The costs of over-control in anorexia nervosa: Evidence from fMRI and ecological momentary assessment

Research output: Contribution to journalResearch articleContributedpeer-review

Abstract

A growing body of evidence suggests that a high level of self-control may, despite its positive effects, influence cognitive processing in an unfavorable manner. However, the affective costs of self-control have only rarely been investigated. Anorexia nervosa (AN) is an eating disorder that is often characterized by excessive self-control. Here, we used fMRI to explore whether over-control in AN may have negative affective consequences. 36 predominantly adolescent female AN patients and 36 age-matched healthy controls (HC) viewed negative and neutral pictures during two separate fMRI sessions before and after 10 min of rest. We tested whether abnormally elevated neural activity during the initial presentation in a brain region broadly implicated in top-down control, the dorsolateral prefrontal cortex (dlPFC), could predict subsequent activation in limbic areas relevant to bottom-up affective processing. Using ecological momentary assessment (EMA), we also tested for associations between the aforementioned neuroimaging markers and negative affective states in the two weeks following the experiment. fMRI data revealed that higher initial activation of the dlPFC in AN predicted increased amygdala reactivity during the second fMRI session, which in turn was related to increased self-reported tension during two weeks following the scan. These data suggest that over-control in AN patients may come at a cost including negative affective states on a short (minutes) as well as a longer time scale (days). This mechanism may significantly contribute to the persistence of AN.

Details

Original languageEnglish
Article number304
Pages (from-to)304
JournalTranslational Psychiatry
Volume11
Issue number1
Publication statusPublished - 21 May 2021
Peer-reviewedYes

External IDs

PubMedCentral PMC8138008
Scopus 85106318852
ORCID /0000-0002-9426-5397/work/141543177
ORCID /0000-0002-2864-5578/work/142233454
ORCID /0000-0003-2132-4445/work/142236318
ORCID /0000-0002-6152-5834/work/142241979

Keywords

Keywords

  • Adolescent, Anorexia Nervosa/diagnostic imaging, Brain/diagnostic imaging, Ecological Momentary Assessment, Emotions, Female, Humans, Magnetic Resonance Imaging