# Reward Re-Training: A new treatment to address reward imbalance during the COVID-19 pandemic

> **NIH NIH R01** · DREXEL UNIVERSITY · 2020 · $232,682

## Abstract

PROJECT SUMMARY
Public health approaches to reducing the spread of COVID-19 such as social distancing, shelter-in-place
orders, quarantine, telework, and remote learning have produced a sudden and widespread disruption to social
networks. The observed disruptions to social networks are leading to increases in social isolation and loneliness
and limited opportunities to obtain sufficient reward from day-to-day life activities. Reduced exposure to day-to-
day sources of reward can lead to a hypo-reward response to conventionally rewarding stimuli and reduce an
individual’s motivation to engage in activities that they usually find pleasurable. When insufficient pleasure is
experienced from day-to-day life activities, some individuals may be more likely to seek out stimuli that can
immediately and powerfully activate neural reward pathways. A hyper-reward response to disorder specific
stimuli may develop as individuals seek out larger quantities or more frequent exposure to a limited range of
intensely stimulating sources of reward. Collectively, this may produce a reward imbalance such that individuals
achieve very little reward from typically enjoyable day-to-day life activities and instead achieve most of their
reward from behaviors or substances that have high potential for adverse consequences. While the reward
imbalance is likely a relevant maintenance factor for numerous mental health conditions, there is a strong body
of literature suggesting that individuals with an eating disorders (ED) characterized predominately by binge
eating experience a reward imbalance.
Prior to the COVID-19 pandemic, our team began to develop a novel group-based treatment approach for
transdiagnostic binge eating that we call Reward Re-Training (RRT). RRT is designed to indirectly change
disordered eating behaviors by directly focusing on building a more rewarding life. RRT hypothesizes that
reductions in binge eating will occur as life becomes more rewarding because individuals will no longer need to
rely on binge eating as a primary source of momentary reward. RRT notes that in order to live a satisfying life,
individuals need to experience an adequate amount of reward in two overlapping yet distinguishable domains:
momentary reward (i.e., the active experience of pleasure in the moment) and sustained reward (i.e., a deeper
and more long-lasting sense of fulfillment and meaning that arises from building a personally valued life). A key
aspect of RRT is an emphasize on building lasting and meaningful social relationships given the clear evidence
that social activities and social connection can enhance both momentary reward and sustained reward. In the
current study, we will revise our existing 10-session group RRT treatment manual to specifically address the
challenges in enhancing both momentary and sustained reward during the COVID-19 pandemic. We will
conduct a small pilot RCT that will randomize individuals to receive either 10-sessions of RRT (n=30) or
support...

## Key facts

- **NIH application ID:** 10218350
- **Project number:** 3R01MH122392-01S1
- **Recipient organization:** DREXEL UNIVERSITY
- **Principal Investigator:** ADRIENNE SARAH JUARASCIO
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $232,682
- **Award type:** 3
- **Project period:** 2020-09-18 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10218350

## Citation

> US National Institutes of Health, RePORTER application 10218350, Reward Re-Training: A new treatment to address reward imbalance during the COVID-19 pandemic (3R01MH122392-01S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10218350. Licensed CC0.

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