Cognitive remediation, brain function and central coherence: an anorexia nervosa pilot study

IntroductionNeuropsychological impairments in anorexia nervosa (AN) have been considered both as putative risk factors and as a target for treatment. However, the role of neuropsychological variables as predictors of outcome is not clear.AimsOur aim is to investigate the role of neuropsychological variables as predictors of response to treatment in a group of individuals affected by AN.MethodsThe study sample consisted of 144 patients diagnosed with acute AN, according to the DSM-5 criteria, referred to the Eating Unit of the Hospital of Padova, Italy. All participants were assessed by means of a neuropsychological and clinical test battery at intake and followed during outpatient treatment for an average of 531 days. Eighty-three percent of the patients underwent cognitive behavioral therapy, the families of 75% of the patients were included in the treatment and 48% of the patients took antidepressants (SSRI).ResultsBoth body mass index at assessment and illness duration appeared to be independent factors significantly affecting the outcome. The role of neuropsychological variables was explored including cognitive performance in a multivariate analysis including BMI at intake, duration of illness and diagnostic subtype. The inclusion in the model of the Wisconsin Sorting Card Task performance and the central coherence index (calculated by the Rey Figure Test) significantly increased the prediction ability of the model for full remission at the end of treatment.ConclusionsThis is the first study to show that neuropsychological characteristics may predict treatment response in AN. These data support the implementation of cognitive remediation techniques in the treatment of AN.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Follow-up Assessment of Cognitive Remediation Therapy in Adolescent Anorexia Nervosa: A Pilot Study

European Eating Disorders Review ◽

10.1002/erv.2501 ◽

2017 ◽

Vol 25 (2) ◽

pp. 104-113 ◽

Cited By ~ 4

Author(s):

Laura Herbrich ◽

Betteke van Noort ◽

Ernst Pfeiffer ◽

Ulrike Lehmkuhl ◽

Sibylle Winter ◽

...

Keyword(s):

Anorexia Nervosa ◽

Pilot Study ◽

Cognitive Remediation ◽

Cognitive Remediation Therapy ◽

Adolescent Anorexia Nervosa

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Evaluation of a Cognitive Remediation Therapy Group for Adolescents with Anorexia Nervosa: Pilot Study

European Eating Disorders Review ◽

10.1002/erv.2176 ◽

2012 ◽

Vol 20 (4) ◽

pp. 321-325 ◽

Cited By ~ 44

Author(s):

Natalie Pretorius ◽

Mandy Dimmer ◽

Eoin Power ◽

Ivan Eisler ◽

Mima Simic ◽

...

Keyword(s):

Anorexia Nervosa ◽

Pilot Study ◽

Therapy Group ◽

Cognitive Remediation ◽

Cognitive Remediation Therapy

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Cognitive Remediation Therapy as a Feasible Treatment for a Young Person With Anorexia Nervosa and Autism Spectrum Disorder Comorbidity: A Case Study

Clinical Case Studies ◽

10.1177/1534650119890425 ◽

2019 ◽

Vol 19 (2) ◽

pp. 115-132 ◽

Cited By ~ 2

Author(s):

Yasemin Dandil ◽

Claire Baillie ◽

Kate Tchanturia

Keyword(s):

Autism Spectrum Disorder ◽

Anorexia Nervosa ◽

Cognitive Remediation ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Self Report ◽

Complex Case ◽

Central Coherence ◽

Cognitive Remediation Therapy

Anorexia nervosa (AN) is a challenging illness to treat with inefficiencies in central coherence and set-shifting known to be cognitive maintaining factors for the eating disorder. AN is further complicated by comorbidities such as autism spectrum disorder (ASD). Cognitive remediation therapy (CRT) aims to address problems with cognitive style and meta-cognition by stimulating the neural connections involved in cognitive processing through cognitive tasks, reflection, and behavioral experiments. However, to date, no reported studies are supporting individual CRT for patients with AN and ASD comorbidity. This single complex case study provides preliminary evidence to support the efficacy of individual CRT in the treatment of a 21-year-old female patient with AN and ASD comorbidity. Clinical and self-report data collected before and after CRT indicate improvements in cognitive flexibility and central coherence, alongside an increase in body mass index (BMI). This case study reflects the possible ways to adapt and calibrate treatment to individual needs and the efficacy of CRT, before proceeding to more complex individual psychological work, such as cognitive behavioral therapy.

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