Pseudoparadoxical impulsivity in restrictive anorexia nervosa: A consequence of the logic of scarcity

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Abstract
Objective To explain an apparently paradoxical pattern wherein sufferers of restrictive anorexia nervosa exhibit both rigorous self‐restraint and episodic impulsivity. Method The experimental, historical, and clinical literatures were examined for evidence of psychological and behavioral changes accompanying severe dietary constriction; such changes were noted and compared with those reported to occur in anorexics. Results Increased impulsivity in association with dietary constriction is described in diverse literatures. A number of lines of evidence suggest that the serotonergic system mediates this change. Discussion Many forms of impulsivity can be understood as having once constituted fitness‐enhancing responses to resource scarcity. It is suggested that an evolved psychological mechanism calibrates the individual's sensitivity to risk in light of future prospects. Self‐injurious behaviors are explicable as misfirings of such a mechanism. Similarly, excessive exercising by anorexics may reflect the misdirection of reward systems that normally encourage adaptive increases in ranging behavior under conditions of scarcity. © 2002 by Wiley Periodicals, Inc. Int J Eat Disord 31: 376–388, 2002.