Hostname: page-component-77f85d65b8-pkds5 Total loading time: 0 Render date: 2026-04-18T00:53:45.397Z Has data issue: false hasContentIssue false
  • English
  • Français

Temporal delay discounting in acutely ill and weight-recovered patients with anorexia nervosa

Published online by Cambridge University Press:  12 January 2015

F. Ritschel ,
J. A. King ,
D. Geisler ,
L. Flohr ,
F. Neidel ,
I. Boehm ,
M. Seidel ,
J. Zwipp ,
S. Ripke  and
M. N. Smolka
...Show all authors
F. Ritschel
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
J. A. King
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
D. Geisler
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
L. Flohr
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
F. Neidel
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
I. Boehm
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
M. Seidel
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
J. Zwipp
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
S. Ripke
Affiliation:
Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
M. N. Smolka
Affiliation:
Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
V. Roessner
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany
S. Ehrlich*
Affiliation:
Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden, Dresden, Germany MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
*
* Address for correspondence: S. Ehrlich, M.D., Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Dresden University of Technology, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307 Dresden, Germany. (Email: transden.lab@gmail.com)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

Patients with anorexia nervosa (AN) are characterized by a very low body weight but readily give up immediate rewards (food) for long-term goals (slim figure), which might indicate an unusual level of self-control. This everyday clinical observation may be quantifiable in the framework of the anticipation-discounting dilemma.

Method.

Using a cross-sectional design, this study compared the capacity to delay reward in 34 patients suffering from acute AN (acAN), 33 weight-recovered AN patients (recAN) and 54 healthy controls. We also used a longitudinal study to reassess 21 acAN patients after short-term weight restoration. A validated intertemporal choice task and a hyperbolic model were used to estimate temporal discounting rates.

Results.

Confirming the validity of the task used, decreased delay discounting was associated with age and low self-reported impulsivity. However, no group differences in key measures of temporal discounting of monetary rewards were found.

Conclusions.

Increased cognitive control, which has been suggested as a key characteristic of AN, does not seem to extend the capacity to wait for delayed monetary rewards. Differences between our study and the only previous study reporting decreased delay discounting in adult AN patients may be explained by the different age range and chronicity of acute patients, but the fact that weight recovery was not associated with changes in discount rates suggests that discounting behavior is not a trait marker in AN. Future studies using paradigms with disorder-specific stimuli may help to clarify the role of delay discounting in AN.

Keywords

Anorexia nervosadelay discountingimpulsivityintertemporal choiceself-controlweight-recovered anorexia nervosa

Information

Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 6 , April 2015 , pp. 1229 - 1239
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Ballard, K, Knutson, B (2009). Dissociable neural representations of future reward magnitude and delay during temporal discounting. NeuroImage 45, 143–150.Google Scholar
Butler, GKL, Montgomery, AMJ (2005). Subjective self-control and behavioural impulsivity coexist in anorexia nervosa. Eating Behaviors 6, 221–227.Google Scholar
Butow, P, Beumont, P, Touyz, S (1993). Cognitive processes in dieting disorders. International Journal of Eating Disorders 14, 319–329.Google Scholar
Casper, RC (1990). Personality features of women with good outcome from restricting anorexia nervosa. Psychosomatic Medicine 52, 156–170.Google Scholar
Casper, RC, Hedeker, D, McClough, JF (1992). Personality dimensions in eating disorders and their relevance for subtyping. Journal of the American Academy of Child and Adolescent Psychiatry 31, 830–840.CrossRefGoogle ScholarPubMed
Claes, L, Vandereycken, W, Vertommen, H (2005). Impulsivity-related traits in eating disorder patients. Personality and Individual Differences 39, 739–749.CrossRefGoogle Scholar
Cloninger, CR (1994). Temperament and personality. Current Opinion in Neurobiology 4, 266–273.Google Scholar
Coller, M, Williams, MB (1999). Eliciting individual discount rates. Experimental Economics 2, 107–127.Google Scholar
Crean, JP, de Wit, H, Richards, JB (2000). Reward discounting as a measure of impulsive behavior in a psychiatric outpatient population. Experimental and Clinical Psychopharmacology 8, 155–162.Google Scholar
Critchfield, TS, Kollins, SH (2001). Temporal discounting: basic research and the analysis of socially important behavior. Journal of Applied Behavior Analysis 34, 101–122.Google Scholar
Demurie, E, Roeyers, H, Baeyens, D, Sonuga-Barke, E (2012). Temporal discounting of monetary rewards in children and adolescents with ADHD and autism spectrum disorders. Developmental Science 15, 791–800.CrossRefGoogle ScholarPubMed
Evenden, J (1999). Impulsivity: a discussion of clinical and experimental findings. Journal of Psychopharmacology 13, 180–192.Google Scholar
Fichter, MM, Quadflieg, N (1999). Strukturiertes Inventar für Anorektische und Bulimische Essstörungen (SIAB). Fragebogen (SIAB-S) und Interview (SIAB-EX) nach DSM-IV und ICD-10. Hogrefe: Göttingen.Google Scholar
Goth, K, Schmeck, K (2009). Das Junior Temperament und Charakter Inventar (JTCI) . Hogrefe: Göttingen.Google Scholar
Green, L, Myerson, J (2004). A discounting framework for choice with delayed and probabilistic rewards. Psychological Bulletin 130, 769–792.CrossRefGoogle ScholarPubMed
Green, L, Myerson, J, Ostaszewski, P (1999). Discounting of delayed rewards across the life span: age differences in individual discounting functions. Behavioural Processes 46, 89–96.Google Scholar
Harris, PA, Taylor, R, Thielke, R, Payne, J, Gonzalez, N, Conde, JG (2009). Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics 42, 377–381.CrossRefGoogle ScholarPubMed
Hautzinger, M, Keller, F, Kühner, C (2009). BDI-II. Beck-Depressions-Inventar. Pearson Assessment: Frankfurt.Google Scholar
Heerey, EA, Robinson, BM, McMahon, RP, Gold, JM (2007). Delay discounting in schizophrenia. Cognitive Neuropsychiatry 12, 213–221.Google Scholar
Hemmelmann, C, Brose, S, Vens, M, Hebebrand, J, Ziegler, A (2010). Percentiles of body mass index of 18-80-year-old German adults based on data from the Second National Nutrition Survey [in German]. Deutsche Medizinische Wochenschrift 135, 848–852.CrossRefGoogle ScholarPubMed
Holt, DD, Green, L, Myerson, J (2003). Is discounting impulsive? Evidence from temporal and probability discounting in gambling and non-gambling college students. Behavioural Processes 64, 355–367.Google Scholar
IBM Corp. (2012). IBM SPSS Statistics for Windows, Version 21.0. IBM Corp.: Armonk, NY.Google Scholar
Jarmolowicz, DP, Cherry, JBC, Reed, DD, Bruce, JM, Crespi, JM, Lusk, JL, Bruce, AS (2014). Robust relation between temporal discounting rates and body mass. Appetite 78, 63–67.CrossRefGoogle ScholarPubMed
Johnson, MW, Bickel, WK (2002). Within-subject comparison of real and hypothetical money rewards in delay discounting. Journal of the Experimental Analysis of Behavior 77, 129–146.Google Scholar
Juckel, G, Friedel, E, Koslowski, M, Witthaus, H, Özgürdal, S, Gudlowski, Y, Knutson, B, Wrase, J, Brüne, M, Heinz, A, Schlagenhauf, F (2012). Ventral striatal activation during reward processing in subjects with ultra-high risk for schizophrenia. Neuropsychobiology 66, 50–56.Google Scholar
Kirby, KN (2009). One-year temporal stability of delay-discount rates. Psychonomic Bulletin and Review 16, 457–462.Google Scholar
Kirby, KN, Maraković, NN (1995). Modeling myopic decisions: evidence for hyperbolic delay-discounting within subjects and amounts. Organizational Behavior and Human Decision Processes 64, 22–30.Google Scholar
Kirby, KN, Petry, NM, Bickel, WK (1999). Heroin addicts have higher discount rates for delayed rewards than non-drug-using controls. Journal of Experimental Psychology: General 128, 78–87.Google Scholar
Kobiella, A, Ripke, S, Kroemer, NB, Vollmert, C, Vollstädt-Klein, S, Ulshöfer, DE, Smolka, MN (2014). Acute and chronic nicotine effects on behaviour and brain activation during intertemporal decision making. Addiction Biology 19, 918–930.CrossRefGoogle ScholarPubMed
Kromeyer-Hauschild, K, Wabitsch, M, Kunze, D, Geller, F, Geiß, HC, Hesse, V, von Hippel, A, Jaeger, U, Johnsen, D, Korte, W, Menner, K, Müller, G, Müller, JM, Niemann-Pilatus, A, Remer, T, Schaefer, F, Wittchen, H-U, Zabransky, S, Zellner, K, Ziegler, A, Hebebrand, J (2001). Percentiles of body mass index in children and adolescents evaluated from different regional German studies [in German]. Monatsschrift Kinderheilkunde 149, 807–818.Google Scholar
Kullmann, S, Giel, KE, Hu, X, Bischoff, SC, Teufel, M, Thiel, A, Zipfel, S, Preissl, H (2014). Impaired inhibitory control in anorexia nervosa elicited by physical activity stimuli. Social Cognitive and Affective Neuroscience 9, 917–923.Google Scholar
Lawrence, KA, Allen, JS, Chanen, AM (2010). Impulsivity in borderline personality disorder: reward-based decision-making and its relationship to emotional distress. Journal of Personality Disorders 24, 786–799.CrossRefGoogle ScholarPubMed
Lawyer, SR, Schoepflin, F, Green, R, Jenks, C (2011). Discounting of hypothetical and potentially real outcomes in nicotine-dependent and nondependent samples. Experimental and Clinical Psychopharmacology 19, 263–274.Google Scholar
Ledgerwood, DM, Alessi, SM, Phoenix, N, Petry, NM (2009). Behavioral assessment of impulsivity in pathological gamblers with and without substance use disorder histories versus healthy controls. Drug and Alcohol Dependence 105, 89–96.Google Scholar
Lilienthal, KR, Weatherly, JN (2013). Decision-making impulsivity in disordered eating: outcomes from a discounting task. Advances in Eating Disorders 1, 148–160.CrossRefGoogle Scholar
Loewenstein, GF (1988). Frames of mind in intertemporal choice. Management Science 34, 200–214.Google Scholar
Logue, AW (1988). Research on self-control: an integrating framework. Behavioral and Brain Sciences 11, 665–679.Google Scholar
Madden, GJ, Raiff, BR, Lagorio, CH, Begotka, AM, Mueller, AM, Hehli, DJ, Wegener, AA (2004). Delay discounting of potentially real and hypothetical rewards: II. Between- and within-subject comparisons. Experimental and Clinical Psychopharmacology 12, 251–261.Google Scholar
Mazur, JE (1987). An adjusting procedure for studying delayed reinforcement. In The Effect of Delay and of Intervening Events on Reinforcement Value: Quantitative Analyses of Behavior, Volume V (ed. Commons, M. L., Mazur, J. E., Nevin, J. A. and Rachlin, H.), pp. 55–73. Erlbaum: Hillsdale, NJ.Google Scholar
Neurobehavioral Systems (2012). Presentation, Version 16.1. Neurobehavioral Systems Inc.: Albany, CA.Google Scholar
Patrick, K, Norman, GJ, Calfas, KJ, Sallis, JF, Zabinski, MF, Rupp, J, Cella, J (2004). Diet, physical activity, and sedentary behaviors as risk factors for overweight in adolescence. Archives of Pediatrics and Adolescent Medicine 158, 385–390.Google Scholar
Paul, T, Thiel, A (2005). Eating Disorder Inventory-2 (EDI-2): German Version. Hogrefe: Göttingen.Google Scholar
Petermann, F, Daseking, M (2009). Fallbuch HAWIK-IV. Hogrefe: Göttingen.Google Scholar
Pinto, A, Steinglass, JE, Greene, AL, Weber, EU, Simpson, HB (2014). Capacity to delay reward differentiates obsessive-compulsive disorder and obsessive-compulsive personality disorder. Biological Psychiatry 75, 653–659.Google Scholar
Pulcu, E, Trotter, PD, Thomas, EJ, McFarquhar, M, Juhasz, G, Sahakian, BJ, Deakin, JF, Zahn, R, Anderson, IM, Elliott, R (2013). Temporal discounting in major depressive disorder. Psychological Medicine. Published online: 1 November 2013. doi:10.1017/S0033291713002584.Google Scholar
R Core Team (2012). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing: Vienna, Austria.Google Scholar
Reynolds, B (2006). A review of delay-discounting research with humans: relations to drug use and gambling. Behavioural Pharmacology 17, 651–667.Google Scholar
Ripke, S, Hübner, T, Mennigen, E, Müller, KU, Rodehacke, S, Schmidt, D, Jacob, MJ, Smolka, MN (2012). Reward processing and intertemporal decision making in adults and adolescents: the role of impulsivity and decision consistency. Brain Research 1478, 36–47.CrossRefGoogle ScholarPubMed
Robbins T, W, Cardinal R, N, DiCiano, P, Halligan, PW, Hellemans, KGC, Lee, JLC, Everitt, BJ (2005). Neuroscience and Drugs of Addiction V.1.0. Foresight: Brain Science, Addiction and Drugs Project (http://egret.psychol.cam.ac.uk/publications/2005/27_Robbins_2005_Foresight_19567_Neuroscience.pdf). Accessed 28 August 2014.Google Scholar
Rounds, JS, Beck, JG, Grant, DM (2007). Is the delay discounting paradigm useful in understanding social anxiety? Behaviour Research and Therapy 45, 729–735.Google Scholar
Saelens, B, Epstein, LH (1996). Reinforcing value of food in obese and non-obese women. Appetite 27, 41–50.Google Scholar
Scheres, A, de Water, E, Mies, GW (2013). The neural correlates of temporal reward discounting. Wiley Interdisciplinary Reviews: Cognitive Science 4, 523–545.Google Scholar
Scherr, J, Ferraro, FR, Weatherly, JN (2010). Associations between impulsivity and body dissatisfaction in females at risk for developing eating disorders. Current Psychology 29, 297–306.Google Scholar
Schweighofer, N, Bertin, M, Shishida, K, Okamoto, Y, Tanaka, SC, Yamawaki, S, Doya, K (2008). Low-serotonin levels increase delayed reward discounting in humans. Journal of Neuroscience 28, 4528–4532.CrossRefGoogle ScholarPubMed
Shamosh, NA, DeYoung, CG, Green, AE, Reis, DL, Johnson, MR, Conway, ARA, Engle, RW, Braver, TS, Gray, JR (2008). Individual differences in delay discounting relation to intelligence, working memory, and anterior prefrontal cortex. Psychological Science 19, 904–911.CrossRefGoogle ScholarPubMed
Simpson, CA, Vuchinich, RE (2000). Reliability of a measure of temporal discounting. Psychological Record 50, 3–16.CrossRefGoogle Scholar
Steinberg, L, Graham, S, O'Brien, L, Woolard, J, Cauffman, E, Banich, M (2009). Age differences in future orientation and delay discounting. Child Development 80, 28–44.Google Scholar
Steinglass, JE, Figner, B, Berkowitz, S, Simpson, HB, Weber, EU, Walsh, BT (2012). Increased capacity to delay reward in anorexia nervosa. Journal of the International Neuropsychological Society: JINS 18, 773–780.Google Scholar
Swanson, SA, Crow, SJ, Le Grange, D, Swendsen, J, Merikangas, KR (2011). Prevalence and correlates of eating disorders in adolescents. Results from the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry 68, 714–723.Google Scholar
Takahashi, T, Oono, H, Inoue, T, Boku, S, Kako, Y, Kitaichi, Y, Kusumi, I, Masui, T, Nakagawa, S, Suzuki, K, Tanaka, T, Koyama, T, Radford, MHB (2008). Depressive patients are more impulsive and inconsistent in intertemporal choice behavior for monetary gain and loss than healthy subjects – an analysis based on Tsallis’ statistics. Neuro Endocrinology Letters 29, 351–358.Google ScholarPubMed
Von Aster, M, Neubauer, AC, Horn, R (2006). WIE. Wechsler Intelligenztest für Erwachsene. Deutschsprachige Bearbeitung und Adaptation des WAIS-III von David Wechsler. Harcourt Test Services: Frankfurt/Main.Google Scholar
Wagner, A, Aizenstein, H, Venkatraman, VK, Fudge, J, May, JC, Mazurkewicz, L, Frank, GK, Bailer, UF, Fischer, L, Nguyen, V, Carter, C, Putnam, K, Kaye, WH (2007). Altered reward processing in women recovered from anorexia nervosa. American Journal of Psychiatry 164, 1842–1849.Google Scholar
Watson, KK, Werling, DM, Zucker, NL, Platt, ML (2010). Altered social reward and attention in anorexia nervosa. Frontiers in Psychology 1, 36.Google Scholar
Weber, EU, Johnson, EJ, Milch, KF, Chang, H, Brodscholl, JC, Goldstein, DG (2007). Asymmetric discounting in intertemporal choice: a query-theory account. Psychological Science 18, 516–523.Google Scholar
Weller, RE, Avsar, KB, Cox, JE, Reid, MA, White, DM, Lahti, AC (2014). Delay discounting and task performance consistency in patients with schizophrenia. Psychiatry Research 215, 286–293.Google Scholar
Weller, RE, Cook, EW 3rd, Avsar, KB, Cox, JE (2008). Obese women show greater delay discounting than healthy-weight women. Appetite 51, 563–569.Google Scholar
Wolff, G, Serpell, J (1998). A cognitive model and treatment strategies for anorexia nervosa. In Neurobiology in the Treatment of Eating Disorders (ed. Hoek, H., Treasure, J. and Katzman, M.), pp. 400–421. John Wiley & Sons: Chichester.Google Scholar
Zastrow, A, Kaiser, S, Stippich, C, Walther, S, Herzog, W, Tchanturia, K, Belger, A, Weisbrod, M, Treasure, J, Friederich, H-C (2009). Neural correlates of impaired cognitive-behavioral flexibility in anorexia nervosa. American Journal of Psychiatry 166, 608–616.Google Scholar
Zhang, L, Rashad, I (2008). Obesity and time preference: the health consequences of discounting the future. Journal of Biosocial Science 40, 97–113.Google Scholar
Supplementary material: File

Ritschel supplementary material

Ritschel supplementary material

Download Ritschel supplementary material(File)
File 90.6 KB