{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T13:13:57Z","timestamp":1784380437593,"version":"3.55.0"},"posted":{"date-parts":[[2024,2,1]]},"group-title":"Psychiatry and Clinical Psychology","reference-count":89,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,2,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>\n                  Alterations in learning and decision-making systems are thought to contribute to core features of anorexia nervosa (AN), a psychiatric disorder characterized by persistent dietary restriction and weight loss. Instrumental learning theory identifies a dual-system of habit and goal-directed decision-making, linked to model-free and model-based reinforcement learning algorithms. Difficulty arbitrating between these systems, resulting in an over-reliance on one strategy over the other, has been implicated in compulsivity and extreme goal pursuit, both of which are observed in AN. Characterizing alterations in model-free and model-based systems, and their neural correlates, in AN may clarify mechanisms contributing to symptom heterogeneity (e.g., binge\/purge symptoms). This study tested whether adolescents with restricting AN (AN-R;\n                  <jats:italic>n<\/jats:italic>\n                  = 36) and binge\/purge AN (AN-BP;\n                  <jats:italic>n<\/jats:italic>\n                  = 20) differentially utilized model-based and model-free learning systems compared to a healthy control group (HC;\n                  <jats:italic>n<\/jats:italic>\n                  = 28) during a Markov two-step decision-making task under conditions of reward and punishment. Associations between model-free and model-based learning and resting-state functional connectivity between neural regions of interest, including orbitofrontal cortex (OFC), nucleus accumbens (NAcc), putamen, and sensory motor cortex (SMC) were examined. AN-R showed higher utilization of model-free learning compared to HC for reward, but attenuated model-free and model-based learning for punishment. In AN-R only, higher model-based learning was associated with stronger OFC-to-left NAcc functional connectivity, regions linked to goal-directed behavior. Greater utilization of model-free learning for reward in AN-R may differentiate this group, particularly during adolescence, and facilitate dietary restriction by prioritizing habitual control in rewarding contexts.\n                <\/jats:p>","DOI":"10.1101\/2024.01.31.24302097","type":"posted-content","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T18:50:12Z","timestamp":1706813412000},"source":"Crossref","is-referenced-by-count":3,"title":["Greater reliance on model-free learning in adolescent anorexia nervosa: An examination of dual-system reinforcement learning"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4262-1238","authenticated-orcid":false,"given":"Carina S.","family":"Brown","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0445-2763","authenticated-orcid":false,"given":"Sean","family":"Devine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9997-1901","authenticated-orcid":false,"given":"A. 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