Set-shifting abilities, central coherence, and handedness in anorexia nervosa patients, their unaffected siblings and healthy controls: Exploring putative endophenotypes

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.

Download Full-text

Worry and Rumination in Anorexia Nervosa

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465812000847 ◽

2012 ◽

Vol 41 (3) ◽

pp. 301-316 ◽

Cited By ~ 45

Author(s):

Helen Startup ◽

Anna Lavender ◽

Anna Oldershaw ◽

Richard Stott ◽

Kate Tchanturia ◽

...

Keyword(s):

Anorexia Nervosa ◽

Eating Disorder ◽

Anxiety Disorder ◽

Anxiety And Depression ◽

Healthy Controls ◽

Regression Analyses ◽

Set Shifting ◽

Neuropsychological Measures ◽

Comparison Groups ◽

Core Features

Background: Difficulties with comprehending and managing emotions are core features of the pathology of anorexia nervosa (AN). Advancements in understanding aetiology and treatment have been made within other clinical domains by targeting worry and rumination. However, worry and rumination have been given minimal consideration in AN. Aims: This study is the largest to date of worry and rumination in AN. Method: Sixty-two outpatients with a diagnosis of AN took part. Measures of worry, rumination, core AN pathology and neuropsychological correlates were administered. Results: Findings suggest that worry and rumination are elevated in AN patients compared with both healthy controls and anxiety disorder comparison groups. Regression analyses indicated that worry and rumination were significant predictors of eating disorder symptomatology, over and above the effects of anxiety and depression. Worry and rumination were not associated with neuropsychological measures of set-shifting and focus on detail. Conclusions: The data suggest that worry and rumination are major concerns for this group and warrant further study.

Download Full-text

Are There Differences in Central Coherence and Set Shifting Across the Subtypes of Anorexia Nervosa?

The Journal of Nervous and Mental Disease ◽

10.1097/nmd.0000000000000366 ◽

2015 ◽

Vol 203 (10) ◽

pp. 774-780 ◽

Cited By ~ 5

Author(s):

Sara Van Autreve ◽

Myriam Vervaet

Keyword(s):

Anorexia Nervosa ◽

Central Coherence ◽

Set Shifting

Download Full-text

Measuring central coherence and set shifting in anorexia nervosa: the Navon Figures Task

Journal of Eating Disorders ◽

10.1186/2050-2974-2-s1-o45 ◽

2014 ◽

Vol 2 (S1) ◽

Cited By ~ 1

Author(s):

Jenna Blumberg ◽

Karina Allen ◽

Sue Byrne

Keyword(s):

Anorexia Nervosa ◽

Central Coherence ◽

Set Shifting

Download Full-text

Central coherence and set‐shifting between nonunderweight eating disorders and anorexia nervosa: A systematic review and meta‐analysis

International Journal of Eating Disorders ◽

10.1002/eat.23430 ◽

2020 ◽

Author(s):

Ella Keegan ◽

Kate Tchanturia ◽

Tracey D. Wade

Keyword(s):

Systematic Review ◽

Eating Disorders ◽

Anorexia Nervosa ◽

Meta Analysis ◽

Central Coherence ◽

Set Shifting

Download Full-text

Are poor set-shifting and central coherence associated with everyday function in anorexia nervosa? A systematic review

Journal of Eating Disorders ◽

10.1186/s40337-021-00392-x ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Kelly M. Dann ◽

Phillipa Hay ◽

Stephen Touyz

Keyword(s):

Anorexia Nervosa ◽

Functional Outcome ◽

Clinical Symptoms ◽

Neuropsychological Test ◽

Behavioral Flexibility ◽

Central Coherence ◽

Future Research ◽

Set Shifting ◽

Age Cohorts ◽

Everyday Function

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.

Download Full-text