Consistency of reward responses in neutral and anxious states in adolescent females with anorexia nervosa
Bibliographic record
Abstract
BACKGROUND: Anorexia nervosa (AN) is a difficult-to-treat psychiatric disorder that typically onsets in adolescence. AN is marked by atypical reward responsiveness and elevated anxiety. However, the neural dynamics of reward responsivity, and how this is impacted by being in an anxious state, are unknown in AN. To test this, we conducted a novel fMRI task consisting of a monetary reward following anxiety provocation or a neutral condition. METHODS: Forty-seven adolescent participants (25 females with partially or fully weight restored AN, post treatment and 22 mildly anxious controls) were presented with personalized anxiety-provoking or neutral words before receiving a reward. Mildly anxious controls were included to enable dimensional analysis of anxiety severity and to assess whether anxiety effects were specific to AN. To measure trial-by-trial consistency of multivariate patterns associated with reward, and the effects of anxiety on reward, neural responses across reward circuit and cognitive reward control regions were analyzed using representational similarity analysis. RESULTS: As hypothesized, AN participants showed lower representational similarity than controls during neutral-word rewarded trials, indicating more variable reactivity to rewarding outcomes. Contrary to predictions, there were no significant between-group differences for the effects of anxiety-words on reward representational similarity, and representational similarity did not predict longitudinal symptom change over six months. CONCLUSIONS: The results demonstrate more variable responses to reward receipt in AN compared with controls, but no significant effects of anxiety states on the consistency of reward responses. These results provide insight into the dynamics of reward processing in AN, which has potential implications for planning and guiding reward-focused interventions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".