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Maydych V, Pöschel H, Kübler S, Schubert T. The impact of food stimuli and fasting on cognitive control in task switching. PSYCHOLOGICAL RESEARCH 2024; 88:921-935. [PMID: 37855942 DOI: 10.1007/s00426-023-01884-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023]
Abstract
Previous research demonstrated motivation-control interactions in task switching. However, motivational effects on switch costs have been mostly examined using monetary rewards. Here, we investigated whether stimulus material linked to food and fasting affect control processes in task switching. We predicted that switching to the task comprising food stimuli would be facilitated, which should result in lower switch costs for this task, and that these effects would be stronger with higher motivational salience of the food stimuli, i.e. in hungry individuals and/or individuals with restrictive eating. Participants switched between categorising food items as sweet or savoury and digits as odd or even in two task-switching paradigms: an alternating runs and a voluntary task switching. Hunger was induced by 14 h fasting in the experimental compared to the control group. Results showed lower switch costs for the motivational-affective food task in both task-switching paradigms and in both groups. Switch costs for the neutral digit task were significantly higher in the fasting group compared to the control group in alternating runs task switching only. Individual differences in restrictive eating were related negatively but not significantly to the size of the switch costs. All in all, the results demonstrate an impact of motivational-affective stimuli on cognitive control in task switching and suggest a potential modulatory role of motivational states, though the findings need to be replicated.
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Affiliation(s)
- Viktoria Maydych
- Institute for Psychology, Martin Luther University Halle-Wittenberg, Emil-Abderhalden-Str. 26-27, 06108, Halle (Saale), Germany.
| | - Hanna Pöschel
- Institute for Psychology, Martin Luther University Halle-Wittenberg, Emil-Abderhalden-Str. 26-27, 06108, Halle (Saale), Germany
| | - Sebastian Kübler
- Institute for Psychology, Martin Luther University Halle-Wittenberg, Emil-Abderhalden-Str. 26-27, 06108, Halle (Saale), Germany
- Department of Psychology, Humboldt-University, Berlin, Germany
| | - Torsten Schubert
- Institute for Psychology, Martin Luther University Halle-Wittenberg, Emil-Abderhalden-Str. 26-27, 06108, Halle (Saale), Germany
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Nuyttens M, Simons A, Antrop I, Glazemakers I. A longitudinal study of autism spectrum disorder characteristics in adolescents with restrictive type anorexia nervosa during and after underweight. EUROPEAN EATING DISORDERS REVIEW 2024; 32:310-321. [PMID: 37898973 DOI: 10.1002/erv.3042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/16/2023] [Accepted: 10/07/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVES This prospective, longitudinal study aims to compare the prevalence of autism spectrum disorder (ASD) characteristics in adolescents with anorexia nervosa (AN) during and after underweight in order to help unravel the complex link between both conditions. METHODS 24 adolescents with AN completed the youth self-report, autism spectrum quotient (AQ) or autism spectrum quotient adolescent version (AQ - adolescent) and a questionnaire designed by the researchers during a state of underweight and after weight recovery. RESULTS AQ total score and several AQ subscale scores at the time of underweight are significantly higher than after weight recovery with medium to large effect sizes. Linear modelling cannot prove a significant effect of weight gain, internalizing problems or medication use on AQ score, but it does show an association between AQ during underweight and AQ after weight recovery. CONCLUSIONS The results highlight the complexity of the link between AN and ASD characteristics. Although a clear change in AQ score is seen in part of the participants, this effect cannot be generalized and a link with weight change cannot be demonstrated. It seems likely that ASD characteristics in AN are a combination of trait and state: underweight and starvation might exacerbate potentially present traits. Part of our results may indicate the existence of subgroups based on AQ score during underweight. Our study supports the theory that more ASD characteristics at T1 may result in a poorer outcome and a higher need for specified and intensive treatment.
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Affiliation(s)
- Marieke Nuyttens
- Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Annik Simons
- Department for Child and Adolescent Psychiatry, Antwerp University Hospital, Antwerp, Belgium
| | - Inge Antrop
- Ghent University, Faculty of Medicine and Health Sciences, Ghent, Belgium
| | - Inge Glazemakers
- Antwerp University, Faculty of Medicine and Health Sciences, Antwerp, Belgium
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3
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O'Leary J, Georgeaux-Healy C, Serpell L. The impact of continuous calorie restriction and fasting on cognition in adults without eating disorders. Nutr Rev 2024:nuad170. [PMID: 38263325 DOI: 10.1093/nutrit/nuad170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
Research into the effects of calorie restriction continues to intrigue those interested in whether it may allow humans to live longer and healthier lives. Animal studies of continuous calorie restriction (CCR) and fasting have demonstrated substantial advantages to health and longevity. However, concerns remain about the impact of restricting calorie intake on human health and cognition. Given the emerging evidence of cognitive impairments in eating disorders, studies investigating restricted calorie intake in healthy humans (in an ethical way) may also have implications for understanding restrictive eating disorders. In this review, the published literature on the impact of CCR and fasting on cognitive function in healthy human participants is synthesized. Of the 33 studies of CCR and fasting in humans identified, 23 demonstrated significant changes in cognition. Despite variation across the cognitive domains, results suggest CCR benefits inhibition, processing speed, and working memory, but may lead to impairments in cognitive flexibility. The results of fasting studies suggest fasting is associated with impairments in cognitive flexibility and psychomotor abilities. Overall, the results of these studies suggest the degree (ie, the severity) of calorie restriction is what most likely predicts cognitive improvements as opposed to impairments. For individuals engaging in sustained restriction, this may have serious, irreversible consequences. However, there are mixed findings regarding the impact of CCR and fasting on this aspect of human functioning, suggesting further research is required to understand the costs and benefits of different types of calorie restriction.
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Affiliation(s)
- John O'Leary
- North East London NHS Foundation Trust, CEME Centre, West Wing Marsh Way, Rainham, Essex RM13 8GQ, UK
| | - Chloé Georgeaux-Healy
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
| | - Lucy Serpell
- North East London NHS Foundation Trust, CEME Centre, West Wing Marsh Way, Rainham, Essex RM13 8GQ, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
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Sim LA, Whiteside S, Harbeck-Weber C, Sawchuk N, Lebow J. Weight Suppression and Risk for Childhood Psychiatric Disorders. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01617-7. [PMID: 37853282 DOI: 10.1007/s10578-023-01617-7] [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] [Accepted: 09/30/2023] [Indexed: 10/20/2023]
Abstract
Weight suppression, defined as the discrepancy between an individual's highest historical weight and their current weight, has been implicated in the development and maintenance of eating disorders. Although weight suppression has also been found to impact mood, anxiety and suicidal behavior in patients with and without disordered eating, it has not been examined as a transdiagnostic risk factor for general psychopathology. The current study examined growth records of 281 children and adolescents (ages 7 to 17) newly diagnosed with psychiatric disorders to determine whether these children were more likely to be weight suppressed as compared to an age- and gender-matched control group. Findings suggest that weight suppression is related to an increased risk for anxiety disorders and externalizing disorders for males. These results underscore the need for psychiatric and behavioral health providers to review pediatric growth charts as a routine part of psychiatric evaluation. As weight restoration is a necessary precondition for eating disorder recovery, more research is necessary to determine if weight restoration can enhance treatments for psychiatric symptoms occurring in the context of weight suppression.
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Affiliation(s)
- Leslie A Sim
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Stephen Whiteside
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Cynthia Harbeck-Weber
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Nicholas Sawchuk
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jocelyn Lebow
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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5
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Miller ML, Sanzari CM, Timko CA, Hormes JM. Impact of virtual adjunctive cognitive remediation therapy on cognitive flexibility and treatment outcomes in comorbid anorexia nervosa and exercise dependence as quantified using novel biomarkers: A stage 1 registered report. Int J Eat Disord 2023; 56:1449-1460. [PMID: 37464977 DOI: 10.1002/eat.23942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/04/2023] [Accepted: 03/15/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE Anorexia nervosa (AN) is associated with significant individual mental and physical suffering and public health burden and fewer than half of patients recover fully with current treatments. Comorbid exercise dependence (ExD) is common in AN and associated with significantly worse symptom severity and treatment outcomes. Research points to cognitive inflexibility as a prominent executive function inefficiency and transdiagnostic etiologic and maintaining mechanism linking AN and ExD. This study will evaluate the initial efficacy of adjunctive Cognitive Remediation Therapy (CRT), which has been shown to produce cognitive improvements in adults with AN, in targeting cognitive inflexibility in individuals with comorbid AN and ExD. As an exploratory aim, this study also addresses the current lack of quick and cost-effective assessments of cognitive flexibility by establishing the utility of two proposed biomarkers, heart rate variability and salivary oxytocin. METHOD We will conduct a single-group, within-subjects trial of an established CRT protocol delivered remotely as an adjunct to inpatient or intensive outpatient treatment as usual (TAU) to adult patients (n = 42) with comorbid AN and ExD. Assessments, including self-report, neuropsychological, and biomarker measurements, will occur at three time points. RESULTS We expect CRT to increase cognitive flexibility transdiagnostically and consequently, along with TAU, positively impact AN and ExD compulsivity and symptom severity, including weight gain. DISCUSSION Findings will inform the development of more effective integrative interventions for AN and ExD targeting shared mechanisms and facilitate the routine assessment of cognitive flexibility as a transdiagnostic risk and maintaining factor across psychopathologies in clinical and research settings. PUBLIC SIGNIFICANCE Patients with anorexia nervosa often engage in excessive exercise, leading to harmful outcomes, including increased suicidal behavior. This study examines the preliminary efficacy of an intervention that fosters flexible and holistic thinking in patients with problematic eating and exercise to, along with routine treatment, decrease harmful exercise symptoms. This study also examines new biological markers of the inflexible thinking style thought to be characteristic of anorexia nervosa and exercise dependence.
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Affiliation(s)
- McKenzie L Miller
- Department of Psychology, University at Albany, Albany, New York, USA
| | | | - C Alix Timko
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Philadelphia, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, Philadelphia, USA
| | - Julia M Hormes
- Department of Psychology, University at Albany, Albany, New York, USA
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Via E, Calvo A, de la Serna E, Blázquez A, Lázaro L, Andrés-Perpiñá S, Plana MT, Flamarique I, Martínez E, Pariente J, Moreno E, Bargallo N, Castro-Fornieles J. Longitudinal study in adolescent anorexia nervosa: evaluation of cortico-striatal and default mode network resting-state brain circuits. Eur Child Adolesc Psychiatry 2023; 32:513-526. [PMID: 34604924 DOI: 10.1007/s00787-021-01880-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
Anorexia nervosa (AN) typically emerges in adolescence. The cortico-striatal system (CSTS) and the default mode network (DMN) are brain circuits with a crucial development during this period. These circuits underlie cognitive functions that are impaired in AN, such as cognitive flexibility and inhibition, among others. Little is known about their involvement in adolescent AN and how weight and symptom improvement might modulate potential alterations in these circuits. Forty-seven adolescent females (30 AN, 17 healthy control) were clinically/neuropsychologically evaluated and scanned during a 3T-MRI resting-state session on two occasions, before and after a 6-month multidisciplinary treatment of the AN patients. Baseline and baseline-to-follow-up between-group differences in CSTS and DMN resting-state connectivity were evaluated, as well as their association with clinical/neuropsychological variables. Increased connectivity between the left dorsal putamen and the left precuneus was found in AN at baseline. At follow-up, body mass index and clinical symptoms had improved in the AN group. An interaction effect was found in the connectivity between the right dorsal caudate to right mid-anterior insular cortex, with lower baseline AN connectivity that improved at follow-up; this improvement was weakly associated with changes in neuropsychological (Stroop test) performance. These results support the presence of CSTS connectivity alterations in adolescents with AN, which improve with weight and symptom improvement. In addition, at the level of caudate-insula connectivity, they might be associated with inhibitory processing performance. Alterations in CSTS pathways might be involved in AN from the early stages of the disorder.
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Affiliation(s)
- Esther Via
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain.
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
- Mental Health Department, Unitat de Neurociència Traslacional, Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Anna Calvo
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Anna Blázquez
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Luisa Lázaro
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Susana Andrés-Perpiñá
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - María Teresa Plana
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Itziar Flamarique
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Esteve Martínez
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Jose Pariente
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena Moreno
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Nuria Bargallo
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Image Diagnostic Center, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
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7
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Essayli JH, Forrest LN, Zickgraf HF, Stefano EC, Keller KL, Lane-Loney SE. The impact of between-session habituation, within-session habituation, and weight gain on response to food exposure for adolescents with eating disorders. Int J Eat Disord 2023; 56:637-645. [PMID: 36626314 PMCID: PMC9992286 DOI: 10.1002/eat.23894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Exposure therapy is a promising treatment for eating disorders (EDs). However, questions remain about the effectiveness of exposure to feared foods during the weight restoration phase of treatment, and the importance of between-session and within-session habituation. METHOD We recruited 54 adolescents from a partial hospitalization program (PHP) for EDs which included daily food exposure. Throughout treatment, participants provided subjective units of distress (SUDS) ratings before and after eating a feared food, and completed measures of ED symptomatology. RESULTS Multilevel models found that pre-exposure SUDS decreased over time, providing some evidence that between-session habituation occurred. In contrast, the difference between pre-exposure and post-exposure SUDS did not decrease over time, indicating that within-session habituation did not occur. Weight gain predicted greater between-session habituation to feared foods, but did not predict within-session habituation. Between-session habituation, but not within-session habituation, predicted favorable treatment outcomes, including weight gain and improvements on the Children's Eating Attitudes Test and Fear of Food Measure. DISCUSSION Partial hospitalization programs that include daily exposure to feared foods may be effective at decreasing anxiety about foods for adolescents with EDs who are experiencing weight restoration. Further research is warranted to replicate our findings challenging the importance of within-session habituation, and to better understand between-session habituation and inhibitory learning as mechanisms of change when conducting food exposure for EDs. PUBLIC SIGNIFICANCE This study provides some evidence that PHPs that include food exposure may be useful for adolescents with EDs who are experiencing weight restoration. Between-session habituation, but not within-session habituation, predicted favorable treatment outcomes. Further research is needed to determine whether clinicians can disregard within-session habituation when conducting food exposure for EDs, and understand the importance of between-session habituation as a potential mechanism of food exposure.
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Affiliation(s)
- Jamal H Essayli
- Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Lauren N Forrest
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Hana F Zickgraf
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Emily C Stefano
- Bariatric and Weight Management Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Kathleen L Keller
- Department of Nutritional Sciences, Pennsylvania State University, Pennsylvania, USA
- Department of Food Science, Pennsylvania State University, Pennsylvania, USA
| | - Susan E Lane-Loney
- Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
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8
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Cortese S, Besag FM, Clark B, Hollis C, Kilgariff J, Moreno C, Nicholls D, Wilkinson P, Woodbury-Smith M, Sharma A. Common practical questions - and answers - at the British Association for Psychopharmacology child and adolescent psychopharmacology course. J Psychopharmacol 2023; 37:119-134. [PMID: 36476096 PMCID: PMC9912307 DOI: 10.1177/02698811221140005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The British Association for Psychopharmacology course on child and adolescent psychopharmacology has been run for more than 20 years and is currently a very popular course, attracting around 140 delegates/year from across the United Kingdom and abroad. As Faculty of recent sessions of the course, we have selected the most common questions we have been asked in recent years and provided evidence-based and/or expert-informed answers. We have included 27 questions and answers related to attention-deficit/hyperactivity disorder, anxiety and depressive disorders, autism spectrum disorder, bipolar disorder, eating disorders, epilepsy (in differential diagnosis or comorbid with mental health conditions), obsessive-compulsive disorder, personality disorders, psychotic spectrum disorders, and tics/Tourette syndrome in children and young people. We hope that this article will be helpful for prescribers in their daily clinical practice and we look forward to further, high-level evidence informing the answers to these and other questions in child and adolescent psychopharmacology.
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Affiliation(s)
- Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.,Solent NHS Trust, Southampton, UK.,Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA.,Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Frank Mc Besag
- UCL School of Pharmacy, London, UK.,East London Foundation NHS Trust, Bedfordshire, UK.,Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK
| | - Bruce Clark
- National Specialist Clinic for Young People with OCD, BDD and Related Disorders, South London and Maudsley NHS Foundation Trust, London, UK
| | - Chris Hollis
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.,Department of Child and Adolescent Psychiatry, Nottinghamshire Healthcare NHS Foundation Trust, Queen's Medical Centre, Nottingham, UK.,National Institute of Mental Health (NIHR) MindTech Medtech Co-operative, Institute of Mental Health, Nottingham, UK.,NIHR Nottingham Biomedical Research Centre, Mental Health & Technology Theme, Institute of Mental Health, Nottingham, UK
| | - Joseph Kilgariff
- Department of Child and Adolescent Psychiatry, Nottinghamshire Healthcare NHS Foundation Trust, Queen's Medical Centre, Nottingham, UK
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, London, UK.,NIHR ARC Northwest, London, UK
| | - Paul Wilkinson
- School of Clinical Medicine, University of Cambridge, Cambridge, Cambridgeshire, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridgeshire, UK
| | | | - Aditya Sharma
- Academic Psychiatry, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,Specialist Adolescent Mood Disorders Service (SAMS), Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
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9
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Animali S, Steinwurzel C, Dardano A, Sancho-Bornez V, Del Prato S, Morrone MC, Daniele G, Binda P. Effect of fasting on short-term visual plasticity in adult humans. Eur J Neurosci 2023; 57:148-162. [PMID: 36437778 PMCID: PMC10108283 DOI: 10.1111/ejn.15873] [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: 04/27/2022] [Revised: 11/10/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022]
Abstract
Brain plasticity and function is impaired in conditions of metabolic dysregulation, such as obesity. Less is known on whether brain function is also affected by transient and physiological metabolic changes, such as the alternation between fasting and fed state. Here we asked whether these changes affect the transient shift of ocular dominance that follows short-term monocular deprivation, a form of homeostatic plasticity. We further asked whether variations in three of the main metabolic and hormonal pathways affected in obesity (glucose metabolism, leptin signalling and fatty acid metabolism) correlate with plasticity changes. We measured the effects of 2 h monocular deprivation in three conditions: post-absorptive state (fasting), after ingestion of a standardised meal and during infusion of glucagon-like peptide-1 (GLP-1), an incretin physiologically released upon meal ingestion that plays a key role in glucose metabolism. We found that short-term plasticity was less manifest in fasting than in fed state, whereas GLP-1 infusion did not elicit reliable changes compared to fasting. Although we confirmed a positive association between plasticity and supraphysiological GLP-1 levels, achieved by GLP-1 infusion, we found that none of the parameters linked to glucose metabolism could predict the plasticity reduction in the fasting versus fed state. Instead, this was selectively associated with the increase in plasma beta-hydroxybutyrate (B-OH) levels during fasting, which suggests a link between neural function and energy substrates alternative to glucose. These results reveal a previously unexplored link between homeostatic brain plasticity and the physiological changes associated with the daily fast-fed cycle.
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Affiliation(s)
- Silvia Animali
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Cecilia Steinwurzel
- Department of Neuroscience, Psychology, Pharmacology and Child Health, University of Florence, Florence, Italy.,Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Angela Dardano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Stefano Del Prato
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Maria Concetta Morrone
- Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.,IRCCS Stella Maris Foundation, Pisa, Italy
| | - Giuseppe Daniele
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paola Binda
- Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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10
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Vuillier L, Joseph J, Greville-Harris M, May L, Somerville MP, Harrison A, Moseley RL. What about males? Exploring sex differences in the relationship between emotion difficulties and eating disorders. J Eat Disord 2022; 10:193. [PMID: 36514166 PMCID: PMC9749243 DOI: 10.1186/s40337-022-00715-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE While eating disorders (EDs) are more commonly diagnosed in females, there is growing awareness that men also experience EDs and may do so in a different way. Difficulties with emotion processing and emotion regulation are believed to be important in EDs, but as studies have involved predominantly female samples, it is unclear whether this is also true for males. METHODS In a sample of 1604 participants (n = 631 males), we assessed emotion processing and emotion regulation in males with EDs (n = 109) and compared results to both females with EDs (n = 220) and males from the general population (n = 522). We also looked at whether emotion processing and emotion regulation difficulties predicted various aspects of eating psychopathology and whether this was moderated by sex. We assessed emotion processing with the Toronto Alexithymia Scale, emotion regulation with the Difficulties in Emotion Regulation Scale and the Emotion Regulation Questionnaire, and eating psychopathology with the Eating Disorder Examination Questionnaire. RESULTS We found that males with ED, like their female counterparts, suffered from emotion processing and emotion regulation deficits. We did find some sex differences, in that males with EDs tended to report more difficulties with their emotions as well as a more externally oriented thinking style compared to females with EDs. Difficulties with emotion processing and emotion regulation were strongly predictive of various aspects of eating psychopathology in both sexes. Importantly, we found that sex moderated the relationship between cognitive reappraisal and eating restraint. As such, low use of reappraisal was found to be associated with higher levels of restraint in females but not in males. DISCUSSION Difficulties with emotion processing and emotion regulation are associated with eating psychopathology in both males and females. Reappraisal was not found to be associated with reduced eating psychopathology in males, suggesting a cautious approach to interventions targeting this strategy. Research around explanatory mechanisms and interventions must adopt a broader viewpoint including those that are traditionally overlooked in EDs.
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Affiliation(s)
- L Vuillier
- Department of Psychology, Bournemouth University, Poole, UK.
| | - J Joseph
- Department of Psychology, Bournemouth University, Poole, UK
| | | | - L May
- Dorset Healthcare University NHS Foundation Trust, Poole, UK
| | - M P Somerville
- UCL Institute of Education, University College London, London, UK
| | - A Harrison
- UCL Institute of Education, University College London, London, UK
| | - R L Moseley
- Department of Psychology, Bournemouth University, Poole, UK
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Benau EM, Makara A, Orloff NC, Benner E, Serpell L, Timko CA. How Does Fasting Affect Cognition? An Updated Systematic Review (2013-2020). Curr Nutr Rep 2021; 10:376-390. [PMID: 34595721 DOI: 10.1007/s13668-021-00370-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The goal of this review was to provide an update on the literature examining how voluntary, temporary abstention from eating impacts cognitive function. RECENT FINDINGS We evaluated peer-reviewed articles published between August 2013 and January 2021 that assessed adults, included a measure of cognitive functioning with neutral stimuli, and compared individuals in a fasted state to individuals in a fed state (either within- or between-subject designs). Nineteen articles (21 studies) met inclusion criteria. Sample sizes, fasting methods, and tasks varied across studies. Review of studies indicated that fasting was associated with deficits in cognitive functioning; few studies indicated a benefit in cognitive functioning following a single voluntary fast. The heterogeneity and rarity of available studies limits the conclusions that can be drawn. Several crucial psychosocial and sociodemographic moderators remain unexplored. Recommendations for future work are discussed.
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Affiliation(s)
| | - Amanda Makara
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Eleanor Benner
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - C Alix Timko
- Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- University of Pennsylvania, Philadelphia, PA, USA.
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12
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Voigt K, Giddens E, Stark R, Frisch E, Moskovsky N, Kakoschke N, Stout JC, Bellgrove MA, Andrews ZB, Verdejo-Garcia A. The Hunger Games: Homeostatic State-Dependent Fluctuations in Disinhibition Measured with a Novel Gamified Test Battery. Nutrients 2021; 13:nu13062001. [PMID: 34200678 PMCID: PMC8230368 DOI: 10.3390/nu13062001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 11/16/2022] Open
Abstract
Food homeostatic states (hunger and satiety) influence the cognitive systems regulating impulsive responses, but the direction and specific mechanisms involved in this effect remain elusive. We examined how fasting, and satiety, affect cognitive mechanisms underpinning disinhibition using a novel framework and a gamified test-battery. Thirty-four participants completed the test-battery measuring three cognitive facets of disinhibition: attentional control, information gathering and monitoring of feedback, across two experimental sessions: one after overnight fasting and another after a standardised meal. Homeostatic state was assessed using subjective self-reports and biological markers (i.e., blood-derived liver-expressed antimicrobial protein 2 (LEAP-2), insulin and leptin). We found that participants who experienced greater subjective hunger during the satiety session were more impulsive in the information gathering task; results were not confounded by changes in mood or anxiety. Homeostatic state did not significantly influence disinhibition mechanisms linked to attentional control or feedback monitoring. However, we found a significant interaction between homeostatic state and LEAP-2 on attentional control, with higher LEAP-2 associated with faster reaction times in the fasted condition only. Our findings indicate lingering hunger after eating increases impulsive behaviour via reduced information gathering. These findings identify a novel mechanism that may underpin the tendency to overeat and/or engage in broader impulsive behaviours.
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Affiliation(s)
- Katharina Voigt
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (K.V.); (E.G.); (E.F.); (N.M.); (N.K.); (J.C.S.); (M.A.B.)
| | - Emily Giddens
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (K.V.); (E.G.); (E.F.); (N.M.); (N.K.); (J.C.S.); (M.A.B.)
| | - Romana Stark
- Department of Physiology and Biomedicine Discovery Institute, Monash University, Clayton, VIC 3800, Australia; (R.S.); (Z.B.A.)
| | - Emma Frisch
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (K.V.); (E.G.); (E.F.); (N.M.); (N.K.); (J.C.S.); (M.A.B.)
| | - Neda Moskovsky
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (K.V.); (E.G.); (E.F.); (N.M.); (N.K.); (J.C.S.); (M.A.B.)
| | - Naomi Kakoschke
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (K.V.); (E.G.); (E.F.); (N.M.); (N.K.); (J.C.S.); (M.A.B.)
| | - Julie C. Stout
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (K.V.); (E.G.); (E.F.); (N.M.); (N.K.); (J.C.S.); (M.A.B.)
| | - Mark A. Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (K.V.); (E.G.); (E.F.); (N.M.); (N.K.); (J.C.S.); (M.A.B.)
| | - Zane B. Andrews
- Department of Physiology and Biomedicine Discovery Institute, Monash University, Clayton, VIC 3800, Australia; (R.S.); (Z.B.A.)
| | - Antonio Verdejo-Garcia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (K.V.); (E.G.); (E.F.); (N.M.); (N.K.); (J.C.S.); (M.A.B.)
- Correspondence: ; Tel.: +61-3-9905-5374
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13
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Lang K, Kerr-Gaffney J, Hodsoll J, Jassi A, Tchanturia K, Krebs G. Is poor global processing a transdiagnostic feature of Body Dysmorphic Disorder and Anorexia Nervosa? A meta-analysis. Body Image 2021; 37:94-105. [PMID: 33582531 DOI: 10.1016/j.bodyim.2021.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 01/26/2021] [Accepted: 01/26/2021] [Indexed: 11/27/2022]
Abstract
Body dysmorphic disorder (BDD) and anorexia nervosa (AN) are characterised by body image disturbance. It has been suggested that poor global integration in visual processing may underlie distorted body image, but empirical studies have yielded mixed results. The current study involved two meta-analyses aimed at examining the extent to which poor global processing is evident in BDD and AN. Studies were identified through a systematic literature search up to October 2020. The BDD search yielded 16 studies and the AN search yielded 18 studies. Random-effect models demonstrated a small pooled effect size for BDD (g = -0.44, 95 % CI -0.70, -0.17, p < 0.001) and a moderate pooled effect size for AN (g = -0.63, 95 % CI -0.77, -0.49, p < .001), with no evidence of significant publication bias for either. The results provide evidence that poor global processing is a transdiagnostic feature of both BDD and AN, although effects may be more pronounced in AN. Our findings highlight the possibility that interventions aimed at promoting global visual processing could prove beneficial in disorders characterised by distorted body image.
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Affiliation(s)
- Katie Lang
- King's College London (KCL), Psychology Department, Institute of Psychiatry, UK; National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Trust, UK.
| | - Jess Kerr-Gaffney
- King's College London (KCL), Psychological Medicine, Institute of Psychiatry, UK
| | - John Hodsoll
- King's College London (KCL), Department of Biostatistics, Institute of Psychiatry, UK
| | - Amita Jassi
- National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Trust, UK
| | - Kate Tchanturia
- King's College London (KCL), Psychological Medicine, Institute of Psychiatry, UK; National Eating Disorder Unit, South London & Maudsley NHS Trust, UK
| | - Georgina Krebs
- National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Trust, UK; King's College London (KCL), Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, UK
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14
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Rodríguez-Quiroga A, MacDowell KS, Leza JC, Carrasco JL, Díaz-Marsá M. Childhood trauma determines different clinical and biological manifestations in patients with eating disorders. Eat Weight Disord 2021; 26:847-857. [PMID: 32424563 DOI: 10.1007/s40519-020-00922-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 05/06/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE There is a significant relationship between childhood trauma and the development of an eating disorder in adolescence or adulthood, possibly influenced by circulating levels of inflammatory parameters. The main objective is to identify and describe a subgroup of patients with eating disorders and a history of trauma in childhood or adolescence with differential clinical features. METHODS An observational study on a sample of 55 patients who met the diagnostic criteria for any DSM-5 eating disorder was carried out. Inflammatory parameters in white blood cells were examined. Patients underwent different assessments, including clinical and personality scales. RESULTS Patients with a history of trauma had higher scores in the delirious and narcissistic items of the Millon Clinical Multiaxial Inventory (MCMI-II) (p < 0.05) and a higher score in the paranoid item of the SCID-5 Personality Disorders Version (SCID-5-PD) (p < 0.05). Patients with distinguishing personality features were grouped according to the Childhood Trauma Questionnaire sexual subscale. Tumor necrosis alpha (TNF-α) showed a significant association with childhood trauma history. CONCLUSIONS There is a profile of patients with eating disorders who have increased activity in the inflammatory pathways that, if identified precociously, can benefit from specifically aimed interventions. LEVEL OF EVIDENCE Level V, observational study.
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Affiliation(s)
- Alberto Rodríguez-Quiroga
- Department of Psychiatry, Hospital Universitario Infanta Leonor, Gran Vía del Este 80, 28030, Madrid, Spain. .,Department of Psychiatry and Psychology, Medical School, Complutense University, Av. Séneca, 2, 28040, Madrid, Spain.
| | - Karina S MacDowell
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Pharmacology, Medical School, Complutense University, Av. Séneca, 2, 28040, Madrid, Spain.,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Av. Cordoba, s/n, 28041, Madrid, Spain
| | - Juan C Leza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Pharmacology, Medical School, Complutense University, Av. Séneca, 2, 28040, Madrid, Spain.,Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Av. Cordoba, s/n, 28041, Madrid, Spain
| | - José Luis Carrasco
- Department of Psychiatry and Psychology, Medical School, Complutense University, Av. Séneca, 2, 28040, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Calle del Prof Martín Lagos, s/n, 28040, Madrid, Spain
| | - Marina Díaz-Marsá
- Department of Psychiatry and Psychology, Medical School, Complutense University, Av. Séneca, 2, 28040, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Calle del Prof Martín Lagos, s/n, 28040, Madrid, Spain
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15
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Dann KM, Hay P, Touyz S. Are poor set-shifting and central coherence associated with everyday function in anorexia nervosa? A systematic review. J Eat Disord 2021; 9:40. [PMID: 33781337 PMCID: PMC8008586 DOI: 10.1186/s40337-021-00392-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 03/02/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is increasing interest in associations between cognitive impairments and clinical symptoms in Anorexia Nervosa (AN), however, the relationship with everyday function is unclear. The current review synthesizes existing data regarding associations between scores on tests of set-shifting and central coherence and functional outcome measures for individuals with AN. METHOD A systematic electronic database search yielded 13 studies which included participants with current or lifetime AN where scores on a neuropsychological test of set-shifting or central coherence were directly or indirectly compared to a functional outcome measure. RESULTS Associations between set-shifting and central coherence performance measures and functional outcomes were limited in number and noted only in adult or mixed-age cohorts. Associations were noted at subscale level, suggesting they are specific in nature. In younger cohorts, assessments of executive functioning in everyday life appear sensitive to cognitive-behavioral flexibility issues. CONCLUSIONS Associations between cognitive performance and functional outcome have not been as systematically assessed in AN as in other psychiatric disorders. Key factors to address in future research include: (a) the use of function measures which are sensitive to both the level of impairment, and specific rather than general impairments (b) the ecological validity of measures, (c) the task impurity problem, especially in regard to cognitive flexibility assessment, and (d) the need to measure both cognitive deficits and strengths, because tests of specific cognitive processes may underestimate the ability to function in daily life due to compensatory strategies.
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Affiliation(s)
- Kelly M Dann
- School of Psychology, University of Sydney, Sydney, Australia.
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Stephen Touyz
- InsideOut Institute and School of Psychology, University of Sydney, Sydney, Australia
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16
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Overlapping neurocognitive inefficiencies associated with higher disordered eating psychopathology in college women. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-01281-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Yang C, Ma Q, Zhang H, Wu F, Wu M, Yang C, Chen Y, Xiong J, Liu W, Wang H, Wu R, Dai Z, Li Y. Ten days of complete fasting affected subjective sensations but not cognitive abilities in healthy adults. Eur J Nutr 2021; 60:2747-2758. [PMID: 33389084 DOI: 10.1007/s00394-020-02450-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 11/24/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE People may be unable to obtain anything edible for days under some circumstances, but they must maintain their calmness and cognition to navigate solutions. Our aim was to study changes in subjective sensations and cognition in healthy adults during a 10-day complete fasting experiment. METHODS Thirteen healthy male volunteers voluntarily participated in the 22-day experiment comprising 4 phases: 3 days of baseline consumption, 10 days of complete fasting (only water ad libitum), 4 days of calorie restriction, and a 5-day recovery period. The volunteers' subjective sensations, cognitive performance, and serum energy substances were measured at 6 time points. RESULTS Across the 6 time points, the trajectories of subjective sensations in response to fasting were "U"- or " ∩ "-shaped curves instead of progressive discomfort or mood enhancement. A significant fasting time effect was found on depression-dejection (baseline: 16.85 ± 2.88; highest score on the third day of completing fasting: 17.69 ± 3.97, P = 0.04) and self-rated anxiety (baseline: 26.23 ± 4.75; highest score on the sixth day of completing fasting: 30.85 ± 5.58, P = 0.01), and the change curves were consistent with the inflection point of the energy substrates shifting from serum glucose to ketone. In addition, basic cognitive functions appeared to be unaffected during the 10-day fast. CONCLUSIONS Our study showed strong influences on the sensations from the third to sixth days of the prolonged fasting period but no significant effects on basic cognitive abilities associated with the energy substance switch. These findings could contribute to the development and understanding of survival strategies in food-shortage emergencies or of intermittent fasting programmes.
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Affiliation(s)
- Chao Yang
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, No. 26, Beiqing Road, Haidian District, P.O. Box 5132-15, Beijing, 100094, China
| | - Qianying Ma
- Department of Psychology, Beihang University, No. 37, Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Hongyu Zhang
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, No. 26, Beiqing Road, Haidian District, P.O. Box 5132-15, Beijing, 100094, China
| | - Feng Wu
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, No. 26, Beiqing Road, Haidian District, P.O. Box 5132-15, Beijing, 100094, China
| | - Manrui Wu
- Department of Psychology, Beihang University, No. 37, Xueyuan Road, Haidian District, Beijing, 100083, China
| | - Chengjia Yang
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, No. 26, Beiqing Road, Haidian District, P.O. Box 5132-15, Beijing, 100094, China
| | - Ying Chen
- Lab of Epigenetics and Health Technology, SPACEnter Space Science and Technology Institute, Shenzhen, China
| | - Jianghui Xiong
- Lab of Epigenetics and Health Technology, SPACEnter Space Science and Technology Institute, Shenzhen, China
| | - Wenjuan Liu
- Beijing Ziyuan Fasting Training Center, Beijing, China
| | - Hailong Wang
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, No. 26, Beiqing Road, Haidian District, P.O. Box 5132-15, Beijing, 100094, China
| | - Ruilin Wu
- Department of Psychology, Beihang University, No. 37, Xueyuan Road, Haidian District, Beijing, 100083, China.
| | - Zhongquan Dai
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, No. 26, Beiqing Road, Haidian District, P.O. Box 5132-15, Beijing, 100094, China.
| | - Yinghui Li
- State Key Laboratory of Space Medicine Fundamentals and Application, China Astronaut Research and Training Center, No. 26, Beiqing Road, Haidian District, P.O. Box 5132-15, Beijing, 100094, China.
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18
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Zajac I, Herreen D, Hunkin H, James-Martin G, Doyen M, Kakoschke N, Brindal E. Modified Fasting Compared to True Fasting Improves Blood Glucose Levels and Subjective Experiences of Hunger, Food Cravings and Mental Fatigue, But Not Cognitive Function: Results of an Acute Randomised Cross-Over Trial. Nutrients 2020; 13:E65. [PMID: 33379191 PMCID: PMC7824352 DOI: 10.3390/nu13010065] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/16/2022] Open
Abstract
Recent dietary trends have prompted growing support for a variety of fasting paradigms involving extreme restriction or nil-caloric intake on fasting days. Some studies indicate that fasting may negatively influence factors including cognitive function through inducing fatigue, which may prove problematic in the context of completing a range of cognitively demanding activities required by daily obligations such as work. This randomised within-subjects cross-over trial explored the effects of true fasting (i.e., nil-caloric intake) versus modified fasting, the latter of which involved two sub-conditions: (1) extended distribution (three small meals distributed across the day; 522 kcal total); and (2) bulking (two meals eaten early in the day; 512 kcal total) over a period of 7.5 h on a single day with a 7-day washout period between conditions. Participants were n = 17 females (Body Mass Index (BMI) Mean (M) = 25.80, Standard Deviation (SD) = 2.30) aged 21-49 years. Outcomes included cognitive function, subjective mental fatigue, satiety, food cravings and blood glucose. Results showed that there were no differences in cognitive test performance between conditions;however, both modified fasting sub-conditions had improved blood glucose levels, cravings, hunger and fullness compared to true fasting. Moreover, subjective mental fatigue was significantly reduced in the modified fasting conditions relative to true fasting. Overall, results indicated that the subjective experience of true fasting and modified fasting is different, but that cognition does not appear to be impaired.
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Affiliation(s)
- Ian Zajac
- Nutrition & Health, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (D.H.); (H.H.); (G.J.-M.); (M.D.); (N.K.); (E.B.)
| | - Danielle Herreen
- Nutrition & Health, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (D.H.); (H.H.); (G.J.-M.); (M.D.); (N.K.); (E.B.)
- School of Psychology, University of Adelaide, Adelaide, SA 5000, Australia
| | - Hugh Hunkin
- Nutrition & Health, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (D.H.); (H.H.); (G.J.-M.); (M.D.); (N.K.); (E.B.)
- School of Psychology, University of Adelaide, Adelaide, SA 5000, Australia
| | - Genevieve James-Martin
- Nutrition & Health, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (D.H.); (H.H.); (G.J.-M.); (M.D.); (N.K.); (E.B.)
| | - Mathilde Doyen
- Nutrition & Health, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (D.H.); (H.H.); (G.J.-M.); (M.D.); (N.K.); (E.B.)
- Agrocampus Ouest, 65 Rue de Saint-Brieuc, 35000 Rennes, France
| | - Naomi Kakoschke
- Nutrition & Health, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (D.H.); (H.H.); (G.J.-M.); (M.D.); (N.K.); (E.B.)
| | - Emily Brindal
- Nutrition & Health, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (D.H.); (H.H.); (G.J.-M.); (M.D.); (N.K.); (E.B.)
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19
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Schaumberg K, Reilly EE, Gorrell S, Levinson CA, Farrell NR, Brown TA, Smith KM, Schaefer LM, Essayli JH, Haynos AF, Anderson LM. Conceptualizing eating disorder psychopathology using an anxiety disorders framework: Evidence and implications for exposure-based clinical research. Clin Psychol Rev 2020; 83:101952. [PMID: 33221621 DOI: 10.1016/j.cpr.2020.101952] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022]
Abstract
Eating disorders (EDs) and anxiety disorders (ADs) evidence shared risk and significant comorbidity. Recent advances in understanding of anxiety-based disorders may have direct application to research and treatment efforts for EDs. The current review presents an up-to-date, behavioral conceptualization of the overlap between anxiety-based disorders and EDs. We identify ways in which anxiety presents in EDs, consider differences between EDs and ADs relevant to treatment adaptions, discuss how exposure-based strategies may be adapted for use in ED treatment, and outline directions for future mechanistic, translational, and clinical ED research from this perspective. Important research directions include: simultaneous examination of the extent to which EDs are characterized by aberrant avoidance-, reward-, and/or habit-based neurobiological and behavioral processes; improvement in understanding of how nutritional status interacts with neurobiological characteristics of EDs; incorporation of a growing knowledge of biobehavioral signatures in ED treatment planning; development of more comprehensive exposure-based treatment approaches for EDs; testing whether certain exposure interventions for AD are appropriate for EDs; and improvement in clinician self-efficacy and ability to use exposure therapy for EDs.
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Affiliation(s)
| | | | - Sasha Gorrell
- University of California, San Francisco, United States of America
| | - Cheri A Levinson
- University of Louisville, Department of Psychological & Brain Sciences, United States of America
| | | | - Tiffany A Brown
- University of California, San Diego, United States of America
| | - Kathryn M Smith
- Sanford Health, United States of America; University of Southern California, United States of America
| | | | | | - Ann F Haynos
- University of Minnesota, United States of America
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20
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Miles S, Gnatt I, Phillipou A, Nedeljkovic M. Cognitive flexibility in acute anorexia nervosa and after recovery: A systematic review. Clin Psychol Rev 2020; 81:101905. [PMID: 32891022 DOI: 10.1016/j.cpr.2020.101905] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 02/06/2023]
Abstract
Difficulties in cognitive flexibility-the ability to adapt effectively to changes in the environment and/or changing task demands-have been reported in anorexia nervosa (AN). However, findings are inconsistent across studies and it remains unclear which specific aspects of cognitive flexibility patients with AN may struggle with. This systematic review aimed to synthesise existing research on cognitive flexibility in AN and clarify differences between patients with acute AN, patients who are weight-restored and patients who are fully recovered from AN. Electronic databases were searched through to January 2020. 3,310 papers were screened and 70 papers were included in the final review. Although adults with acute AN performed worse in perceptual flexibility tasks and self-report measures compared to HCs, they did not exhibit deficits across all domains of cognitive flexibility. Adolescents with acute AN did not differ to HCs in performance on neurocognitive tasks despite self-reporting poorer cognitive flexibility. Overall, significant differences in cognitive flexibility between acute and recovered participants was not evident, though, the findings are limited by a modest number of studies. Recovered participants performed poorer than HCs in some neurocognitive measures, however, results were inconsistent across studies. These results have implications for the assessment of cognitive flexibility in AN and targeted treatment approaches.
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Affiliation(s)
- Stephanie Miles
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.
| | - Inge Gnatt
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Andrea Phillipou
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, Australia; Department of Mental Health, Austin Health, Melbourne, Australia
| | - Maja Nedeljkovic
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
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21
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Seidel M, Ehrlich S, Breithaupt L, Welch E, Wiklund C, Hübel C, Thornton LM, Savva A, Fundin BT, Pege J, Billger A, Abbaspour A, Schaefer M, Boehm I, Zvrskovec J, Rosager EV, Hasselbalch KC, Leppä V, Sjögren M, Nergårdh R, Feusner JD, Ghaderi A, Bulik CM. Study protocol of comprehensive risk evaluation for anorexia nervosa in twins (CREAT): a study of discordant monozygotic twins with anorexia nervosa. BMC Psychiatry 2020; 20:507. [PMID: 33054774 PMCID: PMC7557028 DOI: 10.1186/s12888-020-02903-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/29/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Anorexia nervosa (AN) is a severe disorder, for which genetic evidence suggests psychiatric as well as metabolic origins. AN has high somatic and psychiatric comorbidities, broad impact on quality of life, and elevated mortality. Risk factor studies of AN have focused on differences between acutely ill and recovered individuals. Such comparisons often yield ambiguous conclusions, as alterations could reflect different effects depending on the comparison. Whereas differences found in acutely ill patients could reflect state effects that are due to acute starvation or acute disease-specific factors, they could also reflect underlying traits. Observations in recovered individuals could reflect either an underlying trait or a "scar" due to lasting effects of sustained undernutrition and illness. The co-twin control design (i.e., monozygotic [MZ] twins who are discordant for AN and MZ concordant control twin pairs) affords at least partial disambiguation of these effects. METHODS Comprehensive Risk Evaluation for Anorexia nervosa in Twins (CREAT) will be the largest and most comprehensive investigation of twins who are discordant for AN to date. CREAT utilizes a co-twin control design that includes endocrinological, neurocognitive, neuroimaging, genomic, and multi-omic approaches coupled with an experimental component that explores the impact of an overnight fast on most measured parameters. DISCUSSION The multimodal longitudinal twin assessment of the CREAT study will help to disambiguate state, trait, and "scar" effects, and thereby enable a deeper understanding of the contribution of genetics, epigenetics, cognitive functions, brain structure and function, metabolism, endocrinology, microbiology, and immunology to the etiology and maintenance of AN.
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Affiliation(s)
- Maria Seidel
- grid.4488.00000 0001 2111 7257Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany ,Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Lauren Breithaupt
- grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA ,grid.32224.350000 0004 0386 9924Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA USA
| | - Elisabeth Welch
- grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden ,grid.467087.a0000 0004 0442 1056Stockholm Health Care Services, Region Stockholm, Stockholm Centre for Eating Disorders, Stockholm, Sweden
| | - Camilla Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Christopher Hübel
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden ,grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839UK National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, London, UK ,grid.7048.b0000 0001 1956 2722National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Laura M. Thornton
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Androula Savva
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Bengt T. Fundin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Jessica Pege
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Annelie Billger
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Afrouz Abbaspour
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Martin Schaefer
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ilka Boehm
- grid.4488.00000 0001 2111 7257Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Johan Zvrskovec
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden ,grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Emilie Vangsgaard Rosager
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Virpi Leppä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Magnus Sjögren
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark ,Eating Disorder Research Unit, Mental Health Center Ballerup, Ballerup, Denmark
| | - Ricard Nergårdh
- grid.4714.60000 0004 1937 0626Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Jamie D. Feusner
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA USA
| | - Ata Ghaderi
- grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden ,grid.10698.360000000122483208Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC USA ,grid.10698.360000000122483208Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
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22
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Howard M, Roiser JP, Gilbert SJ, Burgess PW, Dayan P, Serpell L. Short-Term Fasting Selectively Influences Impulsivity in Healthy Individuals. Front Psychol 2020; 11:1644. [PMID: 32765372 PMCID: PMC7381251 DOI: 10.3389/fpsyg.2020.01644] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 06/17/2020] [Indexed: 12/31/2022] Open
Abstract
Previous research has shown that short-term fasting in healthy individuals is associated with changes in risky decision-making. The current experiment was designed to examine the influence of short-term fasting in healthy individuals on four types of impulsivity: reflection impulsivity, risky decision-making, delay aversion, and action inhibition. Participants were tested twice, once when fasted for 20 h, and once when satiated. Participants demonstrated impaired action inhibition when fasted; committing significantly more errors of commission during a food-related Affective Shifting Task. Participants also displayed decreased reflection impulsivity when fasted, opening significantly more boxes during the Information Sampling Task (IST). There were no significant differences in performance between fasted and satiated sessions for risky decision-making or delay aversion. These findings may have implications for understanding eating disorders such as Bulimia Nervosa (BN). Although BN has been characterized as a disorder of poor impulse control, inconsistent findings when comparing individuals with BN and healthy individuals on behavioral measures of impulsivity question this characterization. Since individuals with BN undergo periods of short-term fasting, the inconsistent findings could be due to differences in the levels of satiation of participants. The current results indicate that fasting can selectively influence performance on the IST, a measure of impulsivity previously studied in BN. However, the results from the IST were contrary to the original hypothesis and should be replicated before specific conclusions can be made.
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Affiliation(s)
- Maxine Howard
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Jonathan P. Roiser
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Sam J. Gilbert
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Paul W. Burgess
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Peter Dayan
- Gatsby Computational Neuroscience Unit, University College London, London, United Kingdom
| | - Lucy Serpell
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Eating Disorder Service, North East London NHS Foundation Trust, Orchards Health & Family Centre, Essex, United Kingdom
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23
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Lock J, Nicholls D. Toward A Greater Understanding of the Ways Family-Based Treatment Addresses the Full Range of Psychopathology of Adolescent Anorexia Nervosa. Front Psychiatry 2020; 10:968. [PMID: 32038319 PMCID: PMC6993050 DOI: 10.3389/fpsyt.2019.00968] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/09/2019] [Indexed: 01/30/2023] Open
Abstract
Family-based treatment (FBT) for anorexia nervosa (AN) is an empirically supported treatment for this disorder. Derived from several different schools of family therapy, it is a highly focused approach that initially targets weight restoration under parental management at home. However, the view that manualized FBT is solely a behavioral therapy directing parents to refeed their children AN with the single purpose of weight gain is a common but misleading over simplification of the therapy. Indeed, weight restoration is the main goal only in phase 1 of this 3-phase treatment. When practiced with fidelity and skill, FBT's broadest aim is to promote adolescent development without AN thoughts and behaviors interfering and disrupting these normal processes. Although weight restoration is a key starting point in FBT, the entire course of treatment takes into consideration the ongoing impact of starvation, cognitions, emotions, and behaviors on adolescent development. These factors associated with maintaining low weight are viewed in FBT as interfering with the adolescent being able to take up the tasks of adolescence and thus must be overcome before fully turning to those broader adolescent tasks. In addition, FBT recognizes that adolescence takes place in the context of family and community and respects the importance of learning in a home environment both for weight gain as well as related developmental tasks to have a lasting effect. Specifically, in this article we describe how the current FBT manualized approach addresses temperament/personality traits, emotional processing, cognitive content and process, social communication and connections, psychiatric comorbidity, and family factors. This report makes no claim to superiority of FBT compared to other therapies in addressing these broader concerns nor does it add interventions to augment the current manual to improve FBT.
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Affiliation(s)
- James Lock
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Dasha Nicholls
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, United Kingdom
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24
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Stewart CS, McEwen FS, Konstantellou A, Eisler I, Simic M. Impact of ASD Traits on Treatment Outcomes of Eating Disorders in Girls. EUROPEAN EATING DISORDERS REVIEW 2017; 25:123-128. [DOI: 10.1002/erv.2497] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/22/2016] [Accepted: 11/14/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Catherine S. Stewart
- National and Specialist Child and Adolescent Eating Disorder Service; South London and Maudsley NHS Foundation Trust; London UK
| | - Fiona S. McEwen
- Child and Adolescent Psychiatry and Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology and Neuroscience, King's College London; London UK
- Biological and Experimental Psychology, School of Biological and Chemical Sciences; Queen Mary University of London; London UK
| | - Anna Konstantellou
- National and Specialist Child and Adolescent Eating Disorder Service; South London and Maudsley NHS Foundation Trust; London UK
| | - Ivan Eisler
- National and Specialist Child and Adolescent Eating Disorder Service; South London and Maudsley NHS Foundation Trust; London UK
| | - Mima Simic
- National and Specialist Child and Adolescent Eating Disorder Service; South London and Maudsley NHS Foundation Trust; London UK
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25
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Watkins E, Serpell L. The Psychological Effects of Short-Term Fasting in Healthy Women. Front Nutr 2016; 3:27. [PMID: 27597946 PMCID: PMC4992682 DOI: 10.3389/fnut.2016.00027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 07/28/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The study aimed to investigate affective responses to 18-h fasting in healthy controls. In particular, the study focused on self-reported mood, irritability, sense of achievement, reward, pride, and control. METHOD Participants were a non-clinical sample of 52 women with a mean age of 25. A repeated-measures design was used, whereby participants provided diary measures of psychological variables throughout both 18-h fasting and non-fasting periods. RESULTS Fasting led to increased irritability, and also to positive affective experiences of increased sense of achievement, reward, pride, and control. DISCUSSION Even short-term fasting in healthy controls can lead to positive psychological experiences. This lends support to cognitive-behavioral and cognitive-interpersonal models of ANR, which suggest that dietary restriction is maintained through positive reinforcement.
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Affiliation(s)
- Ellen Watkins
- East London and City Foundation NHS Trust, London, UK
| | - Lucy Serpell
- University College London, London, UK
- North East London Foundation NHS Trust, Dagenham, Essex, UK
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26
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Bora E, Köse S. Meta-analysis of theory of mind in anorexia nervosa and bulimia nervosa: A specific İmpairment of cognitive perspective taking in anorexia nervosa? Int J Eat Disord 2016; 49:739-40. [PMID: 27425037 DOI: 10.1002/eat.22572] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/20/2016] [Accepted: 05/22/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Deficits in theory of mind (ToM), ability to infer mental states of others, can play a significant role in interpersonal difficulties and/or unawareness of illness observed in AN and other eating disorders including bulimia Nervosa (BN). METHOD Current meta-analysis aimed to summarize available evidence for deficits in ToM in AN and BN and examine the effects of number of study-level variables on observed findings. In this meta-analysis, 15 studies (22 samples with eating disorders) investigating ToM performances of 677 individuals with AN or BN and 514 healthy controls were included. RESULTS AN was associated with significant deficits in ToM (d = 0.59) which were more pronounced in the acute patients (d = 0.67). Small sized deficits in ToM were observed in BN (d = 0.34) and recovered AN (d = 0.35). Both cognitive perspective-taking (ToM-PT) (d = 0.99) and decoding mental states (ToM-decoding) (d = 0.61) aspects of ToM were impaired in acute AN. ToM-decoding impairment in BN was modest. There was no evidence for significant ToM-PT deficit in BN. Several study-level variables including longer duration of illness, lower BMI, and depressive symptoms were associated with more severe deficits in ToM in AN. DISCUSSION ToM deficits, particularly in ToM-PT, can be a specific feature of AN but not BN. ToM impairment can contribute to poor insight, treatment resistance, and social impairment in AN. © 2016 Wiley Periodicals, Inc. RESUMEN META ANÁLISIS DE LA TEORÍA DE LA MENTE EN ANOREXIA NERVOSA Y BULIMIA NERVOSA: ¿Un deterioro de la toma de perspectiva cognitiva en Anorexia Nervosa? OBJETIVO Las deficiencias en la teoría de la mente (ToM), la habilidad parar inferir los estados mentales de otros, pueden jugar una función significativa en las dificultades interpersonales y/o falta de reconocimiento de la enfermedad observada en Anorexia Nervosa (AN) y otros trastornos de la conducta alimentaria incluyendo la Bulimia Nervosa (BN). MÉTODO Los meta análisis actuales dirigidos a resumir la evidencia disponible sobre el déficit en ToM en AN y BN y examinar los efectos de un número de variables a nivel estudio en los resultados observados. En este meta análisis fueron incluidos 15 estudios (22 muestras con trastornos alimenticios) investigando la función de ToM de 677 individuos con AN o BN y 514 controles sanos. RESULTADOS La AN fue relacionada con déficit significativo en ToM (d=0.59) los cuales fueron pronunciados en los pacientes agudos (d=0.67). Se observaron déficits de tamaño pequeño en BN (d=0.34) y AN recuperada (d=0.35). La toma de perspectiva cognitiva (ToM-PT) (d=0.99) y la descodificación de los procesos mentales (descodificación de ToM) (d=0.61) fueron deteriorados en la AN aguda. El deterioro en la descodificación de ToM en BN fue moderado. No se encontró evidencia significativa de déficit en ToM-PT en BN. Algunas variables a nivel estudio incluyendo la larga duración de la enfermedad, índice de masa corporal (IMC) bajo y síntomas depresivos fueron asociados con mayores déficit severos en ToM en AN. DISCUSIÓN: El déficit en ToM, particularmente en ToM-PT puede ser una característica específica en la AN pero no en la BN. El deterioro en la descodificación de ToM puede contribuir a mala percepción, resistencia al tratamiento y deterioro social en AN. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:739-749).
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Affiliation(s)
- Emre Bora
- Department of Psychiatry, The Melbourne Neuropsychiatry Centre, the University of Melbourne and Melbourne Health, Carlton South, VIC, Australia; 6328 Sok no:38/2, Yali Mahallesi, Izmir, Turkey
| | - Sezen Köse
- Department of Child and Adolescent Psychiatry, Ege University, Izmir, Turkey
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27
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Westwood H, Stahl D, Mandy W, Tchanturia K. The set-shifting profiles of anorexia nervosa and autism spectrum disorder using the Wisconsin Card Sorting Test: a systematic review and meta-analysis. Psychol Med 2016; 46:1809-1827. [PMID: 27109830 DOI: 10.1017/s0033291716000581] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Difficulties in set-shifting are commonly reported in both autism spectrum disorder (ASD) and anorexia nervosa (AN) populations. Despite this, it is not known whether this cognitive profile persists across different ages, or whether the profiles seen in ASD and AN are comparable. This systematic review and meta-analyses aimed to compare the set-shifting profiles, as measured by the Wisconsin Card Sorting Test (WCST) in adults and younger people with either ASD or AN, relative to healthy controls (HCs) and to statistically compare performance on the WCST between ASD and AN. In all, 24 studies on ASD and 22 studies on AN were identified. In ASD, there were significant differences between the clinical group and HCs, with the ASD group making significantly more perseverative errors, indicating greater difficulty in set-shifting [pooled effect size of d = 0.67, 95% confidence interval (CI) 0.53-0.81, p ⩽ 0.001]. This effect was consistent across the age span. For AN studies, there was a significant difference between adults with AN and HCs (d = 0.52, 95% CI 0.36-0.68, p ⩽ 0.001) but a non-significant effect in child studies (d = 0.25, 95% CI -0.05 to 0.55, z = 1.66, p = 0.096). Meta-regression indicated no effect of diagnosis (AN or ASD) on performance in adult studies but there was a non-significant trend (p = 0.053) towards children with ASD performing worse than children with AN. While difficulties with set-shifting appear to be stable in ASD, there may be differences between children and adults with AN, which warrant further investigation.
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Affiliation(s)
- H Westwood
- Psychological Medicine,King's College London,Institute of Psychiatry, Psychology & Neuroscience,London,UK
| | - D Stahl
- Department of Biostatistics,King's College London,Institute of Psychiatry, Psychology & Neuroscience,London,UK
| | - W Mandy
- University College London,Research Department of Clinical, Educational and Health Psychology,London,UK
| | - K Tchanturia
- Psychological Medicine,King's College London,Institute of Psychiatry, Psychology & Neuroscience,London,UK
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28
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McAdams CJ, Jeon-Slaughter H, Evans S, Lohrenz T, Montague PR, Krawczyk DC. Neural differences in self-perception during illness and after weight-recovery in anorexia nervosa. Soc Cogn Affect Neurosci 2016; 11:1823-1831. [PMID: 27354739 PMCID: PMC5091684 DOI: 10.1093/scan/nsw092] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 06/22/2016] [Indexed: 02/06/2023] Open
Abstract
Anorexia nervosa (AN) is a severe mental illness characterized by problems with self-perception. Whole-brain neural activations in healthy women, women with AN and women in long-term weight recovery following AN were compared using two functional magnetic resonance imaging tasks probing different aspects of self-perception. The Social Identity-V2 task involved consideration about oneself and others using socially descriptive adjectives. Both the ill and weight-recovered women with AN engaged medial prefrontal cortex less than healthy women for self-relevant cognitions, a potential biological trait difference. Weight-recovered women also activated the inferior frontal gyri and dorsal anterior cingulate more for direct self-evaluations than for reflected self-evaluations, unlike both other groups, suggesting that recovery may include compensatory neural changes related to social perspectives. The Faces task compared viewing oneself to a stranger. Participants with AN showed elevated activity in the bilateral fusiform gyri for self-images, unlike the weight-recovered and healthy women, suggesting cognitive distortions about physical appearance are a state rather than trait problem in this disease. Because both ill and recovered women showed neural differences related to social self-perception, but only recovered women differed when considering social perspectives, these neurocognitive targets may be particularly important for treatment.
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Affiliation(s)
- Carrie J McAdams
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX 75390, USA .,Psychiatry, Texas Health Presbyterian Hospital of Dallas, Dallas, TX 75321, USA
| | - Haekyung Jeon-Slaughter
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX 75390, USA
| | - Siobahn Evans
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX 75390, USA
| | - Terry Lohrenz
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
| | - P Read Montague
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA.,Computational Psychiatry Unit, Virginia Tech, Roanoke, VA 24016, USA.,Wellcome Trust Centre for Neuroimaging, University College London, 12 Queen Square, London, WCIN 3BG, UK.,Department of Physics, Virginia Tech, Blacksburg, VA 24061, USA
| | - Daniel C Krawczyk
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX 75390, USA.,Center for Brain Health, University of Texas at Dallas, Dallas, TX 75390, USA
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Abstract
Studies published between the beginning of 2013 and May 2015 on the neuropsychological functioning of patients with anorexia nervosa compared with healthy participants framed in the context of the Research Domain Criteria matrix identifies evidence for functional differences in three domains: Negative Valance Systems-negative attentional biases and lack of neural responsivity to hunger; Cognitive Systems-limited congruence between clinical and cognitive performance, poorer non-verbal than verbal performance, altered attentional styles to disorder related stimuli, perceptual processing impairment in discriminating body images, weaknesses in central coherence, set shifting weaknesses at low weight status, decision-making weaknesses, and greater neural resources required for working memory; Systems for Social Processes-patients appear to have a different attentional response to faces, and perception and understanding of self and others. Hence, there is evidence to suggest that patients with anorexia nervosa have a specific neuropsychological performance style across tasks in three domains of functioning. Some current controversies and areas for future development are identified.
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Affiliation(s)
- Marie-Claire Reville
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK.
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
| | - Lorna O'Connor
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
- Department of Psychology, University of Bath, Bath, UK
| | - Ian Frampton
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1N 3JH, UK
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
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