Cognitive-affective neuropsychology of binge eating disorder

Increased reward sensitivity, cognitive biases in response to food cues and associated psychophysiological arousal and craving as well as a reduced cognitive and behavioral control are assumed to be maintaining factors for binge eating disorder (BED). The present article gives an overview of studies on cognitive and affective mechanisms regarding the processing of stimuli typical for the disorder and general stimuli in BED. Against the background of theoretical maintenance models of BED, fundamental studies on the processing of stimuli typical for the disorder and general stimuli are presented and implications for interventions are discussed. In accordance with the corresponding model assumptions individuals with BED show an increased reward sensitivity in response to food cues compared to weight-matched controls. Furthermore, in various phases of information processing they display a range of cognitive biases associated with increased arousal and craving. Additionally, a reduced cognitive and behavioral control is typical for individuals with BED. Most studies are of correlational nature, even though there is initial evidence of a causal influence for some factors. This, in turn, may lead to psychotherapeutic interventions that target the respective maintaining mechanisms.