Computational Perspectives on Cognition in Anorexia Nervosa: A Systematic Review

Anorexia nervosa (AN) is a severe eating disorder, marked by persistent changes in behaviour, cognition and neural activity that result in insufficient body weight. Recently, there has been a growing interest in using computational approaches to understand the cognitive mechanisms that underlie AN symptoms, such as persistent weight loss behaviours, rigid rules around food and preoccupation with body size. Our aim was to systematically review progress in this emerging field. Based on articles selected using systematic and reproducible criteria, we identified five current themes in the computational study of AN: 1) reinforcement learning; 2) value-based decision-making; 3) goal-directed and habitual control over behaviour; 4) cognitive flexibility; and 5) theory-based accounts. In addition to describing and appraising the insights from each of these areas, we highlight methodological considerations for the field and outline promising future directions to establish the clinical relevance of (neuro)computational changes in AN.