|
1
|
Wang SB, Gray EK, Coniglio KA, Murray HB, Stone M, Becker KR, Thomas JJ, Eddy KT. Cognitive rigidity and heightened attention to detail occur transdiagnostically in adolescents with eating disorders. Eat Disord 2021; 29:408-420. [PMID: 31675280 PMCID: PMC7192764 DOI: 10.1080/10640266.2019.1656470] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cognitive inflexibility and attention to detail bias represent a promising target in eating disorder (ED) treatment. While prior research has found that adults with eating disorders exhibit significant cognitive inflexibility and heightened attention to detail, less is known about these cognitive impairments among adolescents, and across EDs transdiagnostically. To address this gap, adolescent females (N = 143) from a residential ED program with anorexia nervosa, bulimia nervosa, or other specified feeding or eating disorder completed the Detail and Flexibility Questionnaire (DFlex) and measures of ED and general psychopathology. Transdiagnostically, adolescents with EDs scored higher than an archival sample of healthy control adolescents on both cognitive rigidity (p < .001; Cohen's d = 1.92) and attention to detail (p < .001; Cohen's d = 1.16). These cognitive impairments were significantly associated with severity of eating pathology, and these relationships existed independent of age, duration of illness, or body mass index (BMI). Our findings suggest cognitive inflexibility and heightened attention to detail occur transdiagnostically in adolescents with eating disorders and are unlikely to be a scar of the disorder. Future prospective research is needed to determine whether these cognitive styles represent an endophenotype of eating disorders.
Collapse
Affiliation(s)
- Shirley B Wang
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Emily K Gray
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | | | - Helen B Murray
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | | | - Kendra R Becker
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
|
2
|
Reilly EE, Brown TA, Gray EK, Kaye WH, Menzel JE. Exploring the cooccurrence of behavioural phenotypes for avoidant/restrictive food intake disorder in a partial hospitalization sample. Eur Eat Disorders Rev 2019; 27:429-435. [DOI: 10.1002/erv.2670] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/14/2019] [Accepted: 02/11/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Erin E. Reilly
- Department of PsychiatryUniversity of California, San Diego San Diego CA USA
| | - Tiffany A. Brown
- Department of PsychiatryUniversity of California, San Diego San Diego CA USA
| | - Emily K. Gray
- Department of PsychiatryUniversity of California, San Diego San Diego CA USA
| | - Walter H. Kaye
- Department of PsychiatryUniversity of California, San Diego San Diego CA USA
| | - Jessie E. Menzel
- Department of PsychiatryUniversity of California, San Diego San Diego CA USA
| |
Collapse
|
|
3
|
Schmelkin C, Plessow F, Thomas JJ, Gray EK, Marengi DA, Pulumo R, Silva L, Miller KK, Hadjikhani N, Franko DL, Eddy KT, Lawson EA. Low oxytocin levels are related to alexithymia in anorexia nervosa. Int J Eat Disord 2017; 50:1332-1338. [PMID: 29044580 PMCID: PMC5772992 DOI: 10.1002/eat.22784] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/03/2017] [Accepted: 09/10/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Anorexia nervosa is associated with social-emotional functioning deficits and low levels of the social neurohormone oxytocin, even after weight gain. The relationship between low oxytocin levels and social-emotional functioning impairment has not been studied. METHOD We performed a cross-sectional study of 79 women (19 who were less than 85% of ideal body weight [IBW] with anorexia nervosa [AN], 26 who were 90-120% IBW with a history of AN [AN-WR], and 34 who were 90-120% IBW with no eating disorder history [H]). We administered the Eating Disorder Examination-Questionnaire (EDE-Q), Leibowitz Social Anxiety Scale-Self Report (LSAS-SR), Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ; suspiciousness and insecure attachment subscales), and the Toronto Alexithymia Scale (TAS-20). We also analyzed fasting serum oxytocin levels. RESULTS Most measures of social-emotional functioning showed impairment in women with AN and AN-WR compared to H. Oxytocin levels were low in AN-WR compared to H. Across groups, low oxytocin levels were associated with difficulty identifying feelings (r = -.45, p = .008) and overall alexithymia (r = -.34, p = .0489). DISCUSSION We speculate that low oxytocin levels may contribute to alexithymia in women with anorexia nervosa.
Collapse
Affiliation(s)
- Cindy Schmelkin
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Franziska Plessow
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Jennifer J. Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Emily K. Gray
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Dean A. Marengi
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Reitumetse Pulumo
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Lisseth Silva
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Karen K. Miller
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Nouchine Hadjikhani
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Debra L. Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA,Department of Applied Psychology, Northeastern University, Boston, MA 02115, USA
| | - Kamryn T. Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Elizabeth A. Lawson
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA,Corresponding author: Elizabeth A. Lawson, M.D., M.M.Sc., Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street Bulfinch 457-D, Boston, MA 02114, USA,
| |
Collapse
|