# Incentive Processing and Learning in Anorexia Nervosa and Bulimia Nervosa

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2022 · $777,256

## Abstract

PROJECT SUMMARY/ABSTRACT
The etiology of eating disorders (ED) is complex, yet largely unknown, resulting in a profound lack of effective
treatments and a “crisis in care”. Common to EDs are alterations in the motivation to eat, ranging from extreme
food restriction and weight loss, to binge eating coupled with compensatory strategies like self-induced vomiting.
Despite the traditional emphasis on diagnostic differentiation based on these physical symptoms, they often
overlap, and, along with significant diagnostic crossover (e.g., from anorexia nervosa to bulimia nervosa) over
time, suggest shared features that are not well captured by current diagnostic criteria. Persistence of restricted
eating, binge eating and/or purging despite negative consequences, along with evidence of altered reward and
punishment sensitivity in ED, raise the question of whether a failure to appropriately process and/or learn from
rewarding and/or punishing experiences might contribute to repeated engagement in maladaptive approach and
avoidance behavior and illness maintenance. This is the first study to apply a multi-dimensional framework of
reward processing to ED, by examining how the interplay of RDoC-based Positive Valence measures of `liking'
(i.e., the hedonic impact of reward consumption), `wanting' or incentive salience (i.e., motivation to pursue a
reward), and learning (i.e., the acquisition of reward-outcome contingencies), which are associated with distinct
frontostriatal neurocircuitry, differ across ED subtype and correspond to clinical symptoms at baseline and one
year later. We will study 150 demographically-matched women with ED (50 AN-restricting type (AN-R), 50 AN-
binge eating/purging type (AN-BP), 50 bulimia nervosa (BN)) and 50 healthy controls (HC) aged 18-35. During
fMRI, participants will complete 1) a modified monetary incentive delay (MID) task to assess group differences
in both neural anticipation (`wanting') and receipt (`liking') of rewarding and aversive disorder-specific (taste) and
generalized (money) stimuli (Aim 1), and 2) a probabilistic associative learning task to assess decision-making
and instrumental learning from monetary wins and losses (Aim 2). Aim 3 will examine interactions between
`liking', `wanting' and learning and associations with symptoms at study entry and 1 year later. An Exploratory
Aim will examine associations of dopamine function, as measured by neuromelanin MRI (NM-MRI), with ED
diagnosis and brain response to `liking', `wanting', and learning to further inform mechanistic models of reward
in ED. This study is innovative and significant in several ways: 1) it adopts a multi-dimensional framework of
reward processing to examine independent and interactive contributions of understudied, yet critically important
constructs (e.g., `liking', `wanting', learning) in ED, 2) it assesses the role of stimulus modality (taste, money) and
valence in `liking' and `wanting', and 3) relates these constructs to actual sympt...

## Key facts

- **NIH application ID:** 10363934
- **Project number:** 1R01MH125880-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** CHRISTINA E WIERENGA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $777,256
- **Award type:** 1
- **Project period:** 2022-02-15 → 2027-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10363934

## Citation

> US National Institutes of Health, RePORTER application 10363934, Incentive Processing and Learning in Anorexia Nervosa and Bulimia Nervosa (1R01MH125880-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10363934. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*