Neurobiological substrates of fear conditioning and intimacy in anorexia nervosa

• Applicant: Professor Dr. Andreas Joos
• Subject Area: Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry
• Term: from 2014 to 2018
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 258785314

Anorexia nervosa (AN) is a severe mental disorder with high mortality. It mainly affects adolescent women. Neurobiological, psychosocial as well as cultural factors play a role in the disposition, the initiation and the maintenance of the disease. Modern cerebral imaging of AN has demonstrated cerebral atrophy of various brain regions as well as disturbances of cerebral activation when confronted with disease specific items, i.e. food or body stimuli. However, there have been no (imaging) studies so far focussing on two central aspects of the disorder, which are closely rated to each other: 1. AN patients are overanxious, which is often preceding the onset of AN symptoms; pathological fear conditioning has been postulated but has not been tested empirically.2. AN patients have strong fear of intimacy, which is one of the core psychopathological features. The disorder usually starts in adolescence and patients have major difficulties in taking over the role as psychosexually mature adults. The proposed study aims at unravelling psychobiological mechanisms of these central aspects of AN. Cerebral activation will be investigated in the context of instructed fear as well as during exposure to intimate and romantic, but not explicitly sexual scenes. The subjective experience as well as skin conductance, heart rate variability and hormonal parameters, including oxytocin, will be recorded. As part of a multimodal imaging approach the anterior insula, which is an important structure related to anxiety, will be studied by magnetic resonance.In order to target the question whether abnormalities are state or trait related presently ill and recovered patients will be investigated. A better understanding of these mechanisms is essential for the development of improved prevention and treatment strategies of this difficult to treat disease.

• DFG Programme: Research Grants
• Participating Persons: Professor Ludger Tebartz van Elst, Ph.D.; Professor Dr. Oliver Tüscher