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Cross-diagnostic Prediction of Dimensional Psychiatric Phenotypes in Anorexia Nervosa and Body Dysmorphic Disorder Using Multimodal Neuroimaging and Psychometric Data

  • Jamie D. Feusner
  • Wesley T. Kerr
  • Teena D. Moody
  • Aifeng F. Zhang
  • Mark S. Cohen
  • Alex D. Leow
  • Michael A. Strober
  • Don A. Vaughn
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 11044)

Abstract

Anorexia nervosa (AN) and body dysmorphic disorder (BDD) share several phenomenological features including distorted perception of appearance, obsessions/compulsions, and limited insight. They also show partially overlapping patterns of brain activation, white matter connectivity, and electrophysiological responses. These markers have also shown associations with symptom severity within each disorder. We aimed to determine: (a) if, cross-diagnostically, neural activity and connectivity predict dimensional clinical phenotypes, and (b) the relative contribution of multimodal markers to these predictions beyond demographics and psychometrics, in a multivariate context. We used functional magnetic resonance imaging (fMRI) data from a visual task, graph theory metrics of white matter connectivity from diffusor tensor imaging, anxiety and depression psychometric scores, and demographics to predict dimensional phenotypes of insight and obsession/compulsions across a sample of unmedicated adults with BDD (n = 29) and weight-restored AN (n = 24). The multivariate model that included fMRI and white matter connectivity data performed significantly better in predicting both insight and obsessions/compulsions than a model only including demographics and psychometrics. These results demonstrate the utility of neurobiologically-based markers to predict important clinical phenotypes. The findings also contribute to understanding potential cross-diagnostic substrates for these phenotypes in these related but nosologically discrete disorders.

Keywords

fMRI DTI Insight Obsessions Compulsions Multivariate 

Notes

Funding and Disclosure

This work was supported by NIMH grants (R01MH093535 and R01MH105662) to JDF, a Postdoctoral Fellowship to DAV from the UCLA Collaboratory directed by Matteo Pellegrini. The authors declare no conflict of interest in this publication.

References

  1. 1.
    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). American Psychiatric Publishing (2013)Google Scholar
  2. 2.
    Hartmann, A.S., Thomas, J.J., Wilson, A.C., Wilhelm, S.: Insight impairment in body image disorders: delusionality and overvalued ideas in anorexia nervosa versus body dysmorphic disorder. Psychiatr. Res. 210, 1129–1135 (2013)CrossRefGoogle Scholar
  3. 3.
    Zhang, A., et al.: Brain connectome modularity in weight-restored anorexia nervosa and body dysmorphic disorder. Psychol. Med. 46, 2785–2797 (2016)CrossRefGoogle Scholar
  4. 4.
    Woodside, B.D., Staab, R.: Management of psychiatric comorbidity in anorexia nervosa and bulimia nervosa. CNS Drugs 20, 655–663 (2006)CrossRefGoogle Scholar
  5. 5.
    Grant, J.E., Kim, S.W., Eckert, E.D.: Body dysmorphic disorder in patients with anorexia nervosa: prevalence, clinical features, and delusionality of body image. Int. J. Eat. Disord. 32, 291–300 (2002)CrossRefGoogle Scholar
  6. 6.
    Ruffolo, J.S., Phillips, K.A., Menard, W., Fay, C., Weisberg, R.B.: Comorbidity of body dysmorphic disorder and eating disorders: severity of psychopathology and body image disturbance. Int. J. Eat. Disord. 39, 11–19 (2006)CrossRefGoogle Scholar
  7. 7.
    Kittler, J.E., Menard, W., Phillips, K.A.: Weight concerns in individuals with body dysmorphic disorder. Eat. Behav. 8, 115–120 (2007)CrossRefGoogle Scholar
  8. 8.
    Cororve, M.B., Gleaves, D.H.: Body dysmorphic disorder: a review of conceptualizations, assessment, and treatment strategies. Clin. Psychol. Rev. 21, 949–970 (2001)CrossRefGoogle Scholar
  9. 9.
    Li, W., et al.: Anorexia nervosa and body dysmorphic disorder are associated with abnormalities in processing visual information. Psychol. Med. 45, 2111–2122 (2015)CrossRefGoogle Scholar
  10. 10.
    Li, W., et al.: Aberrant early visual neural activity and brain-behavior relationships in anorexia nervosa and body dysmorphic disorder. Front. Hum. Neurosci. 9, 301 (2015)Google Scholar
  11. 11.
    Feusner, J.D., et al.: Abnormalities of visual processing and frontostriatal systems in body dysmorphic disorder. Arch. Gen. Psychiatr. 67, 197–205 (2010)CrossRefGoogle Scholar
  12. 12.
    Beucke, J.C., Sepulcre, J., Buhlmann, U., Kathmann, N., Moody, T., Feusner, J.D.: Degree connectivity in body dysmorphic disorder and relationships with obsessive and compulsive symptoms. Eur. Neuropsychopharmacol. 26, 1657–1666 (2016)CrossRefGoogle Scholar
  13. 13.
    Arienzo, D., et al.: Abnormal brain network organization in body dysmorphic disorder. Neuropsychopharmacology 38, 1130–1139 (2013)CrossRefGoogle Scholar
  14. 14.
    Feusner, J.D., et al.: White matter microstructure in body dysmorphic disorder and its clinical correlates. Psychiatr. Res.: Neuroimaging 211, 132–140 (2013)CrossRefGoogle Scholar
  15. 15.
    Brainstorm Consortium: Analysis of shared heritability in common disorders of the brain. Science 360 (2018).  https://doi.org/10.1126/science.aap8757
  16. 16.
    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. American Psychiatric Publishing Incorporated (2000)Google Scholar
  17. 17.
    Eisen, J.L., et al.: The Brown assessment of beliefs scale: reliability and validity. Am. J. Psychiatr. 155, 102–108 (1998)CrossRefGoogle Scholar
  18. 18.
    Hamilton, M.: Diagnosis and rating of anxiety. Br. J. Psychiatr. 3, 76–79 (1969)Google Scholar
  19. 19.
    Montgomery, S.A., Asberg, M.: A new depression scale designed to be sensitive to change. Br. J. Psychiatr. 134, 382–389 (1979)CrossRefGoogle Scholar
  20. 20.
    Phillips, K.A., Hollander, E., Rasmussen, S.A., Aronowitz, B.R., DeCaria, C., Goodman, W.K.: A severity rating scale for body dysmorphic disorder: development, reliability, and validity of a modified version of the Yale-Brown Obsessive Compulsive Scale. Psychopharmacol. Bull. 33, 17–22 (1997)Google Scholar
  21. 21.
    Mazure, C.M., Halmi, K.A., Sunday, S.R., Romano, S.J., Einhorn, A.M.: The Yale-Brown-Cornell eating disorder scale: development, use, reliability and validity. J. Psychiatr. Res. 28, 425–445 (1994)CrossRefGoogle Scholar
  22. 22.
    Moody, T.D., et al.: Functional connectivity for face processing in individuals with body dysmorphic disorder and anorexia nervosa. Psychol. Med. 45, 3491–3503 (2015)MathSciNetCrossRefGoogle Scholar
  23. 23.
    Sporns, O., Chialvo, D., Kaiser, M., Hilgetag, C.: Organization, development and function of complex brain networks. Trends Cogn. Sci. 8, 418–425 (2004)CrossRefGoogle Scholar
  24. 24.
    Rubin, D.B.: Multiple imputation after 18+ years. J. Am. Stat. Assoc. 91, 473–489 (1996)CrossRefGoogle Scholar
  25. 25.
    Rubin, D.B.: Multiple Imputation for Nonresponse in Surveys. Wiley, Hoboken (2004)zbMATHGoogle Scholar
  26. 26.
    Insel, T., et al.: Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am. J. Psychiatr. 167, 748–751 (2010)CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Jamie D. Feusner
    • 1
    • 2
  • Wesley T. Kerr
    • 1
    • 2
    • 3
  • Teena D. Moody
    • 1
    • 2
  • Aifeng F. Zhang
    • 4
  • Mark S. Cohen
    • 1
    • 2
  • Alex D. Leow
    • 4
    • 5
  • Michael A. Strober
    • 1
    • 2
  • Don A. Vaughn
    • 1
    • 6
  1. 1.Semel Institute for Neuroscience and Human BehaviorUniversity of CaliforniaLos AngelesUSA
  2. 2.David Geffen School of MedicineUniversity of CaliforniaLos AngelesUSA
  3. 3.Department of Internal MedicineEisenhower HealthRancho MirageUSA
  4. 4.Department of PsychiatryUniversity of IllinoisChicagoUSA
  5. 5.Department of BioengineeringUniversity of IllinoisChicagoUSA
  6. 6.Department of PsychologySanta Clara UniversitySanta ClaraUSA

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