Positive Emotion and Motivational Dynamics in Anorexia Nervosa: A Positive Emotion Amplification Model (PE-AMP)

The role of positive emotion in anorexia nervosa (AN) has been underappreciated in both theory and treatment. Yet, people with AN demonstrate high motivation for and sustained effort toward weight loss, achieving success to an extreme beyond the capability of most people. Positive emotion dysregulat...

Full description

Saved in:
Bibliographic Details
Published in:Psychological review 2020-10, Vol.127 (5), p.853-890
Main Authors: Selby, Edward A, Coniglio, Kathryn A
Format: Article
Language:English
Subjects:
Anorexia
Anorexia Nervosa
Anorexia Nervosa - psychology
Autonomy
Behavior
Cognitive-behavioral factors
Emotional regulation
Emotions
Feedback
Female
Happiness
Hospitalization
Human
Humans
Medical treatment
Models, Psychological
Motivation
Negative Emotions
Personal Autonomy
Positive Emotions
Psychopathology
Quality of Life
Relatedness
Rewards
Self determination
Sense of purpose
Suicide
Weight Loss
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The role of positive emotion in anorexia nervosa (AN) has been underappreciated in both theory and treatment. Yet, people with AN demonstrate high motivation for and sustained effort toward weight loss, achieving success to an extreme beyond the capability of most people. Positive emotion dysregulation may facilitate and reinforce such efforts. The positive emotion amplification (PE-AMP) model of AN describes a dynamic interplay between biologically based enhanced reward responding and cognitive-behavioral factors that amplify positive emotion, resulting in positive feedback cycles that motivate and reinforce weight loss behavior during the AN onset phase. These experiences subvert the pursuit of happiness by providing artificial senses of autonomy, competency, and relatedness to others (self-determination theory; Ryan & Deci, 2000) that provide a stark contrast to an otherwise negative emotional environment, resulting in the emergence and persistence of AN psychopathology as a self-sustaining sense of purpose. Ultimately, negative emotion, PE dysregulation, and artificial self-determination threats continue to drive AN behavior during the AN maintenance phase, pushing patients toward a genuine self-determination breakdown that can lead to hospitalization, health crises, relational strife and diminished quality of life, or even manifest in suicidal behavior. Future research directions and novel methodological approaches inspired by the PE-AMP model are discussed, as are important treatment implications for addressing this highly treatment-resistant disorder.
ISSN:0033-295X
1939-1471
DOI:10.1037/rev0000198