Guido Frank

Guido Frank
University of California, San Diego | UCSD · Department of Psychiatry

MD

About

189
Publications
31,837
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9,491
Citations
Citations since 2016
74 Research Items
4618 Citations
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Publications

Publications (189)
Article
Full-text available
Background Recent research suggests that anhedonia, or the inability to experience pleasure, is elevated in individuals with eating disorders (EDs). However, past literature has only studied anhedonia in EDs as a unidimensional construct rather than separately examining anticipatory (i.e., prediction of pleasure for a future event) and consummatory...
Article
Full-text available
Background Loss of control eating (LOC-E) in youth predicts the later development of full-syndrome binge-eating disorder (BED), and therefore, could be a relevant target for prevention treatments. To develop these treatments, it is important to understand the underlying disease processes and mechanisms. Based on the putative role of neurocognitive...
Article
Full-text available
Anxious traits are elevated in eating disorders (EDs), are considered risk factors for ED development, and trait anxiety has been linked to ED psychopathology. How trait anxiety relates to ED neurobiology is not well understood. In this study 197 individuals across the ED spectrum (anorexia nervosa n = 91; other specified EDs n = 34; bulimia nervos...
Article
Objective: Anorexia nervosa (AN) is a severe psychiatric illness with complex etiology. Recently, we found elevated striatal brain response to sweet taste stimuli in adolescents and young adults with AN. Here, we tested the hypothesis that nutritional rehabilitation normalizes prediction error activation, a measure for dopamine-related reward circ...
Article
Full-text available
Purpose Anorexia nervosa (AN) is a severe psychiatric disorder, and shape and weight concerns are often chronic despite weight normalization. No specific treatments exist for those preoccupations that interfere with recovery and trigger relapse. A case study using a ketogenic diet followed by ketamine infusions led to sustained remission in one pat...
Preprint
Background: Loss of control eating (LOC-E) in youth predicts the later development of full-syndrome binge-eating disorder (BED), and therefore, could be a relevant target for prevention treatments. To develop these treatments, it is important to understand the underlying disease processes and mechanisms. Based on the putative role of neurocognitive...
Article
Endurance or aerobic exercise has many physical and mental health benefits, but less is known about the specific impact that cardiovascular activity may have on dopamine-associated brain circuits involved in reward processing and mood regulation in humans. Understanding such effects will help to explain individual differences in both exercise uptak...
Article
Background The pattern of structural brain abnormalities in anorexia nervosa (AN) is still not well understood. While several studies report substantial deficits in grey matter volume and cortical thickness in acutely underweight patients, others find no differences, or even increases in patients compared with healthy controls. Recent weight regain...
Article
Background Many individuals with eating disorders remain symptomatic after a course of psychotherapy and pharmacotherapy; therefore, the development of innovative treatments is essential. Method To learn more about the current evidence for treating eating disorders with stimulants, we searched for original articles and reviews published up to Apri...
Article
This editorial seeks to encourage the increased application of three open science practices in eating disorders research: Preregistration, Registered Reports, and the sharing of materials, data, and code. For each of these practices, we introduce updated International Journal of Eating Disorders author and reviewer guidance. Updates include the int...
Article
Importance Eating disorders are severe psychiatric disorders; however, disease models that cross subtypes and integrate behavior and neurobiologic factors are lacking. Objective To assess brain response during unexpected receipt or omission of a salient sweet stimulus across a large sample of individuals with eating disorders and healthy controls...
Article
Full-text available
Background Cognitive disturbances such as impairments in learning are thought to play a role in adult Anorexia Nervosa (AN). It is remains unclear to what extent these disturbances result from starvation of the brain, or relate to an abnormal premorbid cognitive profile. This study investigates learning processes in adolescents with AN, hypothesizi...
Article
Full-text available
Anorexia nervosa is a severe psychiatric illness associated with food avoidance. Animal models from Berridge et al. over the past decade showed that environmental ambience, pleasant or fear inducing, can trigger either appetitive (desire) or avoidance (dread) behaviors in animals via frontal cortex, nucleus accumbens dopamine D1 and D2 receptors, a...
Article
PurposeIndividuals with anorexia (AN) or bulimia nervosa (BN) often present with fear of loss of control in the context of eating. It is unclear whether this fear of loss of control, which has been associated with fear of failure and a sense of not being in charge of one’s own life in eating disorders, can be distinguished from self-perceived maint...
Article
Full-text available
Severe and enduring eating disorders (EDs) have the highest mortality rate of all psychiatric illnesses (Arch Gen Psychiatry, 2011, 68, 724), especially when comorbid with treatment‐resistant depression (TRD) (Psychiatr Res, 2016, 244, 45). We report on four patients with enduring EDs and TRD treated with repeat ketamine over 12 + months, showing i...
Article
Background Adolescence is a critical period for development of personality but also psychopathology. Those processes may be specific to sex and brain reward circuits may have a role. Here we studied how reward processing and temperament associations differ across adolescent and adult females. Methods Twentynine adolescent girls and 41 adult women...
Article
Full-text available
Compared to our understanding of positive prediction error signals occurring due to unexpected reward outcomes, less is known about the neural circuitry in humans that drives negative prediction errors during omission of expected rewards. While classical learning theories such as Rescorla–Wagner or temporal difference learning suggest that both typ...
Article
Body image disturbance (BID) in anorexia nervosa (AN) is poorly understood and the individual contribution of perceptual, cognitive, and affective components remains unclear. This study compared females with AN and matched healthy controls (HC) on a perceptual size estimation task. Participants (AN n=19 M[SD] age=16.97[2.24], HC n=19, age=15.77[2.1...
Chapter
Anorexia nervosa is a severe psychiatric disorder characterized by food restriction and high mortality rate. Research has identified consistently changes in brain monoamine neurotransmitter systems, some of which persist after recovery. There is also a host of neuroendocrine alterations during the course of illness, and it has been hypothesized tha...
Chapter
Eating disorders are severe psychiatric disorders with complex bio-psycho-social underpinnings. Research has made progress understanding contributing genetic and neurobiological factors to eating disorder illness development and maintenance. However, we need to continue developing models for targeted pharmacological interventions in eating disorder...
Article
Objective: Relapse after weight restoration in anorexia nervosa (AN) is a critical problem. Higher body fat percentage after weight gain has been shown to predict better weight maintenance outcome. Leptin, a fat-derived hormone, has been associated with progress during weight gain, but its association with weight maintenance is unknown. This study...
Preprint
Full-text available
Background cognitive disturbances such as impairments in learning are thought to play a role in adult Anorexia Nervosa (AN). It is remains unclear to what extend these disturbances result from starvation of the brain, or relate to an abnormal premorbid cognitive profile. This study investigates learning processes in adolescents with AN, hypothesizi...
Article
Background Functional brain imaging has been used to study brain reward function and behavioral traits in anorexia nervosa (AN). Here we tested whether eye blink relates to behavior and brain imaging response as a method that is less costly and more accessible. Method We recruited 26 women with AN and 50 healthy matched controls. All underwent a r...
Book
This book provides a comprehensive overview of our current understanding of binge eating, which is characterized by the uncontrollable consumption of large amounts of food in a discrete time period. Written by experts on eating disorders, it first introduces the phenotype of binge eating, including its epidemiology and assessment. It then describe...
Chapter
This chapter reviews human neuroimaging studies that investigate the neurobiology of reward processing in eating disorders associated with binge eating. Across the relatively small research literature on binge-eating disorder (BED) and bulimia nervosa (BN) using food and nonfood stimuli, neuroimaging studies consistently suggest alterations in brai...
Article
Full-text available
This editorial reports on an anonymous survey question posed to eating disorders researchers about changes the International Journal of Eating Disorders (IJED) should implement to support the eating disorders research community affected by COVID‐19. The editorial accompanies an IJED article that details responses to the larger survey focusing more...
Article
Full-text available
Background: The increasing incidence of allergies and allergic reactions among children and adults has become a major public health concern. The etiology of allergic reactions can often be confirmed based on a detailed history and supportive testing. However, there are cases where the underlying factors are more complex and difficult to identify....
Article
Introduction: Anorexia nervosa is a severe psychiatric illness and no medication has been approved for its treatment. This lack of biological treatments requires the development of new directions for pharmacological research. Areas covered: There is modest but emerging evidence that dopamine D2 and serotonin 1A and 2A receptor agonistic and antagon...
Book
This book provides a comprehensive overview of our current understanding of binge eating, which is characterized by the uncontrollable consumption of large amounts of food in a discrete time period. Written by experts on eating disorders, it first introduces the phenotype of binge eating, including its epidemiology and assessment. It then describe...
Article
Objective: This virtual issue of the International Journal of Eating Disorders highlights recently published research that is based on neuroscience concepts, to mark the 49th Society for Neuroscience Annual Meeting in Chicago, IL, in November 2019. Methods and results: The collection of articles includes research published between 2018 and 2019...
Article
Eating disorders are severe psychiatric illnesses with a typical age of onset in adolescence. Brain research in youth and young adults may help us identify specific neurobiology that contributes to onset and maintenance of those disorders. This article provides a state-of-the-art review of our current understanding of the neurobiology of anorexia n...
Article
Purpose of review: Eating disorders are severe psychiatric disorders with a suspected complex biopsychosocial cause. The purpose of this review is to synthesize the recent literature on brain imaging in eating disorders. Recent findings: Food restriction as well as binge eating and purging behaviors are associated with lower regional brain volum...
Article
Full-text available
Anorexia nervosa is a complex psychiatric illness associated with food restriction and high mortality. Recent brain research in adolescents and adults with anorexia nervosa has used larger sample sizes compared with earlier studies and tasks that test specific brain circuits. Those studies have produced more robust results and advanced our knowledg...
Article
Full-text available
Anorexia nervosa is a severe psychiatric illness with high mortality. Brain imaging research has indicated altered reward circuits in the disorder. Here we propose a disease model for anorexia nervosa, supported by recent studies, that integrates psychological and biological factors. In that model, we propose that there is a conflict between the co...
Chapter
AM:STARs is the official publication of the AAP Section on Adolescent Health. Published 2 times a year, it offers adolescent specialists and primary care physicians timely information on matters relating to adolescent health and wellness. https://shop.aap.org/amstars-advances-in-adolescent-eating-disorders-paperback/
Article
Individuals with eating disorders (ED) make extreme food choices, raising the possibility of altered food-value computation. We utilized an associative taste reward learning paradigm to test whether value signaling differs between participants with EDs vs. healthy controls (HC). We followed up on previous work examining prediction error (PE) signal...
Article
Full-text available
Importance Anorexia nervosa (AN) is associated with adolescent onset, severe low body weight, and high mortality as well as high harm avoidance. The brain reward system could have an important role in the perplexing drive for thinness and food avoidance in AN. Objective To test whether brain reward learning response to taste in adolescent AN is al...
Article
Full-text available
The prediction error model is a widely used paradigm that is conceptually based on neuronal dopamine function. However, whether dopamine receptor gene alleles contribute to human neuroimaging prediction error results is uncertain. Recent research implicated the dopamine D2 receptor in behavior response during a prediction error paradigm and we expe...
Article
Objective: Only few studies have investigated cortical thickness in anorexia nervosa (AN), and it is unclear whether patterns of altered cortical thickness can be identified as biomarkers for AN. Method: Cortical thickness was measured in 19 adult women with restricting-type AN, 24 individuals recovered from restricting-type AN (REC-AN) and 24 h...
Article
Human brain imaging can help improve our understanding of mechanisms underlying brain function and how they drive behavior in health and disease. Such knowledge may eventually help us to devise better treatments for psychiatric disorders. However, the brain imaging literature in psychiatry and especially eating disorders has been inconsistent, and...
Article
Full-text available
This Virtual Issue of the International Journal of Eating Disorders (IJED)marks the 51st Annual Convention of the Association for Behavioraland Cognitive Therapies (ABCT), held in San Diego in November 2017.It consists of a set of recent papers published in IJED, providing keyevidence about the current status of cognitive behavior therapy foreating...
Article
Anorexia nervosa (AN) is a serious eating disorder characterized by self-starvation and extreme weight loss. Pseudoatrophic brain changes are often readily visible in individual brain scans and AN may be a valuable model disorder to study structural neuroplasticity. Structural MRI studies have found reduced gray matter (GM) volume and cortical thi...
Article
Full-text available
Objective—Only few studies have investigated cortical thickness in anorexia nervosa (AN), and it is unclear whether patterns of altered cortical thickness can be identified as biomarkers for AN. Method—Cortical thickness was measured in 19 adult women with restricting-type AN, 24 individuals recovered from restricting-type AN (REC-AN) and 24 health...
Article
Full-text available
Objective: Finding medication to support treatment of anorexia nervosa has been difficult. Neuroscience-based approaches may help in this effort. Recent brain imaging studies in adults and adolescents with anorexia nervosa suggest that dopamine-related reward circuits are hypersensitive and could provide a treatment target. Methods: Here, we pre...
Article
Objective: Anorexia nervosa is a psychiatric disorder of unknown etiology. Understanding associations between behavior and neurobiology is important in treatment development. Using a novel monetary reward task during functional magnetic resonance brain imaging, the authors tested how brain reward learning in adolescent anorexia nervosa changes wit...
Conference Paper
Full-text available
Learning about conditioned inhibitors, which predict omission of outcome delivery, has been relatively understudied compared to learning about reward predictors. Reward omissions lead to inhibition of dopamine neurons, driven by the lateral habenula, an important region that is also involved in learning about predictors of punishment. How could a c...
Article
Full-text available
Anorexia and bulimia nervosa are severe eating disorders that share many behaviors. Structural and functional brain circuits could provide biological links that those disorders have in common. We recruited 77 young adult women, 26 healthy controls, 26 women with anorexia and 25 women with bulimia nervosa. Probabilistic tractography was used to map...
Book
Full-text available
Eating disorders come in various forms. Their presentations range from the emaciated individual with anorexia nervosa, to the person with bulimia nervosa who eats large amount of food ("binge eat") only to throw those up, to individuals with binge eating disorder, and there are also many in-between states of disordered eating. For most, the existe...
Article
Full-text available
Despite the prevalence of obesity, our understanding of its neurobiological underpinnings is insufficient. Diffusion weighted imaging and calculation of white matter connection strength are methods to describe the architecture of anatomical white matter tracts. This study aimed to characterize white matter architecture within taste-reward circuitry...
Article
Major depressive disorder (MDD) often emerges during adolescence, a critical period of brain development. Recent resting-state fMRI studies of adults suggest that MDD is associated with abnormalities within and between resting-state networks (RSNs). Here we tested whether adolescent MDD is characterized by abnormalities in interactions among RSNs....
Article
Anorexia nervosa (AN) is a severe psychiatric disorder without approved medication intervention. Every class of psychoactive medication has been tried to improve treatment outcome; however, randomized controlled trials have been ambiguous at best and across studies have not shown robust improvements in weight gain and recovery. Here we review the a...
Article
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We appreciate the opportunity to discuss body image further than was possible in our original Primer (Anorexia nervosa. Nat.
Article
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Objective: Eating disorders are severe psychiatric disorders of unknown etiology. Understanding how neuronal function affects food choices could help personalize treatment based on brain function. Here we wanted to determine whether disordered eating behavior is associated with alterations in the primary taste cortex's ability to classify taste st...
Article
Full-text available
The eating disorders (EDs), anorexia nervosa (AN), and bulimia nervosa (BN) are severe psychiatric disorders of unknown etiology. EDs usually begin during adolescence and occur most commonly in females (American Psychiatric Association, 2013). The diagnostic criteria for AN include restriction of energy intake leading to significantly low body weig...
Article
Full-text available
Inspired by an article on 50 terms that, in the interest of clarity in scientific reasoning and communication in psychology, psychiatry, and allied fields, “should be avoided or at most be used sparingly and only with explicit caveats,”1 we propose a list of terms to avoid or think twice about before using when writing for the International Journal...
Article
Full-text available
Background: Previous research in patients with anorexia nervosa showed heightened brain response during a taste reward conditioning task and heightened sensitivity to rewarding and punishing stimuli. Here we tested the hypothesis that individuals recovered from anorexia nervosa would also experience greater brain activation during this task as wel...
Article
Objective: Purging behaviors, including self-induced vomiting, laxative abuse, and diuretic abuse, are present across many of the eating disorders. Here we review the major medical complications of these behaviors. Method: Although we identified over 100 scholarly articles describing medical complications associated with purging, most papers inv...
Article
Anorexia nervosa (AN) is a psychiatric condition characterized by severe weight loss and secondary problems associated with malnutrition. AN predominantly develops in adolescence in the peripubertal period. Without early effective treatment, the course is protracted with physical, psychological and social morbidity and high mortality. Despite these...
Article
Full-text available
Anorexia nervosa (AN) is a severe and complex psychiatric disorder and no medication has been approved for its treatment. This case series in youth with severe, recurrent AN supports the hypothesis that dopamine receptor agonists could be helpful in supporting fear extinction during eating disorder focused psychotherapy and therefore support recove...
Article
Anorexia nervosa is a severe psychiatric disorder associated with reduced drive to eat. Altered taste-reward circuit white matter fiber organization in anorexia nervosa after recovery could indicate a biological marker that alters the normal motivation to eat. Women recovered from restricting-type anorexia (Recovered AN, n=24, age=30.3±8.1 years) a...
Article
Full-text available
Background. Body size overestimation is a fundamental feature in anorexia nervosa (AN). There have been inconclusive findings about the extent to which this feature distinguishes psychopathology and some authors have argued that overestimation may be a function of lower body mass index (BMI). Methods. We examine body size estimation accuracy and b...
Article
Full-text available
Background. Body size overestimation is a fundamental feature in anorexia nervosa (AN). There have been inconclusive findings about the extent to which this feature distinguishes psychopathology and some authors have argued that overestimation may be a function of lower body mass index (BMI). Methods. We examine body size estimation accuracy and b...
Article
Over the past decade, brain imaging has helped to better define eating disorder-related brain circuitry. Brain research on gray matter (GM) and white matter (WM) volumes had been inconsistent, possibly due to the effects of acute starvation, exercise, medication, and comorbidity, but newer studies have controlled for such effects. Those studies sug...
Article
The eating disorders (EDs) anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are severe psychiatric disorders with high mortality. There are many symptoms, such as food restriction, episodic binge eating, purging, or excessive exercise that are either overlapping or lie on opposite ends of a scale or spectrum across those...