Anorexia nervosa, emotional go/no-go, and the distinct effect of testosterone

Abstract

Objective Behavioral disinhibition in the context of negative emotion (e.g., disgust, fear, etc.) may promote the core psychopathology of anorexia nervosa (AN). Affective models of AN position a number of clinical behaviors as functioning to reduce negative affect. Gonadal hormone dysregulation, in particular testosterone, likely plays some role in this process. Method Adolescent and young adult AN (n = 32) and healthy control (HC; n = 20) participants completed an emotional go/no-go task - a valenced measure of behavioral disinhibition - and had blood drawn to assess gonadal steroid hormone concentrations. Results Analyses indicated that patients with AN committed significantly more commission errors, which measures the tendency to respond to nontarget stimuli. This effect was qualified by the valence of the stimulus; the higher relative level of error was true for disgust and happy stimuli, but not neutral stimuli. Hormone analyses revealed a testosterone by group interaction. Testosterone was associated with decreased commission errors for patients with AN, but had no discernible relationship with task outcome for HCs. These effects were not confounded by weight, pubertal status, or self-reported anxiety or depression. Discussion These findings suggest patients with AN have difficulty inhibiting behavior in the context of emotional stimuli, and that this disinhibition is negatively related to levels of circulating androgens.