Longitudinal examination of decision-making performance in anorexia nervosa: before and after weight restoration

Lindsay P Bodell; Pamela K Keel; Michael C Brumm; Ashley Akubuiro; Joseph Caballero; Daniel Tranel; Brendan Hodis; Laurie M McCormick

doi:10.1016/j.jpsychires.2014.05.015

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Longitudinal examination of decision-making performance in anorexia nervosa: before and after weight restoration

Journal article

Open access

Peer reviewed

Longitudinal examination of decision-making performance in anorexia nervosa: before and after weight restoration

Lindsay P Bodell, Pamela K Keel, Michael C Brumm, Ashley Akubuiro, Joseph Caballero, Daniel Tranel, Brendan Hodis and Laurie M McCormick

Journal of psychiatric research, Vol.56(1), pp.150-157

09/2014

DOI: 10.1016/j.jpsychires.2014.05.015

PMCID: PMC4127974

PMID: 24939417

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Abstract

This study aimed to extend previous work on decision-making deficits in anorexia nervosa (AN) by using a longitudinal design to examine decision-making before and after weight restoration. Participants were 22 women with AN and 20 healthy comparison participants who completed the Iowa Gambling Task (IGT). Decision-making was assessed both before and after weight restoration in a subset of 14 AN patients. Self-report and interview assessments were used to measure psychological correlates of decision-making performance including depression, anxiety, and eating disorder symptoms, and magnetic resonance imaging (MRI) scans were conducted to explore associations between brain volume in the orbitofrontal cortex (OFC) and decision-making in individuals with AN. Currently ill AN patients performed worse on the IGT compared to the control group. Although decision-making performance did not improve significantly with weight restoration in the full AN sample, AN patients who were poor performers at baseline did improve task performance with weight-restoration. When actively ill, lower body mass index (BMI) and decreased left medial OFC volume were significantly associated with worse IGT performance, and these associations were no longer significant after weight restoration. Findings suggest that decision-making deficits in AN in the acute phase of illness are associated with low weight and decreased left medial OFC volume, but increases in brain volume and BMI may not have been sufficient to improve decision-making in all patients. Findings contribute to a model for understanding how some patients may sustain self-starvation, and future work should examine whether decision-making deficits predict relapse.

Body Mass Index

Gambling

Humans

Prefrontal Cortex - physiopathology

Self Report

Anorexia Nervosa - physiopathology

Anorexia Nervosa - pathology

Organ Size

Weight Gain - physiology

Functional Laterality

Prefrontal Cortex - pathology

Neuropsychological Tests

Young Adult

Magnetic Resonance Imaging

Adult

Female

Anorexia Nervosa - psychology

Decision Making - physiology

Interview, Psychological

Details

Title: Subtitle: Longitudinal examination of decision-making performance in anorexia nervosa: before and after weight restoration
Creators: Lindsay P Bodell - Florida State University, Department of Psychology, United States. Electronic address: bodell@psy.fsu.edu
Pamela K Keel - Florida State University, Department of Psychology, United States
Michael C Brumm - University of Iowa Carver College of Medicine, Department of Psychiatry, United States
Ashley Akubuiro - University of Iowa, Department of Neuroscience, United States
Joseph Caballero - University of Iowa Carver College of Medicine, United States
Daniel Tranel - University of Iowa Carver College of Medicine, Division of Behavioral Neurology and Cognitive Neuroscience, United States; University of Iowa, Department of Psychology, United States
Brendan Hodis - University of Iowa Carver College of Medicine, United States
Laurie M McCormick - University of Iowa Carver College of Medicine, Department of Psychiatry, United States; University of the Virgin Islands, United States; Roy Lester Schneider Hospital, United States. Electronic address: laurie-mccormick@uiowa.edu
Resource Type: Journal article
Publication Details: Journal of psychiatric research, Vol.56(1), pp.150-157
DOI: 10.1016/j.jpsychires.2014.05.015
PMID: 24939417
PMCID: PMC4127974
NLM abbreviation: J Psychiatr Res
ISSN: 0022-3956
eISSN: 1879-1379
Publisher: England
Grant note: K23 MH083879 / NIMH NIH HHS T32 MH093311 / NIMH NIH HHS T32 MH93311 / NIMH NIH HHS K23 MH083879-01 / NIMH NIH HHS
Language: English
Date published: 09/2014
Academic Unit: Neurology; Psychiatry; Psychological and Brain Sciences; Iowa Neuroscience Institute
Record Identifier: 9984002338702771

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