Fear as a translational mechanism in the psychopathology of anorexia nervosa

摘要

Anorexia nervosa (AN) is an often chronic and potentially lethal psychiatric disorder, for which the precise etiology remains elusive. While current treatment outcomes are modest at best, it is thought that the identification of translational mechanisms driving the psychopathology of AN will assist in the development and optimization of novel treatments. AN is a disorder characterized by fear and avoidance, hypervigilant scrutiny of one's body, and an unnatural fear of weight gain. Moreover, a suite of anxious traits and regimentation of behavior are atypically common well in advance of the onset of restrictive eating in those with AN. Here we consider the promise of shedding light on causal mechanisms of AN by interrogating the role of fear-related learning, deficits in discriminating safety cues, and extinction of acquired fear. We offer a translational rationale for this line of inquiry, and discuss the clinical implications of considering fear as a translational mechanism in the psychopathology of AN.