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Lavigne KM, Deng J, Raucher-Chéné D, Hotte-Meunier A, Voyer C, Sarraf L, Lepage M, Sauvé G. Transdiagnostic cognitive biases in psychiatric disorders: A systematic review and network meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2024; 129:110894. [PMID: 37956787 DOI: 10.1016/j.pnpbp.2023.110894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/13/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
Psychiatric disorders are characterized by cognitive deficits, which have been proposed as a transdiagnostic feature of psychopathology ("C" factor). Similarly, cognitive biases (e.g., in attention, memory, and interpretation) represent common tendencies in information processing that are often associated with psychiatric symptoms. However, the question remains whether cognitive biases are also transdiagnostic or are specific to certain psychiatric disorders/symptoms. The current systematic review sought to address whether the proposed "C" factor of transdiagnostic cognitive dysfunction in psychopathology can be extended to cognitive biases. Overall, 31 studies comprising 4401 participants (2536 patients, 1865 non-clinical controls) met inclusion criteria, assessing 19 cognitive biases across 20 diagnostic categories, with most studies focusing on interpretation (k = 22) and attention (k = 11) biases and only 2 assessing memory biases. Traditional meta-analyses found a moderate effect size (g = 0.32) for more severe cognitive biases in all patients relative to non-clinical controls, as well as small but significant associations between interpretation biases and transdiagnostic symptom categories (general psychopathology: r = 0.20, emotion dysfunction: r = 0.17, psychotic symptoms: r = 0.25). Network meta-analyses revealed significant patient versus non-clinical control differences on attention and interpretation biases across diagnoses, as well as significant differences between diagnoses, with highest severity in panic disorder for attention biases and obsessive-compulsive disorder for interpretation biases. The current findings extend the big "C" interpretation of transdiagnostic cognitive dysfunction in psychiatric disorders to cognitive biases and transdiagnostic symptom dimensions. Results also suggest that while the presence of cognitive biases is transdiagnostic, bias severity differs across diagnoses, as in traditional neurocognitive deficits.
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Affiliation(s)
- Katie M Lavigne
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Douglas Research Centre, Montreal, QC, Canada.
| | | | - Delphine Raucher-Chéné
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Douglas Research Centre, Montreal, QC, Canada
| | | | - Chloe Voyer
- Douglas Research Centre, Montreal, QC, Canada
| | - Lisa Sarraf
- Douglas Research Centre, Montreal, QC, Canada; Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, QC, Canada; Douglas Research Centre, Montreal, QC, Canada
| | - Geneviève Sauvé
- Douglas Research Centre, Montreal, QC, Canada; Département d'éducation et pédagogie, Université de Québec à Montréal, Montréal, QC, Canada
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Tenconi E, Meregalli V, Buffa A, Collantoni E, Cavallaro R, Meneguzzo P, Favaro A. Belief Inflexibility and Cognitive Biases in Anorexia Nervosa-The Role of the Bias against Disconfirmatory Evidence and Its Clinical and Neuropsychological Correlates. J Clin Med 2023; 12:jcm12051746. [PMID: 36902532 PMCID: PMC10003469 DOI: 10.3390/jcm12051746] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
The aim of this study was to explore, in a sample of patients with a diagnosis of AN, the ability to question their first impression and, in particular, the willingness to integrate their prior ideas and thoughts with additional progressive incoming information. A total of 45 healthy women and 103 patients with a diagnosis of AN, consecutively admitted to the Eating Disorder Padova Hospital-University Unit, underwent a broad clinical and neuropsychological assessment. All participants were administered the Bias Against Disconfirmatory Evidence (BADE) task, which specifically investigates belief integration cognitive bias. Acute AN patients showed a significantly greater bias toward disconfirming their previous judgment, in comparison to healthy women (BADE score, respectively, 2.5 ± 2.0 vs. 3.3 ± 1.6; Mann-Whitney test, p = 0.012). A binge-eating/purging subtype of AN individuals, compared to restrictive AN patients and controls, showed greater disconfirmatory bias and also a significant propensity to uncritically accept implausible interpretations (BADE score, respectively, 1.55 ± 1.6 and 2.70 ± 1.97 vs. 3.33 ± 1.63; Kruskal-Wallis test, p = 0.002 and liberal acceptance score, respectively, 1.32 ± 0.93 and 0.92 ± 1.21 vs. 0.98 ± 0.75; Kruskal-Wallis test p = 0.03). Abstract thinking skills and cognitive flexibility, as well as high central coherence, are neuropsychological aspects positively correlated with cognitive bias, in both patients and controls. Research into belief integration bias in AN population could enable us to shed light on hidden dimensional aspects, facilitating a better understanding of the psychopathology of a disorder that is so complex and difficult to treat.
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Affiliation(s)
- Elena Tenconi
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
- Correspondence: ; Tel.: +39-0498217771
| | - Valentina Meregalli
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
| | - Adriana Buffa
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Enrico Collantoni
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Roberto Cavallaro
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
- IRCCS San Raffaele Turro, Scientific Institute Hospital, 20127 Milan, Italy
| | - Paolo Meneguzzo
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
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De Rossi G, Georgiades A. Thinking biases and their role in persecutory delusions: A systematic review. Early Interv Psychiatry 2022; 16:1278-1296. [PMID: 35396904 PMCID: PMC10084105 DOI: 10.1111/eip.13292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 01/21/2022] [Accepted: 03/13/2022] [Indexed: 01/15/2023]
Abstract
AIM Thinking biases are posited to be involved in the genesis and maintenance of delusions. Persecutory delusions are one of the most commonly occurring delusional subtypes and cause substantial distress and disability to the individuals experiencing them. Their clinical relevance confers a rationale for investigating them. Particularly, this review aims to elucidate which cognitive biases are involved in their development and persistence. METHODS MEDLINE, Embase, PsycINFO and Global Health were searched from the year 2000 to June 2020. A formal narrative synthesis was employed to report the findings and a quality assessment of included studies was conducted. RESULTS Twenty five studies were included. Overall, 18 thinking biases were identified. Hostility and trustworthiness judgement biases appeared to be specific to persecutory delusions while jumping to conclusions, self-serving attributional biases and belief inflexibility were proposed to be more closely related to other delusional subtypes. While the majority of the biases identified were suggested to be involved in delusion maintenance, hostility biases, need for closure and personalizing attributional biases were believed to also have aetiological influences. CONCLUSIONS These findings show that some cognitive biases are specific to paranoid psychosis and appear to be involved in the formation and/or persistence of persecutory delusions.
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Affiliation(s)
- Giorgia De Rossi
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), London, England
| | - Anna Georgiades
- King's College London, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), London, England.,Brent Early Intervention Service, CNWL, NHS Foundation Trust, London, UK
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Balzan RP, Gilder M, Nancarrow T, Mavrangelos T, Wade TD. Hasty decision-making in individuals at higher risk of developing an eating disorder. J Behav Ther Exp Psychiatry 2022; 75:101717. [PMID: 34929485 DOI: 10.1016/j.jbtep.2021.101717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 11/04/2021] [Accepted: 12/06/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES The Jumping to Conclusions (JTC) bias is the tendency to make hasty decisions based on limited evidence and may contribute to the formation of over-valued beliefs about the importance of weight, shape and eating. Previous research investigating the JTC bias in clinical eating disorder samples, as assessed by the beads task, is inconclusive. The current study investigated the JTC bias in a non-clinical sample of undergraduate students identified as being lower or higher risk of developing an eating disorder. The study used a more reliable 'distractor' beads task that also incentivised hastier decisions by elevating the pressure of the task. METHODS Female undergraduate students (N = 156, 48%, classified as higher risk) completed a pressure and non-pressure distractor beads task, along with measures of weight concern and body-image flexibility. RESULTS Higher risk participants displayed a hastier decision-making style than lower risk participants. Task pressure elicited a hastier decision-making style across the whole sample, however, was unable to distinguish between higher and lower eating disorder risk status. LIMITATIONS Interpretation of findings are limited to non-clinical samples and may not generalise to clinical eating disorder populations. CONCLUSIONS Findings suggest the need for replication in a clinical eating disorder sample using the distractor beads task. Future research should investigate whether eating disorder salient stimuli elicits a stronger bias.
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Affiliation(s)
- Ryan P Balzan
- College of Education, Psychology, and Social Work, Flinders University, Australia; Blackbird Initiative, Órama Institute for Mental Health and Wellbeing, Australia.
| | - Madeline Gilder
- College of Education, Psychology, and Social Work, Flinders University, Australia
| | - Tenille Nancarrow
- College of Education, Psychology, and Social Work, Flinders University, Australia
| | - Teri Mavrangelos
- College of Education, Psychology, and Social Work, Flinders University, Australia
| | - Tracey D Wade
- College of Education, Psychology, and Social Work, Flinders University, Australia; Blackbird Initiative, Órama Institute for Mental Health and Wellbeing, Australia
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Xenaki LA, Stefanatou P, Ralli E, Hatzimanolis A, Dimitrakopoulos S, Soldatos RF, Vlachos II, Selakovic M, Foteli S, Kosteletos I, Nianiakas N, Ntigridaki A, Triantafyllou TF, Voulgaraki M, Mantonakis L, Tsapas A, Bozikas VP, Kollias K, Stefanis NC. The relationship between early symptom severity, improvement and remission in first episode psychosis with jumping to conclusions. Schizophr Res 2022; 240:24-30. [PMID: 34915248 DOI: 10.1016/j.schres.2021.11.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/22/2021] [Accepted: 11/26/2021] [Indexed: 11/29/2022]
Abstract
It is suggested that Jumping To Conclusions (JTC) reasoning bias might contribute to the distortion of external reality. However, the association between psychotic manifestations and JTC is obscure, especially if general intelligence is considered as a mediator. The aim of this study is to investigate the relation between severity, early clinical improvement and remission of symptoms in First Episode Psychosis (FEP) with JTC as an explanatory factor. One hundred seventy-one FEP individuals were evaluated with the Positive and Negative Syndrome Scale (PANSS) at baseline and one month after treatment initiation. Clinical improvement was ascribed as symptom change one-month post-baseline measurements. Symptomatic remission was assessed with the Andreasen severity criteria and JTC with the Beads Task, operationalized through Draws To Decision (DTD) (the lower the number of DTD, the higher the JTC bias). Regarding symptoms severity, total psychotic, total positive psychotic, and hallucinations-item PANSS scores showed a negative association with JTC after controlling for IQ. Regarding early clinical improvement, the association with JTC was non-significant. No significant association was detected between one month remission status of FEP and JTC. Our findings indicate that severity of positive symptoms is not associated with hastiness in decision-making, but rather with a heightened conservatism in terms of increased data gathering. Further research is required to replicate the results and clarify the cognitive processes involved.
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Affiliation(s)
- Lida Alkisti Xenaki
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece.
| | - Pentagiotissa Stefanatou
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Eirini Ralli
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Alex Hatzimanolis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Stefanos Dimitrakopoulos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece; Psychiatric Clinic, 414 Military Hospital of Athens, Palea Penteli, Greece
| | - Rigas Filippos Soldatos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Ilias I Vlachos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Mirjana Selakovic
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Stefania Foteli
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Ioannis Kosteletos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Nikos Nianiakas
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Aggeliki Ntigridaki
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | | | - Marina Voulgaraki
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Leonidas Mantonakis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Apostolos Tsapas
- 2nd Medical Clinic, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Vasilios P Bozikas
- 2nd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Konstantinos Kollias
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Nikos C Stefanis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
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People with jumping to conclusions bias tend to make context-independent decisions rather than context-dependent decisions. Conscious Cogn 2022; 98:103279. [PMID: 35093732 DOI: 10.1016/j.concog.2022.103279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/31/2021] [Accepted: 01/09/2022] [Indexed: 11/21/2022]
Abstract
Beads task (BT) uses a probabilistic reasoning paradigm and reveals jumping to conclusions (JTC) bias, the tendency to make premature judgments based on insufficient information (i.e., making fewer draws to decision-DTD). In this study, healthy participants (N = 207) were tested on the 80:20 and 60:40 color ratio versions of BT. We investigated associations of JTC bias with a set of cognitive bias problems and Cognitive Bias Task (CBT), a non-veridical (agent-centered) decision-making task that determines context-dependent and context-independent decision-making bias.Results showed that the converted CBT scores were negatively, and cognitive bias scores were positively correlated with JTC bias (DTD ≤ 2) on both versions of the BT. The CBT demonstrated to have satisfactory convergent and predictive validity for JTC bias. The findings suggest that people with JTC bias fail to solve cognitive bias problems and are more likely to make context-independent response selections than context-dependent response selections.
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7
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Hagan WS, Mericle S, Hunt BJ, Harper JA, Palka JM, Pelfrey S, McAdams CJ. Qualitative patient experiences from the Self-Blame and Perspective-Taking Intervention for eating disorders. J Eat Disord 2021; 9:127. [PMID: 34649621 PMCID: PMC8515668 DOI: 10.1186/s40337-021-00483-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 09/22/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Problems in social cognition and social support contribute to eating disorders (ED). Group therapy provides an ideal format to create an experiential learning environment focused on understanding social interactions. This pilot study examined the qualitative content of the participants' experiences in the Self-Blame and Perspective-Taking Intervention (SBPI) for ED. METHODS The SBPI was a 4-week group therapy intervention involving art therapy and psychoeducation that focused on social behaviors in ED patients. Participants received surveys immediately after the intervention and at 1 to 4 weeks after the post-intervention. Thematic analyses of qualitative feedback were performed using Braun and Clarke's thematic analysis framework. RESULTS Inductive analyses revealed three main themes: (1) Developing self-acceptance through emotional reflection, (2) Changing expectations with neurosocial knowledge, and (3) Bonding and vulnerability in social interactions; all concepts intentionally targeted by the SBPI. Participants varied in their support of a guideline to exclude personal discussion of ED-related cognitions and behaviors in the group. CONCLUSIONS As a whole, patients valued the combination of psychosocial education with group experientials focused on social behavior. Positive feedback from the SBPI suggests that adjunctive treatments that target mental-wellness constructs indirectly related to ED pathology may be helpful by allowing patients to see themselves as separable from the illness. Trial registration ClinicalTrials.gov, NCT0487758. Registered 7 May 2021-Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT04877158 .
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Affiliation(s)
- Whitney Smith Hagan
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9070, USA
| | - Susan Mericle
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9070, USA
| | - Bethany J Hunt
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9070, USA
| | - Jessica A Harper
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9070, USA
| | - Jayme M Palka
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9070, USA
| | - Sarah Pelfrey
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9070, USA
| | - Carrie J McAdams
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9070, USA.
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Sastre-Buades A, Ochoa S, Lorente-Rovira E, Barajas A, Grasa E, López-Carrilero R, Luengo A, Ruiz-Delgado I, Cid J, González-Higueras F, Sánchez-Alonso S, Baca-García E, Barrigón ML. Jumping to conclusions and suicidal behavior in depression and psychosis. J Psychiatr Res 2021; 137:514-520. [PMID: 33812324 DOI: 10.1016/j.jpsychires.2021.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/09/2021] [Accepted: 03/11/2021] [Indexed: 12/24/2022]
Abstract
Suicidal behavior (SB) involves an impairment in decision-making (DM). Jumping to conclusions bias (JTC), described as the tendency to make hasty decisions based on insufficient information, could be considered as analogous of impaired DM. However, the link between JTC and SB in psychosis and other diagnoses (e.g., depression) has never been studied. This study aims to explore the presence of JTC and SB in a sample comprising 121 patients with psychosis and 101 with depression. Sociodemographic and clinical data were collected, including history of SB and symptom-severity scores. JTC was assessed by the beads task, and patients who reached decisions with the second bead or before were considered to exhibit JTC. Age, gender, diagnosis, educational level, symptom severity, substance use, and SB were compared according to JTC presence. Variables found to be significantly different in this comparison were included in a multivariate analysis. JTC was more prevalent in patients with depression than with psychosis: 55.6% in an 85:15 ratio and 64.6% in a 60:40 ratio. When multivariate logistic regression was applied to study the influence of diagnosis (psychosis versus depression), age, and SB, only SB remained statistically significant (OR 2.05; 95% CI 0.99-4.22; p = 0.05). The population studied was assembled by grouping different samples from previous research, and we have not included control variables such as other clinical variables, neurocognitive measurements, or personality traits. JTC may be more closely linked to SB, as a transdiagnostic variable, rather than to a specific diagnosis.
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Affiliation(s)
- Aina Sastre-Buades
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | | | - Ana Barajas
- Centre D'Higiene Mental Les Corts, Barcelona, Spain; Departament de Psicologia Clínica I de La Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de La Santa Creu I Sant Pau, Institut D'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Ana Luengo
- Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Psychiatry Service, Hospital Clínico Universitario de Valencia, Spain
| | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Málaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud, Málaga, Spain
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi. Institut D'Assistència Sanitària, Girona, Spain
| | | | | | - Enrique Baca-García
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; Department of Psychiatry, University Hospital Rey Juan Carlos, Móstoles, Spain; Department of Psychiatry, General Hospital of Villalba, Madrid, Spain; Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain; Universidad Católica Del Maule, Talca, Chile
| | - Maria L Barrigón
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain; Department of Psychiatry, IIS-Jimenez Diaz Foundation, Madrid, Spain; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; Department of Psychiatry. Centre Hospitalier Universitaire de Nîmes, France.
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Keegan E, Tchanturia K, Wade TD. Central coherence and set-shifting between nonunderweight eating disorders and anorexia nervosa: A systematic review and meta-analysis. Int J Eat Disord 2021; 54:229-243. [PMID: 33305366 DOI: 10.1002/eat.23430] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis compared previously documented inefficiencies in central coherence and set-shifting between people with nonunderweight eating disorders (bulimia nervosa and binge-eating disorder) and people with anorexia nervosa. METHOD We performed random-effects meta-analyses on 16 studies (1,112 participants) for central coherence and 38 studies (3,505 participants) for set-shifting. Random effects meta-regressions were used to test whether the effect sizes for people with nonunderweight eating disorders were significantly different from the effect sizes for people with anorexia nervosa. RESULTS People with anorexia nervosa (Hedge's g = -0.53, 95% CIs: -0.80, -0.27, p < .001) and bulimia nervosa (Hedge's g = -0.70, 95% CIs: -1.14, -0.25, p = .002), but not binge-eating disorder, had significantly poorer central coherence than healthy controls. Similarly, people with anorexia nervosa (Hedge's g = -0.38, 95% CIs: -0.50, -0.26, p < .001) and bulimia nervosa (Hedge's g = -0.55, 95% CIs: -0.81, -0.29, p < .001), but not binge-eating disorder, had significantly poorer set-shifting than healthy controls. The effect sizes for people with nonunderweight eating disorders did not significantly differ from those for people with anorexia nervosa. DISCUSSION Our meta-analysis was underpowered to make definitive judgments about people with binge-eating disorder. However, we found that people with bulimia nervosa clearly have central coherence and set-shifting inefficiencies which do not significantly differ from those observed in people with anorexia nervosa. Clinically, this suggests that people with bulimia nervosa might benefit from adjunctive approaches to address these inefficiencies, such as cognitive remediation therapy.
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Affiliation(s)
- Ella Keegan
- Blackbird Initiative, Órama Research Institute, Flinders University, Adelaide, Australia
| | | | - Tracey D Wade
- Blackbird Initiative, Órama Research Institute, Flinders University, Adelaide, Australia
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Nieto I, Robles E, Vazquez C. Self-reported cognitive biases in depression: A meta-analysis. Clin Psychol Rev 2020; 82:101934. [DOI: 10.1016/j.cpr.2020.101934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/18/2020] [Accepted: 10/13/2020] [Indexed: 12/12/2022]
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Pelizza L, Poletti M, Azzali S, Garlassi S, Scazza I, Paterlini F, Chiri LR, Pupo S, Raballo A. Subjective experience of social cognition in adolescents at ultra-high risk of psychosis: findings from a 24-month follow-up study. Eur Child Adolesc Psychiatry 2020; 29:1645-1657. [PMID: 32016572 DOI: 10.1007/s00787-020-01482-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/23/2020] [Indexed: 12/18/2022]
Abstract
Deficits in social cognition have been reported in people at ultra-high risk (UHR) of psychosis exclusively using socio-cognitive tasks and in adolescent and young adult mixed population. Aim of this study was (1) to assess subjective experience of social cognition in adolescent help-seekers identified through UHR criteria, (2) to explore its significant correlations with psychopathology and functioning in UHR individuals; and (3) to monitor longitudinally its stability after a 24-month follow-up period. Participants [51 UHR, 91 first-episode psychosis (FEP), and 48 non-UHR/FEP patients], aged 13-18 years, completed the comprehensive assessment of at-risk mental states and the GEOPTE scale of social cognition for psychosis. In comparison with non-UHR/FEP patients, both UHR and FEP adolescents showed significantly higher GEOPTE total scores. After 12 months of follow-up, UHR individuals had a significant decrease in severity on GEOPTE "Social Cognition" subscore. In the UHR group at baseline, GEOPTE scores had significant positive correlations with general psychopathology, positive and negative dimensions. Across the 2-year follow-up period, social cognition subscores specifically showed more stable associations with general psychopathology and negative symptoms. Social cognition deficits are prominent in UHR adolescents and similar in severity to those of FEP patients at baseline. However, these impairments decreased over time, presumably together with delivery of targeted, specialized models for early intervention in psychosis.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy. .,Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Strada del Quartiere n.2, 43100, Parma, PR, Italy.
| | - Michele Poletti
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Sara Garlassi
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Ilaria Scazza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Federica Paterlini
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Luigi Rocco Chiri
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy.,Department of Primary Care, Azienda USL di Parma, Strada del Quartiere n.2, 43100, Parma, PR, Italy
| | - Simona Pupo
- Service of Anesthesiology and Resuscitaton, Azienda Ospedaliera-Universitaria di Parma, Via Gramsci n.1, 43100, Parma, PR, Italy.,Intensive Care Unit, Guastalla Civil Hospital, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Andrea Raballo
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Piazzale Lucio Severi n.1, Perugia, Italy.,Center for Translational, Phenomenological and Developmental Psychopathology, Perugia University Hospital, Perugia, Italy
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12
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Pytlik N, Soll D, Hesse K, Moritz S, Bechdolf A, Herrlich J, Kircher T, Klingberg S, Landsberg MW, Müller BW, Wiedemann G, Wittorf A, Wölwer W, Wagner M, Mehl S. Problems in measuring the JTC-bias in patients with psychotic disorders with the fish task: a secondary analysis of a baseline assessment of a randomized controlled trial. BMC Psychiatry 2020; 20:554. [PMID: 33228583 PMCID: PMC7685639 DOI: 10.1186/s12888-020-02959-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 11/16/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The jumping to conclusions bias (JTC) is considered to be an important causal factor in theoretical models for the formation and maintenance of delusions. However, recent meta-analytic findings show a rather equivocal pattern of results regarding associations between JTC and delusions. Thus, the present study aims to investigate in a large sample whether the JTC-bias is more pronounced in patients with psychotic disorders in comparison to controls and whether the JTC bias is associated with a more severe delusional conviction, persecutory delusions, and positive symptoms in general. METHODS Patients with psychotic disorders (n = 300) enrolled in a therapy trial and healthy controls (n = 51) conducted a variant of the beads task (fish task) as a measure for the JTC-bias at the start of the trial. Further, clinical interviews were used to assess patients' delusional severity and delusional conviction. RESULTS There were no statistically significant differences between patients with psychotic disorders (with 53% displaying the JTC-bias) and controls (41%). Furthermore, there were no statistically significant correlations between JTC measures and persecutory delusions, delusional conviction, and positive symptoms. CONCLUSIONS We found no differences in JTC between patients with psychotic disorders and healthy controls, which is in part in line with meta-analytic findings using a wide range of JTC task variants. Interestingly, patients with psychotic disorders displayed JTC rates commonly found in the literature, while healthy control subjects showed an unexpectedly high level of JTC. The task variant we used in the present study (fish task) is discussed as a potential reason for our results, as it may induce a more deliberative reasoning style in controls as compared to the traditional beads task. Furthermore, possible implications for the measurement of the JTC-bias, in general, are discussed. TRIAL REGISTRATION ISRCTN29242879 ( isrctn.com ), date of registration: April 12th 2006, retrospectively registered.
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Affiliation(s)
- Nico Pytlik
- Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior (MCMBB), Philipps-University, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany.
| | - Daniel Soll
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior (MCMBB), Philipps-University, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Klaus Hesse
- grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Steffen Moritz
- grid.9026.d0000 0001 2287 2617Department of Psychiatry and Psychotherapy, University of Hamburg, Hamburg, Germany
| | - Andreas Bechdolf
- grid.6190.e0000 0000 8580 3777Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany ,grid.433867.d0000 0004 0476 8412Department of Psychiatry and Psychotherapy, Vivantes Klinikum am Urban - Teaching Hospital Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jutta Herrlich
- grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatics and Psychotherapy, University of Frankfurt, Frankfurt, Germany
| | - Tilo Kircher
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior (MCMBB), Philipps-University, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Stefan Klingberg
- grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Martin W. Landsberg
- grid.10388.320000 0001 2240 3300Department of Psychiatry and Psychotherapy, Friedrich-Wilhelms University of Bonn, Bonn, Germany
| | - Bernhard W. Müller
- grid.5718.b0000 0001 2187 5445Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Georg Wiedemann
- Departmenf of Psychiatry and Psychotherapy, Hospital Fulda, Fulda, Germany
| | - Andreas Wittorf
- grid.10392.390000 0001 2190 1447Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Wolfgang Wölwer
- grid.411327.20000 0001 2176 9917Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
| | - Michael Wagner
- grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatics and Psychotherapy, University of Frankfurt, Frankfurt, Germany
| | - Stephanie Mehl
- grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior (MCMBB), Philipps-University, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany ,grid.7839.50000 0004 1936 9721Department of Psychiatry, Psychosomatics and Psychotherapy, University of Frankfurt, Frankfurt, Germany
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13
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McLean BF, Balzan RP, Mattiske JK. Jumping to conclusions in the less-delusion-prone? Further evidence from a more reliable beads task. Conscious Cogn 2020; 83:102956. [PMID: 32502909 DOI: 10.1016/j.concog.2020.102956] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/10/2020] [Accepted: 05/20/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND A single meta-analysis has found that healthy people with higher delusion-proneness tend to gather less information (i.e., make fewer draws to decision, or DTD) on the beads task, although the findings of contributing studies were mixed, and the pooled effect size was small. However, using a new and more reliable "distractor sequences" beads task, we recently found a positive relationship between delusion-proneness and DTD in a healthy sample. In the current study, we re-tested this relationship in a new sample, and tested the possibility that the relationship is driven by participant's ability to understand and use odds or likelihood information ("odds literacy"). METHODS Healthy participants (N = 167) completed the distractor sequences beads task, the Peters Delusions Inventory (PDI) which measures delusion-proneness, a measure of odds literacy, and the Depression, Anxiety, and Stress scale. RESULTS PDI and DTD were positively correlated, and comparing PDI quartiles on DTD confirmed a statistically significant trend of increasing DTD with PDI quartile. Odds literacy was positively rather than negatively associated with both DTD and PDI. Anxiety was positively correlated with PDI and DTD. CONCLUSIONS We replicated our earlier finding that DTD and delusion-proneness were positively related in a non-clinical sample, but found that increased odds-literacy did not drive lower PDI and DTD, and hence did not explain their covariance. It is possible however that anxiety and co-occurring risk aversion drive increased delusion-proneness and information-gathering, potentially accounting for the positive relationship between PDI and DTD.
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Affiliation(s)
- Benjamin F McLean
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia; ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia
| | - Ryan P Balzan
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia; ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia.
| | - Julie K Mattiske
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
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14
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Brooks SJ, Funk SG, Young SY, Schiöth HB. The Role of Working Memory for Cognitive Control in Anorexia Nervosa versus Substance Use Disorder. Front Psychol 2017; 8:1651. [PMID: 29018381 PMCID: PMC5615794 DOI: 10.3389/fpsyg.2017.01651] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 09/07/2017] [Indexed: 01/20/2023] Open
Abstract
Prefrontal cortex executive functions, such as working memory (WM) interact with limbic processes to foster impulse control. Such an interaction is referred to in a growing body of publications by terms such as cognitive control, cognitive inhibition, affect regulation, self-regulation, top-down control, and cognitive–emotion interaction. The rising trend of research into cognitive control of impulsivity, using various related terms reflects the importance of research into impulse control, as failure to employ cognitions optimally may eventually result in mental disorder. Against this background, we take a novel approach using an impulse control spectrum model – where anorexia nervosa (AN) and substance use disorder (SUD) are at opposite extremes – to examine the role of WM for cognitive control. With this aim, we first summarize WM processes in the healthy brain in order to frame a systematic review of the neuropsychological, neural and genetic findings of AN and SUD. In our systematic review of WM/cognitive control, we found n = 15 studies of AN with a total of n = 582 AN and n = 365 HC participants; and n = 93 studies of SUD with n = 9106 SUD and n = 3028 HC participants. In particular, we consider how WM load/capacity may support the neural process of excessive epistemic foraging (cognitive sampling of the environment to test predictions about the world) in AN that reduces distraction from salient stimuli. We also consider the link between WM and cognitive control in people with SUD who are prone to ‘jumping to conclusions’ and reduced epistemic foraging. Finally, in light of our review, we consider WM training as a novel research tool and an adjunct to enhance treatment that improves cognitive control of impulsivity.
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Affiliation(s)
- Samantha J Brooks
- Functional Pharmacology, Department of Neuroscience, Uppsala UniversityUppsala, Sweden.,Department of Psychiatry and Mental Health, University of Cape TownCape Town, South Africa
| | - Sabina G Funk
- Department of Psychiatry and Mental Health, University of Cape TownCape Town, South Africa
| | - Susanne Y Young
- Department of Psychiatry, Stellenbosch UniversityBellville, South Africa
| | - Helgi B Schiöth
- Functional Pharmacology, Department of Neuroscience, Uppsala UniversityUppsala, Sweden
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15
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McLean BF, Mattiske JK, Balzan RP. Association of the Jumping to Conclusions and Evidence Integration Biases With Delusions in Psychosis: A Detailed Meta-analysis. Schizophr Bull 2017; 43:344-354. [PMID: 27169465 PMCID: PMC5605251 DOI: 10.1093/schbul/sbw056] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We completed a meta-analysis to investigate the relationship between delusions in psychosis and 4 cognitive biases: "jumping to conclusions" (JTC), the "bias against disconfirmatory evidence" (BADE), the "bias against confirmatory evidence" (BACE), and "liberal acceptance" (LA). Building on recent meta-analyses we compared more narrowly defined groups. We identified 35 JTC, 8 BADE, 7 BACE, and 6 LA studies for inclusion. Groups with schizophrenia who were currently experiencing delusions demonstrated greater JTC, BADE, BACE, and LA than groups with schizophrenia who were not currently experiencing delusions, who in turn demonstrated no more JTC than healthy control groups. Hence JTC, BADE, BACE, and LA co-vary with delusions in cross-sectional samples of people with schizophrenia. Groups who were experiencing delusions due to other psychiatric illnesses also demonstrated greater JTC than healthy controls, and equivalent JTC to groups with schizophrenia currently experiencing delusions. Hence JTC is associated with delusions across a range of diagnoses. Groups with other, non-delusional psychiatric illnesses demonstrated less JTC, BADE, BACE, and LA than groups with schizophrenia currently experiencing delusions, less JTC than groups experiencing delusions due to other diagnoses, and no more JTC, BADE, BACE, or LA than healthy control groups. Hence JTC, BADE, BACE, and LA were not associated with psychiatric illnesses in general. Our results indicate all 4 biases are associated with delusions specifically rather than merely with a diagnosis of schizophrenia or with being psychiatrically ill, consistent with the possibility that they contribute to delusional severity.
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Affiliation(s)
- Benjamin F. McLean
- School of Psychology, Flinders University, Adelaide, Australia;,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia
| | | | - Ryan P. Balzan
- School of Psychology, Flinders University, Adelaide, Australia;,ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia
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16
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Cutting J, Musalek M. The nature of delusion: psychologically explicable? psychologically inexplicable? philosophically explicable? Part 2. HISTORY OF PSYCHIATRY 2016; 27:21-37. [PMID: 26573284 DOI: 10.1177/0957154x15613741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The first part of this article dealt with the extant formulations of delusion, psychiatric and psychological, suggestions which, respectively, regard delusion as psychologically inexplicable or explicable. All this was subjected to critique. This second part puts forward informed philosophical thesis whereby delusion can be explained within the philosophical movement known as phenomenology and, in particular, Max Scheler's version of this.
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Affiliation(s)
- J Cutting
- Honorary Senior Lecturer, Institute of Psychiatry, London
| | - M Musalek
- Anton Proksch Institut, Wien, Austria
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17
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McAdams CJ, Lohrenz T, Montague PR. Neural responses to kindness and malevolence differ in illness and recovery in women with anorexia nervosa. Hum Brain Mapp 2015; 36:5207-19. [PMID: 26416161 DOI: 10.1002/hbm.23005] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 08/26/2015] [Accepted: 09/16/2015] [Indexed: 11/12/2022] Open
Abstract
In anorexia nervosa, problems with social relationships contribute to illness, and improvements in social support are associated with recovery. Using the multiround trust game and 3T MRI, we compare neural responses in a social relationship in three groups of women: women with anorexia nervosa, women in long-term weight recovery from anorexia nervosa, and healthy comparison women. Surrogate markers related to social signals in the game were computed each round to assess whether the relationship was improving (benevolence) or deteriorating (malevolence) for each subject. Compared with healthy women, neural responses to benevolence were diminished in the precuneus and right angular gyrus in both currently-ill and weight-recovered subjects with anorexia, but neural responses to malevolence differed in the left fusiform only in currently-ill subjects. Next, using a whole-brain regression, we identified an office assessment, the positive personalizing bias, that was inversely correlated with neural activity in the occipital lobe, the precuneus and posterior cingulate, the bilateral temporoparietal junctions, and dorsal anterior cingulate, during benevolence for all groups of subjects. The positive personalizing bias is a self-report measure that assesses the degree with which a person attributes positive experiences to other people. These data suggest that problems in perceiving kindness may be a consistent trait related to the development of anorexia nervosa, whereas recognizing malevolence may be related to recovery. Future work on social brain function, in both healthy and psychiatric populations, should consider positive personalizing biases as a possible marker of neural differences related to kindness perception.
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Affiliation(s)
- Carrie J McAdams
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, Texas.,Psychiatry, Texas Health Presbyterian Hospital of Dallas, Dallas, Texas
| | - Terry Lohrenz
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, Virginia
| | - P Read Montague
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, Virginia.,Computational Psychiatry Unit, Virginia Tech, Roanoke, Virginia.,Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom.,Department of Physics, Virginia Tech, Blacksburg, Virginia
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18
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Wu M, Brockmeyer T, Hartmann M, Skunde M, Herzog W, Friederich HC. Set-shifting ability across the spectrum of eating disorders and in overweight and obesity: a systematic review and meta-analysis. Psychol Med 2014; 44:3365-3385. [PMID: 25066267 DOI: 10.1017/s0033291714000294] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND In this meta-analysis we review the findings from neuropsychological studies on set-shifting in people with eating disorders (EDs) or overweight/obesity. METHOD Four databases (PubMed, PsycINFO, PSYNDEX and Web of Science) were searched for eligible studies. Effect sizes (ESs) were pooled using random-effects models. Moderator analyses were conducted for ED and overweight/obese subgroups, adult/adolescent samples and measures of set-shifting. RESULTS Sixty-four studies with a total of 1825 ED patients [1394 anorexia nervosa (AN), 376 bulimia nervosa (BN) and 55 binge eating disorder (BED)] and 10 studies with a total of 449 overweight/obese individuals were included. The meta-analysis revealed a small to medium ES for inefficient set-shifting across all three ED diagnoses (Hedges' g = -0.45). Subgroup analyses yielded small to medium ESs for each ED subtype (g = -0.44 for AN, -0.53 for BED, -0.50 for BN), which did not differ significantly. There was a medium ES for restricting type AN (ANR; g = -0.51) but no significant ES for binge/purge type AN (AN/BP; g = -0.18). A medium ES was found across obesity studies (g = -0.61). The ES across overweight studies was not significant (g = -0.07). Adult samples did not differ from adolescent samples in either ED or overweight/obesity studies. The different set-shifting measures were associated with largely varying ESs. CONCLUSIONS The meta-analysis provides strong support that inefficient set-shifting is a salient neuropsychological phenomenon across ED subtypes and obesity, but is less prominent in AN/BP and overweight. Compulsivity seems to be a common underlying factor supporting a dimensional and transdiagnostic conceptualization of EDs and obesity.
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Affiliation(s)
- M Wu
- Department of General Internal Medicine and Psychosomatics,University of Heidelberg,Germany
| | - T Brockmeyer
- Department of General Internal Medicine and Psychosomatics,University of Heidelberg,Germany
| | - M Hartmann
- Department of General Internal Medicine and Psychosomatics,University of Heidelberg,Germany
| | - M Skunde
- Department of General Internal Medicine and Psychosomatics,University of Heidelberg,Germany
| | - W Herzog
- Department of General Internal Medicine and Psychosomatics,University of Heidelberg,Germany
| | - H-C Friederich
- Department of General Internal Medicine and Psychosomatics,University of Heidelberg,Germany
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19
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Mehl S, Landsberg MW, Schmidt AC, Cabanis M, Bechdolf A, Herrlich J, Loos-Jankowiak S, Kircher T, Kiszkenow S, Klingberg S, Kommescher M, Moritz S, Müller BW, Sartory G, Wiedemann G, Wittorf A, Wölwer W, Wagner M. Why do bad things happen to me? Attributional style, depressed mood, and persecutory delusions in patients with schizophrenia. Schizophr Bull 2014; 40:1338-46. [PMID: 24743864 PMCID: PMC4193715 DOI: 10.1093/schbul/sbu040] [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] [Indexed: 11/13/2022]
Abstract
Theoretical models postulate an important role of attributional style (AS) in the formation and maintenance of persecutory delusions and other positive symptoms of schizophrenia. However, current research has gathered conflicting findings. In a cross-sectional design, patients with persistent positive symptoms of schizophrenia (n = 258) and healthy controls (n = 51) completed a revised version of the Internal, Personal and Situational Attributions Questionnaire (IPSAQ-R) and assessments of psychopathology. In comparison to controls, neither patients with schizophrenia in general nor patients with persecutory delusions (n = 142) in particular presented an externalizing and personalizing AS. Rather, both groups showed a "self-blaming" AS and attributed negative events more toward themselves. Persecutory delusions were independently predicted by a personalizing bias for negative events (beta = 0.197, P = .001) and by depression (beta = 0.152, P = .013), but only 5% of the variance in persecutory delusions could be explained. Cluster analysis of IPSAQ-R scores identified a "personalizing" (n = 70) and a "self-blaming" subgroup (n = 188), with the former showing slightly more pronounced persecutory delusions (P = .021). Results indicate that patients with schizophrenia and patients with persecutory delusions both mostly blamed themselves for negative events. Nevertheless, still a subgroup of patients could be identified who presented a more pronounced personalizing bias and more severe persecutory delusions. Thus, AS in patients with schizophrenia might be less stable but more determined by individual and situational characteristics that need further elucidation.
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Affiliation(s)
- Stephanie Mehl
- Department of Psychiatry and Psychotherapy, Philipps-University, Marburg, Germany; Department of Psychiatry and Psychotherapy, Rhineland Friedrich Wilhelms University, Bonn, Germany;
| | - Martin W. Landsberg
- Department of Psychiatry and Psychotherapy, Rhineland Friedrich Wilhelms University, Bonn, Germany
| | - Anna-Christine Schmidt
- Department of Psychiatry and Psychotherapy, Rhineland Friedrich Wilhelms University, Bonn, Germany
| | - Maurice Cabanis
- Department of Psychiatry and Psychotherapy, Philipps-University, Marburg, Germany
| | - Andreas Bechdolf
- Department of Psychiatry and Psychotherapy, University of Cologne, Nordrhein-Westfalen, Germany
| | - Jutta Herrlich
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Frankfurt, Hessen, Germany
| | - Stephanie Loos-Jankowiak
- Clinic for Psychiatry and Psychotherapy, University of Duisburg- Essen, Nordrhein-Westfalen, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University, Marburg, Germany
| | - Stephanie Kiszkenow
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, LVR-Clinic Düsseldorf, Nordrhein-Westfalen, Germany
| | - Stefan Klingberg
- Department of Psychiatry and Psychotherapy, University of Tübingen, Baden-Wuertenberg, Germany
| | - Mareike Kommescher
- Department of Psychiatry and Psychotherapy, University of Cologne, Nordrhein-Westfalen, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University of Hamburg, Hamburg, Germany
| | - Bernhard W. Müller
- Clinic for Psychiatry and Psychotherapy, University of Duisburg- Essen, Nordrhein-Westfalen, Germany
| | - Gudrun Sartory
- Department of Psychology, University of Wuppertal, Nordrhein-Westfalen, Germany
| | | | - Andreas Wittorf
- Department of Psychiatry and Psychotherapy, University of Tübingen, Baden-Wuertenberg, Germany
| | - Wolfgang Wölwer
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, LVR-Clinic Düsseldorf, Nordrhein-Westfalen, Germany
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, Rhineland Friedrich Wilhelms University, Bonn, Germany
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20
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Corlett PR, Fletcher PC. Computational psychiatry: a Rosetta Stone linking the brain to mental illness. Lancet Psychiatry 2014; 1:399-402. [PMID: 26361002 DOI: 10.1016/s2215-0366(14)70298-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Philip R Corlett
- Yale University, Department of Psychiatry, Ribicoff Research Facility. New Haven, CT, USA
| | - Paul C Fletcher
- University of Cambridge, Department of Psychiatry, Addenbrooke's Hospital, Cambridge, Cambridge; Peterborough Foundation Trust, and Wellcome-MRC Behavioural and Clinical Neuroscience Institute.
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21
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McKenna G, Fox JRE, Haddock G. Investigating the 'jumping to conclusions' bias in people with anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2014; 22:352-9. [PMID: 25103274 DOI: 10.1002/erv.2310] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/03/2014] [Accepted: 07/06/2014] [Indexed: 11/06/2022]
Abstract
'Jumping to conclusions' (JTC) is an established reasoning bias in people with psychosis and delusion proneness. Research investigating the JTC bias in other clinical populations remains in its infancy. This study investigated whether individuals with anorexia (AN) displayed the JTC bias compared with healthy controls and, if so, whether the bias was greater in relation to emotionally salient information. The study also investigated whether delusionality was correlated with the JTC bias. JTC was measured using the 'beads task'. Three versions were employed: the standard version and two emotionally salient tasks. Results indicated that a majority (55.6%) of people with AN (n=26) displayed poor insight into their eating disorder beliefs but did not display an elevated JTC compared with healthy controls (n=33) on any task. The level of delusionality in the AN group was not correlated with JTC bias. Findings suggest that although a majority of people with AN demonstrated limited insight, they did not display the JTC bias. This may suggest that poor insight in eating disorders has different characteristics to that found in psychotic disorders, which may suggest that differences are needed in relation to how they are treated using psychological means. However, this was a small study, and study replication is required.
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Affiliation(s)
- Gráinne McKenna
- School of Psychological Sciences, University of Manchester, UK
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Rapp AM, Langohr K, Mutschler DE, Wild B. Irony and proverb comprehension in schizophrenia: do female patients "dislike" ironic remarks? SCHIZOPHRENIA RESEARCH AND TREATMENT 2014; 2014:841086. [PMID: 24991434 PMCID: PMC4060160 DOI: 10.1155/2014/841086] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 05/06/2014] [Indexed: 01/19/2023]
Abstract
Difficulties in understanding irony and sarcasm are part of the social cognition deficits in patients with schizophrenia. A number of studies have reported higher error rates during comprehension in patients with schizophrenia. However, the relationships of these impairments to schizotypal personality traits and other language deficits, such as the comprehension of proverbs, are unclear. We investigated irony and proverb comprehension in an all-female sample of 20 schizophrenia patients and 27 matched controls. Subjects indicated if a statement was intended to be ironic, literal, or meaningless and furthermore rated the meanness and funniness of the stimuli and certainty of their decision. Patients made significantly more errors than controls did. Globally, there were no overall differences in the ratings. However, patients rated the subgroup of stimuli with answers given incorrectly as having significantly less meanness and in case of an error indicated a significantly higher certainty than controls. Across all of the study participants, performances in irony (r = -0.51) and proverb (r = 0.56) comprehension were significantly correlated with schizotypal personality traits, suggesting a continuum of nonliteral language understanding. Because irony is so frequent in everyday conversations, this makes irony an especially promising candidate for social cognition training in schizophrenia.
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Affiliation(s)
- Alexander M. Rapp
- Department of Psychiatry, University of Tuebingen, Calwerstraße 14, 72076 Tuebingen, Germany
| | - Karin Langohr
- Department of Psychiatry, University of Tuebingen, Calwerstraße 14, 72076 Tuebingen, Germany
| | - Dorothee E. Mutschler
- Department of Psychiatry, University of Tuebingen, Calwerstraße 14, 72076 Tuebingen, Germany
| | - Barbara Wild
- Department of Psychiatry, University of Tuebingen, Calwerstraße 14, 72076 Tuebingen, Germany
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Caglar-Nazali HP, Corfield F, Cardi V, Ambwani S, Leppanen J, Olabintan O, Deriziotis S, Hadjimichalis A, Scognamiglio P, Eshkevari E, Micali N, Treasure J. A systematic review and meta-analysis of ‘Systems for Social Processes’ in eating disorders. Neurosci Biobehav Rev 2014; 42:55-92. [PMID: 24333650 DOI: 10.1016/j.neubiorev.2013.12.002] [Citation(s) in RCA: 190] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 11/08/2013] [Accepted: 12/02/2013] [Indexed: 11/28/2022]
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Dudley R, Daley K, Nicholson M, Shaftoe D, Spencer H, Cavanagh K, Freeston M. ‘Jumping to conclusions’ in first-episode psychosis: A longitudinal study. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2013; 52:380-93. [DOI: 10.1111/bjc.12023] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 05/15/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Robert Dudley
- Clinical Psychology; Institute of Neuroscience; Newcastle University; Newcastle-upon-Tyne UK
- Early Intervention in Psychosis Service, Northumberland, Tyne and Wear Foundation Trust; Sunderland; UK
| | - Kate Daley
- Clinical Psychology; School of Psychology; Newcastle University; Newcastle-upon-Tyne UK
| | - Marsha Nicholson
- Early Intervention in Psychosis Service, Northumberland, Tyne and Wear Foundation Trust; Sunderland; UK
| | - Debra Shaftoe
- Early Intervention in Psychosis Service, Northumberland, Tyne and Wear Foundation Trust; Sunderland; UK
| | - Helen Spencer
- Early Intervention in Psychosis Service, Northumberland, Tyne and Wear Foundation Trust; Sunderland; UK
| | - Kate Cavanagh
- School of Psychology; University of Sussex; Falmer UK
| | - Mark Freeston
- Clinical Psychology; Institute of Neuroscience; Newcastle University; Newcastle-upon-Tyne UK
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Cuntz U, Enck P, Frühauf E, Lehnert P, Riepl RL, Fichter MM, Otto B. Cholecystokinin revisited: CCK and the hunger trap in anorexia nervosa. PLoS One 2013; 8:e54457. [PMID: 23349895 PMCID: PMC3547916 DOI: 10.1371/journal.pone.0054457] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 12/11/2012] [Indexed: 01/04/2023] Open
Abstract
Objective Despite a number of studies in the past decades, the role of Cholecystokinin (CCK) in anorexia nervosa (AN) has remained uncertain. In this study a highly specific assay for the biologically active part of CCK was used in patients with bulimic as well as with the restricting type of AN who were followed over the course of weight gain. Methods Ten patients with restricting and 13 with bulimic AN were investigated upon admission (T0), after a weight gain of at least 2 kg on two consecutive weighting dates (T1), and during the last week before discharge (T2) from inpatient treatment in a specialized clinic. Blood samples were drawn under fasting conditions and 20 and 60 minutes following a standard meal (250 kcal). Data were compared to those of eight controls matched for sex and age. Gastrointestinal complaints of patients were measured by a questionnaire at each of the follow-up time points. Results At admission, AN patients exhibited CCK-levels similar to controls both prior to and after a test meal. Pre and post-meal CCK levels increased significantly after an initial weight gain but decreased again with further weight improvement. CCK release was somewhat lower in bulimic than in restricting type AN but both subgroups showed a similar profile. There was no significant association of CCK release to either initial weight or BMI, or their changes, but CCK levels at admission predicted gastrointestinal symptom improvement during therapy. Conclusions Normal CCK profiles in AN at admission indicates hormonal responses adapted to low food intake while change of eating habits and weight gain results in initially increased CCK release (counteracting the attempts to alter eating behavior) that returns towards normal levels with continuous therapy.
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Affiliation(s)
- Ulrich Cuntz
- Klinik Roseneck - Center for Behavioral Medicine, Prien, Germany
- Paracelsus Medical University, Salzburg, Austria
| | - Paul Enck
- Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
- * E-mail:
| | - Erich Frühauf
- Klinik Roseneck - Center for Behavioral Medicine, Prien, Germany
| | - Peter Lehnert
- Medical Department - Innenstadt, University Clinic of Munich, Munich, Germany
| | - Rudolf L. Riepl
- Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany
| | | | - Bärbel Otto
- Medical Department - Innenstadt, University Clinic of Munich, Munich, Germany
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Is impaired set-shifting a feature of "pure" anorexia nervosa? Investigating the role of depression in set-shifting ability in anorexia nervosa and unipolar depression. Psychiatry Res 2012; 200:538-43. [PMID: 22748187 DOI: 10.1016/j.psychres.2012.06.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 05/25/2012] [Accepted: 06/07/2012] [Indexed: 11/24/2022]
Abstract
Impaired set-shifting has been reported in patients with anorexia nervosa (AN) and in patients with affective disorders, including major depression. Due to the prevalent comorbidity of major depression in AN, this study aimed to examine the role of depression in set-shifting ability. Fifteen patients with AN without a current comorbid depression, 20 patients with unipolar depression (UD) and 35 healthy control participants were assessed using the Trail Making Test (TMT), the Wisconsin Card Sorting Test (WCST) and a Parametric Go/No-Go Test (PGNG). Set-shifting ability was intact in patients with AN without a comorbid depression. However, patients with UD performed significantly poorer in all three tasks compared to AN patients and in the TMT compared to healthy control participants. In both patient groups, set-shifting ability was moderately negatively correlated with severity of depressive symptoms, but was unrelated to BMI and severity of eating disorder symptoms in AN patients. Our results suggest a pivotal role of comorbidity for neuropsychological functioning in AN. Impairments of set-shifting ability in AN patients may have been overrated and may partly be due to comorbid depressive disorders in investigated patients.
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