101
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Executive functioning and central coherence in anorexia nervosa: Pilot investigation of a neurocognitive endophenotype. EUROPEAN EATING DISORDERS REVIEW 2018; 26:489-498. [DOI: 10.1002/erv.2597] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/19/2018] [Accepted: 03/21/2018] [Indexed: 11/07/2022]
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102
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Buzzichelli S, Marzola E, Amianto F, Fassino S, Abbate-Daga G. Perfectionism and cognitive rigidity in anorexia nervosa: Is there an association? EUROPEAN EATING DISORDERS REVIEW 2018; 26:360-366. [DOI: 10.1002/erv.2591] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/19/2018] [Accepted: 02/26/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Sara Buzzichelli
- Eating Disorder Center, Department of Neuroscience; University of Turin; Turin Italy
| | - Enrica Marzola
- Eating Disorder Center, Department of Neuroscience; University of Turin; Turin Italy
| | - Federico Amianto
- Eating Disorder Center, Department of Neuroscience; University of Turin; Turin Italy
| | - Secondo Fassino
- Eating Disorder Center, Department of Neuroscience; University of Turin; Turin Italy
| | - Giovanni Abbate-Daga
- Eating Disorder Center, Department of Neuroscience; University of Turin; Turin Italy
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103
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Giombini L, Nesbitt S, Cox H, Foxall A, Sharia T, Easter A, Tchanturia K. Cognitive remediation therapy (CRT) in a specialist inpatient eating disorder service for children and adolescents: CAN-CRT study protocol for a pilot randomised controlled trial. EUROPEAN EATING DISORDERS REVIEW 2018; 26:438-446. [PMID: 29577512 DOI: 10.1002/erv.2592] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 02/19/2018] [Accepted: 02/26/2018] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Research on treatments for young people (YP) with anorexia nervosa (AN) is scarce. Evidence supports the use of cognitive remediation therapy (CRT) to improve central coherence and set-shifting, inefficiencies that can negatively impact on prognosis. OBJECTIVE The study aims to evaluate the feasibility of individual CRT in an inpatient setting for YP aged 10-18 years with AN and to qualitatively examine YP's and their parents experiences. METHOD In a single-centre, pilot, randomised controlled trial, 80 patients aged 10-18 years with AN will be randomly allocated to the immediate or delayed CRT group, in addition to standard treatment. A repeated measures design will be conducted across 3 time points. DISCUSSION The data will provide evidence regarding the feasibility of individual CRT in YP with AN, informing directions of further development of CRT. The study is in preparation for a definitive randomised controlled trial. The aim of this manuscript is to describe the study protocol.
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Affiliation(s)
- Lucia Giombini
- Psychology Department, Rhodes Wood Hospital, Elysium Healthcare, UK.,Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Sophie Nesbitt
- Psychology Department, Rhodes Wood Hospital, Elysium Healthcare, UK
| | - Hannah Cox
- Psychology Department, Rhodes Wood Hospital, Elysium Healthcare, UK
| | - Anna Foxall
- Psychology Department, Rhodes Wood Hospital, Elysium Healthcare, UK
| | - Teo Sharia
- Department of Mathematics, Royal Holloway University of London, UK
| | - Abigail Easter
- Centre for Implementation Science, Health Services Research and Population Research Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Kate Tchanturia
- Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK.,Department of Psychology, Illia State University, Georgia.,Eating Disorders National Service, South London and Maudsley NHS Foundation Trust, UK
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104
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Harrison A, Stavri P, Ormond L, McEnemy F, Akyol D, Qureshi A, Al-Khairulla H. Cognitive remediation therapy for adolescent inpatients with severe and complex anorexia nervosa: A treatment trial. EUROPEAN EATING DISORDERS REVIEW 2018. [PMID: 29542258 DOI: 10.1002/erv.2584] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Cognitive remediation therapy (CRT) is a low-intensity treatment adjunct for individuals with severe and complex anorexia nervosa (AN) with difficulties in globally oriented, flexible thinking. Previously trialled in adults, this study investigated whether individual and group CRT was a feasible, acceptable, and beneficial treatment for 125 adolescent inpatients with severe and complex AN. Seventy patients (mean age = 15.22, SD = 1.44) received 10 sessions of individual CRT, and 55 patients (mean age = 14.89, SD = 1.74) received 10 sessions of group CRT. In individual CRT, 1 patient (1.43%) dropped out, and there were medium-sized improvements in bigger picture thinking and set-shifting, small to large-sized improvements in switching-related initiation and inhibition skills, and large-sized improvements in motivation to recover. Group CRT had higher dropout (9.09%; n = 5) and produced small-sized improvements in global information processing and medium-sized improvements in self-reported cognitive flexibility and high acceptability ratings. Data suggest that a randomised controlled trial for adolescents with AN is warranted.
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Affiliation(s)
- Amy Harrison
- Department of Psychology and Human Development, University College London, London, UK.,Ellern Mede Service for Eating Disorders, London, UK
| | - Pamela Stavri
- Ellern Mede Service for Eating Disorders, London, UK
| | - Lynn Ormond
- Ellern Mede Service for Eating Disorders, London, UK
| | | | - Dilan Akyol
- Ellern Mede Service for Eating Disorders, London, UK
| | - Annum Qureshi
- Ellern Mede Service for Eating Disorders, London, UK
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105
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Lock J, Fitzpatrick KK, Agras WS, Weinbach N, Jo B. Feasibility Study Combining Art Therapy or Cognitive Remediation Therapy with Family-based Treatment for Adolescent Anorexia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2018; 26:62-68. [PMID: 29152825 PMCID: PMC5732028 DOI: 10.1002/erv.2571] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 10/02/2017] [Accepted: 10/23/2017] [Indexed: 12/25/2022]
Abstract
Adolescents with anorexia nervosa who have obsessive-compulsive (OC) features respond poorly to family-based treatment (FBT). This study evaluated the feasibility of combining FBT with either cognitive remediation therapy (CRT) or art therapy (AT) to improve treatment response in this at-risk group. Thirty adolescents with anorexia nervosa and OC features were randomized to 15 sessions of FBT + CRT or AT. Recruitment rate was 1 per month, and treatment attrition was 16.6% with no differences between groups. Suitability, expectancy and therapeutic relationships were acceptable for both combinations. Correlations between changes in OC traits and changes in cognitive inefficiencies were found for both combinations. Moderate changes in cognitive inefficiencies were found in both groups but were larger in the FBT + AT combination. This study suggests that an RCT for poor responders to FBT because of OC traits combining FBT with either CRT or AT is feasible to conduct. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- James Lock
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Kathleen Kara Fitzpatrick
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - W. Stewart Agras
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Noam Weinbach
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
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106
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Leppanen J, Adamson J, Tchanturia K. Impact of Cognitive Remediation Therapy on Neurocognitive Processing in Anorexia Nervosa. Front Psychiatry 2018; 9:96. [PMID: 29615940 PMCID: PMC5869183 DOI: 10.3389/fpsyt.2018.00096] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 03/08/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Anorexia nervosa (AN) is characterized by severe malnutrition as well as inefficiencies in neurocognitive functioning, which are believed to contribute to the maintenance of disordered eating. The aim of this study was to examine the impact of individual cognitive remediation therapy (CRT) on neurocognition in AN. METHODS A total of 145 adult women from an eating disorders inpatient program took part in the present study. All participants were given individual CRT in addition to treatment as usual. Neurocognitive processes were assessed at baseline and at the end of treatment using task-based and self-report measures. The task-based measures included the Rey-Osterrieth Complex Figure test and the Brixton test, which were used to assess central coherence and set-shifting. The Detail and Flexibility Questionnaire was used to examine patients self-reported detail focus and cognitive flexibility. RESULTS Participants showed significant improvement in task-based measures of neurocognition following CRT. There were no significant changes in self-report measures. CONCLUSION These findings suggest that CRT may be an effective intervention targeting inefficiencies in neurocognition in AN. Future studies may benefit from assessing neural changes associated with these improvements and conducting randomized controlled trials to replicate these findings.
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Affiliation(s)
- Jenni Leppanen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - James Adamson
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Psychology, Illia State University, Tbilisi, Georgia
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107
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Björnsdotter M, Davidovic M, Karjalainen L, Starck G, Olausson H, Wentz E. Grey matter correlates of autistic traits in women with anorexia nervosa. J Psychiatry Neurosci 2017; 43:1-8. [PMID: 29214796 PMCID: PMC5837888 DOI: 10.1503/jpn.170072] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/27/2017] [Accepted: 07/11/2017] [Indexed: 12/27/2022] Open
Abstract
Background Patients with anorexia nervosa exhibit higher levels of behaviours typically associated with autism-spectrum disorder (ASD), but the neural basis is unclear. We sought to determine whether elevated autistic traits in women with anorexia nervosa may be reflected in cortical morphology. Methods We used voxel-based morphometry (VBM) to examine regional grey matter volumes in high-resolution MRI structural brain scans in women with anorexia nervosa and matched healthy controls. The Autism-spectrum Quotient (AQ) scale was used to assess autistic traits. Results Women with anorexia nervosa (n = 25) had higher AQ scores and lower bilateral superior temporal sulcus (STS) grey matter volumes than the control group (n = 25). The AQ scores correlated negatively with average left STS grey matter volume in women with anorexia nervosa. Limitations We did not control for cognitive ability and examined only women with ongoing anorexia nervosa. Conclusion Elevated autistic traits in women with anorexia nervosa are associated with morphometric alterations of brain areas linked to social cognition. This finding provides neurobiological support for the behavioural link between anorexia nervosa and ASD and emphasizes the importance of recognizing autistic traits in preventing and treating anorexia nervosa.
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Affiliation(s)
- Malin Björnsdotter
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Monika Davidovic
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Louise Karjalainen
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Göran Starck
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Håkan Olausson
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
| | - Elisabet Wentz
- From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck)
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108
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Tchanturia K, Adamson J, Leppanen J, Westwood H. Characteristics of autism spectrum disorder in anorexia nervosa: A naturalistic study in an inpatient treatment programme. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 23:123-130. [DOI: 10.1177/1362361317722431] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Previous research has demonstrated links between anorexia nervosa and autism spectrum disorder however, few studies have examined the possible impact of symptoms of autism spectrum disorder on clinical outcomes in anorexia nervosa. The aim of this study was to examine the association between symptoms of autism spectrum disorder and eating disorders, and other psychopathology during the course of inpatient treatment in individuals with anorexia nervosa. Participants with anorexia nervosa (n = 171) completed questionnaires exploring eating disorder psychopathology, symptoms of depression and anxiety, and everyday functioning at both admission and discharge. Characteristics associated with autism spectrum disorder were assessed using the Autism Spectrum Quotient, short version. Autism spectrum disorder symptoms were significantly positively correlated with eating disorder psychopathology, work and social functioning, and symptoms of depression and anxiety, but not with body mass index. Autism Spectrum Quotient, short version scores remained relatively stable from admission to discharge but there was a small, significant reduction in scores. There was no interaction between time and Autism Spectrum Quotient, short version scores on clinical symptom change. In anorexia nervosa, autism spectrum disorder symptoms appear to be associated with a more severe clinical presentation on admission to inpatient care. Autism spectrum disorder symptoms as assessed by self-report measures may be exacerbated by other mental health psychopathology, which warrants further investigation.
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Affiliation(s)
- Kate Tchanturia
- King’s College London, UK
- South London and Maudsley NHS Foundation Trust, UK
- Ilia State University, Georgia
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109
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Lalani SJ, Duffield TC, Trontel HG, Bigler ED, Abildskov TJ, Froehlich A, Prigge MBD, Travers BG, Anderson JS, Zielinski BA, Alexander A, Lange N, Lainhart JE. Auditory attention in autism spectrum disorder: An exploration of volumetric magnetic resonance imaging findings. J Clin Exp Neuropsychol 2017; 40:502-517. [PMID: 29072106 DOI: 10.1080/13803395.2017.1373746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Studies have shown that individuals with autism spectrum disorder (ASD) tend to perform significantly below typically developing individuals on standardized measures of attention, even when controlling for IQ. The current study sought to examine within ASD whether anatomical correlates of attention performance differed between those with average to above-average IQ (AIQ group) and those with low-average to borderline ability (LIQ group) as well as in comparison to typically developing controls (TDC). Using automated volumetric analyses, we examined regional volume of classic attention areas including the superior frontal gyrus, anterior cingulate cortex, and precuneus in ASD AIQ (n = 38) and LIQ (n = 18) individuals along with 30 TDC. Auditory attention performance was assessed using subtests of the Test of Memory and Learning (TOMAL) compared among the groups and then correlated with regional brain volumes. Analyses revealed group differences in attention. The three groups did not differ significantly on any auditory attention-related brain volumes; however, trends toward significant size-attention function interactions were observed. Negative correlations were found between the volume of the precuneus and auditory attention performance for the AIQ ASD group, indicating larger volume related to poorer performance. Implications for general attention functioning and dysfunctional neural connectivity in ASD are discussed.
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Affiliation(s)
- Sanam J Lalani
- a Department of Psychology , Brigham Young University , Provo , UT , USA
| | - Tyler C Duffield
- a Department of Psychology , Brigham Young University , Provo , UT , USA
| | - Haley G Trontel
- a Department of Psychology , Brigham Young University , Provo , UT , USA
| | - Erin D Bigler
- a Department of Psychology , Brigham Young University , Provo , UT , USA.,b Neuroscience Center , Brigham Young University , Provo , UT , USA.,c Department of Psychology , University of Utah , Salt Lake City , UT , USA.,d Department of Pediatrics , University of Utah , Salt Lake City , UT , USA
| | - Tracy J Abildskov
- a Department of Psychology , Brigham Young University , Provo , UT , USA
| | - Alyson Froehlich
- c Department of Psychology , University of Utah , Salt Lake City , UT , USA
| | - Molly B D Prigge
- d Department of Pediatrics , University of Utah , Salt Lake City , UT , USA
| | - Brittany G Travers
- e Waisman Laboratory for Brain Imaging and Behavior , University of Wisconsin-Madison , Madison , WI , USA.,f Department of Kinesiology , University of Wisconsin-Madison , Madison , WI , USA
| | - Jeffrey S Anderson
- g Department of Radiology , University of Utah , Salt Lake City , UT , USA
| | - Brandon A Zielinski
- d Department of Pediatrics , University of Utah , Salt Lake City , UT , USA.,h Department of Neurology, School of Medicine , University of Utah , Salt Lake City , UT , USA
| | - Andrew Alexander
- e Waisman Laboratory for Brain Imaging and Behavior , University of Wisconsin-Madison , Madison , WI , USA.,i Department of Medical Physics , University of Wisconsin-Madison , Madison , WI , USA.,j Department of Psychiatry , University of Wisconsin-Madison , Madison , WI , USA
| | - Nicholas Lange
- k Department of Psychiatry , Harvard Medical School , Boston , MA , USA.,l Neurostatistics Laboratory , McLean Hospital , Belmont , MA , USA
| | - Janet E Lainhart
- e Waisman Laboratory for Brain Imaging and Behavior , University of Wisconsin-Madison , Madison , WI , USA.,j Department of Psychiatry , University of Wisconsin-Madison , Madison , WI , USA
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Øverås M, Kapstad H, Brunborg C, Landrø NI, Rø Ø. Is overestimation of body size associated with neuropsychological weaknesses in anorexia nervosa? EUROPEAN EATING DISORDERS REVIEW 2017; 25:129-134. [PMID: 28217881 DOI: 10.1002/erv.2500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 10/21/2016] [Accepted: 11/25/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Recent research indicates some evidence of neuropsychological weaknesses in visuospatial memory, central coherence and set-shifting in adults with anorexia nervosa (AN). The growing interest in neuropsychological functioning of patients with AN is based upon the assumption that neuropsychological weaknesses contribute to the clinical features of the illness. However, due to a paucity of research on the connection between neuropsychological difficulties and the clinical features of AN, this link remains hypothetical. The main objective of this study was to explore the association between specific areas of neuropsychological functioning and body size estimation in patients with AN and healthy controls. METHODS The sample consisted of 36 women diagnosed with AN and 34 healthy female controls. Participants were administered the continuous visual memory test and the recall trials of Rey Complex Figure Test to assess visual memory. Central coherence was assessed using the copy trial of Rey Complex Figure Test, and the Wisconsin Card Sorting Test was used to assess set-shifting. Body size estimation was assessed with a computerized morphing programme. RESULTS The analyses showed no significant correlations between any of the neuropsychological measures and body size estimation. CONCLUSION The results suggest that there is no association between these areas of neuropsychological difficulties and body size estimation among patients with AN. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Maria Øverås
- Regional Department for Eating Disorders (RASP), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Hilde Kapstad
- Regional Department for Eating Disorders (RASP), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Nils Inge Landrø
- Clinical Neuroscience Research Group, Department of Psychology, Oslo, Norway
| | - Øyvind Rø
- Regional Department for Eating Disorders (RASP), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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111
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Okuda T, Asano K, Numata N, Hirano Y, Yamamoto T, Tanaka M, Matsuzawa D, Shimizu E, Iyo M, Nakazato M. Feasibility of cognitive remediation therapy for adults with autism spectrum disorders: a single-group pilot study. Neuropsychiatr Dis Treat 2017; 13:2185-2191. [PMID: 28860776 PMCID: PMC5565247 DOI: 10.2147/ndt.s141555] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Set-shifting (SS) difficulties and weak central coherence (CC) are commonly associated with autism spectrum disorders (ASD). Cognitive remediation therapy (CRT) aims to improve such cognitive processing; however, there are no reports on CRT for patients with ASD. This pilot study aimed to provide preliminary evidence to support the use of CRT for individuals with ASD and provide data to inform future studies. PARTICIPANTS AND METHODS Nineteen individuals with ASD were recruited and administered a series of neuropsychological and questionnaire measures to examine cognitive function and clinical outcomes such as anxiety and depression. Participants received CRT, and cognitive function and clinical variables were re-evaluated at postintervention and after 3 months. RESULTS The participants demonstrated significant improvement in CC and anxiety at postintervention, which was maintained at 3-month follow-up. Although SS scores had improved with a large effect size, this was not statistically significant. CONCLUSION CRT improved CC and anxiety scores for individuals with ASD, suggesting that CRT is an effective treatment for individuals with ASD.
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Affiliation(s)
- Tomoko Okuda
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Chiba-shi, Chiba
- Department of Psychiatry, Chibaken Saiseikai Narashino Hospital, Narashino
| | - Kenichi Asano
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Chiba-shi, Chiba
- Research Center for Child Mental Development, Chiba University
| | - Noriko Numata
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University
| | - Yoshiyuki Hirano
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Chiba-shi, Chiba
- Research Center for Child Mental Development, Chiba University
| | | | - Mari Tanaka
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University
| | - Daisuke Matsuzawa
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University
| | - Eiji Shimizu
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Chiba-shi, Chiba
- Research Center for Child Mental Development, Chiba University
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University
| | - Masaomi Iyo
- Center for Forensic Mental Health, Chiba University
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michiko Nakazato
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Chiba-shi, Chiba
- Research Center for Child Mental Development, Chiba University
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
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112
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Harper JA, Brodrick B, Van Enkevort E, McAdams CJ. Neuropsychological and Cognitive Correlates of Recovery in Anorexia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2017; 25:491-500. [PMID: 28799287 DOI: 10.1002/erv.2539] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To identify clinical or cognitive measures either predictive of illness trajectory or altered with sustained weight recovery in adult women with anorexia nervosa. METHODS Participants were recruited from prior studies of women with anorexia nervosa (AN-C) and in weight-recovery following anorexia nervosa (AN-WR). Participants completed a neuropsychological battery at baseline and clinical assessments at both baseline and follow-up. Groups based on clinical outcome (continued eating disorder, AN-CC; newly in recovery, AN-CR; sustained weight-recovery, AN-WR) were compared by using one-way ANOVAs with Bonferroni-corrected post hoc comparisons. RESULTS Women with continued eating disorder had poorer neuropsychological function and self-competence at baseline than AN-CR. AN-CR showed changes in depression and externalizing bias, a measure of self-related attributions. AN-WR differed from both AN-CC and AN-CR at baseline in externalizing bias, but only from AN-CC at outcome. DISCUSSION Neuropsychological function when recently ill may be a prognostic factor, while externalizing bias may provide a clinical target for recovery. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Jessica A Harper
- Department of Psychiatry, University of Texas Southwestern Medical Center, TX, USA
| | - Brooks Brodrick
- Department of Internal Medicine, University of Texas Southwestern Medical Center, TX, USA
| | - Erin Van Enkevort
- Department of Psychiatry, University of Texas Southwestern Medical Center, TX, USA
| | - Carrie J McAdams
- Department of Psychiatry, University of Texas Southwestern Medical Center, TX, USA.,Department of Psychiatry, Children's Medical Center, TX, USA.,Department of Psychiatry, Texas Health Presbyterian Hospital of Dallas, TX, USA
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113
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Kinnaird E, Norton C, Tchanturia K. Clinicians' views on working with anorexia nervosa and autism spectrum disorder comorbidity: a qualitative study. BMC Psychiatry 2017; 17:292. [PMID: 28797223 PMCID: PMC5553805 DOI: 10.1186/s12888-017-1455-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 08/03/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Anorexia nervosa (AN) and autism spectrum disorder (ASD) form a relatively common comorbidity, with poorer illness outcomes and poorer responses to treatments for AN compared to individuals without ASD. However, the treatment of this comorbidity remains poorly understood: no research to date has examined how clinicians currently approach treating AN/ASD. This study aimed to explore the experiences of clinicians working with comorbid AN/ASD using qualitative methods in order to identify areas for future improvement. METHODS Interviews with individual clinicians (n = 9) were carried out and explored using thematic analysis. RESULTS The findings suggest that many clinicians lack confidence in treating this comorbidity, which requires specific changes to treatment to accommodate the issues raised by comorbid ASD. At present, any adaptations to treatment are based on the previous experience of individual clinicians, rather than representing a systematic approach. CONCLUSIONS Further research is needed to empirically assess potential treatment modifications for this group and to establish guidelines for best clinical practice.
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Affiliation(s)
- Emma Kinnaird
- 0000 0001 2322 6764grid.13097.3cKing’s College London, London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK
| | - Caroline Norton
- 0000 0000 9439 0839grid.37640.36Eating Disorders National Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Kate Tchanturia
- King's College London, London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK. .,Eating Disorders National Service, South London and Maudsley NHS Foundation Trust, London, UK. .,Illia State University, Tbilisi, Georgia. .,PO59, King's College London, IoPPN, Psychological Medicine, 16 De Crespigny Park, London, SE5 8AF, UK.
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114
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Abstract
PURPOSE OF REVIEW There is growing interest in the relationship between anorexia nervosa (AN) and autism spectrum disorder (ASD). This review aimed to synthesise the most recent research on this topic to identify gaps in current knowledge, directions for future research and reflect on implications for treatment. RECENT FINDINGS Eight studies assessing the presence of ASD in AN were identified in the literature along with three studies examining the impact of symptoms of ASD on treatment outcome. Research with young people and using parental-report measures suggest lower rates of co-morbidity than previous adult studies. CONCLUSIONS The wide range of diagnostic tools, methodologies and populations studied make it difficult to determine the prevalence of ASD in AN. Despite this, studies consistently report over-representation of symptoms of ASD in AN. Co-morbid AN and ASD may require more intensive treatment or specifically tailored interventions. Future longitudinal research and female-specific diagnostic tools would help elucidate the relationship between these two disorders.
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Affiliation(s)
- Heather Westwood
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Kate Tchanturia
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.
- South London and Maudsley NHS Trust National Eating Disorders Service, Psychological Medicine Clinical Academic Group, London, UK.
- Department of Psychology, Illia State University, Tbilisi, Georgia.
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115
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Tchanturia K, Giombini L, Leppanen J, Kinnaird E. Evidence for Cognitive Remediation Therapy in Young People with Anorexia Nervosa: Systematic Review and Meta-analysis of the Literature. EUROPEAN EATING DISORDERS REVIEW 2017; 25:227-236. [DOI: 10.1002/erv.2522] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 03/30/2017] [Accepted: 04/05/2017] [Indexed: 01/02/2023]
Affiliation(s)
- Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience; King's College London; London UK
- South London and Maudsley NHS Foundation Trust; London UK
- Illia State University; Tbilisi Georgia
| | - Lucia Giombini
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience; King's College London; London UK
- Rhodes Wood Hospital; Elysium Healthcare; London UK
| | - Jenni Leppanen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience; King's College London; London UK
| | - Emma Kinnaird
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience; King's College London; London UK
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116
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Amodeo DA, Rivera E, HCook EH, Sweeney JA, Ragozzino ME. 5HT 2A receptor blockade in dorsomedial striatum reduces repetitive behaviors in BTBR mice. GENES, BRAIN, AND BEHAVIOR 2017; 16:342-351. [PMID: 27717169 PMCID: PMC5334373 DOI: 10.1111/gbb.12343] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 09/17/2016] [Accepted: 09/19/2016] [Indexed: 12/01/2022]
Abstract
Restricted and repetitive behaviors are a defining feature of autism, which can be expressed as a cognitive flexibility deficit or stereotyped, motor behaviors. There is limited knowledge about the underlying neuropathophysiology contributing to these behaviors. Previous findings suggest that central 5HT2A receptor activity is altered in autism, while recent work indicates that systemic 5HT2A receptor antagonist treatment reduces repetitive behaviors in an idiopathic model of autism. 5HT2A receptors are expressed in the orbitofrontal cortex and striatum. These two regions have been shown to be altered in autism. The present study investigated whether 5HT2A receptor blockade in the dorsomedial striatum or orbitofrontal cortex in the BTBR mouse strain, an idiopathic model of autism, affects the phenotype related to restricted and repetitive behaviors. Microinfusion of the 5HT2A receptor antagonist, M100907 into the dorsomedial striatum alleviated a reversal learning impairment and attenuated grooming behavior. M100907 infusion into the orbitofrontal cortex increased perseveration during reversal learning and potentiated grooming. These findings suggest that increased 5HT2A receptor activity in the dorsomedial striatum may contribute to behavioral inflexibility and stereotyped behaviors in the BTBR mouse. 5HT2A receptor signaling in the orbitofrontal cortex may be critical for inhibiting a previously learned response during reversal learning and expression of stereotyped behavior. The present results suggest which brain areas exhibit abnormalities underlying repetitive behaviors in an idiopathic mouse model of autism, as well as which brain areas systemic treatment with M100907 may principally act on in BTBR mice to attenuate repetitive behaviors.
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Affiliation(s)
- Dionisio A. Amodeo
- Department of Psychology, University of Illinois at Chicago, Chicago, IL 1007 West Harrison Street, Chicago, IL 60607-7137
| | - Elaine Rivera
- Department of Psychology, University of Illinois at Chicago, Chicago, IL 1007 West Harrison Street, Chicago, IL 60607-7137
| | - Edwin H. HCook
- Institute of Juvenile Research, University of Illinois at Chicago, Chicago, IL 1747 West Roosevelt Road, Chicago, IL 60608
| | - John A. Sweeney
- University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9086
| | - Michael E. Ragozzino
- Department of Psychology, University of Illinois at Chicago, Chicago, IL 1007 West Harrison Street, Chicago, IL 60607-7137
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117
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Bentz M, Jepsen JRM, Kjaersdam Telléus G, Moslet U, Pedersen T, Bulik CM, Plessen KJ. Neurocognitive functions and social functioning in young females with recent-onset anorexia nervosa and recovered individuals. J Eat Disord 2017; 5:5. [PMID: 28261479 PMCID: PMC5327534 DOI: 10.1186/s40337-017-0137-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/26/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Young individuals with anorexia nervosa (AN) or recovered from AN display impairments of social function. To date, however, it is not clear whether they differ from controls with respect to neurocognitive performance and whether those functions contribute to the compromised social function observed in individuals with AN. METHODS We included 43 young females with first-episode AN, 28 individuals recovered from adolescent-onset AN, and 41 control individuals (14-22 yr), all without comorbid autism spectrum disorder. We compared the performance of participants across groups in seven neurocognitive functions relevant to social functioning: set-shifting, local processing, processing speed, working memory, sustained attention, verbal memory, and verbal abstraction. Further, we tested the association between neurocognitive function and social function, measured by Autism Diagnostic Observation Schedule (ADOS), with an ordinal logistic regression model. RESULTS First, participants did not differ on any neurocognitive function across groups. Second, only the neurocognitive function "verbal memory" was significantly associated with social function. Higher performance in verbal memory was associated with lower odds of impaired social function. Diagnostic group remained a significant factor, but the absence of an interaction between group and neurocognitive performance indicated that the association between verbal memory and social function was independent of group membership. CONCLUSION Young individuals with AN and those recovered from AN did not differ from controls with respect to neurocognitive performance. Verbal memory was associated with social function in all groups.
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Affiliation(s)
- Mette Bentz
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Bispebjerg Bakke 30, 2400 København NV, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Richardt Moellegaard Jepsen
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Bispebjerg Bakke 30, 2400 København NV, Denmark.,Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Psychiatric Center Glostrup, Glostrup, Denmark
| | - Gry Kjaersdam Telléus
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Ulla Moslet
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Bispebjerg Bakke 30, 2400 København NV, Denmark
| | - Tine Pedersen
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Bispebjerg Bakke 30, 2400 København NV, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Jessica Plessen
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Bispebjerg Bakke 30, 2400 København NV, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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118
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Burns BD, Zhang Y, Wieth M, Touyz S. An exploratory study of creativity and eating disorders. J Eat Disord 2017; 5:45. [PMID: 29075495 PMCID: PMC5649089 DOI: 10.1186/s40337-017-0176-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 10/02/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND We examined whether cognitive rigidity associated with having an eating disorder generalized to creativity. METHOD One hundred twelve participants from the participant pool of an Australian university were given a measure of disordered eating (EDE-Q), asked if they had ever had a diagnosis of an eating disorder (16 reported yes), and given 3 min to generate alternative uses for a paper-clip. The alternative uses task yielded measures of creative fluency, originality, elaboration and flexibility. RESULTS A logistic regression found that only lower flexibility predicted a self-reported ED diagnosis. Across the spectrum of disordered eating behaviour there was no association between creativity measures and EDE-Q global scores. CONCLUSION Our results were consistent with previous findings of an association between cognitive inflexibility and having an ED. However we found no evidence that cognitive inflexibility generalized to creativity more broadly. Our results may lend support to Cognitive Remediation Therapy, but further study is required.
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Affiliation(s)
- Bruce D Burns
- University of Sydney, Sydney, New South Wales Australia
| | | | | | - Stephen Touyz
- University of Sydney, Sydney, New South Wales Australia
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119
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Rose M, Stedal K, Reville MC, van Noort BM, Kappel V, Frampton I, Watkins B, Lask B. Similarities and Differences of Neuropsychological Profiles in Children and Adolescents with Anorexia Nervosa and Healthy Controls Using Cluster and Discriminant Function Analyses. Arch Clin Neuropsychol 2016; 31:877-895. [PMID: 27600452 DOI: 10.1093/arclin/acw068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2016] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE This study aimed to identify discrete neuropsychological profiles and their relationship to clinical symptoms in 253 female children and adolescents with anorexia nervosa (AN) and 170 healthy controls (HCs) using a standardised neuropsychological assessment battery. METHOD Hierarchical cluster analysis was used to identify the optimum number of clusters, and participants were assigned using K-means cluster analysis. Confirmatory discriminant function analysis determined which combination of neuropsychological variables best distinguished the clusters. RESULTS Three distinct clusters in the AN sample emerged- AN cluster 1 (19%) - "neuropsychologically low average to average"; AN cluster 2 (33%) - "verbal/visuo-spatial discrepancy"; and AN cluster 3 (48%) - "verbally strong and neuropsychologically average to high average". Two distinct clusters in HCs were identified. HC cluster 1 (48%) demonstrated poor visuo-spatial memory scores and high verbal fluency scores, whilst HC cluster 2 (52%) scored within the average range on all neuropsychological tasks. Neuropsychological performance was associated with clinical symptoms of body mass index centile, Eating Disorder Examination subscale and global score, anxiety, depression and obsessions, and compulsions between the AN and HC groups. However, niether significant differences emerged between AN clusters only nor HC clusters only at the post-hoc level. DISCUSSION An underlying neuropsychological heterogeneity may exist in AN. We encourage future studies to investigate whether the identified profiles and their association with clinical characteristics are replicable. We cautiously suggest that neuropsychological profiling may have potential to both inform future research and have possible clinical benefits through individually tailored treatment strategies.
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Affiliation(s)
- Mark Rose
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,The Huntercombe Group, Maidenhead, UK
| | - Kristin Stedal
- Regional Eating Disorders Service, Oslo University Hospital, Oslo, Norway
| | - Marie-Claire Reville
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Betteke Maria van Noort
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charite-Universitatsmedizin Berlin, Germany
| | - Viola Kappel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charite-Universitatsmedizin Berlin, Germany
| | - Ian Frampton
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,Regional Eating Disorders Service, Oslo University Hospital, Oslo, Norway.,College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Beth Watkins
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Bryan Lask
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,Regional Eating Disorders Service, Oslo University Hospital, Oslo, Norway.,College of Life and Environmental Sciences, University of Exeter, Exeter, UK.,Rhodes Farm Clinic, Care UK, London, UK
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120
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Mansour S, Rozenblat V, Fuller-Tyszkiewicz M, Paganini C, Treasure J, Krug I. Emotions mediate the relationship between autistic traits and disordered eating: A new autistic-emotional model for eating pathology. Psychiatry Res 2016; 245:119-126. [PMID: 27541347 DOI: 10.1016/j.psychres.2016.08.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/28/2016] [Accepted: 08/06/2016] [Indexed: 01/30/2023]
Abstract
The aim of the study was to assess the extent of overlap between autistic traits, body dissatisfaction and disordered eating and to explore the mediating effects of negative attitudes towards emotional expression and emotion dysregulation. The sample comprised 416 university students (82% females, 17-48 years [M=19.76, SD=3.85]), who completed an online questionnaire assessing eating attitudes and behaviours (including dieting, bulimia and oral control), body dissatisfaction, and autistic traits (including the Autism Quotient [AQ] and its related subscales as well as the Empathising Quotient). Attitudes towards emotional expression and emotion regulation were also assessed. Results revealed that eating pathology correlated highly with all AQ subscales, with the exception of the attention to detail subscale. However, there was no significant relationship between empathising and eating pathology. Path-analyses indicated that emotion dysregulation, but not negative attitudes towards emotional expression, was a significant mediator of the relationship between AQ, body dissatisfaction and eating pathology. Direct relationships were also obtained for the AQ-bulimia and the AQ-oral control paths. Prevention and early intervention programs for eating pathology would likely benefit from addressing abnormalities in emotion processes in individuals who score highly on measures of autistic traits.
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Affiliation(s)
- Salma Mansour
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Vanja Rozenblat
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Burwood, Victoria, Australia; Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia
| | - Chiara Paganini
- Faculty of Health, University of Tasmania, Tasmania, Australia
| | - Janet Treasure
- King's College London, Institute of Psychiatry and Neuroscience, Department of Psychological medicine, Section of Eating Disorders, United Kingdom
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
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121
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Tchanturia K, Larsson E, Adamson J. How anorexia nervosa patients with high and low autistic traits respond to group Cognitive Remediation Therapy. BMC Psychiatry 2016; 16:334. [PMID: 27682072 PMCID: PMC5041290 DOI: 10.1186/s12888-016-1044-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 09/19/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The current study aimed to evaluate group Cognitive remediation therapy (CRT) inpatients with Anorexia Nervosa (AN). We aimed to examine the treatment response of group CRT in AN patients with high or low levels of autistic traits. METHODS Thirty-five in patients with an AN diagnosis received group CRT intervention for 6 sessions in a national eating disorder unit. All participants completed self-report questionnaires on thinking styles and motivation before and after the intervention. RESULTS Patients with low autistic traits had statistically significant medium size effect improvements in self-reported thinking style scales as well as confidence (ability) to change. Patients with high autistic traits showed no statistically significant improvements in any outcome measure. CONCLUSIONS The brief group format CRT intervention improves self-reported cognitive and motivational aspects in people with AN without autistic traits. For patients with higher autistic traits brief group CRT does not improve self-reported cognitive style or motivation. This finding suggests that brief group format CRT might not be the best suited format for individuals with elevated autistic traits and individual or more tailored CRT should be explored.
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Affiliation(s)
- Kate Tchanturia
- King’s College London, Division of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF UK
- Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, Beckenham, UK
- Illia State University Tbilisi, Tbilisi, Georgia
| | - Emma Larsson
- King’s College London, Division of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF UK
| | - James Adamson
- Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, Beckenham, UK
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122
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Steward T, Mestre-Bach G, Agüera Z, Granero R, Martín-Romera V, Sánchez I, Riesco N, Tolosa-Sola I, Fernández-Formoso JA, Fernández-García JC, Tinahones FJ, Casanueva FF, Baños RM, Botella C, Crujeiras AB, de la Torre R, Fernández-Real JM, Frühbeck G, Ortega FJ, Rodríguez A, Jiménez-Murcia S, Menchón JM, Fernández-Aranda F. Enduring Changes in Decision Making in Patients with Full Remission from Anorexia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2016; 24:523-527. [DOI: 10.1002/erv.2472] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 07/25/2016] [Accepted: 07/29/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Trevor Steward
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Zaida Agüera
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Roser Granero
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut; Universitat Autònoma de Barcelona; Barcelona Spain
| | | | - Isabel Sánchez
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Nadine Riesco
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Iris Tolosa-Sola
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Jose A Fernández-Formoso
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Jose C. Fernández-García
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Diabetes, Endocrinology and Nutrition; Hospital Clínico Universitario Virgen de Victoria; Málaga Spain
| | - Francisco J Tinahones
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Diabetes, Endocrinology and Nutrition; Hospital Clínico Universitario Virgen de Victoria; Málaga Spain
| | - Felipe F Casanueva
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Medicine, Endocrinology Division; Santiago de Compostela University, Complejo Hospitalario Universitario; Santiago de Compostela Spain
| | - Rosa M. Baños
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Psychological; Personality, Evaluation and Treatment of the University of Valencia; Valencia Spain
| | - Cristina Botella
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Basic Psychology; Clinic and Psychobiology of the University Jaume I; Castelló Spain
| | - Ana B Crujeiras
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Medicine, Endocrinology Division; Santiago de Compostela University, Complejo Hospitalario Universitario; Santiago de Compostela Spain
| | - Rafael de la Torre
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Integrated Pharmacology and Systems Neurosciences Research Group, Neuroscience Research Program Organization IMIM (Hospital del Mar Medical Research Institute); Barcelona Spain
- Department of Health and Experimental Sciences; Universitat Pompeu Fabra; Barcelona Spain
| | - Jose M Fernández-Real
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Diabetes, Endocrinology and Nutrition; Institu d'Investigació, Biomèdica de Girona (IdIBGi), Hospital Dr Josep Trueta; Girona Spain
| | - Gema Frühbeck
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Metabolic Research Laboratory; Clínica Universidad de Navarra, University of Navarra-IdiSNA; Pamplona Spain
| | - Francisco J. Ortega
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Diabetes, Endocrinology and Nutrition; Institu d'Investigació, Biomèdica de Girona (IdIBGi), Hospital Dr Josep Trueta; Girona Spain
| | - Amaia Rodríguez
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Metabolic Research Laboratory; Clínica Universidad de Navarra, University of Navarra-IdiSNA; Pamplona Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Clinical Sciences, School of Medicine; University of Barcelona; Spain
| | - Jose M. Menchón
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Department of Clinical Sciences, School of Medicine; University of Barcelona; Spain
- CIBER Salud Mental (CIBERSAM), Instituto Salud Carlos III; Barcelona Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Clinical Sciences, School of Medicine; University of Barcelona; Spain
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