Proactive inhibition: An element of inhibitory control in eating disorders

- Altered behavioural control is a component of core symptoms of eating disorders.
- Proactive inhibition has not been explicitly studied in eating disorders.
- Commonly used neuropsychological tests elicit functions akin to proactive inhibition.
- Neural regions implicated in proactive inhibition and eating disorders overlap.
- Intolerance of uncertainty may influence proactive inhibition in eating disorders.

The aetiology of eating disorders (EDs) is unclear, but many hypotheses implicate alterations in behavioural control. Specifically and because of its relevance to symptomatology, there has been much interest in inhibitory control, i.e., the ability to inhibit inappropriate/unwanted behaviours. This has been studied in relation to reactive motor inhibition (withholding a response in reaction to a signal), reward-based inhibition (e.g., temporal discounting paradigms) and to reversal learning (e.g., set shifting tasks assessing cognitive flexibility and compulsivity). However, there has been less explicit exploration of proactive inhibitory control, i.e., a preparatory form of inhibitory control where responses are pre-emptively suppressed to improve performance either in terms of a dynamic strategy (e.g., post-error slowing) or as a more general suppression in the context of uncertainty (e.g., when the appropriateness of a response is less certain). This review considers proactive inhibition within the context of broader conceptual considerations of inhibitory control in EDs, discusses the existing behavioural and neural evidence, and concludes that this is a construct worthy of further exploration.