Craving is defined as an irrepressible urge to consume certain products and represents
one of the key factors in severe substance use disorders, as illustrated by its recent
inclusion as a diagnostic criterion in the most recent fifth edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM 5). However, the pathophysiological
models of craving remain debated.
The "metacognitive hub model", a conceptual, experimental and clinical approach to
craving, proposes that craving should be considered as the embedded consequence of the
interaction between three components (the reflexive, automatic and interoceptive
systems), each of which has an implicit and explicit element. This model links the three
components by suggesting that metacognitive abilities, the ability to understand one's
own cognitive functioning, may be a skill of individuals that allows them to make the
three sub-components explicit or not.
To date, the conception of eating disorders is increasingly similar to that of addictive
disorders. Indeed, there is growing evidence that the symptomatology of bulimia nervosa
and binge eating disorder can be considered in part as an "food addiction" and would fit
the diagnostic criteria of an addictive disorder. Bulimia nervosa is an eating disorder
(DSM 5) characterized by a cycle of binge eating and compensatory behaviors such as
self-induced vomiting that tend to negate or compensate for the effects of the binge
eating. Binge eating disorder (DSM 5) is characterized by a cycle of binge eating, but
without the compensatory behaviors seen in bulimia nervosa. In addition, there are common
neurological aspects as well as similar cognitions between these eating disorders and
addictive disorders. Given the importance of craving in addictive pathology, it seems
essential to address this issue in bulimia nervosa and binge eating disorder. The
cognitive difficulties of patients with bulimia nervosa and binge eating disorder, which
are close to the difficulties observed in patients with addictive behaviors, suggest that
the "metacognitive hub model" could provide a clear and measurable theoretical framework
of the different dimensions of craving.
The overall objective of this project is to explore the relationship between the level of
craving induced by food picture exposure and the level of impairment of the reflexive,
automatic, interoceptive, and metacognitive systems in women with bulimia nervosa and
binge eating disorder and to compare these impairments according to the nature of the
eating disorder (i.e., binge eating versus bulimia nervosa).
Our hypotheses are:
the induction of food craving will affect the reflexive, automatic, and
interoceptive systems of patients with bulimia nervosa and binge eating disorder.
the magnitude of the effect of food craving induction on implicit craving and
explicit craving will be modulated by the participants' metacognitive abilities.
