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A Reference-Dependent Computational Model of Anorexia Nervosa

Rigoli, F. ORCID: 0000-0003-2233-934X & Martinelli, C. (2021). A Reference-Dependent Computational Model of Anorexia Nervosa. Cognitive, Affective, & Behavioral Neuroscience, 21(2), pp. 269-277. doi: 10.3758/s13415-021-00886-w


Influential accounts interpret anorexia as arising from perfectionism, dichotomous thinking, and poor control expressed in a variety of life domains, resulting in low self-esteem. In this context, restraining eating would allow patients to re-establish some control and self-esteem. Although this view has offered important insight, one shortcoming is that constructs such as perfectionism, control, and dichotomous thinking, remain poorly specified. To clarify these constructs, we propose a computational model of anorexia. This relies on previous theories of evaluation, which highlight its reference-dependent nature: when attributing a value to an outcome, our brain automatically assesses the outcome relative to its context. Following these theories, the model proposes that a high reference point explains general characteristics such as perfectionism, dichotomous thinking, low self-esteem, and low sense of control. These characteristics would result specifically in anorexia when the sense of control regarding body shape, compared with other life domains, is relatively high. The model raises the possibility that reference effects also might explain why patients pursue extremely low weight; exposure to skinny body images—one product of obsessive dieting—might change the reference point for their own body, hence leading to extremely low body weight, staunch refusal to gain weight, and body misperceptions. The model contributes to clarify key concepts adopted in the literature and their relation. Such computational formulation might help to foster theoretical debate, formulating novel empirical predictions, and integrate psychological and neuroscientific perspectives on anorexia.

Publication Type: Article
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Publisher Keywords: Anorexia, Evaluation, Reference dependent, Perfectionism, Dichotomous thinking, Control
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health & Psychological Sciences > Psychology
Text - Published Version
Available under License Creative Commons: Attribution International Public License 4.0.

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