Avoidance-driven Decision Making and Learning in Anorexia Nervosa and Bulimia Nervosa

The purpose of this study is to investigate areas of the brain responsible for avoidance learning in adults with eating disorders using brain imaging techniques, computer tasks, and self-report questionnaires and interviews. The investigators will study changes in brain activity using a procedure called functional magnetic resonance imaging (fMRI). This study will include 78 women with an eating disorder (26 with anorexia nervosa [AN], 26 with bulimia nervosa [BN]) and 26 healthy controls (HC) aged 18-39.

Aim 1: Evaluate behavioral differences in active and passive avoidance learning in eating disorders and associations with symptoms.

Aim 2: Evaluate whether corticostriatal and limbic-prefrontal fMRI BOLD response associated with avoidance learning differs in eating disorders relative to healthy controls and relates to symptoms.

Aim 3: Evaluate whether functional connectivity of avoidance learning neural circuity differs in eating disorders relative to healthy controls.

Study Overview

• Status: Recruiting
• Conditions: Anorexia Nervosa; Bulimia Nervosa

• Study Type: Observational
• Enrollment (Estimated): 78

Contacts and Locations

• Study Contact: Name: Christina E Wierenga, PhD; Phone Number: 858-534-8047; Email: cwierenga@health.ucsd.edu

Study Locations

• United States
  • California
    • La Jolla, California, United States, 92121
      • Recruiting
      • UCSD Eating Disorders Treatment and Research Program
      • Contact: Sophie R Abber, MS; Phone Number: 858-534-0371; Email: sabber@health.ucsd.edu
      • Contact: Katherine Gandee, BS; Phone Number: 858-534-0371; Email: kgandee@health.ucsd.edu
      • Principal Investigator: Christina E Wierenga, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study will recruit 52 adult women currently ill with an eating disorder, including anorexia nervosa (AN; n=26) and bulimia nervosa (BN, n=26), and 26 healthy control (HC) women between the ages of 18 and 39.

Description

Inclusion Criteria:

Eating Disorder Group:

• Between the ages of 18 and 39 years old
• Meet DSM-V criteria for anorexia nervosa or bulimia nervosa

Healthy Controls:

• Between the ages of 18 and 39 years old
• Have maintained 85% to 120% ideal body weight since menarche

Exclusion Criteria:

• Psychotic illness/other mental illness requiring hospitalization
• Current dependence on drugs or alcohol defined by DSM IV criteria. Additionally, positive test results for drug use on the day of the scan, apart of marijuana, will result in cancelling or rescheduling the scan because acute use will impact MRI measures.
• Physical conditions (e.g. diabetes mellitus, pregnancy) known to influence eating or weight
• Neurological disorder, neurodevelopmental disorder, or history of head injury with >30 min loss of consciousness
• Any contraindication to undergoing an MRI
• Primary obsessive compulsive disorder or primary major depressive disorder

Additional Exclusion Criteria for ED Group:

• If taking other psychotropic medication, any change in dosage in the 2 weeks before scanning

Additional Exclusion Criteria for Healthy Control Group:

• Meet criteria for the diagnosis of any psychiatric disorder currently
• Any history of binge eating or purging behaviors, including self-induced vomiting, laxative or diuretic misuse
• Use of any psychoactive or other medication known to affect mood or concentration in the last 3 months

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort
Healthy Controls; Participants that do not meet DSM-V criteria for any disorder.
Anorexia Nervosa; Participants that meet Diagnostic And Statistical Manual Of Mental Disorders (DSM-V) criteria for Anorexia Nervosa.
Bulimia Nervosa; Participants that meet DSM-V criteria for Bulimia Nervosa.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Learning rate	Behavioral responses during a card game gambling task	25 minutes
fMRI brain response	fMRI brain activity associated with the card game gambling task	25 minutes
Brain connectivity	Whole-brain functional connectivity associated with the card game gambling task	10 minutes

Collaborators and Investigators

• Sponsor: University of California, San Diego

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2024
• Primary Completion (Estimated): July 31, 2026
• Study Completion (Estimated): July 31, 2027

Study Registration Dates

• First Submitted: August 15, 2024
• First Submitted That Met QC Criteria: August 20, 2024
• First Posted (Actual): August 22, 2024

Study Record Updates

• Last Update Posted (Actual): May 1, 2026
• Last Update Submitted That Met QC Criteria: April 27, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Feeding and Eating Disorders; Anorexia Nervosa; Bulimia Nervosa
• Other Study ID Numbers: 810384

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No