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Nervenheilkunde 2011; 30(08): 578-584
DOI: 10.1055/s-0038-1628397
DOI: 10.1055/s-0038-1628397
Ulmer Heft
Das 10. Gebot: Du sollst hungern, dünn sein und Sport treiben bis zum Umfallen
Neue Befunde zur Anorexia nervosaThe tenth commandment: You shall starve, be thin and work out till you dropNew empirical findings on anorexia nervosaFurther Information
Publication History
Eingegangen am:
20 April 2011
angenommen am:
04 May 2011
Publication Date:
23 January 2018 (online)
Zusammenfassung
Tierstudien zufolge führt die Kombination eines bestimmten Diätplanes und freiwilliger physischer Aktivität zu einem rapiden Gewichtsverlust, der bis zum Tod führen kann. Ausschlaggebend dafür sind Prozesse im Belohnungssystem des Gehirns, die das Hungern positiv verstärken und so das Abmagern aufrechterhalten. Dies dient als Erklärungsmodell für das Hungern bei Patientinnen mit Anorexia nervosa, die durch ihren kachektischen Körper belohnt werden. Alternative Modelle zur Anorexia nervosa vermuten den zusätzlichen oder alleinigen Einfluss negativer Verstärkung, indem das Hungern negative Emotionen reduziert.
Die vorliegende Arbeit gibt eine Übersicht über die Datenlage und stellt eine eigene Studie an anorektischen Patientinnen vor, die einen Hinweis auf den Belohnungsaspekt des Hungerns liefert.
Summary
According to animal studies the combination of a certain diet and voluntary physical activity leads to a rapid loss of weight that might result in the death of the animal. Crucial for this observation are processes within the reward system of the brain which positively reinforce starvation and maintain emaciation. This may also serve as a theoretical model for starvation in patients with anorexia nervosa who are rewarded by their cachectic body. Alternative models of anorexia nervosa suppose the additional or exclusive influence of negative reinforcement, by means of reducing negative emotions by starvation.
This article provides a survey of relevant empirical findings and presents a study from our group on patients with anorexia nervosa which points to the reward aspect of starvation.
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Literatur
- 1 Grunwald M, Wesemann D, Rall L. Pro-anorexia websites: An underestimated and uncharted danger. Child and Adolescent Mental Health 2008; 13 (02) 96.
- 2 Davis C. et al. The prevalence of high-level exercise in the eating disorders: etiological implications. Compr Psychiatry 1997; 38 (06) 321-6.
- 3 Association AP. Diagnostic and statistical manual of mental disorders: DSM-IV. Washington D.C: American Psychiatric Press; 1994
- 4 Sullivan PF. Mortality in anorexia nervosa. American Journal of Psychiatry 1995; 152 (07) 1073-4.
- 5 Zhu AJ, Walsh BT. Pharmacologic treatment of eating disorders. Canadian Journal of Psychiatry – Revue Canadienne de Psychiatrie 2002; 47 (03) 227-34.
- 6 Attia E. Anorexia nervosa: current status and future directions. Annual Review of Medicine 2010; 61: 425-35.
- 7 Hay P. et al. Individual psychotherapy in the outpatient treatment of adults with anorexia nervosa. Cochrane Database of Systematic Reviews 2003; 04: CD003909.
- 8 Treasure J, Schmidt U. Anorexia nervosa. Clinical Evidence 2005; 14: 1140-8.
- 9 Kaye WH, Frank GK, Bailer UF, Henry SE. Neurobiology of anorexia nervosa: clinical implications of alterations of the function of serotonin and other neuronal systems. International Journal of Eating Disorders 2005; 37 Suppl: S15-9.
- 10 Wagner A. et al. Personality traits after recovery from eating disorders: do subtypes differ?. International Journal of Eating Disorders. 2006; 39 (04) 276-84.
- 11 Schmidt U, Treasure J. Anorexia nervosa: valued and visible. A cognitive-interpersonal maintenance model and its implications for research and practice. British Journal of Clinical Psychology. 2006; 45 (Pt 3): 343-66.
- 12 Shafran R, de Silva P. Cognitive-behavioral models. In: Treasure J, Schmidt U, Van Furth E. (eds.). Handbook of eating disorders. Chichester: Wiley; 2003
- 13 Keel PK, Klump KL. Are eating disorders culturebound syndromes? Implications for conceptualizing their etiology. Psychological Bulletin 2003; 129 (05) 747-69.
- 14 Pearce JM. Richard Morton: origins of anorexia nervosa. Europ Neurol 2004; 52 (04) 191-2.
- 15 Haber SN, Knutson B. The reward circuit: linking primate anatomy and human imaging. Neuropsychopharmacology 2010; 35 (01) 4-26.
- 16 Balleine BW, Dickinson A. Goal-directed instrumental action: contingency and incentive learning and their cortical substrates. Neuropharmacology 1998; 37 (4–5): 407-19.
- 17 O’Doherty J. et al. Dissociable roles of ventral and dorsal striatum in instrumental conditioning. Science 2004; 304 (5669): 452-4.
- 18 Holroyd CB, Coles MG. The neural basis of human error processing: reinforcement learning, dopamine, and the error-related negativity. Psychological Review 2002; 109 (04) 679-709.
- 19 Kalivas PW, Volkow ND. The neural basis of addiction: a pathology of motivation and choice. American Journal of Psychiatry 2005; 162 (08) 1403-13.
- 20 Hall JF, Hanford PV. Activity as a function of a restricted feeding schedule. Journal of Comparative and Physiological Psychology 1954; 47: 362-3.
- 21 Oscai LB, Holloszy JO. Effects of weight changes produced by exercise, food restriction, or overeating on body composition. Journal of Clinical Investigation 1969; 48 (11) 2124-8.
- 22 Inoue T, Tsuchiya K, Koyama T. Regional changes in dopamine and serotonin activation with various intensity of physical and psychological stress in the rat brain. Pharmacol Biochem Behav 1994; 49 (04) 911-20.
- 23 Jean A. et al. Anorexia induced by activation of serotonin 5-HT4 receptors is mediated by increases in CART in the nucleus accumbens. Proceedings of the National Academy of Sciences of the United States of America 2007; 104 (41) 16335-40.
- 24 Boakes RA. Self-starvation in the rat: running versus eating. Span Jn Psychol 2007; 10 (02) 251-7.
- 25 Marrazzi MALuby. An auto-addiction opioid model of chronic anorexia nervosa. International Journal of Eating Disorders 1986; 05 (02) 191-208.
- 26 Marrazzi MA, Luby ED, Kinzie J, Munjal ID, Spector S. Endogenous codeine and morphine in anorexia and bulimia nervosa. Life Sci 1997; 60 (20) 1741-7.
- 27 Kaye WH, Pickar D, Naber D, Ebert MH. Cerebrospinal fluid opioid activity in anorexia nervosa. American Journal of Psychiatry 1982; 139 (05) 643-5.
- 28 Margules DL. Beta-endorphin and endoloxone: Hormones of the autonomic nervous system for the conservation or expenditure of bodily resources and energy in anticipation of famine or feast. Neuroscience and Biobehavioral Reviews 1979; 03: 155-62.
- 29 Luby ED, Marrazzi MA, Sperti S. Anorexia nervosa: a syndrome of starvation dependence. Compr Ther 1987; 13 (09) 16-21.
- 30 Leone P, Pocock D, Wise RA. Morphine-dopamine interaction: ventral tegmental morphine increases nucleus accumbens dopamine release. Pharmacol Biochem Behav 1991; 39 (02) 469-72.
- 31 Bergh C, Sodersten P. Anorexia nervosa, self-starvation and the reward of stress. Nat Med 1996; 02 (01) 21-2.
- 32 Hotta M. et al. The responses of plasma adrenocorticotropin and cortisol to corticotropin-releasing hormone (CRH) and cerebrospinal fluid immunoreactive CRH in anorexia nervosa patients. Journal of Clinical Endocrinology & Metabolism 1986; 62 (02) 319-24.
- 33 Piazza PV, Deroche V, Deminiere JM, Maccari S, Le Moal M, Simon H. Corticosterone in the range of stress-induced levels possesses reinforcing properties: implications for sensation-seeking behaviors. Proceedings of the National Academy of Sciences of the United States of America 1993; 90 (24) 11738-42.
- 34 Gratton A, Wise RA. Drug-and behavior-associated changes in dopamine-related electrochemical signals during intravenous cocaine self-administration in rats. Journal of Neuroscience 1994; 14 (07) 4130-46.
- 35 Ceccatelli S, Villar MJ, Goldstein M, Hokfelt T. Expression of c-Fos immunoreactivity in transmittercharacterized neurons after stress. Proceedings of the National Academy of Sciences of the United States of America 1989; 86 (23) 9569-73.
- 36 Kaye WH, Frank GK, McConaha C. Altered dopamine activity after recovery from restricting-type anorexia nervosa. Neuropsychopharmacology 1999; 21 (04) 503-6.
- 37 Kaye WH, Ebert MH, Raleigh M, Lake R. Abnormalities in CNS monoamine metabolism in anorexia nervosa. Archives of General Psychiatry 1984; 41 (04) 350-5.
- 38 Bergen AW. et al. Association of multiple DRD2 polymorphisms with anorexia nervosa. Neuropsychopharmacology 2005; 30 (09) 1703-10.
- 39 Frieling H. et al. Epigenetic dysregulation of dopaminergic genes in eating disorders. International Journal of Eating Disorders 2010; 43 (07) 577-83.
- 40 Frank GK. et al. Increased dopamine D2/D3 receptor binding after recovery from anorexia nervosa measured by positron emission tomography and [11c]raclopride. Biological Psychiatry 2005; 58 (11) 908-12.
- 41 Wagner A. et al. Altered insula response to taste stimuli in individuals recovered from restricting-type anorexia nervosa. Neuropsychopharmacology 2008; 33 (03) 513-23.
- 42 Wagner A. et al. Altered reward processing in women recovered from anorexia nervosa. American Journal of Psychiatry 2007; 164 (12) 1842-9.
- 43 Friederich HC. et al. Differential motivational responses to food and pleasurable cues in anorexia and bulimia nervosa: a startle reflex paradigm. Psychological Medicine 2006; 36 (09) 1327-35.
- 44 Lilenfeld LR, Wonderlich S, Riso LP, Crosby R, Mitchell J. Eating disorders and personality: a methodological and empirical review. Clinical Psychology Review 2006; 26 (03) 299-320.
- 45 Stice E. Risk and maintenance factors for eating pathology: a meta-analytic review. Psychological Bulletin 2002; 128 (05) 825-48.
- 46 Bulik CM. et al. Genetic epidemiology, endophenotypes, and eating disorder classification. International Journal of Eating Disorders 2007; 40 Suppl: S52-60.
- 47 Geller J, Cockell SJ, Goldner EM. Inhibited expression of negative emotions and interpersonal orientation in anorexia nervosa. International Journal of Eating Disorders 2000; 28: 8-19.
- 48 Kucharska-Pietura K, Nikolaou V, Masiak M, Treasure J. The recognition of emotion in the faces and voice of anorexia nervosa. International Journal of Eating Disorders 2004; 35 (01) 42-7.
- 49 Zonnevijlle-Bender MJ. et al. Do adolescent anorexia nervosa patients have deficits in emotional functioning?. European Child and Adolescent Psychiatry 2002; 11: 38-42.
- 50 Rastam M, Gillberg C, Gillberg IC, Johansson M. Alexithymia in anorexia nervosa: a controlled study using the 20-item Toronto Alexithymia Scale. Acta Psychiatrica Scandinavica 1997; 95 (05) 385-8.
- 51 Troop NA, Schmidt UH, Treasure JL. Feelings and fantasy in eating disorders: a factor analysis of the Toronto Alexithymia Scale. International Journal of Eating Disorders 1995; 18 (02) 151-7.
- 52 Kaye WH, Fudge JL, Paulus M. New insights into symptoms and neurocircuit function of anorexia nervosa. Nature Reviews Neuroscience 2009; 10 (08) 573-84.
- 53 Vitousek K, Manke F. Personality variables and disorders in anorexia nervosa and bulimia nervosa. Journal of Abnormal Psychology 1994; 103 (01) 137-47.
- 54 Serpell L, Teasdale JD, Troop NA, Treasure J. The development of the P-CAN, a measure to operationalize the pros and cons of anorexia nervosa. International Journal of Eating Disorders 2004; 36 (04) 416-33.
- 55 Casper RC. Behavioral activation and lack of concern, core symptoms of anorexia nervosa?. International Journal of Eating Disorders 1998; 24 (04) 381-93.
- 56 Lasègue C. De l’anorexie hystérique. Arch Gén Méd 1873; 01: 384-403.
- 57 Fladung AK. et al. A neural signature of anorexia nervosa in the ventral striatal reward system. American Journal of Psychiatry 2010; 167 (02) 206-12.
- 58 Zink CF, Weinberger DR. The rewards of self starvation. Nature Medicine 2010; 16 (12) 1382-3.
- 59 Södersten P, Nergardh R, Bergh C, Zandian M, Scheurink A. Behavioral neuroendocrinology and treatment of anorexia nervosa. Frontiers in Neuroendocrinology 2008; 29 (04) 445-62.
- 60 Bergh C, Brodin U, Lindberg G, Sodersten P. Randomized controlled trial of a treatment for anorexia and bulimia nervosa. Proceedings of the National Academy of Sciences of the United States of America 2002; 99 (14) 9486-91.