1
|
Tenconi E, Meregalli V, Buffa A, Collantoni E, Cavallaro R, Meneguzzo P, Favaro A. Belief Inflexibility and Cognitive Biases in Anorexia Nervosa-The Role of the Bias against Disconfirmatory Evidence and Its Clinical and Neuropsychological Correlates. J Clin Med 2023; 12:jcm12051746. [PMID: 36902532 PMCID: PMC10003469 DOI: 10.3390/jcm12051746] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
The aim of this study was to explore, in a sample of patients with a diagnosis of AN, the ability to question their first impression and, in particular, the willingness to integrate their prior ideas and thoughts with additional progressive incoming information. A total of 45 healthy women and 103 patients with a diagnosis of AN, consecutively admitted to the Eating Disorder Padova Hospital-University Unit, underwent a broad clinical and neuropsychological assessment. All participants were administered the Bias Against Disconfirmatory Evidence (BADE) task, which specifically investigates belief integration cognitive bias. Acute AN patients showed a significantly greater bias toward disconfirming their previous judgment, in comparison to healthy women (BADE score, respectively, 2.5 ± 2.0 vs. 3.3 ± 1.6; Mann-Whitney test, p = 0.012). A binge-eating/purging subtype of AN individuals, compared to restrictive AN patients and controls, showed greater disconfirmatory bias and also a significant propensity to uncritically accept implausible interpretations (BADE score, respectively, 1.55 ± 1.6 and 2.70 ± 1.97 vs. 3.33 ± 1.63; Kruskal-Wallis test, p = 0.002 and liberal acceptance score, respectively, 1.32 ± 0.93 and 0.92 ± 1.21 vs. 0.98 ± 0.75; Kruskal-Wallis test p = 0.03). Abstract thinking skills and cognitive flexibility, as well as high central coherence, are neuropsychological aspects positively correlated with cognitive bias, in both patients and controls. Research into belief integration bias in AN population could enable us to shed light on hidden dimensional aspects, facilitating a better understanding of the psychopathology of a disorder that is so complex and difficult to treat.
Collapse
Affiliation(s)
- Elena Tenconi
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
- Correspondence: ; Tel.: +39-0498217771
| | - Valentina Meregalli
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
| | - Adriana Buffa
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Enrico Collantoni
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Roberto Cavallaro
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
- IRCCS San Raffaele Turro, Scientific Institute Hospital, 20127 Milan, Italy
| | - Paolo Meneguzzo
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
| |
Collapse
|
2
|
Abber SR, Forman EM, Wierenga CE, Manasse SM. Intact general and food-specific task-switching abilities in bulimia-spectrum eating disorders. Eat Behav 2022; 46:101636. [PMID: 35753287 DOI: 10.1016/j.eatbeh.2022.101636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 05/24/2022] [Accepted: 05/31/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Prior work evaluating cognitive flexibility (i.e., the ability to alter behavior in response to environmental changes) in bulimia-spectrum eating disorders (BN-ED) has produced mixed findings, perhaps due to reliance on set-shifting paradigms that do not effectively isolate cognitive flexibility. Task-switching paradigms are more precise, but no study has examined task-switching in BN-ED. Further, no study has examined whether cognitive flexibility deficits in BN-ED are disorder-specific (e.g., confined to food-related responses). Thus, the present study re-evaluated cognitive flexibility in BN-ED using general and food-specific task-switching paradigms. METHOD Individuals with BN-ED (n = 28) and healthy controls (HC; n = 39) completed a cued color-shape switching task (CCSST) and a novel food-specific variation (FCCSST). We compared BN-ED and HC on switch costs (reflective of transient task-switching) and mix costs (reflective of maintenance of switching behavior). RESULTS Switch and mix costs were not significantly different between BN-ED and HC in terms of either accuracy or reaction time on the CCSST or FCCSST. CONCLUSIONS Findings suggest neither general nor food-specific cognitive flexibility is impaired in BN-ED. Rigidity in BN-ED (e.g., continued engagement in compensatory behaviors despite psychoeducation that these behaviors are ineffective for weight loss) may be a result of other neurocognitive impairments rather than cognitive flexibility deficits.
Collapse
Affiliation(s)
- Sophie R Abber
- Department of Psychology, Drexel University, Philadelphia, PA, USA; WELL Center, Drexel University, Philadelphia, PA, USA.
| | - Evan M Forman
- Department of Psychology, Drexel University, Philadelphia, PA, USA; WELL Center, Drexel University, Philadelphia, PA, USA
| | - Christina E Wierenga
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | | |
Collapse
|
3
|
Bischoff-Grethe A, Wierenga CE, Bailer UF, McClure SM, Kaye WH. Satiety does not alter the ventral striatum's response to immediate reward in bulimia nervosa. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:862-874. [PMID: 34843290 DOI: 10.1037/abn0000712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Individuals with bulimia nervosa (BN) cycle between periods of binge-eating and compensatory behavior and periods of dietary restraint, suggesting extremes of under and overcontrol that may be metabolic-state related. This study examined the influence of hunger and satiety on impulsivity and neural responding during decision-making. Twenty-three women remitted from BN (RBN) and 20 healthy comparison women (CW) performed a delay discounting task after a 16-hr fast and following a standardized meal during functional neuroimaging. A dual-systems approach examined reward valuation (decision trials where the early reward option was available immediately) and cognitive control (all decision trials). Interactions of Group × Visit (Hungry, Fed) for immediate reward revealed that CW had greater activation when hungry versus fed in the ventral striatum and dorsal caudate, whereas RBN had greater response when fed versus hungry in the dorsal caudate. Compared to CW, RBN showed decreased response when hungry within the left dorsal caudate and ventral striatum and increased response when fed in bilateral dorsal caudate. No differences were found within cognitive control regions or with choice behavior. Reward sensitivity is normally increased when hungry and decreased when fed; our findings in CW provide further support of hunger-based reward sensitivity within the striatum. However, RBN showed no differences for hunger and satiety in the ventral striatum and greater activation in the dorsal caudate when fed compared to hungry. This suggests RBN may be less sensitive to reward when hungry but do not devalue reward when satiated, indicating altered metabolic modulation of self-regulatory control. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | - Ursula F Bailer
- Department of Psychiatry, University of California, San Diego
| | | | - Walter H Kaye
- Department of Psychiatry, University of California, San Diego
| |
Collapse
|
4
|
Brassard SL, Balodis IM. A review of effort-based decision-making in eating and weight disorders. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110333. [PMID: 33905755 DOI: 10.1016/j.pnpbp.2021.110333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/19/2021] [Accepted: 04/21/2021] [Indexed: 12/26/2022]
Abstract
Effort-based decision-making provides a framework to understand the mental computations estimating the amount of work ("effort") required to obtain a reward. The aim of the current review is to systematically synthesize the available literature on effort-based decision-making across the spectrum of eating and weight disorders. More specifically, the current review summarises the literature examining whether 1) individuals with eating disorders and overweight/obesity are willing to expend more effort for rewards compared to healthy controls, 2) if particular components of effort-based decision-making (i.e. risk, discounting) relate to specific binge eating conditions, and 3) how individual differences in effort and reward -processing measures relate to eating pathology and treatment measures. A total of 96 studies were included in our review, following PRISMA guidelines. The review suggests that individuals with binge eating behaviours 1) are more likely to expend greater effort for food rewards, but not monetary rewards, 2) demonstrate greater decision-making impairments under risk and uncertainty, 3) prefer sooner rather than delayed rewards for both food and money, and 4) demonstrate increased implicit 'wanting' for high fat sweet foods. Finally, individual differences in effort and reward -processing measures relating to eating pathology and treatment measures are also discussed.
Collapse
Affiliation(s)
- Sarah L Brassard
- Department of Neuroscience, McMaster University, Canada; Peter Boris Center for Addictions Research, St. Joseph's Healthcare Hamilton, Canada
| | - Iris M Balodis
- Department of Neuroscience, McMaster University, Canada; Peter Boris Center for Addictions Research, St. Joseph's Healthcare Hamilton, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, Canada.
| |
Collapse
|
5
|
Tenconi E, Collantoni E, Meregalli V, Bonello E, Zanetti T, Veronese A, Meneguzzo P, Favaro A. Clinical and Cognitive Functioning Changes After Partial Hospitalization in Patients With Anorexia Nervosa. Front Psychiatry 2021; 12:653506. [PMID: 33959056 PMCID: PMC8093567 DOI: 10.3389/fpsyt.2021.653506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/19/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction: Anorexia nervosa is usually associated with emotional and cognitive difficulties. Little knowledge is available about the changes in cognitive functioning in patients undergoing treatments. The aim of the present study was to longitudinally assess the impact of partial hospitalization on clinical and cognitive functioning in anorexia nervosa. Materials and Methods: 56 women with anorexia nervosa according to DSM-5 criteria and 58 healthy women were enrolled in the study. At baseline, all participants underwent clinical, diagnostic and neuropsychological assessment (T0). Patients were also assessed at the end of the treatment program (T1; n = 56). Results: BMI improved significantly throughout treatment. At baseline, patients showed significantly poorer executive abilities and less specific autobiographical memory. After the day-hospital program, decision-making abilities improved significantly. Response to treatment was predicted by BMI at admission and duration of illness, but neuropsychological performance did not contribute to the prediction model. Discussion: Cognitive difficulties, mostly regarding executive functions, resulted differently affected by clinical improvement. In particular, while cognitive monitoring and cognitive inhibition appear to be mostly stable trait-like characteristics, decision-making is both more state-dependent and sensitive to clinical status. None of the cognitive variables added information about the response to day hospital treatment; patients with short duration of illness and a rapidly decreasing BMI would benefit more from intensive interventions than less "acute" patients. These observations, if confirmed by future studies, have important clinical implications in order to understand the impact of malnutrition on cognitive functioning and to provide individualized effective treatment for patients with anorexia nervosa.
Collapse
Affiliation(s)
- Elena Tenconi
- Department of Neuroscience, University of Padova, Padua, Italy
- Padova Neuroscience Center, University of Padova, Padua, Italy
| | | | - Valentina Meregalli
- Department of Neuroscience, University of Padova, Padua, Italy
- Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Elisa Bonello
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Tatiana Zanetti
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Angela Veronese
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, Padua, Italy
- Padova Neuroscience Center, University of Padova, Padua, Italy
| |
Collapse
|
6
|
Nobile B, Maimoun L, Jaussent ID, Seneque M, Dupuis-Maurin K, Lefebvre P, Courtet P, Renard E, Guillaume S. Effects of Hormonal Contraception Use on Cognitive Functions in Patients With Bulimia Nervosa. Front Psychiatry 2021; 12:658182. [PMID: 34079484 PMCID: PMC8165222 DOI: 10.3389/fpsyt.2021.658182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/06/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Growing evidences indicate that sex hormones have an effect on cognitive functions, and that Bulimia Nervosa (BN) is associated with cognitive impairment. The aim of this study was to determine the effect of hormonal contraception (HC) use on four cognitive functions that are impaired in patients with BN. Methods: This retrospective exploratory study included 103 women with a diagnosis of BN based on the DSM-5 criteria. Their age ranged from 15 to 45 years, and 46.6% were taking HC (oral, transdermal, or intrauterine). Cognition was assessed with the d2 test (attention), Iowa gambling task (IGT; decision making), Brixton spatial anticipation test (set shifting), and Rey-Osterrieth complex figure test (central coherence). Data were analyzed with logistic regression models to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) of HC effect on the neuropsychological test scores. Results: In the multivariate model, HC use was significantly associated with better scores for two d2 test indices: F-score [OR = 0.98, 95% CI = (0.95; 0.99)] and final total score ratio [OR = 0.87, 95% CI = (0.77; 0.99)]. HC was also associated with a better understanding of the IGT explicit rules. No difference between the two groups (HC and non-HC use) was detected for set shifting and central coherence. Conclusions: This exploratory study suggests that HC could have effects on the sustained attention and concentration in women with BN. More studies are needed to confirm these results.
Collapse
Affiliation(s)
- Benedicte Nobile
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Laurent Maimoun
- Department of Nuclear Medicine, CHRU Montpellier, Montpellier, France.,INSERM U1046, UMR9214 CNRS, Physiology and Experimental Medicine of the Heart and Muscles, University of Montpellier, CHRU Montpellier, Montpellier, France
| | | | - Maude Seneque
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France
| | - Kathlyne Dupuis-Maurin
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France
| | - Patrick Lefebvre
- Department of Endocrinology, Diabetes, and Nutrition, CHRU Montpellier, Montpellier, France
| | - Phillippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Eric Renard
- Department of Endocrinology, Diabetes, and Nutrition, CHRU Montpellier, Montpellier, France.,UMR CNRS 5203, INSERM U1191, Institute of Functional Genomics, University of Montpellier, Montpellier, France
| | - Sebastien Guillaume
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| |
Collapse
|
7
|
Ciszewski S, Flood KE, Proctor CJ, Best LA. Exploring the Relationship Between Disordered Eating and Executive Function in a Non-Clinical Sample. Percept Mot Skills 2020; 127:1033-1050. [DOI: 10.1177/0031512520937569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Previous research suggests that individuals diagnosed with eating disorders (ED) may experience executive functioning deficits that help maintain their ED. Although this relationship is reported consistently in clinical samples, it is important to consider whether it holds for individuals with sub-clinical ED symptoms. One hundred eighty-eight university students participated in the present study examining the relationship between executive function (EF) and disordered eating behaviors. Participants completed a demographics questionnaire, self-report questionnaires measuring atypical eating behaviors (EAT-26; EDI-3), and a self-report measure of EF (BRIEF-A). Correlational analyses demonstrated significant positive associations between ED behaviors and problems with emotional control, shifting, inhibition, and self-monitoring. Six hierarchical multiple regressions were conducted, using EF scores to predict scores on EAT-26 subscales (Dieting, Bulimia, Total ED Risk) and EDI-3 scales (Drive for Thinness, Bulimia, Risk Composite). In all regression analyses, BRIEF-A Emotional Control emerged as a significant predictor. As would be expected, EDI-3 Bulimia scores were also predicted by problems with inhibition. These results provide preliminary evidence of an association between non-clinical patterns of disordered eating and executive dysfunction, specifically including the ability to control one’s emotions, suggesting that emotional control problems may help predict ED risk. Future research could examine how these factors predict the development of eating disorders.
Collapse
Affiliation(s)
- Stefanie Ciszewski
- Department of Psychology, University of British Columbia, Okanagan Campus
| | | | | | - Lisa A. Best
- Department of Psychology, University of New Brunswick
| |
Collapse
|
8
|
Saure E, Laasonen M, Lepistö-Paisley T, Mikkola K, Ålgars M, Raevuori A. Characteristics of autism spectrum disorders are associated with longer duration of anorexia nervosa: A systematic review and meta-analysis. Int J Eat Disord 2020; 53:1056-1079. [PMID: 32181530 DOI: 10.1002/eat.23259] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Anorexia nervosa (AN) is associated with neuropsychological characteristics such as impairments in central coherence, cognitive flexibility, and emotion recognition. The same features also manifest in autism spectrum disorders (ASD) and have been suggested to be associated with illness prolongation in AN. The purpose of this meta-analysis was to examine whether pronounced neuropsychological characteristics related to ASD are associated with illness duration in AN. METHOD Four databases (Medline, PsycINFO, Scopus, PubMed) were searched for eligible studies. Search terms were (a) "anorexia nervosa" and (b) "cognitive flexibility" or "set-shifting" or "central coherence" or "emotion recognition" or "theory of mind". The final sample consisted of 53 studies. Duration of AN was divided into three categories in order to investigate differences between the groups with varying illness duration. The meta-analysis was performed with Review Manager using a random-effects model. RESULTS Deficits in central coherence, cognitive flexibility, and emotion recognition were pronounced among individuals with prolonged AN compared to those with shorter illness duration. DISCUSSION A prolonged course of AN appears to be associated with underlying neuropsychological characteristics that are also distinctive to ASD. Neuropsychological impairments may lead to prolonged AN, and prolonged illness may contribute to the subsequent "neurological scar effect," further strengthening these impairments.
Collapse
Affiliation(s)
- Emma Saure
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marja Laasonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland.,Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Katri Mikkola
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Monica Ålgars
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Åbo Akademi University, Department of Psychology, Åbo Akademi Fakulteten för humaniora psykologi och teologi, Turku, Finland
| | - Anu Raevuori
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland.,Department of Adolescent Psychiatry, Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
9
|
Abstract
Objectives: Binge-eating disorder (BED) has been associated with cognitive impairment, including on measures of impulsivity, but it is not clear in prior literature whether these deficits may have been associated with obesity, rather than BED per se. Impulsivity may play a role in predisposing people towards BED as well as in the chronicity of symptoms. The aim of this study was to examine cognitive functions between BED and healthy controls matched for age, gender, and body mass indices.Methods: Individuals with BED and healthy controls were recruited from the general community using media advertisements. After providing informed consent, study participants completed a clinical interview and computerised neuropsychological testing. Group differences were analysed.Results: Groups did not differ significantly on age, gender, education levels, or body mass indices. The BED group (N = 17) exhibited significantly impaired stop-signal response inhibition (Stop-Signal Task) and executive planning (Stockings of Cambridge Task) compared to healthy controls (N = 17). Spatial working memory and set-shifting were intact.Discussion: BED appears to be associated with motor disinhibition and impaired executive planning even controlling for obesity. Longitudinal work is needed to clarify whether motor impulsivity predisposes people to BED, and/or contributes to persistence of symptoms over time.Key pointsBinge-eating disorder is common, under-recognised, and associated with untoward physical and health sequelae.The neurobiological basis of binge-eating disorder is unclear; cognitive testing may offer insights.Many prior cognitive studies have not controlled for potential confounds, especially group differences in body mass indices (BMI). Obesity in itself has been linked with cognitive dysfunction.Here, we compared cognition between people with binge-eating disorder and controls, matched for BMI and other measures.Binge-eating disorder was associated with impaired response inhibition and executive planning.These results inform neurobiological models of binge-eating disorder and may suggest new treatment targets for this condition.
Collapse
Affiliation(s)
- Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridge and Peterborough NHS Foundation Trust, Fulbourn, UK
| |
Collapse
|
10
|
The implications of previous history of anorexia nervosa in patients with current bulimia nervosa: Alterations in daily functioning, decision‐making, and bone status. EUROPEAN EATING DISORDERS REVIEW 2019; 28:34-45. [DOI: 10.1002/erv.2712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 10/28/2019] [Accepted: 11/05/2019] [Indexed: 12/17/2022]
|
11
|
Dahlgren CL, Hage TW, Wonderlich JA, Stedal K. General and Eating Disorder Specific Flexibility: Development and Validation of the Eating Disorder Flexibility Index (EDFLIX) Questionnaire. Front Psychol 2019; 10:663. [PMID: 31024374 PMCID: PMC6454114 DOI: 10.3389/fpsyg.2019.00663] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/11/2019] [Indexed: 01/28/2023] Open
Abstract
Findings from studies investigating cognitive flexibility in eating disorders (EDs) are inconsistent, and although neuropsychological tests are commonly used to measure these skills, they may not be particularly effective in predicting everyday functioning. Also, extant studies have largely focused on flexibility in anorexia nervosa (AN), with assessments targeting general rather than specific flexibility, and cognitive, rather than behavioral flexibility. Knowledge regarding ED specific flexibility and flexibility in bulimia nervosa (BN) and binge eating disorder (BED) is still scarce. The aim of this study was to develop and validate a novel measure assessing general and ED specific flexibility in a diagnostically diverse sample, and in healthy controls (HCs). A sample of 207 adult individuals with EDs (55% AN, 29% BN, 16% BED) and 288 HCs responded to an online, 51-item, pilot questionnaire on ED specific and general flexibility. In addition, participants completed the shift subscale from the Behavior Rating Inventory of Executive Function Adult version (BRIEF-A), and the Eating Disorder Diagnostic Scale (EDDS). A principal component analysis (PCA) in the clinical sample yielded a 36-item, three-factor solution capturing general flexibility, flexibility related to food and exercise, and flexibility concerning body shape and weight. Results showed that the measure had good to excellent internal consistency, and good convergent validity. A confirmatory factor analysis (CFA) using data from HCs revealed good fit indexes, supporting the original factor solution. A receiver operating characteristics analysis (ROC) demonstrated excellent accuracy in distinguishing scores from those with and without EDs. A cutoff score of 136 yielded the most balanced sensitivity and specificity. Significant differences in general and ED specific flexibility were found between individuals with and without EDs. Overall, HCs achieved the highest flexibility scores, followed by those with BED, BN, and AN. In sum this novel measure, the Eating Disorder Flexibility Index (EDFLIX) questionnaire, was found to be reliable and valid in the assessment of cognitive and behavioral flexibility, with results offering support for the conceptual distinction between general and ED related flexibility. The study also provides strong evidence for the discriminant validity of the EDFLIX with results revealing significant differences in flexibility in people with and without EDs. In addition, significant differences in flexibility also emerged when comparing diagnostic groups, indicating the utility of the assessment instrument for classification purposes.
Collapse
Affiliation(s)
- Camilla Lindvall Dahlgren
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Trine Wiig Hage
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Kristin Stedal
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
12
|
Collantoni E, Solmi M, Gallicchio D, Santonastaso P, Meneguzzo P, Carvalho AF, Stubbs B, Clementi M, Pinato C, Forzan M, Cassina M, Fontana F, Piva I, Siani R, Salvo P, Tenconi E, Veronese N, Correll CU, Favaro A. Catechol-O-Methyltransferase (COMT) Val158Met Polymorphism and Eating Disorders: Data From a New Biobank and Meta-Analysis of Previously Published Studies. EUROPEAN EATING DISORDERS REVIEW 2018; 25:524-532. [PMID: 29057600 DOI: 10.1002/erv.2555] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 08/22/2017] [Accepted: 08/22/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVES We investigated whether catechol-O-methyltransferase (COMT) Val158Met polymorphism is associated with eating disorders (EDs). METHODS We conducted a systematic literature search of studies published until 15 January 2017 and added data from the Italian 'Biobanca Veneta per i Disturbi Alimentari' biobank, performing a meta-analysis comparing COMT Val158Met genotype and allele frequencies in EDs and anorexia nervosa (AN) or bulimia nervosa (BN) patients versus controls. RESULTS Ten studies plus Biobanca Veneta per i Disturbi Alimentari (ED: n = 920, controls: n = 261 controls) with 3541 ED patients (AN = 2388; BN = 233) and 3684 controls were included. There were no significant group differences in COMT Val158Met alleles and genotype frequencies between patients and controls, for all EDs pooled together [range of odds ratios (ORs): 0.96-1.04, p-values: 0.46-0.97, I2 = 0%] and when analysing separately patients with AN (ORs: 0.94-1.04, p-values: 0.31-0.61, I2 = 0%) or BN (ORs: 0.80-1.09, p-values: 0.28-0.64, I2 = 0-44%). CONCLUSIONS Meta-analysing data results from 11 studies and 7225 subjects show that COMT Val158Met polymorphism is not associated with EDs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
Collapse
Affiliation(s)
- Enrico Collantoni
- Neuroscience Department, University of Padua, Italy
- BIO.VEDA Group (Biobanca Veneta per i Disturbi dell'Alimentazione: Biobank of the Veneto Region Eating Disorders Units), Italy
| | - Marco Solmi
- Neuroscience Department, University of Padua, Italy
- BIO.VEDA Group (Biobanca Veneta per i Disturbi dell'Alimentazione: Biobank of the Veneto Region Eating Disorders Units), Italy
| | - Davide Gallicchio
- Neuroscience Department, University of Padua, Italy
- BIO.VEDA Group (Biobanca Veneta per i Disturbi dell'Alimentazione: Biobank of the Veneto Region Eating Disorders Units), Italy
| | - Paolo Santonastaso
- Neuroscience Department, University of Padua, Italy
- BIO.VEDA Group (Biobanca Veneta per i Disturbi dell'Alimentazione: Biobank of the Veneto Region Eating Disorders Units), Italy
- Centro Neuroscienze Cognitive (CNC), University of Padua, Italy
| | - Paolo Meneguzzo
- Neuroscience Department, University of Padua, Italy
- BIO.VEDA Group (Biobanca Veneta per i Disturbi dell'Alimentazione: Biobank of the Veneto Region Eating Disorders Units), Italy
| | - Andrè F Carvalho
- Translational Psychiatry Research Group, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Brazil
| | - Brendon Stubbs
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, UK
- Faculty of Health, Social Care and Education, Anglia Ruskin University, UK
| | - Maurizio Clementi
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padua, Italy
| | - Claudia Pinato
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padua, Italy
| | - Monica Forzan
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padua, Italy
| | - Matteo Cassina
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padua, Italy
| | - Francesca Fontana
- BIO.VEDA Group (Biobanca Veneta per i Disturbi dell'Alimentazione: Biobank of the Veneto Region Eating Disorders Units), Italy
| | - Ivana Piva
- BIO.VEDA Group (Biobanca Veneta per i Disturbi dell'Alimentazione: Biobank of the Veneto Region Eating Disorders Units), Italy
| | - Roberta Siani
- BIO.VEDA Group (Biobanca Veneta per i Disturbi dell'Alimentazione: Biobank of the Veneto Region Eating Disorders Units), Italy
| | - Pierandrea Salvo
- BIO.VEDA Group (Biobanca Veneta per i Disturbi dell'Alimentazione: Biobank of the Veneto Region Eating Disorders Units), Italy
| | - Elena Tenconi
- Neuroscience Department, University of Padua, Italy
- BIO.VEDA Group (Biobanca Veneta per i Disturbi dell'Alimentazione: Biobank of the Veneto Region Eating Disorders Units), Italy
- Centro Neuroscienze Cognitive (CNC), University of Padua, Italy
| | | | - Christoph U Correll
- Department of Psychiatry Research, Northwell Health, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine Hempstead, Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Angela Favaro
- Neuroscience Department, University of Padua, Italy
- BIO.VEDA Group (Biobanca Veneta per i Disturbi dell'Alimentazione: Biobank of the Veneto Region Eating Disorders Units), Italy
- Centro Neuroscienze Cognitive (CNC), University of Padua, Italy
| |
Collapse
|
13
|
Eichen DM, Matheson BE, Appleton-Knapp SL, Boutelle KN. Neurocognitive Treatments for Eating Disorders and Obesity. Curr Psychiatry Rep 2017; 19:62. [PMID: 28744627 PMCID: PMC5669379 DOI: 10.1007/s11920-017-0813-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW Recent research has highlighted executive function and neurocognitive deficits among individuals with eating and weight disorders, identifying a potential target for treatment. Treatments targeting executive function for eating and weight disorders are emerging. This review aims to summarize the recent literature evaluating neurocognitive/executive function-oriented treatments for eating and weight disorders and highlights additional work needed in this area. RECENT FINDINGS Cognitive remediation therapy (CRT) for anorexia nervosa has been the most extensively studied neurocognitive treatment for eating disorders. Results demonstrate that CRT improves executive function and may aid in the reduction of eating disorder symptomatology. Computer training programs targeting modifying attention and increasing inhibition are targeting reduction of binge eating and weight loss with modest success. Neurocognitive treatments are emerging and show initial promise for eating and weight disorders. Further research is necessary to determine whether these treatments can be used as stand-alone treatments or whether they need to be used as an adjunct to or in conjunction with other evidence-based treatments to improve outcomes.
Collapse
Affiliation(s)
- Dawn M. Eichen
- Department of Pediatrics, University of California San Diego, La Jolla, California,Corresponding Author Contact: , Dawn Eichen, 9500 Gilman Dr, MC0874, La Jolla CA, 92093
| | - Brittany E. Matheson
- Department of Pediatrics, University of California San Diego, La Jolla, California,San Diego State University/University of California, San Diego
| | | | - Kerri N. Boutelle
- Department of Pediatrics, University of California San Diego, La Jolla, California
| |
Collapse
|
14
|
Steward T, Mestre-Bach G, Agüera Z, Granero R, Martín-Romera V, Sánchez I, Riesco N, Tolosa-Sola I, Fernández-Formoso JA, Fernández-García JC, Tinahones FJ, Casanueva FF, Baños RM, Botella C, Crujeiras AB, de la Torre R, Fernández-Real JM, Frühbeck G, Ortega FJ, Rodríguez A, Jiménez-Murcia S, Menchón JM, Fernández-Aranda F. Enduring Changes in Decision Making in Patients with Full Remission from Anorexia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2016; 24:523-527. [DOI: 10.1002/erv.2472] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 07/25/2016] [Accepted: 07/29/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Trevor Steward
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Zaida Agüera
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Roser Granero
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut; Universitat Autònoma de Barcelona; Barcelona Spain
| | | | - Isabel Sánchez
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Nadine Riesco
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Iris Tolosa-Sola
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Jose A Fernández-Formoso
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
| | - Jose C. Fernández-García
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Diabetes, Endocrinology and Nutrition; Hospital Clínico Universitario Virgen de Victoria; Málaga Spain
| | - Francisco J Tinahones
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Diabetes, Endocrinology and Nutrition; Hospital Clínico Universitario Virgen de Victoria; Málaga Spain
| | - Felipe F Casanueva
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Medicine, Endocrinology Division; Santiago de Compostela University, Complejo Hospitalario Universitario; Santiago de Compostela Spain
| | - Rosa M. Baños
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Psychological; Personality, Evaluation and Treatment of the University of Valencia; Valencia Spain
| | - Cristina Botella
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Basic Psychology; Clinic and Psychobiology of the University Jaume I; Castelló Spain
| | - Ana B Crujeiras
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Medicine, Endocrinology Division; Santiago de Compostela University, Complejo Hospitalario Universitario; Santiago de Compostela Spain
| | - Rafael de la Torre
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Integrated Pharmacology and Systems Neurosciences Research Group, Neuroscience Research Program Organization IMIM (Hospital del Mar Medical Research Institute); Barcelona Spain
- Department of Health and Experimental Sciences; Universitat Pompeu Fabra; Barcelona Spain
| | - Jose M Fernández-Real
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Diabetes, Endocrinology and Nutrition; Institu d'Investigació, Biomèdica de Girona (IdIBGi), Hospital Dr Josep Trueta; Girona Spain
| | - Gema Frühbeck
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Metabolic Research Laboratory; Clínica Universidad de Navarra, University of Navarra-IdiSNA; Pamplona Spain
| | - Francisco J. Ortega
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Diabetes, Endocrinology and Nutrition; Institu d'Investigació, Biomèdica de Girona (IdIBGi), Hospital Dr Josep Trueta; Girona Spain
| | - Amaia Rodríguez
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Metabolic Research Laboratory; Clínica Universidad de Navarra, University of Navarra-IdiSNA; Pamplona Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Clinical Sciences, School of Medicine; University of Barcelona; Spain
| | - Jose M. Menchón
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Department of Clinical Sciences, School of Medicine; University of Barcelona; Spain
- CIBER Salud Mental (CIBERSAM), Instituto Salud Carlos III; Barcelona Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III; Barcelona Spain
- Department of Clinical Sciences, School of Medicine; University of Barcelona; Spain
| |
Collapse
|