Excessive Avoidance Behaviors in Anorexia Nervosa: the Role of Reward

NCT ID: NCT04405440

Last Updated: 2020-05-28

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 100 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2019-05-01
• Study Completion Date: 2021-09-01

Brief Summary

This study investigates excessive avoidance behaviors in patients with a diagnosis of Anorexia Nervosa (AN) compared to a healthy control group. The study further examines the role of reward (relief) as a putative factor in maintaining excessive avoidance behaviors in AN.

Detailed Description

Anorexia Nervosa (AN) is a life-threatening mental disease with a disappointing treatment outcome. Fear of weight gain and diet restrictions are considered the core symptoms of AN. Although from a diagnostic perspective AN is conceptualized as an eating-related disorder connected to an extremely low Body Mass Index (BMI) and body image distortion, AN might represent a specific phenotype of anxiety disorders characterized by tenacious avoidance behaviors, especially the restrictive subtype. To date, avoidance in AN is often investigated as a general personality trait (e.g. harm avoidance) but poorly examined in its behavioral form (which is life-threatening, such as food-avoidance). Hence, the investigators will perform a systematic investigation of excessive avoidance behaviors within a laboratory setting. Within a learning perspective, the investigators will investigate excessive avoidance in a group of 30 AN patients and 30 healthy volunteers. To achieve this, a well-validated avoidance paradigm will be used. Most critically, the investigators will examine whether patients with a diagnosis of anorexia nervosa show persistent avoidance behaviors compared to a control group. Additionally, the investigators will examine if, in the anorexia group, higher subjective relief to successful omissions of negative events during avoidance learning predicts persistent (excessive) avoidance behaviors after fear extinction.

Conditions

Eating Disorders; Anxiety; Anorexia Nervosa

Study Design

• Observational Model Type: CASE_CONTROL
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

Healthy controls

The healthy control group will perform a well-validated avoidance (behavioral) task and will fill in some questionnaires about eating behaviors, emotions, and feelings.

Behavioral avoidance task

Intervention Type: BEHAVIORAL

Behavioral task able to measure avoidance actions, US-expectancy, and reward-related indexes in different learning times

Anorexia Nervosa patients

As the healthy controls, the participants of the anorexia nervosa group will perform the same behavioral task and will fill in the same questionnaires

Behavioral avoidance task

Intervention Type: BEHAVIORAL

Behavioral task able to measure avoidance actions, US-expectancy, and reward-related indexes in different learning times

Interventions

Behavioral avoidance task

Behavioral task able to measure avoidance actions, US-expectancy, and reward-related indexes in different learning times

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• For the AN group, patients need to be physically strong and sufficiently emotionally stable
• For the healthy group, the investigators will recruit participants without a previous or current history of psychiatric, cardiovascular, neurological or other relevant disorder

Exclusion Criteria

• For the AN group, the investigators will exclude patients who are insufficiently emotionally stable and/or physically weak to participate in the study as estimated by the treating physicians of the units on which the patients are admitted
• Insufficient verbal skills to understand the questionnaires and the computer task
• Participants who are pregnant or breastfeeding

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Bram Vervliet

OTHER

Sponsor Role: lead

Responsible Party

Bram Vervliet

Principal Investigator Prof. Dr. Bram Vervliet

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Laurence Claes, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

KU Leuven

Locations

Psychiatry | UZ Leuven campus Gasthuisberg

Leuven, , Belgium

Site Status: RECRUITING

University of KU Leuven, Faculteit Psychologie en Pedagogische Wetenschappen

Leuven, , Belgium

Site Status: RECRUITING

Countries

Belgium

Central Contacts

Laurence Claes, Prof. Dr.

Role: CONTACT

laurence.claes@kuleuven.be

+32 16 32 61 33

Bram Vervliet, Prof. Dr.

Role: CONTACT

bram.vervliet@kuleuven.be

Facility Contacts

Laurence Claes, Prof. Dr.

Role: primary

laurence.claes@kuleuven.be

Laurence Claes, Prof. Dr.

Role: primary

laurence.claes@kuleuven.be

32 16 32 61 33

Bram Vervliet, Prof. Dr.

Role: backup

bram.vervliet@kuleuven.be

References

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Reference Type: BACKGROUND

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Reference Type: BACKGROUND

PMID: 10713801 (View on PubMed)

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Reference Type: BACKGROUND

PMID: 23201859 (View on PubMed)

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Reference Type: BACKGROUND

PMID: 27463780 (View on PubMed)

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Reference Type: BACKGROUND

PMID: 30392878 (View on PubMed)

Wierenga CE, Bischoff-Grethe A, Melrose AJ, Irvine Z, Torres L, Bailer UF, Simmons A, Fudge JL, McClure SM, Ely A, Kaye WH. Hunger does not motivate reward in women remitted from anorexia nervosa. Biol Psychiatry. 2015 Apr 1;77(7):642-52. doi: 10.1016/j.biopsych.2014.09.024. Epub 2014 Oct 22.

Reference Type: BACKGROUND

PMID: 25481622 (View on PubMed)

Park RJ, Godier LR, Cowdrey FA. Hungry for reward: How can neuroscience inform the development of treatment for Anorexia Nervosa? Behav Res Ther. 2014 Nov;62:47-59. doi: 10.1016/j.brat.2014.07.007. Epub 2014 Jul 26.

Reference Type: BACKGROUND

PMID: 25151600 (View on PubMed)

Other Identifiers

S62060

Identifier Type: -

Identifier Source: org_study_id