Neuropsychological weaknesses in anorexia nervosa: Set-shifting, central coherence, and decision making in currently ill and recovered women

BackgroundMental capacity to consent to treatment in anorexia nervosa is a neglected area in clinical decision-making.AimsTo examine clinical and neuropsychological parameters associated with diminished mental capacity in anorexia nervosa.MethodAn explorative study was conducted in 70 adult female patients with severe anorexia nervosa. Mental capacity to consent to treatment was assessed by experienced psychiatrists. Further measurements included the MacCAT-T (to assess mental capacity status), a range of clinical measures (body mass index (BMI) and comorbidity) and neuropsychological tests assessing decision-making, central coherence and set-shifting capacity.ResultsDiminished mental capacity occurs in a third of patients with severe anorexia nervosa and is associated with a low BMI, less appreciation of illness and treatment, previous treatment for anorexia nervosa, low social functioning and poor set shifting.ConclusionsAssessment of diminished mental capacity in anorexia nervosa requires careful evaluation of not only BMI, but also the degree of appreciation of illness and treatment, history and the tendency to have a rigid thinking style.

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Differences in set-shifting and central coherence across anorexia nervosa subtypes in children and adolescents

European Eating Disorders Review ◽

10.1002/erv.2605 ◽

2018 ◽

Vol 26 (5) ◽

pp. 499-507 ◽

Cited By ~ 5

Author(s):

Laura Herbrich ◽

Viola Kappel ◽

Betteke Maria van Noort ◽

Sibylle Winter

Keyword(s):

Anorexia Nervosa ◽

Children And Adolescents ◽

Central Coherence ◽

Set Shifting

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Contribution of executive functions to eating behaviours in obesity and eating disorders

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465820000260 ◽

2020 ◽

Vol 48 (6) ◽

pp. 725-733 ◽

Cited By ~ 2

Author(s):

Mara Segura-Serralta ◽

Sonia Ciscar ◽

Lorena Blasco ◽

Javier Oltra-Cucarella ◽

María Roncero ◽

...

Keyword(s):

Decision Making ◽

Eating Disorders ◽

Executive Functions ◽

Iowa Gambling Task ◽

Clinical Symptoms ◽

Wisconsin Card Sorting Test ◽

Central Coherence ◽

Healthy Controls ◽

Set Shifting ◽

Eating Behaviours

AbstractBackground:Patients with eating disorders (ED) or obesity show difficulties in tasks assessing decision-making, set-shifting abilities and central coherence.Aims:The aim of this study was to explore executive functions in eating and weight-related problems, ranging from restricting types of ED to obesity.Method:Two hundred and eighty-eight female participants (75 with obesity; 149 with ED: 76 with restrictive eating, 73 with bingeing-purging symptoms; and 64 healthy controls) were administered the Wisconsin Card Sorting Test, the Iowa Gambling Task, and the Group Embedded Figures Test to assess set-shifting, decision-making and central coherence, respectively.Results:Participants with either obesity or ED performed poorly on tests measuring executive functioning compared with healthy controls, even after controlling for age and intelligence. Both participants with obesity and participants with ED showed a preference for global information processing.Conclusions:The findings suggest that treatments for obesity and ED would benefit from addressing difficulties in cognitive functioning, in addition to the more evident clinical symptoms related to eating, body weight and shape.

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