Anorexia Nervosa (AN) is characterized by severe and persistent dietary restriction that persists even when individuals consciously seek to change, suggesting that food avoidance in this population cannot be fully explained by either habit-based or goal-directed decision-making frameworks alone. The present study investigated the neural and behavioral mechanisms underlying maladaptive food-related decision making in AN, with a focus on task-dependent functional connectivity between the dorsolateral prefrontal cortex (dlPFC) and ventromedial prefrontal cortex (vmPFC) during food choice. Using secondary fMRI data from Foerde et al. (2015), behavioral and neural responses during a food choice task were examined in individuals with AN and healthy controls. Behaviorally, AN rated foods less favorably, chose food at lower rates across all categories, and resisted liked-unhealthy foods significantly more than HC, reflecting both altered food perception and excessive dietary control. At the neural level, HC showed significantly stronger dlPFC-vmPFC connectivity than AN during high-fat food trials specifically, and significant group differences manifested during self-control failure rather than success trials. Taken together, these findings suggest that the prefrontal valuation circuit supporting flexible dietary self-control in healthy individuals is not the mechanism driving food restriction in AN. Instead, food avoidance in this population appears to reflect a more rigid, reorganized decision-making system operating through altered control and valuation pathways. Beyond this implication, these results suggest that interventions aimed at restoring flexible, context dependent communication between prefrontal control and valuation regions may be more effective than approaches that inadvertently reinforce rigid neural patterns already driving restriction in AN.

Previous researchers have investigated decisions under risk and uncertainty in the pursuit of better understanding the psychological factors that influence how we formulate our decisions. Several theories for modeling decision-making behavior have developed as a result of this research, such as expected value theory and prospect theory. This study expands on the previous experiment conducted by Gonzalez and Wu (1999), which investigated distortions of probability relative to stated probabilities, by exploring the effect that financial literacy has on probability distortion. 53 subjects participated in this study, all current Princeton University undergraduate students. Subjects completed a five-question financial literacy assessment (Task 1) followed by a revealed probability distortion task (Task 2). It was hypothesized that there would be an inverse relationship between subjects’ financial literacy scores and their degree of probability distortion, given subjects with higher financial literacy scores having a stronger ability to understand the characteristics of probabilities and rational decision-making models (Rieger et al., 2015, p. 644). It was further hypothesized that this relationship would not exist for measures of diminishing marginal utility, the other determinant of risk. A correlation analysis of the results from Tasks 1 and 2 found a significant and positive relationship between financial literacy and risk-seeking behavior. We then estimated parameters of prospect theory that best fit each subject’s choices in Task 2. Analysis of the financial literacy scores and the estimated parameters of prospect theory suggest that this relationship is mediated by probability distortion, and not by diminishing marginal utility, as hypothesized. The results from this study offer novel insights into the effect that financial literacy has on decision-making under uncertainty and support the notion that initiatives to improve financial literacy can benefit decision-making.