyetracking, and fMRI measures obtained while individuals with AN (n=75) and HC (n=75) perform a novel multi-attribute decision task during which they will rate food items on attributes such as healthiness, tastiness, and savoriness, and then choose between 2 “meals” each composed of three different food items from different categories. We hypothesize that compared to HC, individuals with AN will base their subjective valuation of meal options largely on healthiness-related attributes and attend more to healthiness- related attributes. We also hypothesize that representations of healthiness in patterns of BOLD activity in the orbitofrontal cortex (OFC) will be more related to food choice in AN than HC. Study 2 will use cue-approach training (CAT), which has shown that the mere association of a cue and an action (a button press) with an image leads to enduring preference changes and attentional biases in favor of cued items. We will combine CAT with multi-attribute choices used in Study 1 and cue highly tasty foods for all participants. We hypothesize that attentional bias following CAT will alter the value construction process in AN (but not HCs) by increasing the value of tastiness attributes, and that healthiness representations in patterns of BOLD activity in AN OFC will be no more related to meal choices than tastiness representations. This research is the first effort to identify mechanisms underlying subjective food valuation in AN, and test whether value construction can be altered to normalize food-choice behavior. Results will inform the development of novel, neuroscience-based interventions designed to modify food preferences in AN and enhance the efficacy of existing treatments.