Impaired decision-making in symptomatic anorexia and bulimia nervosa patients: a meta-analysis

2015 ◽  
Vol 45 (16) ◽  
pp. 3377-3391 ◽  
Author(s):  
S. Guillaume ◽  
P. Gorwood ◽  
F. Jollant ◽  
F. Van den Eynde ◽  
P. Courtet ◽  
...  
Keyword(s):  
Decision Making ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Acute Phase ◽  
Selection Criteria ◽  
Iowa Gambling Task ◽  
Meta Analysis ◽  
Healthy Controls ◽  
Negative Effect

Background.Impaired decision-making is a potential neurocognitive phenotype of eating disorders. It is therefore important to disentangle the decision-making deficits associated with the eating disorder subtypes and determine whether this putative impairment is a state or trait marker of the disease or more related to starvation. We systematically reviewed the literature on decision-making in eating disorders and conducted a meta-analysis to explore its role in anorexia nervosa (AN), bulimia nervosa (BN) and binge-eating disorder (BED).Method.A search of the Medline and EMBASE databases and article references was performed. A total of 23 studies (2044 participants) met the selection criteria. When the Iowa gambling task (IGT) was used in at least three of the studies, a meta-analysis was run.Results.IGT performance was significantly worse in patients with an eating disorder diagnosis (AN, BN or BED) compared with healthy controls, indicating that eating disorders have a negative effect on decision-making. Hedges’ g effect sizes were moderate to large (−0.72 in AN, −0.62 in BN, and −1.26 in BED). Recovered AN patients had IGT scores similar to those of healthy controls. Restrictive AN patients had significantly lower IGT net scores than purging AN patients, and both AN subtypes had worse performances than healthy controls. Age and body mass index did not explain results.Conclusions.Decision-making was significantly altered in patients with eating disorders. Poor decision-making was more pronounced during the acute phase than in the recovered state of AN. Nutritional status during the acute phase of the disease did not seem to influence decision-making skills.

The links between body dysmorphic disorder and eating disorders

2000 ◽  
Vol 15 (5) ◽  
pp. 302-305 ◽  
Author(s):  
J. Rabe-Jablonska Jolanta ◽  
M. Sobow Tomasz
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Mental Disorders ◽  
Bulimia Nervosa ◽  
Life Events ◽  
Affective Disorders ◽  
Body Dysmorphic Disorder ◽  
Control Group ◽  
Healthy Controls

SummaryThe aim of the study was to search for a body dysmorphic disorder (BDD) period preceding the symptoms meeting the criteria of either anorexia or bulimia nervosa, and an evaluation of the prevalence of BDD symptoms in a control group of girls without any eating disorder. Ninety-three girls (12–21 years old) were included in the study (36 with anorexia nervosa, 17 with bulimia nervosa and 40 healthy controls). The Structured Clinical Interview (SCID), including the BDD module, and a novel questionnaire (for the presence of preceding life events) were used. We found the symptoms of BDD in 25% of anorexia nervosa sufferers for at least six months before observing a clear eating disorder picture. Moreover, other mental disorders were also present among these patients. The results may support the idea that BDD and anorexia nervosa both belong to either OCD or affective disorders spectra.

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

2020 ◽  
Vol 48 (6) ◽  
pp. 725-733 ◽  
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.

scholarly journals Decision-making in obesity without eating disorders: a systematic review and meta-analysis of Iowa gambling task performances

2017 ◽  
Vol 18 (8) ◽  
pp. 936-942 ◽  
Author(s):  
J.-Y. Rotge ◽  
C. Poitou ◽  
P. Fossati ◽  
J. Aron-Wisnewsky ◽  
J.-M. Oppert
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Eating Disorders ◽  
Iowa Gambling Task ◽  
Meta Analysis ◽  
Gambling Task

scholarly journals Obsessive-Compulsive Disorder and Decision Making under Ambiguity: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 11 (2) ◽  
pp. 143
Author(s):  
Veronica Nisticò ◽  
Andrea De Angelis ◽  
Roberto Erro ◽  
Benedetta Demartini ◽  
Lucia Ricciardi
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Obsessive Compulsive Disorder ◽  
Clinical Manifestation ◽  
Iowa Gambling Task ◽  
Meta Analysis ◽  
Healthy Controls ◽  
Gambling Task ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

In the last decade, decision-making has been proposed to have a central role in obsessive-compulsive disorder (OCD) aetiology, since patients show pathological doubt and an apparent inability to make decisions. Here, we aimed to comprehensively review decision making under ambiguity, as measured by the Iowa Gambling Task (IGT), in OCD, using a meta-analytic approach. According to PRISMA Guidelines, we selected 26 studies for a systematic review and, amongst them, 16 studies were included in a meta-analysis, comprising a total of 846 OCD patients and 763 healthy controls (HC). Our results show that OCD patients perform significantly lower than HC at the IGT, pointing towards the direction of a decision making impairment. In particular, this deficit seems to emerge mainly in the last three blocks of the IGT. IGT scores in OCD patients under the age of 18 were still significantly lower than in HC. Finally, no difference emerged between medicated and unmedicated patients, since they both scored significantly lower at the IGT compared to HC. In conclusion, our results are in line with the hypothesis according to which decision making impairment might represent a potential endophenotype lying between the clinical manifestation of OCD and its neurobiological aetiology.

scholarly journals Neuropsychological Learning Deficits as Predictors of Treatment Outcome in Patients with Eating Disorders

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2145
Author(s):  
Ignacio Lucas ◽  
Romina Miranda-Olivos ◽  
Giulia Testa ◽  
Roser Granero ◽  
Isabel Sánchez ◽  
...  
Keyword(s):  
Decision Making ◽  
Eating Disorders ◽  
Treatment Outcome ◽  
Iowa Gambling Task ◽  
Control Sample ◽  
Learning Performance ◽  
Healthy Controls ◽  
Gambling Task ◽  
Learning Deficits ◽  
Starting Point

Eating disorders (EDs) are severe psychiatric illnesses that require individualized treatments. Decision-making deficits have been associated with EDs. Decision-making learning deficits denote a lack of strategies to elaborate better decisions that can have an impact on recovery and response to treatment. This study used the Iowa Gambling Task (IGT) to investigate learning differences related to treatment outcome in EDs, comparing between patients with a good and bad treatment outcome and healthy controls. Likewise, the predictive role of impaired learning performance on therapy outcome was explored. Four hundred twenty-four participants (233 ED patients and 191 healthy controls) participated in this study. Decision making was assessed using the Iowa Gambling Task before any psychological treatment. All patients received psychological therapy, and treatment outcome was evaluated at discharge. Patients with bad outcome did not show progression in the decision-making task as opposed to those with good outcome and the healthy control sample. Additionally, learning performance in the decision-making task was predictive of their future outcome. The severity of learning deficits in decision making may serve as a predictor of the treatment. These results may provide a starting point of how decision-making learning deficits are operating as dispositional and motivational factors on responsiveness to treatment in EDs.

Differences in Reward and Persistency characterise Behavior in Chronic Pain for the Iowa Gambling Task in a Web-based Lab-in-the-field study (Preprint)

2020 ◽  
Author(s):  
Lili Zhang ◽  
Himanshu Vashisht ◽  
Alekhya Nethra ◽  
Brian Slattery ◽  
Tomas Ward
Keyword(s):  
Decision Making ◽  
Social Media ◽  
Chronic Pain ◽  
Iowa Gambling Task ◽  
Learning Curves ◽  
Self Report ◽  
Healthy Controls ◽  
Gambling Task ◽  
Convenience Sample ◽  
Pain Experiences

BACKGROUND Chronic pain is a significant world-wide health problem. It has been reported that people with chronic pain experience decision-making impairments, but these findings have been based on conventional lab experiments to date. In such experiments researchers have extensive control of conditions and can more precisely eliminate potential confounds. In contrast, there is much less known regarding how chronic pain impacts decision-making captured via lab-in-the-field experiments. Although such settings can introduce more experimental uncertainty, it is believed that collecting data in more ecologically valid contexts can better characterize the real-world impact of chronic pain. OBJECTIVE We aim to quantify decision-making differences between chronic pain individuals and healthy controls in a lab-in-the-field environment through taking advantage of internet technologies and social media. METHODS A cross-sectional design with independent groups was employed. A convenience sample of 45 participants were recruited through social media - 20 participants who self-reported living with chronic pain, and 25 people with no pain or who were living with pain for less than 6 months acting as controls. All participants completed a self-report questionnaire assessing their pain experiences and a neuropsychological task measuring their decision-making, i.e. the Iowa Gambling Task (IGT) in their web browser at a time and location of their choice without supervision. RESULTS Standard behavioral analysis revealed no differences in learning strategies between the two groups although qualitative differences could be observed in learning curves. However, computational modelling revealed that individuals with chronic pain were quicker to update their behavior relative to healthy controls, which reflected their increased learning rate (95% HDI from 0.66 to 0.99) when fitted with the VPP model. This result was further validated and extended on the ORL model because higher differences (95% HDI from 0.16 to 0.47) between the reward and punishment learning rates were observed when fitted on this model, indicating that chronic pain individuals were more sensitive to rewards. It was also found that they were less persistent in their choices during the IGT compared to controls, a fact reflected by their decreased outcome perseverance (95% HDI from -4.38 to -0.21) when fitted using the ORL model. Moreover, correlation analysis revealed that the estimated parameters had predictive value for the self-reported pain experiences, suggesting that the altered cognitive parameters could be potential candidates for inclusion in chronic pain assessments. CONCLUSIONS We found that individuals with chronic pain were more driven by rewards and less consistent when making decisions in our lab-in-the-field experiment. In this case study, it was demonstrated that compared to standard statistical summaries of behavioral performance, computational approaches offered superior ability to resolve, understand and explain the differences in decision- making behavior in the context of chronic pain outside the lab.

Pharmacotherapy for Eating Disorders

2017 ◽  
Author(s):  
Susan McElroy ◽  
Anna I. Guerdjikova ◽  
Nicole Mori ◽  
Paul E. Keck
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Mental Disorders ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Night Eating Syndrome ◽  
Night Eating

This chapter addresses the pharmacotherapy of the eating disorders (EDs). Many persons with EDs receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. This chapter first provides a brief rationale for using medications in the treatment of EDs. It then reviews the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES). It concludes by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.

Epidemiology and Course of Eating Disorders

2010 ◽  
pp. 24-32 ◽  
Author(s):  
Pamela Keel
Keyword(s):  
Public Health ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
The Public ◽  
Purging Disorder ◽  
Not Otherwise Specified ◽  
Public Health Significance ◽  
Health Significance

The epidemiology of eating disorders holds important clues for understanding factors that may contribute to their etiology. In addition, epidemiological findings speak to the public health significance of these deleterious syndromes. Information on course and outcome are important for clinicians to understand the prognosis associated with different disorders of eating and for treatment planning. This chapter reviews information on the epidemiology and course of anorexia nervosa, bulimia nervosa, and two forms of eating disorder not otherwise specified, binge eating disorder and purging disorder.

Pharmacotherapy of the Eating Disorders

2010 ◽  
pp. 416-451 ◽  
Author(s):  
Susan L. McElroy ◽  
Anna I. Guerdjikova ◽  
Anne M. O’Melia ◽  
Nicole Mori ◽  
Paul E. Keck
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Mental Disorders ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Night Eating Syndrome ◽  
Night Eating

Many persons with eating disorders (EDs) receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. In this chapter, we first provide a brief rationale for using medications in the treatment of EDs. We then review the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa, binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES) and sleep-related eating disorder (SRED). We conclude by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.

Sign in / Sign up

Export Citation Format

Share Document