A Pilot Study Investigating the Influence of Oxytocin on Attentional Bias to Food Images in Women with Bulimia Nervosa or Binge Eating Disorder

This is the peer reviewed version of the following article: Leslie, M., Leppanen, J., Paloyelis, Y., Treasure, J. (2020). A pilot study investigating the influence of oxytocin on attentional bias to food images in women with bulimia nervosa or binge eating disorder. Journal of Neuroendocrinology, 32(5), e12843, which has been published in final form at https://onlinelibrary.wiley.com/doi/full/10.1111/jne.12843. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Background: Previous research has found that exogenous oxytocin administration has the potential to modulate attentional biases in women with anorexia nervosa. Recent work has indicated that attentional biases to food may reinforce the recurrent binge eating behaviour which characterises bulimia nervosa and binge eating disorder. To date, however, no study has yet investigated the effect of oxytocin on attentional biases to palatable food in women with bulimia nervosa and binge eating disorder. Methods: This study employed a single-session crossover design to test the hypothesis that a divided dose of 64IU intranasal oxytocin, administered as one intranasal dose of 40IU oxytocin followed by a top-up of 24IU oxytocin 80 minutes later, versus placebo administration administered in the same dosing schedule, would reduce attentional biases towards food images in a dot probe task. We hypothesised that oxytocin administration would reduce vigilance towards food to a greater degree in women with bulimia nervosa or binge eating disorder, versus healthy comparison women. Twenty-five women with bulimia nervosa or binge eating disorder and 27 comparison women without history of an eating disorder were recruited to take part in the study. Results: Contrary to our hypothesis, there was no main effect of diagnosis on attentional bias to food (fixed effect = 5.70, p = .363), nor a significant interaction between diagnosis and drug condition (fixed effect = -14.80, p = .645). There was a main effect of drug condition, such that oxytocin increased vigilance towards food, versus neutral, images in the dot probe task (fixed effect = 10.42, p = .044). A correlation analysis revealed that this effect was moderated by attentional bias in the placebo condition, such that greater avoidance of food stimuli in the placebo condition was associated with a greater increase in vigilance induced by oxytocin. Conclusion: The current findings add to a mixed body of literature investigating the therapeutic effects of oxytocin in women. Future research would benefit from dose-response studies investigating the optimal dose of oxytocin for modulating the attentional processing of palatable food in populations with eating disorders

The Influence of Oxytocin on Eating Behaviours and Stress in Women with Bulimia Nervosa and Binge Eating Disorder

The current study aimed to test the influence of oxytocin on palatable food intake, 24-hour caloric consumption, and stress in women with bulimia nervosa and binge eating disorder. We recruited 25 women with DSM-5 bulimia nervosa or binge eating disorder, and 27 weight-matched comparison women without history of an eating disorder. We employed a double-blind, placebo-controlled crossover design in which each participant attended the lab for two experimental sessions, receiving a divided dose of 64IU intranasal oxytocin in one session and equivalent volume of placebo nasal spray in the opposite session. The order of administration was pseudo-randomised across participants. We hypothesised that a divided dose of 64IU intranasal oxytocin administration would reduce subjective hunger, the immediate consumption of palatable food, 24-hour calorie consumption, and the incidence of binge eating when compared to placebo. We also hypothesised that oxytocin administration would be associated with lower levels of stress and salivary cortisol, and that there would be an interaction with participant group such that oxytocin would reduce eating behaviour and stress to a greater degree in women with bulimia nervosa or binge eating disorder, compared to women without history of an eating disorder. We did not find a significant effect of oxytocin on any of the measurements of eating behaviour, subjective stress, or salivary cortisol. We recommend that future studies test the dose-response effect of oxytocin on eating behaviours and stress in human populations with eating disorders to further clarify the moderating factors for oxytocin’s effect on eating

Autism and anorexia nervosa:longitudinal prediction of eating disorder outcomes

BACKGROUND: Recently, elevated levels of autistic features and autism diagnoses have been reported among people with anorexia nervosa (AN). In clinical settings high levels of autistic features have been linked to more complex, highly comorbid illness presentation and poorer treatment outcome. This study aimed to examine whether autistic features predict AN symptom profile in long term. METHODS: Altogether 118 women with lived experience of AN completed two autism assessments at time 1, the Autism Diagnostic Observation Schedule (ADOS) and the short version of the Autism Quotient (AQ10). Measures assessing AN symptom profile, including eating disorders symptoms, anxiety, depression, OCD symptoms, and Body Mass Index (BMI), were also recorded. The symptom profile measures were administered again 6 months and 2 years later. We conducted two analyses to examine the extent to which the ADOS and AQ10 scores predicted broad AN symptom profile at each three time points. RESULTS: Overall, high levels of autistic features were consistently associated with worse psychological symptoms, but not BMI, across all time points. Both the analysis using baseline ADOS scores and self-reported AQ10 scores showed similar pattern. CONCLUSION: The present findings consolidate previously reported associations between autistic features and worse psychological outcome among people with AN. The findings also suggest that self-report measures may be sufficient for assessing the impact of autistic features on illness outcome among people with AN. Importantly, the study highlights the need for development and further investigation of neurodiversity accommodations in the treatment of AN

Longitudinal Analysis of Mental Health in Autistic University Students Across an Academic Year

Background Autistic people have worse mental health (MH) than non-autistic people. This proof-of-concept study explored feasibility of longitudinal research with autistic university students, focusing on their MH and coping styles across an academic year. Methods Twenty-two students took part at all timepoints. They completed four rounds of online MH questionnaires. Results Over 80% of students were retained. They started the year with high levels of all MH issues, which remained stable across the year. Network Change analysis showed the connections between MH and coping style changed over time. Conclusions Autistic students are engaged participants who are likely to take part in longitudinal research. While MH levels were stable, it may be that coping styles are a useful target for intervention

The use of a positive mood induction video-clip to target eating behaviour in people with bulimia nervosa or binge eating disorder: An experimental study

Recent theoretical models and empirical research have indicated that momentary negative affect increases the likelihood of binge eating episodes for individuals with bulimia nervosa and binge eating disorder. However, relatively little research has explored the potential for positive mood to serve a protective effect in reducing the likelihood of overeating behaviour in bulimia nervosa and binge eating disorder. The current study included 30 women with bulimia nervosa or binge eating disorder in a within-subjects crossover design. Following exposure to a video designed to induce food craving, we found that a positive mood vodcast was associated with significantly lower levels of negative mood and food consumption in a taste test meal, when compared to a neutral vodcast (p = .002). These findings support a role for decreasing negative mood in reducing the likelihood of binge eating behaviour in women with bulimia nervosa and binge eating disorder

The Influence of Oxytocin on Risk-Taking in the Balloon Analogue Risk Task Among Women with Bulimia Nervosa and Binge Eating Disorder

This is the peer reviewed version of the following article: Leslie, M., Leppanen, J., Paloyelis, Y., & Treasure, J. (2019). The influence of oxytocin on risk-taking in the balloon analogue risk task among women with bulimia nervosa and binge eating disorder. Journal of Neuroendocrinology, 31(8), e12771. doi:10.1111/jne.12771, which has been published in final form at https://onlinelibrary.wiley.com/doi/abs/10.1111/jne.12771. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Previous theoretical models of bulimia nervosa (BN) and binge eating disorder (BED) have implicated cross-domain risk-taking behaviour as a significant maintenance factor in both disorders. The current study sought to test this hypothesis by administering the Balloon Analogue Risk Task (BART) to 25 women with BN or BED and 27 healthy comparison women without history of an eating disorder. Furthermore, we tested the effect of a divided dose of 64IU oxytocin on risk-taking behaviour in the BART. Contrary to our hypothesis, women with BN or BED did not exhibit baseline differences in performance on the BART in the placebo condition (t = 1.42, df = 50, p = .161, d = 0.39). Oxytocin did not have a main effect on performance in the BART (F = 0.01, df = 1, p = .907, η2partial < .001); however, there was an interaction such that participants in the BN/BED participant group, compared to the healthy comparison group, demonstrated safer behaviour on the BART specifically in the oxytocin condition, but not in the placebo condition (F = 4.29, df = 1, p = .044, η2partial = .082). These findings cast doubt on the common assumption that individuals with BN and BED exhibit greater risk-taking behaviour in all domains and add to evidence that oxytocin plays a functional role in modulating behaviours which entail trade-offs between reward approach and risk in humans. We recommend that future dose-response studies further investigate the effect of oxytocin on reward approach behaviour in women with recurrent binge eating behaviour and the clinical significance of this effect

Effects of intranasal oxytocin on the attentional bias to emotional stimuli in patients with bulimia nervosa

Background: Bulimia nervosa (BN) is characterized by binge eating and emotional dysregulation including increased negative affectivity (anger, anxiety). The aim of this study was to examine the effect of oxytocin on attentional processes towards anger in patients with BN. Method: The study design consisted of a double-blind, placebo-controlled within-subject crossover, single dose experiment. Sixty-four women (31 patients with BN and 33 healthy comparisons) completed self-reported measures to evaluate emotional difficulties and were administered a single dose of intranasal oxytocin (40IU) or placebo followed by a visual probe detection task to examine attentional orienting to angry or happy faces. Results: Patients with BN reported higher emotional dysregulation and more difficulties in controlling anger compared to the healthy comparison group. Patients with BN and the healthy women exhibited similar attentional bias to angry faces in the placebo condition. Intranasal oxytocin reduced the attentional bias towards angry faces in both the BN patients and the healthy women. Conclusions: We found that a single dose of oxytocin reduced vigilance towards angry faces in patients with BN as well as healthy women. The results showed that patients with BN are not different from healthy women in terms of vigilance towards threat