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When evaluating ambiguous situations, humans sometimes use their behavior as a source of information (behavior-as-information effect) and interpret safety behaviors as evidence for danger. Accordingly, we hypothesized that eating disorder safety behaviors (restrictive eating, body checking, etc.) might aggravate fear and anxiety in individuals with...
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... we calculated bivariate correlations between 'danger', 'threat', 'pleasantness' and 'want for experience' ratings. Based on the high correlations (see Table 2), we combined 'danger' and 'threat' ratings into an average score (from now on called 'threat' ratings). We tested our hypotheses by running several LMMs with 'threat', 'pleasantness' and 'want for experience' ratings as dependent variables. ...Citations
... Accordingly, individuals with or at risk of developing anorexia nervosa might (a) unnecessarily avoid stimuli not associated with aversive consequences, (b) excessively avoid food and eating-related stimuli disproportionate to the anticipated consequences, and (c) continue to avoid food and eating-related stimuli even though positive and aversive consequences of avoidance are no longer present (extinction deficits). Once in place, these maladaptive avoidance behaviors potentially exacerbate fear and prevent individuals from testing their threat beliefs (Lovibond et al., 2009;Spix, Melles, et al., 2023;Spix, Schutzeichel, et al., 2023). Thereby, maladaptive food avoidance can contribute to the development and maintenance of eating disorders-making it of crucial importance to understand what mechanisms reinforce and facilitate these behaviors. ...
... When considering the various safety behaviors used by patients with anorexia nervosa (Schaumberg et al., 2021), body checking after eating very small portions or low-calorie foods could be an example of unnecessary low-cost avoidance. While this type of maladaptive avoidance might not appear as harmful as excessive food restriction, it could still have a detrimental impact on the development and maintenance of anorexia nervosa symptoms: engaging in eating disorder-related avoidance behaviors in the absence of danger can aggravate threat beliefs (Spix, Melles, et al., 2023) and might hinder individuals to test these incorrect assumptions (Lovibond et al., 2009;Spix, Schutzeichel, et al., 2023). Specifying the type of maladaptive avoidance underlying Figure 6. ...
Previous research has shown that food avoidance can be learned via classical and operant conditioning. This leads to the question of whether learning deficits could contribute to the harmful food avoidance seen in individuals with anorexia nervosa. Accordingly, we tested whether healthy women with increased levels of anorexia nervosa symptoms and characteristics show learning abnormalities related to the acquisition and extinction of food avoidance behaviors. Data from a previous experiment (Spix, Schutzeichel, et al., 2023) was used and supplemented with new questionnaire data. Based on participants' levels of anorexia nervosa symptoms and characteristics, we subtyped an analogue and a healthy group and compared their performance on a food avoidance learning task. We assessed the frequency of avoidance responses, as well as relief, frustration, eating desires, fear, and liking for the conditioned stimulus (CS) associated with food intake. The analogue group showed more unnecessary food avoidance behaviors, a greater relief about the omission of the food, and a faster and more persistent reduction in eating desires than the healthy group. There were no differences between groups in frustration, fear, and liking. Learning abnormalities might contribute to the development and maintenance of food avoidance in individuals with anorexia nervosa.
... Finally, a recent study by Spix et al. (2023) conducted in individuals with an eating disorder (vs. controls) employed the vignette technique described above, but adapted to eating-related scenarios. ...
Although numerous behavioral constructs have been proposed to account for anxiety disorders, how these disorders develop within an individual has been difficult to predict. In this perspective, I selectively review clinical and experimental evidence suggesting that avoidance (i.e., safety) behavior increases beliefs of threat or fear. The experimental evidence has been replicated numerous times, with different parameters, and shows that when human participants emit avoidance responses in the presence of a neutral stimulus, they later show heightened expectations of threat in the presence of the neutral stimulus. I interpret these findings as resulting from prediction errors as anticipated by the Rescorla–Wagner model, although other animal learning theories can also predict the phenomenon. I discuss some implications and offer a few novel predictions. The analysis presented here sheds light on a phenomenon of theoretical and clinical relevance which is accommodated by basic associative learning theory.
