
doi: 10.1002/erv.2211
pmid: 23080262
In contrast to the interest that has been shown in understanding and treatment of the behaviours, physical consequences and thoughts, emotions have been somewhat neglected. Perhaps, this neglect mirrors the emotional avoidance and attachment difficulties that are characteristic of people with eating disorders and that can distort introspection and self-report. Figure 1 is a schematic representation of the emotional brain based on Panksepp’s model (Panksepp, 2011) of three interacting processes. The primary process lies within the evolutionary oldest parts of the brain and represents the affective consciousness from sensory, homeostatic and emotional inputs. The secondary process involves learning and memory that contribute to emotional habits. Finally, there is the tertiary process of cognitive control. How does what we know about eating disorder fit within this model? I selectively look at the literature in order to set the scene for the papers in this edition that follow. Eating disorders may result from abnormal functioning in each of these three processes. First, there appears to be enhanced sensitivity to punishment in the primary process whereas the response to reward is attenuated in anorexia nervosa and exaggerated in bulimic disorders (Harrison, Treasure, & Smillie, 2011). Anxiety, internalising traits and threat sensitivity can emerge before the onset of the eating disorder (Adambegan et al., 2012) in particular social anxiety (Swinbourne et al., 2012). These traits are also seen in family members (Lilenfeld et al., 1998), which suggest that theymay in part be genetically or epigenetically determined. Anomalies in the secondary process may arise from particular experiences that account for how and why negative emotional reactions to food weight and social stimuli are learned (Treasure, Cardi and Kan, 2012; Treasure, Corfield, & Cardi, 2012). Many eating disorder behaviours represent cognitive control of the tertiary system. Functional differences in the dorsal cognitive system (dorsal caudate, hippocampus, parietal dorsolateral prefrontal and anterior cingulate) are present in both the ill and recovered state in anorexia nervosa (Wagner et al., 2007; Zastrow et al., 2009). These are associated with altered dopamine and serotonin function (Bailer & Kaye, 2011). In this edition, anomalies between the top down control and the experiential bottom level in eating disorders are described. Emotional inhibition suggestive of high levels of control are reported in anorexia nervosa (Claes et al., 2012; Davies, Swan,
Feeding and Eating Disorders, Eating Disorders, Emotions, Humans
Feeding and Eating Disorders, Eating Disorders, Emotions, Humans
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