Neurobiological and Psychological Maintenance Mechanisms Associated With Anticipatory Reward in Bulimia Nervosa

NCT ID: NCT04917068

Last Updated: 2026-01-08

Basic Information

• Recruitment Status: RECRUITING
• Total Enrollment: 100 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2022-04-01
• Study Completion Date: 2026-11-30

Brief Summary

The purpose of this investigation is to identify the potentially crucial role of anticipatory reward mechanisms maintaining bulimic behavior (i.e., binge eating and purging) in bulimia nervosa (BN). The research will investigate neural and psychological anticipatory processes in BN, both in the scanner and the natural environment.

Detailed Description

Bulimia nervosa (BN), an eating disorder characterized by recurrent bulimic episodes of binge eating and often persists in spite of treatment, likely indicating ineffectively targeted maintenance mechanisms. Treatment outcome data suggest that < 30-45% of adults who receive treatment for BN exhibit prolonged remission. Further, BN is often characterized by a worsening course in which symptom severity increases with duration of illness. Intervention advances require identification of both the mechanisms that underlie reward derived from bulimic behavior and the mechanisms that maintain these behaviors over time. Current treatments for BN focus on immediate antecedents and consequences of bulimic behavior, despite the possibility that the reward derived from these behaviors may occur well before this point during the anticipation of binge eating and purging. A majority (>75%) of individuals with BN report "planning" some or most of their bulimic episodes. Thus, determining the role of reward anticipation in BN will facilitate the application of novel interventions that more precisely target these neglected mechanisms. Further, research indicates that reward mechanisms become increasingly focused on anticipation in later phases of reward learning. Therefore, it is important to determine how reward anticipation processes contribute to the maintenance of bulimic behaviors and interact with illness duration to facilitate BN chronicity. The purpose of this investigation is to identify the potentially crucial role of anticipatory reward mechanisms maintaining bulimic behavior (i.e., binge eating and purging) in bulimia nervosa (BN). The research will investigate neural and psychological anticipatory processes in BN, both in the scanner and the natural environment.

Conditions

Bulimia Nervosa

Study Design

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

Study Groups

Bulimia Nervosa

Participants with diagnosed bulimia nervosa (BN) who will complete all tasks during Visits 1 and 2 in addition to ecological momentary assessment (EMA) procedures following Visit 2.

No interventions assigned to this group

Healthy Control

Participants without diagnosed BN or other current or past eating disorders who will complete all tasks during Visits 1 and 2 and will not complete EMA procedures following Visit 2.

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

Bulimia nervosa (BN) and healthy control (HC) groups:

• Right-handed
• Ability to read and speak in English

BN group only:

• Eating Disorder Examination (EDE) diagnosis of BN (i.e., at least one objective bulimic episode and one self-induced vomiting episode per week for at three months) with binge episodes always accompanied by self-induced vomiting
• Stable dose for at least 6 weeks of any recent changes in medication impacting mood, appetite, or weight

HC group only:

• No binge eating or purging episodes for the past three months on the EDE
• No current or past history of an eating disorder as diagnosed by Structured Clinical Interview for DSM-5 Disorders

Exclusion Criteria

• History of gastric bypass surgery
• Medical condition acutely affecting eating behavior and/or weight (i.e., pregnancy, lactation, thyroid disease)
• Current medical or psychiatric instability (i.e., hospitalization required in the past three months)
• Lifetime history of psychosis or bipolar disorder
• History of neurological disorder or injury (i.e., stoke, head injury with >10 minutes loss of consciousness)
• Current substance use disorder
• BMI less than 19 kg/m^2
• Acute suicidality requiring hospitalization
• fMRI exclusions as specifiedd by the Center for Magnetic Resonance Research
• Food allergy that cannot be accommodated through substitutions to the laboratory test snack

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

University of Minnesota

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Carol B Peterson, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Minnesota Department of Psychiatry and Behavioral Sciences

Locations

University of Minnesota

Minneapolis, Minnesota, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Carol B Peterson, PhD

Role: CONTACT

peter161@umn.edu

(612)-273-9811

Facility Contacts

Carol B Peterson, PhD

Role: primary

612-273-9811

Other Identifiers

PSYCH-2020-28854

Identifier Type: -

Identifier Source: org_study_id