The aetiology of eating disorders (EDs) is unclear, but it has been proposed that altered inhibitory control is an important element to their development and maintenance. This thesis aimed to characterise the role of inhibitory control across the ED spectrum by (a) exploring its potential as a risk factor for EDs, and (b) investigating the specificity of three inhibitory control subtypes as correlates of EDs and their symptomatology. The first aim was addressed in: a systematic review exploring the neural correlates of EDs in adolescent patients (Chapter 2); a study investigating factors that affect identification of symptoms in adolescents in the community (Chapter 3); and a prospective, longitudinal neuroimaging study exploring the way in which the neural and behavioural correlates of inhibitory control relate to symptom onset (Chapter 4). The second aim was addressed in several ways. These included: a systematic review characterising the relationship between reactive inhibition (action cancellation in response to a signal) and eating behaviours in clinical and non-clinical populations (Chapter 5); a theoretical review proposing the involvement of proactive inhibition (slowing of responses in the context of uncertainty (Chapter 6)) in EDs; two studies examining reactive and proactive inhibition (Chapter 7) and reward-related inhibition (the ability to wait for delayed rewards, Chapter 8) in EDs; and lastly, a study assessing how these types of inhibitory control are affected by acute food restriction to begin to explore possible mechanisms underlying altered inhibitory control in EDs (Chapter 9). The data provide support for the neural substrates of failed inhibitory control (altered medial prefrontal and inferior parietal activity) as a correlate and risk factor for EDs, and revealed that different subtypes of inhibitory control are not uniformly implicated across the ED spectrum. The findings extend current concepts related to correlates of illness, and provide direction for biomarker identification and neuroscience-driven interventions.
Inhibitory control across the eating disorder spectrum: An investigation of inhibitory control subtypes and potential markers of risk for disordered eating.
Bartholdy, S. (Author). 1 Jan 2017
Student thesis: Doctoral Thesis › Doctor of Philosophy