# Influence of Reward and Punishment on Goal-directed and Habit Learning in Adolescent Anorexia Nervosa

> **NIH NIH R21** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2020 · $236,250

## Abstract

PROJECT SUMMARY/ABSTRACT
Anorexia nervosa (AN) is a debilitating, often chronic, and sometimes fatal eating disorder (ED) that typically
develops in adolescence. The etiology of AN is likely complex, yet remains unknown, and as a result, current
treatments lack sufficient efficacy. Significant symptom heterogeneity exists, yet is not well captured by current
diagnostic criteria. Thus, the identification of dimensional constructs underlying ED symptoms and their neural
correlates is critical to improve our mechanistic understanding of ED and identify novel therapeutic targets to
inform precision medicine. Behavioral symptoms of AN, such as food restriction (AN-R) and binge/purge
episodes (AN-BP), arise from maladaptive decision-making. Decision-making is governed by two systems: 1)
goal-directed learning reflects flexible and purposeful actions based on anticipated outcome, and 2) habit
learning reflects automatic, efficient, and inflexible choices established by previous reinforcement. These
learning systems are mediated by separate, yet overlapping, corticostriatal circuits and can be computationally
modeled using a two-step sequential decision-making task. Difficulty arbitrating between these systems,
resulting in an over-reliance on one strategy over the other, may contribute to divergent AN symptoms. This
proposal tests the novel hypothesis that goal-directed and habit learning under conditions of reward and loss
differs in AN and is uniquely associated with divergent symptoms and corticostriatal connectivity. Adolescent
girls ages 14-17 with AN-R, AN-BP or who are healthy controls will undergo neuroimaging to assess resting
state functional connectivity and microstructural integrity of corticostriatal networks, followed by performing the
two-step learning task outside the scanner under conditions of reward and loss. For each participant, a weighting
factor (ω), representing the relative balance between goal-directed and habit learning, will be calculated for gain
and loss conditions. After scanning, AN participants will complete a 14-day ecological momentary assessment
protocol to evaluate naturalistic, momentary experiences of ED symptoms. Aim 1 will determine the behavioral
differences in goal-directed and habit learning under conditions of reward and punishment in individuals with AN-
R, AN-BP and healthy controls. Aim 2 will examine the association of goal-directed and habit learning for reward
and punishment with symptoms and real-world experiences in AN to determine whether learning differences
contribute to divergent symptoms. Aim 3 will determine whether corticostriatal circuits associated with goal-
directed and habit learning for reward and punishment differ by group and condition to inform neural mechanisms
of altered reinforcement learning in AN. Data will support a future longitudinal R01 application to test a
dimensional approach of behavioral phenotyping based on reinforcement learning in a wider spectrum of
restricting and bi...

## Key facts

- **NIH application ID:** 9899323
- **Project number:** 5R21MH118409-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** CHRISTINA E WIERENGA
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $236,250
- **Award type:** 5
- **Project period:** 2019-04-01 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9899323

## Citation

> US National Institutes of Health, RePORTER application 9899323, Influence of Reward and Punishment on Goal-directed and Habit Learning in Adolescent Anorexia Nervosa (5R21MH118409-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9899323. Licensed CC0.

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