Anhedonia and Anorexia Nervosa: A Neurocognitive Perspective

Abstract

Individuals with a diagnosis of anorexia nervosa (AN) persistently engage in behaviors aimed to reduce their weight, which leads to severe underweight status, and death in up to 20 % of cases. Theoretical models applied in seminal investigations of the etiology of the disorder have focused on various constructs, including anhedonia – the reduced capacity to experience pleasure or reward. Anhedonia has been utilized as a model for multiple symptoms in AN including; food, i.e., the reduced capacity to experience reward associated with palatable foods, social impairments, i.e., reduced capacity to experience pleasure or reward from social interactions and exercise reward, i.e., excessive exercise, aimed to compensate for an anhedonic and dysphoric mood state. These symptom domains have been researched via various modalities including; behavioral and neuroimaging investigations. While there is an established literature on taste reward processing in AN, body image and particularly exercise and social reward have received comparatively less attention. Up to 80 % of individuals with AN reportedly excessively exercise, and social impairments are considered both causal and maintaining in the illness. Despite the relevance of reward and reinforcement in maintaining the illness, a unified model for reward processing in AN is yet to be agreed upon. The purpose of this chapter is to discuss the relevance of anhedonia as an explanatory framework for symptoms of AN.