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Affect, reward, and punishment in anorexia nervosa: a narrative overview

  • Margarita Sala
  • Amy H. Egbert
  • Jason M. Lavender
  • Andrea B. Goldschmidt
Review
  • 192 Downloads

Abstract

Introduction

Anorexia nervosa (AN) is a serious psychiatric disorder that is difficult to treat and often follows a protracted course. A number of theoretical models have been proposed for the etiology and maintenance of AN. Two domains that have received substantial attention in the literature on AN are affect and reward/punishment processes. However, despite an overlap in the nature and implications of these processes, studies of AN addressing these constructs have typically investigated them independently.

Purpose

The purpose of this narrative review is to integrate the literature on the role of affect, reward, and punishment in AN.

Method

We provide a focused narrative overview of the literature relating to the affect, reward, and punishment in AN via a synthesis of recent reviews and meta-analyses.

Results

We first describe several prominent affect and reward/punishment-based conceptualizations of AN, followed by a brief overview of the existing empirical literature in these domains.

Conclusion

We provide a critical discussion of the disparate nature of these literatures in AN, including associated limitations. We then conclude with an extensive discussion of directions for future research that integrate the study of affect and reward/punishment processes in AN.

Level of evidence

Level V, narrative review.

Keywords

Reward Punishment Affect Emotion Anorexia nervosa 

Notes

Acknowledgements

Margarita Sala is supported by the National Science Foundation (NSF) Graduate Research Fellowship under Grant No. DGE-1645420. Amy H. Egbert is supported by the National Science Foundation (NSF) Graduate Research Fellowship. Jason Lavender is supported by National Institute of Health (NIH) grant K23MH101342. Andrea Goldschmidt is supported by NIH grant K23DK105234. Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF or NIH.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of PsychologySouthern Methodist UniversityDallasUSA
  2. 2.Department of PsychologyLoyola University ChicagoChicagoUSA
  3. 3.Department of PsychiatryUniversity of CaliforniaSan DiegoUSA
  4. 4.Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University, Weight Control and Diabetes Research Center/The Miriam HospitalProvidenceUSA

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