Articlegold2011

Cognitive Flexibility and Clinical Severity in Eating Disorders

Kate Tchanturia · Amy Harrison · Helen A. Davies · Marion Roberts · Anna Oldershaw · Michiko Nakazato +4 more

231 citations0/0 files storedPLoS ONE

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Eating Disorders and Behaviors Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Neural and Behavioral Psychology Studies

Abstract

OBJECTIVES: The aim of this study was to explore cognitive flexibility in a large dataset of people with Eating Disorders and Healthy Controls (HC) and to see how patient characteristics (body mass index [BMI] and length of illness) are related to this thinking style. METHODS: A dataset was constructed from our previous studies using a conceptual shift test--the Brixton Spatial Anticipation Test. 601 participants were included, 215 patients with Anorexia Nervosa (AN) (96 inpatients; 119 outpatients), 69 patients with Bulimia Nervosa (BN), 29 Eating Disorder Not Otherwise Specified (EDNOS), 72 in long-term recovery from AN (Rec AN) and a comparison group of 216 HC. RESULTS: The AN and EDNOS groups had significantly more errors than the other groups on the Brixton Test. In comparison to the HC group, the effect size decrement was large for AN patients receiving inpatient treatment and moderate for AN outpatients. CONCLUSIONS: These findings confirm that patients with AN have poor cognitive flexibility. Severity of illness measured by length of illness does not fully explain the lack of flexibility and supports the trait nature of inflexibility in people with AN.

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References

1997The Hayling and Brixton Tests 2006Anorexia nervosa: Valued and visible. A cognitive‐interpersonal maintenance model and its implications for research and practice 2007A systematic review and meta-analysis of set-shifting ability in eating disorders 2009Defining recovery from an eating disorder: Conceptualization, validation, and examination of psychosocial functioning and psychiatric comorbidity 2005Is Impaired Set-Shifting an Endophenotype of Anorexia Nervosa?2001The NART as an index of prior intellectual functioning: a retrospective validity study covering a 66-year interval 2004Cognitive flexibility in anorexia nervosa and bulimia nervosa 2004Set shifting in anorexia nervosa: an examination before and after weight gain, in full recovery and relationship to childhood and adult OCPD traits

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2015The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC): Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) with specialist supportive clinical management (SSCM) in outpatients with broadly defined anorexia nervosa: A randomized controlled trial.2014Set-shifting ability across the spectrum of eating disorders and in overweight and obesity: a systematic review and meta-analysis 2014Cognitive Remediation in Anorexia Nervosa and Related Conditions: A Systematic Review

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