Impulse control under emotion processing: an fMRI investigation in borderline personality disorder compared to non-patients and cluster-C personality disorder patients.

Impulsivity is a characteristic syndromal and neurobehavioral feature of borderline personality disorder (BPD). Research suggests an important interaction between high negative emotions and low behavioral inhibition in BPD. However, knowledge about the generalizability across stimulus categories and diagnosis specificity is limited. We investigated neural correlates of hypothesized impaired response inhibition of BPD patients to negative, positive and erotic stimuli, by comparing them to non-patients and cluster-C personality disorder patients. During fMRI scanning, 53 BPD patients, 34 non-patients and 20 cluster-C personality disorder patients completed an affective go/no-go task, including social pictures. BPD patients showed more omission errors than non-patients, independent of the stimulus category. Furthermore, BPD patients showed higher activity in the inferior parietal lobule and frontal eye fields when inhibiting negative versus neutral stimuli. Activity of the inferior parietal lobule correlated positively with the BPD checklist subscale impulsivity. When inhibiting emotional stimuli, BPD patients showed an altered brain activity in the inferior parietal lobe and frontal eye fields, whereas previously shown dysfunctional prefrontal activity was not replicated. BPD patients showed a general responsivity across stimulus categories in the frontal eye fields, whereas effects in the inferior parietal lobe were specific for negative stimuli. Results of diagnosis specificity support a dimensional rather than a categorical differentiation between BPD and cluster-C patients during inhibition of social emotional stimuli. Supported by behavioral results, BPD patients showed no deficiencies in emotionally modulated response inhibition per se but the present findings rather hint at attentional difficulties for emotional information.

Patients with borderline personality disorder and comorbid PTSD show biased attention for threat in the facial dot-probe task.

BACKGROUND AND OBJECTIVES: Biased attention to threat is likely to play a crucial role in the dysfunctional emotion-related information processing in borderline personality disorder (BPD). However, the role of comorbid posttraumatic stress disorder (PTSD) has not yet been fully disentangled. METHODS: BPD patients with (n = 24) and without (n = 46) PTSD, 35 patients with Cluster-C personality disorder and 52 non-patients participated in the facial dot-probe task with angry, happy and neutral faces during automatic (100 ms), controlled (600 ms), and later (1200 ms) stages of information processing. RESULTS: BPD patients showed a greater congruency effect to angry faces during the controlled stage of processing than controls. Specifically, in BPD with PTSD compared to controls, this effect was due to difficulties disengaging from threat, indicated by slower reaction times to incongruent angry targets compared to neutral trials. Regarding automatic and later stages of information processing, there was no attentional bias (AB) in BPD. None of the groups revealed biased attention for happy faces at any stages of information processing. LIMITATIONS: We did not include a control group of PTSD patients without BPD. Therefore, we cannot rule out that the present AB in BPD is mainly due to PTSD-specific psychopathology. CONCLUSIONS: These findings provide first evidence for an AB towards angry faces and difficulties disengaging from these threat-related social cues in adult BPD patients. Although BPD patients in general demonstrated an AB when compared with controls, this effect was especially pronounced for BPD with PTSD, suggesting a significant effect of trauma-related psychopathology on social attention in BPD.

Biased Attention to Facial Expressions of Ambiguous Emotions in Borderline Personality Disorder: An Eye-Tracking Study.

Preliminary evidence suggests that biased attention could be crucial in fostering the emotion recognition abnormalities in borderline personality disorder (BPD). We compared BPD patients to Cluster-C personality disorder (CC) patients and non-patients (NP) regarding emotion recognition in ambiguous faces and their visual attention allocation to the eyes. The role of comorbid posttraumatic stress disorder (PTSD) in BPD regarding emotion recognition and visual attention was explored. BPD patients fixated the eyes of angry/happy, sad/happy, and fearful/sad blends longer than non-patients. This visual attention pattern was mainly driven by BPD patients with PTSD. This subgroup also demonstrated longer fixations than CC patients and a trend towards longer fixations than BPD patients without PTSD for the angry/happy and fearful/sad blends. Emotion recognition was not altered in BPD. Biased visual attention towards the eyes of ambiguous facial expressions in BPD might be due to trauma-related attentional bias rather than to impairments in facial emotion recognition.

Anger provocation increases limbic and decreases medial prefrontal cortex connectivity with the left amygdala in reactive aggressive violent offenders.

Neurobiological models propose reactive aggression as a failure in emotion regulation, caused by an imbalance between prefrontal cortical control and excessive bottom-up signals of negative affect by limbic regions, including the amygdala. Therefore, we hypothesize a negative correlation between PFC and amygdala activity (pre/post resting-state scans) in violent offenders. In this study resting-state fMRI was administered before and after an emotion (anger and happiness) provocation or engagement task within 18 male violent offenders scoring high on reactive aggression, and 18 male non-offender controls. Research in emotional pre/post resting-state showed altered connectivity by task performance. Therefore, bilateral amygdala region of interest (ROI) whole brain functional connectivity analysis tested dynamic change differences between pre and post resting-state connectivity between groups. Self-reported anger showed a positive significant relationship with medial prefrontal cortex activity in the pre-task scan and significantly increased during the emotion task in both the violent and control group. Imaging results showed a significant decrease in amygdala - medial prefrontal functional connectivity in the violent offenders and an increase in the non-offender controls after the emotion task. The opposite pattern was found for amygdala connectivity with the (para) limbic regions: violent offenders showed increased connectivity and non-offender controls showed decreased connectivity. The present results indicate that reactive aggression might stem from a focus on emotion processing, as indicated by an increase in limbic functional connectivity. The combination of a focus on emotion, along with a lack of medial prefrontal cortex regulation, has the potential to grow out of control e.g. in reactive aggression.

Always on guard: emotion regulation in women with borderline personality disorder compared to nonpatient controls and patients with cluster-C personality disorder.

BACKGROUND: Borderline personality disorder (BPD) is characterized by emotion dysregulation; however, it is unclear whether this is restricted to negative emotional stimuli or to what degree this is specific to BPD. We investigated neural correlates of hypothesized increased emotional sensitivity and impaired emotion regulation in patients with BPD. METHODS: During functional MRI (fMRI) scanning, patients with BPD, nonpatient controls and patients with cluster-C personality disorder completed an emotion regulation task, including negative, positive and erotic social pictures. RESULTS: We included 55 patients with BPD, 42 nonpatient controls and 24 patients with cluster-C personality disorder in our analyses. Passive viewing of negative stimuli resulted in greater activity in the anterior insula, temporoparietal junction and dorsolateral prefrontal cortex in patients with BPD than in nonpatient controls. The increased activity in the anterior insula and temporoparietal junction was also present when patients with BPD viewed positive stimuli. During regulation of negative stimuli compared with passive viewing, nonpatient controls showed greater activity in the dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, middle temporal gyrus and bilateral inferior parietal lobule. Patients with BPD did not show this increase in activity. LIMITATIONS: Findings cannot be generalized to men, and patients represented a heterogeneous group regarding comorbid diagnoses and medication. CONCLUSION: When looking at emotional stimuli, patients with BPD showed a unique pattern of activity, suggesting an increase in brain activity involved in emotion generation. In the case of negative stimuli this is accompanied by increased activity in regulation areas. In contrast, increase of regulation processes seems absent when patients with BPD are explicitly instructed to regulate. Results of diagnosis specificity support a dimensional rather than a dichotomous differentiation between BPD and cluster-C personality disorder regarding emotional sensitivity and emotional regulation of social stimuli.

Always on guard: emotion regulation in women with borderline personality disorder compared to nonpatient controls and patients with cluster-C personality disorder.

BACKGROUND: Borderline personality disorder (BPD) is characterized by emotion dysregulation; however, it is unclear whether this is restricted to negative emotional stimuli or to what degree this is specific to BPD. We investigated neural correlates of hypothesized increased emotional sensitivity and impaired emotion regulation in patients with BPD. METHODS: During fMRI scanning, patients with BPD, nonpatient controls and patients with cluster-C personality disorder completed an emotion regulation task, including negative, positive and erotic social pictures. RESULTS: We included 55 patients with BPD, 42 nonpatient controls and 24 patients with cluster-C personality disorder in our analyses. Passive viewing of negative stimuli resulted in greater activity in the anterior insula, temporoparietal junction and dorsolateral prefrontal cortex in patients with BPD than in nonpatient controls. The increased activity in the anterior insula and temporoparietal junction was also present when patients with BPD viewed positive stimuli. During regulation of negative stimuli compared with passive viewing, nonpatient controls showed greater activity in the dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, middle temporal gyrus and bilateral inferior parietal lobule. Patients with BPD did not show this increase in activity. LIMITATIONS: Findings cannot be generalized to men, and patients represented a heterogeneous group regarding comorbid diagnoses and medication. CONCLUSION: When looking at emotional stimuli, patients with BPD showed a unique pattern of activity, suggesting an increase in brain activity involved in emotion generation. In the case of negative stimuli this is accompanied by increased activity in regulation areas. In contrast, increase of regulation processes seems absent when patients with BPD are explicitly instructed to regulate. Results of diagnosis specificity support a dimensional rather than a dichotomous differentiation between BPD and cluster-C personality disorder regarding emotional sensitivity and emotional regulation of social stimuli.

Anger provocation in violent offenders leads to emotion dysregulation.

Anger and anger regulation problems that result in aggressive behaviour pose a serious problem for society. In this study we investigated differences in brain responses during anger provocation or anger engagement, as well as anger regulation or distraction from anger, and compared 16 male violent offenders to 18 non-offender controls. During an fMRI adapted provocation and regulation task participants were presented with angry, happy and neutral scenarios. Prior research on violent offenders indicates that a combination of increased limbic activity (involved in emotion), along with decreased prefrontal activity (involved in emotion regulation), is associated with reactive aggression. We found increased ventrolateral prefrontal activity during anger engagement in violent offenders, while decreased dorsolateral and ventrolateral prefrontal activity was found during anger distraction. This activity pattern was specific for anger. We found no exclusive pattern for happiness. In violent offenders, this suggests an increased need to regulate specifically during anger engagement and regulation difficulties when explicitly instructed to distract. The constant effort required for violent offenders to regulate anger might exhaust the necessary cognitive resources, resulting in a risk for self-control failure. Consequently, continuous provocation might ultimately contribute to reactive aggression.

Deficient amygdala-prefrontal intrinsic connectivity after effortful emotion regulation in borderline personality disorder.

Emotion instability in borderline personality disorder (BPD) has been associated with an impaired fronto-limbic inhibitory network. However, functional connectivity (FC) underlying altered emotion regulation in BPD has yet to be established. Here, we used resting-state fMRI to investigate enduring effects of effortful emotion regulation on the amygdala intrinsic FC in BPD. In this multicenter study, resting-state fMRI was acquired before and after an emotion regulation task in 48 BPD patients and 39 non-patient comparison individuals. The bilateral amygdalae were used as a seed in the whole-brain FC analysis and two-way mixed ANOVA to test whether BPD patients exhibited weaker post-task increase in the amygdala intrinsic FC with the prefrontal cortex (PFC), compared to non-patients. Subsequently, we explored whether the results are common for personality disorders characterized by emotional problems, using additional data of 21 cluster-C personality disorder patients. In contrast to non-patients, BPD patients failed to show increased post-task amygdala resting-state FC with the medial, dorsolateral, ventrolateral PFC, and superior temporal gyrus, but surprisingly exhibited decreased FC with the posterior cingulate cortex and increased FC with the superior parietal lobule. In BPD patients, the emotion regulation task failed to increase resting-state amygdala FC with brain regions essential for effortful emotion regulation, which suggests: (a) altered cognitive control typically used to indirectly alleviate distress by reinterpreting the meaning of emotional stimuli; (b) impaired direct regulation of emotional responses, which might be common for personality disorders;

Negative mood-induction modulates default mode network resting-state functional connectivity in chronic depression.

BACKGROUND: The aim of this study was to investigate the effects of sad mood on default mode network (DMN) resting-state connectivity in persons with chronic major depressive disorder (cMDD). METHODS: Participants with a diagnosis of cMDD (n=18) and age, gender and education level matched participants without a diagnosis of depression (n=18) underwent a resting-state fMRI scan, before and after a sad mood induction. The posterior cingulate cortex (PCC) was used as a seed for DMN functional connectivity across the two resting-state measurements. RESULTS: Mood ratings decreased in both groups following the sad mood induction procedure. PCC connectivity with the parahippocampal gyrus, the superior temporal gyrus and the anterior inferior temporal cortex increased in cMDD patients following the sad mood induction, whereas it decreased in non-patient controls. PCC connectivity with the anterior prefrontal cortex and the precuneus decreased in cMDD patients following the sad mood induction, whereas it increased in non-patient controls. LIMITATIONS: Limitations of this study include the relatively small sample size and lack of a clinical control group. CONCLUSIONS: These findings are in line with neurobiological models of depression suggesting that the observed changes in DMN connectivity following the sad mood induction might reflect a failure to exert cognitive control over negative memory retrieval in patients with cMDD.

Brain Activation Associated with Automatic Processing of Alcohol-Related Cues in Young Heavy Drinkers and Its Modulation by Alcohol Administration.

BACKGROUND: While the automatic processing of alcohol-related cues by alcohol abusers is well established in experimental psychopathology approaches, the cerebral regions involved in this phenomenon and the influence of alcohol intake on this process remain unknown. The aim of this functional magnetic resonance imaging (fMRI) study was to investigate the neural mechanisms underlying the processing of task-irrelevant alcohol-related stimuli in young heavy drinkers and their modulation by alcohol administration. METHODS: Twelve heavy drinking male participants were scanned on 2 separate days; once after a low dose of alcohol intake (0.4 g/kg), and once after a placebo intake, in balanced order. Images of alcoholic drinks, soft drinks, or neutral objects were shown while participants' neural activity was recorded through fMRI. Moreover, participants' attentional focus was manipulated using a task which required them to process the central images of interest (focus alcohol condition) or a center unattended task (focus not on alcohol condition). RESULTS: Results indicated that an explicit judgment on beverage-related cues increased activation in the prefrontal area compared with the judgment of neutral objects. By comparison with that of task-irrelevant neutral cues, the processing of task-irrelevant alcohol-related cues increased the activation in a large network of cerebral areas including visual and temporal regions, the bilateral anterior cingulate cortex, the posterior cingulate cortex, and the putamen. Moreover, in the condition with focus not on alcohol, the ventral tegmental area (VTA) was particularly activated by the presentation of (task-irrelevant) alcohol-related cues compared to task-irrelevant soft-drink-related cues. CONCLUSIONS: The VTA was especially involved in the automatic processing of alcohol-related cues in young heavy drinkers. Low dose of alcohol did not modulate the neural substrates involved in the processing of salient alcohol-related cues.

Neural correlates of self-referential processing and implicit self-associations in chronic depression.

BACKGROUND: Patients with depression tend to process negative information with regard to the self (i.e. self-referential processing). A better understanding of the neural underpinnings of self-referential processing in patients with depression is clinically important as it can inform on potential treatment targets. METHOD: This fMRI study sought to study the neural correlates of self-referential processing in patients with chronic major depressive disorder (cMDD) (n=17) and non-patient controls (n=18) using a passive processing paradigm. Stimuli consisted of positive, negative, negative depression related and neutral personality trait words or non-words. Participants were instructed to indicate whether a presented word was an existing word or a non-word while undergoing an fMRI scan. Participants also completed an explicit and an implicit measure of positive and negative self-associations outside the scanner. RESULTS: Non-patient controls had relatively increased activity in the medial prefrontal cortex (mPFC) during processing of negative depression related vs. neutral words whereas patients with cMDD had relatively decreased activity. Non-patient controls had relatively increased dorsolateral prefrontal cortex (dlPFC) activity during processing of positive vs. neutral words whereas patients with cMDD had relatively decreased activity. Explicit but not implicit self-associations with depression related words were associated with neural activity in the mPFC and the dlPFC. LIMITATIONS: The study did not include a clinical control group and therefore the specificity of findings remains unknown. CONCLUSIONS: The distinct neural processing of emotional self-relevant stimuli in the mPFC and the dlPFC in patients with cMDD might represent an emotional blunting response towards negative self-relevant stimuli.

Emotional sensitivity, emotion regulation and impulsivity in borderline personality disorder: a critical review of fMRI studies.

Emotional sensitivity, emotion regulation and impulsivity are fundamental topics in research of borderline personality disorder (BPD). Studies using fMRI examining the neural correlates concerning these topics is growing and has just begun understanding the underlying neural correlates in BPD. However, there are strong similarities but also important differences in results of different studies. It is therefore important to know in more detail what these differences are and how we should interpret these. In present review a critical light is shed on the fMRI studies examining emotional sensitivity, emotion regulation and impulsivity in BPD patients. First an outline of the methodology and the results of the studies will be given. Thereafter important issues that remained unanswered and topics to improve future research are discussed. Future research should take into account the limited power of previous studies and focus more on BPD specificity with regard to time course responses, different regulation strategies, manipulation of self-regulation, medication use, a wider range of stimuli, gender effects and the inclusion of a clinical control group.

Neural predictors of chocolate intake following chocolate exposure.

Previous studies have shown that one's brain response to high-calorie food cues can predict long-term weight gain or weight loss. The neural correlates that predict food intake in the short term have, however, hardly been investigated. This study examined which brain regions' activation predicts chocolate intake after participants had been either exposed to real chocolate or to control stimuli during approximately one hour, with interruptions for fMRI measurements. Further we investigated whether the variance in chocolate intake could be better explained by activated brain regions than by self-reported craving. In total, five brain regions correlated with subsequent chocolate intake. The activation of two reward regions (the right caudate and the left frontopolar cortex) correlated positively with intake in the exposure group. The activation of two regions associated with cognitive control (the left dorsolateral and left mid-dorsolateral PFC) correlated negatively with intake in the control group. When the regression analysis was conducted with the exposure and the control group together, an additional region's activation (the right anterior PFC) correlated positively with chocolate intake. In all analyses, the intake variance explained by neural correlates was above and beyond the variance explained by self-reported craving. These results are in line with neuroimaging research showing that brain responses are a better predictor of subsequent intake than self-reported craving. Therefore, our findings might provide for a missing link by associating brain activation, previously shown to predict weight change, with short-term intake.

The craving stops before you feel it: neural correlates of chocolate craving during cue exposure with response prevention.

Cue reactivity and craving can be influenced by cue exposure with response prevention (CERP). This study investigated the neural correlates of CERP using functional magnetic resonance imaging, while participants smelled chocolate (17 participants) or a control object (17 participants). CERP was interrupted by 7 scanning sequences measuring the brain response to neutral and chocolate pictures. Chocolate craving was hypothesized to be mirrored by activation in brain reward regions. As expected, control group craving remained similar throughout the session. A short exposure (30 min) increased chocolate craving in the experimental group, which was mirrored by significant group differences in activation in brain reward regions. Unexpectedly, a long exposure (60 min) did not lead to craving extinction in the experimental group, although craving started to decrease at this point. On a neural level, however, activation in regions of interest in the experimental group seemed to have extinguished after the long exposure, as activation levels returned to or fell below control group levels. These results indicate that brain reward activation during CERP is linked to craving, at least for a short exposure. Regarding a longer exposure, the decline in brain reward activation in the experimental group may be a precursor of a decrease in craving.

Serotonin transporter genotype modulates cognitive reappraisal of negative emotions: a functional magnetic resonance imaging study.

A functional polymorphism within the serotonin transporter gene (5-HTTLPR) has been reported to modulate emotionality and risk for affective disorders. The short (S) allele has less functional efficacy than the long (L) allele and has been associated with enhanced emotional reactivity. One possible contributing factor to the high emotionality in S carriers may be inefficient use of cognitive strategies such as reappraisal to regulate emotional responses. The aim of the present study was to test whether the 5-HTTLPR genotype modulates the neural correlates of emotion regulation. To determine neural differences between S and L allele carriers during reappraisal of negative emotions, 15 homozygous S (S'/S') and 15 homozygous L (L'/L') carriers underwent functional magnetic resonance imaging (fMRI), while performing an instructed emotion regulation task including downregulation, upregulation and passive viewing of negative emotional pictures. Compared to L'/L' allele carriers, subjects who carry the S'/S' allele responded with lower posterior insula and prefrontal brain activation during passive perception of negative emotional information but showed greater prefrontal activation and anterior insula activation during down- and upregulation of negative emotional responses. The current results support and extend previous findings of enhanced emotionality in S carriers by providing additional evidence of 5-HTTLPR modulation of volitional emotion regulation.

Of cats and women: temporal dynamics in the right temporoparietal cortex reflect auditory categorical processing of vocalizations.

Understanding the temporal dynamics underlying cortical processing of auditory categories is complicated by difficulties in equating temporal and spectral features across stimulus classes. In the present magnetoencephalography (MEG) study, female voices and cat sounds were filtered so as to match in most of their acoustic properties, and the respective auditory evoked responses were investigated with a paradigm that allowed us to examine auditory cortical processing of two natural sound categories beyond the physical make-up of the stimuli. Three cat or human voice sounds were first presented to establish a categorical context. Subsequently, a probe sound that was congruent, incongruent, or ambiguous to this context was presented. As an index of a categorical mismatch, MEG responses to incongruent sounds were stronger than the responses to congruent sounds at ~250 ms in the right temporoparietal cortex, regardless of the sound category. Furthermore, probe sounds that could not be unambiguously attributed to any of the two categories ("cat" or "voice") evoked stronger responses after the voice than cat context at 200-250 ms, suggesting a stronger contextual effect for human voices. Our results suggest that categorical templates for human and animal vocalizations are established at ~250 ms in the right temporoparietal cortex, likely reflecting continuous online analysis of spectral stimulus features during auditory categorizing task.

Fighting food temptations: the modulating effects of short-term cognitive reappraisal, suppression and up-regulation on mesocorticolimbic activity related to appetitive motivation.

The premise of cognitive therapy is that one can overcome the irresistible temptation of highly palatable foods by actively restructuring the way one thinks about food. Testing this idea, participants in the present study were instructed to passively view foods, up-regulate food palatability thoughts, apply cognitive reappraisal (e.g., thinking about health consequences), or suppress food palatability thoughts and cravings. We examined whether these strategies affect self-reported food craving and mesocorticolimbic activity as assessed by functional magnetic resonance imaging. It was hypothesized that cognitive reappraisal would most effectively inhibit the mesocorticolimbic activity and associated food craving as compared to suppression. In addition, it was hypothesized that suppression would lead to more prefrontal cortex activity, reflecting the use of more control resources, as compared to cognitive reappraisal. Self-report results indicated that up-regulation increased food craving compared to the other two conditions, but that there was no difference in craving between the suppression and cognitive reappraisal strategy. Corroborating self-report results, the neuroimaging results showed that up-regulation increased activity in important regions of the mesocorticolimbic circuitry, including the ventral tegmental area, ventral striatum, operculum, posterior insular gyrus, medial orbitofrontal cortex and ventromedial prefrontal cortex. Contrary to our hypothesis, suppression more effectively decreased activity in the core of the mesocorticolimbic circuitry (i.e., ventral tegmental area and ventral striatum) compared to cognitive reappraisal. Overall, the results support the contention that appetitive motivation can be modulated by the application of short-term cognitive control strategies.

Positive erotic picture stimuli for emotion research in heterosexual females.

In most experimental studies, emotional pictures are widely used as stimulus material. However, there is still a lack of standardization of picture stimuli displaying erotic relationships, despite the association between a number of psychological problems and severe impairments and problems in intimate relationships. The aim of the study was to test a set of erotic stimuli, with the potential to be used in experimental studies, with heterosexual female subjects. Twenty International Affective Picture System (IAPS) pictures and an additional 100 pictures showing romantic but not explicitly sexual scenes and/or attractive single males were selected. All pictures were rated with respect to valence, arousal, and dominance by 41 heterosexual women and compared to pictures with negative, positive, and neutral emotional valence. Erotic IAPS pictures and our additional erotic pictures did not differ in any of the evaluation dimensions. Analyses of variance (ANOVAs) for valence, arousal, and dominance comparing different picture valence categories showed strong effects for category. However, valence was not significantly different between erotic and positive pictures, while arousal and control were not significantly different between positive and neutral pictures. The pictures of our new set are as positive for heterosexual women as highly positive IAPS pictures, but higher in arousal and dominance. The picture set can be used in experimental psychiatric studies requiring high numbers of stimuli per category. Limitations are the restriction of stimuli application to heterosexual females only and to self-report data.

Cognitions and emotions in eating disorders.

The cognitive model of eating disorders (EDs) states that the processing of external and internal stimuli might be biased in mental disorders. These biases, or cognitive errors, systematically distort the individual's experiences and, in that way, maintains the eating disorder. This chapter presents an updated literature review of experimental studies investigating these cognitive biases. Results indicate that ED patients show biases in attention, interpretation, and memory when it comes to the processing of food-, weight-, and body shape-related cues. Some recent studies show that they also demonstrate errors in general cognitive abilities such as set shifting, central coherence, and decision making. A future challenge is whether cognitive biases and processes can be manipulated. Few preliminary studies suggest that an attention retraining and training in the cognitive modulation of food reward processing might be effective strategies to change body satisfaction, food cravings, and eating behavior.

Sensory-specific satiety is impervious to the tasting of other foods with its assessment.

Sensory-specific satiety (SSS) refers to the reduction in pleasantness of a food with its consumption relative to other unconsumed foods. In a typical SSS paradigm, the participants receive a range of food items to taste and evaluate and then one of the foods is consumed ad libitum until satiation. After the consumption of the test food, all the foods (including the test food) are then again tasted and evaluated. If SSS is the result of habituation this evaluation of the test food after its consumption would be subject to dishabituation (i.e. recovery of SSS) if the other unconsumed foods are evaluated first. To examine whether this is the case a total of 57 participants were randomly assigned to one of two groups: Test Food First (TFF; n=28) or Test Food Last (TFL; n=29). We hypothesized that group TFF would show stronger SSS than TFL. We found clear indication of SSS, but the degree of SSS did not differ between the two groups (F[1,55]<1). This finding suggests that SSS is unaffected by the sequence of tasting food items with its assessment. The potential implications for understanding SSS in terms of habituation are discussed.