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Norton B, Sheen J, Burns L, Enticott PG, Fuller-Tyszkiewicz M, Kirkovski M. Overlap of eating disorders and neurodivergence: the role of inhibitory control. BMC Psychiatry 2024; 24:454. [PMID: 38890597 PMCID: PMC11186180 DOI: 10.1186/s12888-024-05837-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Difficulties with inhibitory control have been identified in eating disorders (EDs) and neurodevelopmental disorders (NDs; including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder), and there appear to be parallels between the expression of these impairments. It is theorised that impairments in inhibitory control within NDs may represent a unique vulnerability for eating disorders (EDs), and this same mechanism may contribute to poorer treatment outcomes. This review seeks to determine the state of the literature concerning the role of inhibitory control in the overlap of EDs and neurodivergence. METHOD A scoping review was conducted to summarise extant research, and to identify gaps in the existing knowledge base. Scopus, Medline, PsycInfo, Embase, and ProQuest were systematically searched. Studies were included if the study measured traits of ADHD or autism, and symptoms of ED, and required participants to complete a performance task measure of inhibitory control. Where studies included a cohort with both an ND and ED, these results had to be reported separately from cohorts with a singular diagnosis. Studies were required to be published in English, within the last 10 years. RESULTS No studies explored the relationship between autism and EDs using behavioural measures of inhibitory control. Four studies exploring the relationship between ADHD and EDs using behavioural measures of inhibitory control met selection criteria. These studies showed a multifaceted relationship between these conditions, with differences emerging between domains of inhibitory control. ADHD symptoms predicted poorer performance on measures of response inhibition in a non-clinical sample; this was not replicated in clinical samples, nor was there a significant association with EDs. Both ADHD and ED symptoms are associated with poor performance on attentional control measures; where these diagnoses were combined, performance was worse than for those with a singular diagnosis of ADHD. This was not replicated when compared to those with only ED diagnoses. CONCLUSION Impairments in attentional control may represent a unique vulnerability for the development of an ED and contribute to poor treatment outcomes. Further research is needed to explore the role of inhibitory control in EDs, ADHD and autism, including the use of both self-report and behavioural measures to capture the domains of inhibitory control.
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Affiliation(s)
- Bethany Norton
- School of Psychology, Deakin University, Geelong, Australia.
| | - Jade Sheen
- School of Psychology, Deakin University, Geelong, Australia
| | - Lewis Burns
- School of Psychology, Deakin University, Geelong, Australia
| | | | | | - Melissa Kirkovski
- School of Psychology, Deakin University, Geelong, Australia.
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia.
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El Archi S, Cortese S, Ballon N, Réveillère C, De Luca A, Barrault S, Brunault P. Negative Affectivity and Emotion Dysregulation as Mediators between ADHD and Disordered Eating: A Systematic Review. Nutrients 2020; 12:nu12113292. [PMID: 33121125 PMCID: PMC7693832 DOI: 10.3390/nu12113292] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 12/16/2022] Open
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with disordered eating, especially addictive-like eating behavior (i.e., binge eating, food addiction, loss of control overeating). The exact mechanisms underlying this association are unclear. ADHD and addictive-like eating behavior are both associated with negative affectivity and emotion dysregulation, which we hypothesized are mediators of this relationship. The purpose of this systematic review was to review the evidence related to this hypothesis from studies assessing the relationship between childhood or adulthood ADHD symptomatology, negative affectivity, emotion dysregulation and addictive-like eating behavior. The systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations. The literature search was conducted in PubMed and PsycINFO (publication date: January 2015 to August 2020; date of search: 2 September 2020). Out of 403 potentially relevant articles, 41 were retained; 38 publications reported that ADHD and disordered eating or addictive-like eating behavior were significantly associated, including 8 articles that suggested a mediator role of negative affectivity or emotion dysregulation. Sixteen publications reported that the association between ADHD symptomatology and disordered eating or addictive-like eating behavior differed according to gender, eating behavior and ADHD symptoms (hyperactivity, impulsivity and inattention). We discuss the practical implications of these findings and directions future research.
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Affiliation(s)
- Sarah El Archi
- Qualipsy, EE 1901, Université de Tours, 37041 Tours, France; (S.E.A.); (C.R.); (S.B.)
| | - Samuele Cortese
- Center for Innovation in Mental Health, Academic Unit of Psychology, Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK;
- Solent NHS Trust, Southampton SO19 8BR, UK
- New York University Child Study Center, New York, NY 10016, USA
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham NG72UH, UK
| | - Nicolas Ballon
- CHRU de Tours, Service d’Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, 37044 Tours, France;
- UMR 1253, iBrain, Université de Tours, INSERM, 37032 Tours, France
| | - Christian Réveillère
- Qualipsy, EE 1901, Université de Tours, 37041 Tours, France; (S.E.A.); (C.R.); (S.B.)
| | - Arnaud De Luca
- CHRU de Tours, Centre Spécialisé de l’Obésité, 37044 Tours, France;
- UMR 1069, Nutrition, Croissance et Cancer, Université de Tours, INSERM, 37032 Tours, France
| | - Servane Barrault
- Qualipsy, EE 1901, Université de Tours, 37041 Tours, France; (S.E.A.); (C.R.); (S.B.)
- CHRU de Tours, Service d’Addictologie Universitaire, Centre de Soins d’Accompagnement et de Prévention en Addictologie d’Indre-et-Loire (CSAPA-37), 37000 Tours, France
| | - Paul Brunault
- Qualipsy, EE 1901, Université de Tours, 37041 Tours, France; (S.E.A.); (C.R.); (S.B.)
- CHRU de Tours, Service d’Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, 37044 Tours, France;
- UMR 1253, iBrain, Université de Tours, INSERM, 37032 Tours, France
- Correspondence: ; Tel.: +33-2-18-37-05-81
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Pérez-Lalama K, Urrutia M, Mancheno-Durán S, Balseca-Bolaños D, Gamboa-Proaño M. [A quasi-experimental study on the decisions, behavioral regulation, and metacognition of Ecuadorian men]. Medwave 2020; 20:e7855. [PMID: 32343681 DOI: 10.5867/medwave.2020.03.7855] [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: 10/19/2019] [Accepted: 02/18/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction Decision-making is one of the most critical components of people's lives. It involves cognitive factors, which are responsible for processing the stimuli present in the task, remembering past experiences, and assessing the possible consequences that emotional decisions can have. So far, there are no studies of this nature in Ecuador, so this research seeks to establish the characteristics of the Ecuadorian population. With the results obtained, we expect to gain insight into the way this population handles decisions in daily life. Objective To relate decision-making to behavioral regulation and metacognition in a sample of Ecuadorian men. Methods We used a quasi-experimental design. We recruited 33 male subjects from the general population. We evaluated decision-making through the experimental Iowa Gambling Task. Behavior regulation and metacognition were assessed with the Executive Func-tion Behavior Classification (adult version). Results The main result was that, in the index of behavior regulation, decision-making is related to change and emotional control. In the metacognition index, it is related to working memory, task organization, and planning and organization. We found that the partic-ipants tend to make risky decisions at the beginning of the task, but as it progresses, participants make less risky decisions. Conclusions The implicit learning of the test operation allows the participants to assign emotional values to the results obtained when choos-ing a particular deck that takes into account past experiences, thus making it possible to anticipate consequences. The results are novel in that the relationship between an experimental behavior pattern linked to risky and non-risky decisions and its association with different executive functions is analyzed through the application of a questionnaire.
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Affiliation(s)
- Karla Pérez-Lalama
- Programa de doctorado en Psicología de la Facultad de Ciencias Sociales, Departamento de Psicología, Universidad de Concepción, Concepción, Chile. ORCID: 0000-0002-1536-6350
| | - Mabel Urrutia
- Facultad de Educación, Universidad de Concepción, Concepción, Chile. . ORCID: 0000-0002-8475-1383
| | - Silvia Mancheno-Durán
- Facultad de Ciencias Psicológicas, Universidad Central del Ecuador, Quito, Ecuador. ORCID: 0000-0002-3843-4619
| | - David Balseca-Bolaños
- Facultad de Ciencias Psicológicas, Universidad Central del Ecuador, Quito, Ecuador. ORCID: 0000-0002-1608-6270
| | - Marco Gamboa-Proaño
- Facultad de Ciencias Psicológicas, Universidad Central del Ecuador, Quito, Ecuador. ORCID: 0000-0002-3971-5156
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Leslie M, Leppanen J, Paloyelis Y, Nazar BP, Treasure J. The influence of oxytocin on risk-taking in the balloon analogue risk task among women with bulimia nervosa and binge eating disorder. J Neuroendocrinol 2019; 31:e12771. [PMID: 31283053 DOI: 10.1111/jne.12771] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/09/2019] [Accepted: 07/03/2019] [Indexed: 12/12/2022]
Abstract
Previous theoretical models of bulimia nervosa (BN) and binge eating disorder (BED) have implicated cross-domain risk-taking behaviour as a significant maintenance factor in both disorders. The present study aimed to test this hypothesis by administering the Balloon Analogue Risk Task (BART) to 25 women with BN or BED and 27 healthy comparison women without a history of an eating disorder. Furthermore, we tested the effect of a divided dose of 64 IU of oxytocin on risk-taking behaviour in the BART. Contrary to our hypothesis, women with BN or BED did not exhibit baseline differences in performance on the BART in the placebo condition (t = 1.42, df = 50, P = 0.161, d = 0.39). Oxytocin did not have a main effect on performance in the BART (F = 0.01, df = 1, P = .907, η2partial < 0.001); however, there was an interaction, such that participants in the BN/BED participant group, compared to the healthy comparison group, demonstrated safer behaviour on the BART in the oxytocin condition, but not in the placebo condition (F = 4.29, df = 1, P = 0.044, η2partial = 0.082). These findings cast doubt on the common assumption that individuals with BN and BED exhibit greater risk-taking behaviour in all domains and add to the evidence that oxytocin plays a functional role in modulating behaviours that entail trade-offs between reward approach and risk in humans. We recommend that future dose-response studies investigate the effect of oxytocin on reward approach behaviour further in women with recurrent binge eating behaviour, as well as the clinical significance of this effect.
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Affiliation(s)
- Monica Leslie
- King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
| | - Jenni Leppanen
- King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
| | - Yannis Paloyelis
- King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
| | - Bruno Palazzo Nazar
- King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Janet Treasure
- King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK
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