The Influence of Sensitivity to Punishment on Obsessive-Compulsive Disorder Symptoms in Individuals with Anorexia Nervosa

Abstract

Introduction: Individuals with anorexia nervosa (AN) with either anorexia nervosa-restrictive or anorexia nervosa-binge purge subtype are underweight because they restrict the food intake since they have a strong fear to gain weight (American Psychiatric Association, 2013). Obsessive compulsive disorder (OCD) is often a comorbid disorder in individuals with AN (Levinson et al., 2018). This comorbidity impairs the possibility to fully benefit from treatment (Pallister & Waller, 2008). Sensitivity to punishment is both very common in OCD and in AN (e.g. Alonso et al., 2008; Ceschi, Hearn, Billieux, & Van der Linden, 2011), which makes it a mutual underlying factor. This study therefore examines if sensitivity to punishment influences OCD-symptoms in individuals with anorexia nervosa restrictive and binge purge subtype and healthy controls. Method: 95 individuals diagnosed with ANR, 77 individuals diagnosed with ANBP, and 82 healthy control participants were included in this study and completed the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ) and the Obsessive Compulsive Inventory-Revised (OCI-R) questionnaire. Results and discussion: Individuals with AN were more sensitive to punishment than healthy controls and individuals with ANBP were more sensitive to punishment than individuals with ANR. Furthermore, results showed that sensitivity to punishment influences OCD-symptoms in individuals with AN, independently of the AN-subtype. However, this study did not include other factors which may explain the difference between sensitivity to punishment in the AN-subtypes, like symptom severity which Glashouwer and colleagues (2014) included. Future research should take this into account.