Investigating Associations Between General and Disorder-Specific Reward and Suicidality in Anorexia Nervosa

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Altered reward processing is a key feature in the pathology of anorexia nervosa (AN).
• Suicidal thoughts and behaviors (STBs) are a significant concern in individuals with AN.

Purpose of the Study:

• To investigate the relationship between general and disorder-specific reward processing and STBs in AN.
• To examine if interactions between reward types predict STB risk in AN.

Main Methods:

• Compared self-reported general (anticipatory, consummatory, social) and disorder-specific (self-starvation) reward in individuals with AN with (AN + STBs) or without (AN) lifetime STBs, and healthy controls (HC).
• Assessed the association between reward processing, STBs, and depression.

Main Results:

• The AN + STBs group reported lower anticipatory and social reward compared to AN and HC groups.
• Both AN and AN + STBs groups reported higher self-starvation reward than HCs.
• The interaction between anticipatory and self-starvation reward significantly predicted STB risk, even after controlling for depression.

Conclusions:

• General and disorder-specific reward processes interact to shape distinct suicidality risk profiles in AN.
• Self-starvation reward is a critical factor in understanding STB risk in AN.