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Ciszewski S, Flood KE, Proctor CJ, Best LA. Exploring the Relationship Between Disordered Eating and Executive Function in a Non-Clinical Sample. Percept Mot Skills 2020; 127:1033-1050. [DOI: 10.1177/0031512520937569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Previous research suggests that individuals diagnosed with eating disorders (ED) may experience executive functioning deficits that help maintain their ED. Although this relationship is reported consistently in clinical samples, it is important to consider whether it holds for individuals with sub-clinical ED symptoms. One hundred eighty-eight university students participated in the present study examining the relationship between executive function (EF) and disordered eating behaviors. Participants completed a demographics questionnaire, self-report questionnaires measuring atypical eating behaviors (EAT-26; EDI-3), and a self-report measure of EF (BRIEF-A). Correlational analyses demonstrated significant positive associations between ED behaviors and problems with emotional control, shifting, inhibition, and self-monitoring. Six hierarchical multiple regressions were conducted, using EF scores to predict scores on EAT-26 subscales (Dieting, Bulimia, Total ED Risk) and EDI-3 scales (Drive for Thinness, Bulimia, Risk Composite). In all regression analyses, BRIEF-A Emotional Control emerged as a significant predictor. As would be expected, EDI-3 Bulimia scores were also predicted by problems with inhibition. These results provide preliminary evidence of an association between non-clinical patterns of disordered eating and executive dysfunction, specifically including the ability to control one’s emotions, suggesting that emotional control problems may help predict ED risk. Future research could examine how these factors predict the development of eating disorders.
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Affiliation(s)
- Stefanie Ciszewski
- Department of Psychology, University of British Columbia, Okanagan Campus
| | | | | | - Lisa A. Best
- Department of Psychology, University of New Brunswick
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Sargénius HL, Bylsma FW, Lydersen S, Hestad K. Visual-Constructional Ability in Individuals with Severe Obesity: Rey Complex Figure Test Accuracy and the Q-Score. Front Psychol 2017; 8:1629. [PMID: 28979230 PMCID: PMC5611536 DOI: 10.3389/fpsyg.2017.01629] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 09/04/2017] [Indexed: 11/23/2022] Open
Abstract
The aims of this study were to investigate visual-construction and organizational strategy among individuals with severe obesity, as measured by the Rey Complex Figure Test (RCFT), and to examine the validity of the Q-score as a measure for the quality of performance on the RCFT. Ninety-six non-demented morbidly obese (MO) patients and 100 healthy controls (HC) completed the RCFT. Their performance was calculated by applying the standard scoring criteria. The quality of the copying process was evaluated per the directions of the Q-score scoring system. Results revealed that the MO did not perform significantly lower than the HC on Copy accuracy (mean difference −0.302, CI −1.374 to 0.769, p = 0.579). In contrast, the groups did statistically differ from each other, with MO performing poorer than the HC on the Q-score (mean −1.784, CI −3.237 to −0.331, p = 0.016) and the Unit points (mean −1.409, CI −2.291 to −0.528, p = 0.002), but not on the Order points score (mean −0.351, CI −0.994 to 0.293, p = 0.284). Differences on the Unit score and the Q-score were slightly reduced when adjusting for gender, age, and education. This study presents evidence supporting the presence of inefficiency in visuospatial constructional ability among MO patients. We believe we have found an indication that the Q-score captures a wider range of cognitive processes that are not described by traditional scoring methods. Rather than considering accuracy and placement of the different elements only, the Q-score focuses more on how the subject has approached the task.
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Affiliation(s)
- Hanna L Sargénius
- Department of Psychology, Faculty of Social Sciences and Technology Management, Norwegian University of Science and TechnologyTrondheim, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital TrustOttestad, Norway
| | | | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and TechnologyTrondheim, Norway
| | - Knut Hestad
- Department of Psychology, Faculty of Social Sciences and Technology Management, Norwegian University of Science and TechnologyTrondheim, Norway.,Department of Research, Innlandet Hospital TrustBrumunddal, Norway.,Department of Public Health, Hedmark University of Applied SciencesElverum, Norway
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Rose M, Reville MC, Iszatt A, Levinson S, Frampton I, Lask B. Deconstructing Planning Ability in Children and Adolescents with Anorexia Nervosa. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 6:297-304. [DOI: 10.1080/21622965.2016.1172312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Mark Rose
- The Huntercombe Group, Newmarket, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Marie-Claire Reville
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Amber Iszatt
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | | | - Ian Frampton
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
- Regional Eating Disorders Service, Oslo University Hospital, Oslo, Norway
| | - Bryan Lask
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
- Regional Eating Disorders Service, Oslo University Hospital, Oslo, Norway
- Care UK, Colchester, UK
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Carral-Fernández L, González-Blanch C, Goddard E, González-Gómez J, Benito-González P, Bustamante-Cruz E, Gómez Del Barrio A. Planning Abilities in Patients with Anorexia Nervosa Compared with Healthy Controls. Clin Neuropsychol 2016; 30:228-42. [PMID: 26959649 DOI: 10.1080/13854046.2016.1147603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Altered cognitive functioning could have an important role in the development and maintenance of Anorexia Nervosa (AN). The majority of previous research has focused on flexibility and global-detail processing. The aim of this study was to explore planning abilities in women with AN. METHOD Women with AN (n = 32) were compared to healthy controls (n = 42) using two different types of neuropsychological tasks for the assessment of planning abilities: Tower of London (ToL), a classic measure of planning abilities, and Zoo Map test, a more ecologically valid planning measure. Measures of AN psychopathology, anxiety, depression, and obsessive compulsivity were also collected. RESULTS The AN group did not differ from controls in the ToL (all p-values p > .05), although they performed significantly worse than controls in the main score of the Zoo Map (p = .02). A worse performance in the Zoo Map test More was associated with more eating disorders (rho = -.44, p = .018) and depressive (rho = -.42, p = .026) symptoms in the AN group. CONCLUSIONS Our study suggests the presence of subtle planning difficulties in women with AN which might be better detected using tasks with increased ecological validity.
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Affiliation(s)
- Laura Carral-Fernández
- a Marqués de Valdecilla Public Foundation-Research Institute (FMV-IFIMAV) , Santander , Spain.,b Public Health Institute Carlos III, Ministry of Science and Innovation - Government of Spain , Madrid , Spain.,c Eating Disorders Unit, Department of Psychiatry , University Hospital "Marqués de Valdecilla" , Santander , Spain
| | - César González-Blanch
- d Mental Health Centre , University Hospital "Marqués de Valdecilla" , Santander , Spain
| | - Elizabeth Goddard
- e Section of Eating Disorders, Department of Psychological Medicine , King's College London, Institute of Psychiatry , London , UK
| | - Jana González-Gómez
- a Marqués de Valdecilla Public Foundation-Research Institute (FMV-IFIMAV) , Santander , Spain.,c Eating Disorders Unit, Department of Psychiatry , University Hospital "Marqués de Valdecilla" , Santander , Spain
| | - Pilar Benito-González
- c Eating Disorders Unit, Department of Psychiatry , University Hospital "Marqués de Valdecilla" , Santander , Spain
| | - Encarnación Bustamante-Cruz
- c Eating Disorders Unit, Department of Psychiatry , University Hospital "Marqués de Valdecilla" , Santander , Spain
| | - Andrés Gómez Del Barrio
- c Eating Disorders Unit, Department of Psychiatry , University Hospital "Marqués de Valdecilla" , Santander , Spain.,f CIBERSAM, Centro Investigación Biomédica en Red Salud Mental , Madrid , Spain
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Heled E, Hoofien D, Bachar E, Cooper-Kazaz R, Gur E, Ebstein RP. Employing executive functions of perceptual and memory abilities in underweight and weight-restored anorexia nervosa patients. Eat Weight Disord 2014; 19:479-87. [PMID: 24859670 DOI: 10.1007/s40519-014-0119-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 03/21/2014] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Executive functions (EF) have been widely investigated in anorexia nervosa (AN) revealing difficulties in various aspects. We aimed at testing the effects of EF on stimuli perception and its representations in memory. METHODS Thirty AN underweight patients, 30 weight-restored AN patients, and 44 control participants, were recruited. Various EF were assessed using the Rey-Osterrieth Complex Figure Test, analyzed with the Boston Qualitative Scoring System. RESULTS No differences were found in visuo-constructional measures in either AN groups compared to controls on the copy and memory stages. However, both groups performed significantly worse than controls on most EF variables in the copy stage, while in the immediate and delayed memory stages the difference was less substantial. CONCLUSIONS Difficulties in EF among AN patients, current and weight restored, are more pronounced in the perceptual module and less so when employed through memory retrieval. The pattern, which is apparent after weight gain, suggests that there is no ameliorative effect on these difficulties.
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Affiliation(s)
- Eyal Heled
- Day Treatment Rehabilitation Unit, Sheba Medical Center, Ramat Gan, Israel,
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Abstract
Objective The role of planning in binge eating episodes is unknown. We investigated the characteristics of planning associated with food cues in binging patients. We studied planning based on backward reasoning, reasoning that determines a sequence of actions back to front from the final outcome. Method A cross-sectional study was conducted with 20 healthy participants, 20 bulimia nervosa (BN), 22 restrictive (ANR) and 23 binging anorexia nervosa (ANB), without any concomitant impulsive disorder. In neutral/relaxing, binge food and stressful conditions, backward reasoning was assessed with the Race game, promotion of delayed large rewards with an intertemporal discounting task, attention with the Simon task, and repeating a dominant behavior with the Go/No-go task. Results BN and to a lower extent ANB patients succeeded more at the Race game in food than in neutral condition. This difference discriminated binging from non-binging participants. Backward reasoning in the food condition was associated with lower approach behavior toward food in BN patients, and higher food avoidance in ANB patients. Enhanced backward reasoning in the food condition related to preferences for delayed large rewards in BN patients. In BN and ANB patients the enhanced success rate at the Race game in the food condition was associated with higher attention paid to binge food. Conclusion These findings introduce a novel process underlying binges: planning based on backward reasoning is associated with binges. It likely aims to reduce craving for binge foods and extend binge refractory period in BN patients, and avoid binging in ANB patients. Shifts between these goals might explain shifts between eating disorder subtypes.
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Funciones ejecutivas y sintomatología asociada con los trastornos de la conducta alimentaria. REVISTA LATINOAMERICANA DE PSICOLOGIA 2014. [DOI: 10.1016/s0120-0534(14)70022-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lozano-Serra E, Andrés-Perpiña S, Lázaro-García L, Castro-Fornieles J. Adolescent Anorexia Nervosa: cognitive performance after weight recovery. J Psychosom Res 2014; 76:6-11. [PMID: 24360134 DOI: 10.1016/j.jpsychores.2013.10.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Revised: 10/16/2013] [Accepted: 10/17/2013] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Although there is no definitive consensus on the impairment of neuropsychological functions, most studies of adults with Anorexia Nervosa (AN) find impaired functioning in cognitive domains such as visual-spatial abilities. The objective of this study is to assess the cognitive functions in adolescents with AN before and after weight recovery and to explore the relationship between cognitive performance and menstruation. METHODS Twenty-five female adolescents with AN were assessed by a neuropsychological battery while underweight and then following six months of treatment and weight recovery. Twenty-six healthy female subjects of a similar age were also evaluated at both time points. RESULTS Underweight patients with AN showed worse cognitive performance than control subjects in immediate recall, organization and time taken to copy the Rey's Complex Figure Test (RCFT). After weight recovery, AN patients presented significant improvements in all tests, and differences between patients and controls disappeared. Patients with AN and persistence of amenorrhea at follow-up (n=8) performed worse on Block Design, delayed recall of Visual Reproduction and Stroop Test than patients with resumed menstruation (n=14) and the control group, though the two AN groups were similar in body mass index, age and psychopathological scale scores. CONCLUSION Weight recovery improves cognitive functioning in adolescents with AN. The normalization of neuropsychological performance is better in patients who have recovered at least one menstrual cycle. The normalization of hormonal function seems to be essential for the normalization of cognitive performance, even in adolescents with a very short recovery time.
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Affiliation(s)
- Estefanía Lozano-Serra
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Edifici M-Campus UAB, Barcelona, Spain.
| | - Susana Andrés-Perpiña
- Department of Child and Adolescent Psychiatry and Psychology, SGR-1119, Neurosciencies Institute, Hospital Clinic of Barcelona, CIBERSAM, Villarroel 170, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149-153, Barcelona, Spain
| | - Luisa Lázaro-García
- Department of Child and Adolescent Psychiatry and Psychology, SGR-1119, Neurosciencies Institute, Hospital Clinic of Barcelona, CIBERSAM, Villarroel 170, Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, Health Sciences Division, University of Barcelona, Casanova 143, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149-153, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, SGR-1119, Neurosciencies Institute, Hospital Clinic of Barcelona, CIBERSAM, Villarroel 170, Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, Health Sciences Division, University of Barcelona, Casanova 143, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149-153, Barcelona, Spain
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Neuropsychological variables and clinical status in anorexia nervosa: relationship between visuospatial memory and central coherence and eating disorder symptom severity. Eat Weight Disord 2013; 18:421-8. [PMID: 24014260 DOI: 10.1007/s40519-013-0062-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 08/27/2013] [Indexed: 10/26/2022] Open
Abstract
AIM To explore the relationship between visuospatial memory, weak central coherence, and eating disorder (ED) symptoms in anorexia nervosa (AN) inpatients. SAMPLE 31 female AN inpatients. METHODS Rey complex figure test (RCFT) was used to assess both visuospatial memory and central coherence. RCFT consisted of copy and recall trials. ED symptoms were assessed by The Eating Disorder Examination-Questionnaire (EDE-Q) and The Clinical and Research Inventory for Eating Disorders (CR-EAT). RESULTS We found a statistically significant negative correlation between recall accuracy and the total EDE-Q score. Furthermore, recall accuracy and recall central coherence significantly negatively correlate with several EDE-Q and CR-EAT scales. CONCLUSIONS These findings may contribute to a better understanding of cognitive impairments specifically in ED, and to refining interventions aiming at their improvement.
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Visual processing in anorexia nervosa and body dysmorphic disorder: similarities, differences, and future research directions. J Psychiatr Res 2013; 47:1483-91. [PMID: 23810196 PMCID: PMC3786585 DOI: 10.1016/j.jpsychires.2013.06.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 06/04/2013] [Accepted: 06/06/2013] [Indexed: 12/11/2022]
Abstract
Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are psychiatric disorders that involve distortion of the experience of one's physical appearance. In AN, individuals believe that they are overweight, perceive their body as "fat," and are preoccupied with maintaining a low body weight. In BDD, individuals are preoccupied with misperceived defects in physical appearance, most often of the face. Distorted visual perception may contribute to these cardinal symptoms, and may be a common underlying phenotype. This review surveys the current literature on visual processing in AN and BDD, addressing lower- to higher-order stages of visual information processing and perception. We focus on peer-reviewed studies of AN and BDD that address ophthalmologic abnormalities, basic neural processing of visual input, integration of visual input with other systems, neuropsychological tests of visual processing, and representations of whole percepts (such as images of faces, bodies, and other objects). The literature suggests a pattern in both groups of over-attention to detail, reduced processing of global features, and a tendency to focus on symptom-specific details in their own images (body parts in AN, facial features in BDD), with cognitive strategy at least partially mediating the abnormalities. Visuospatial abnormalities were also evident when viewing images of others and for non-appearance related stimuli. Unfortunately no study has directly compared AN and BDD, and most studies were not designed to disentangle disease-related emotional responses from lower-order visual processing. We make recommendations for future studies to improve the understanding of visual processing abnormalities in AN and BDD.
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Kanakam N, Treasure J. A review of cognitive neuropsychiatry in the taxonomy of eating disorders: state, trait, or genetic? Cogn Neuropsychiatry 2013; 18:83-114. [PMID: 22994309 DOI: 10.1080/13546805.2012.682362] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A greater understanding of neuropsychological traits in eating disorders may help to construct a more biologically based taxonomy. The aim of this paper is to review the current evidence base of neuropsychological traits in people with eating disorders. Evidence of difficulties in set shifting, weak central coherence, emotional processing difficulties, and altered reward sensitivity is presented for people both in the acute and recovered phase of the illness. These traits are also seen in first degree relatives. At present there is limited research linking these neuropsychological traits with genetic and neuroanatomical measures. In addition to improving the taxonomy of eating disorders, neuropsychological traits may be of value in producing targeted treatments.
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Affiliation(s)
- Natalie Kanakam
- Section of Eating Disorders, Psychological Medicine, Institute of Psychiatry, King's College London, London, UK.
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Lindner SE, Fichter MM, Quadflieg N. Decision-making and planning in full recovery of anorexia nervosa. Int J Eat Disord 2012; 45:866-75. [PMID: 22552824 DOI: 10.1002/eat.22025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Based on findings of persisting neuropsychological impairments in women recovered from anorexia nervosa (rec AN), this study examined decision-making and planning, for achieving a desired goal, as central executive functions in a large sample of rec AN. The definition of recovery included physiological, behavioral, and psychological variables. METHOD A total of 100 rec AN women were compared to 100 healthy women, 1:1 matched for age and educational level. Decision-making was assessed with the Iowa Gambling Task and planning with the Tower of London. Expert interviews and self-ratings were used for assessing the inclusion/exclusion criteria and control variables. RESULTS Compared to healthy controls, rec AN women were better in decision-making and worse in planning even after considering control variables. DISCUSSION This study does not support results from other studies showing that rec AN participants perform better in decision-making. Results from this study show that planning is impaired even after full recovery from AN.
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Affiliation(s)
- Susanne E Lindner
- Department of Psychiatry, University of Munich (LMU), Munich, Germany
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