Cognitive flexibility in verbal and nonverbal domains and decision making in anorexia nervosa patients: a pilot study

Abstract

BackgroundThis paper aimed to investigate cognitive rigidity and decision making impairments in patients diagnosed with Anorexia Nervosa Restrictive type (AN-R), assessing also verbal components.MethodsThirty patients with AN-R were compared with thirty age-matched healthy controls (HC). All participants completed a comprehensive neuropsychological battery comprised of the Trail Making Test, Wisconsin Card Sorting Test, Hayling Sentence Completion Task, and the Iowa Gambling Task. The Beck Depression Inventory was administered to evaluate depressive symptomatology. The influence of both illness duration and neuropsychological variables was considered. Body Mass Index (BMI), years of education, and depression severity were considered as covariates in statistical analyses.ResultsThe AN-R group showed poorer performance on all neuropsychological tests. There was a positive correlation between illness duration and the Hayling Sentence Completion Task Net score, and number of completion answers in part B. There was a partial effect of years of education and BMI on neuropsychological test performance. Response inhibition processes and verbal fluency impairment were not associated with BMI and years of education, but were associated with depression severity.ConclusionsThese data provide evidence that patients with AN-R have cognitive rigidity in both verbal and non-verbal domains. The role of the impairment on verbal domains should be considered in treatment. Further research is warranted to better understand the relationship between illness state and cognitive rigidity and impaired decision-making.

The Effectiveness of Cognitive Remediation Therapy in Patients with a Severe or Enduring Eating Disorder: A Randomized Controlled Trial

“…Studies have shown that individuals with eating disorders have deficits in neuropsychological functioning [1,2,3,4,5,6,7,8]. These deficits may decrease both treatment motivation and the efficacy of psychological interventions and may even perpetuate the illness [9,10].…”

“…Set-shifting concerns the ability to move back and forth between multiple tasks, operations or mental sets; it represents cognitive flexibility. Difficulties in set-shifting have been found in women with current and past AN and BN [7] in a variety of neuropsychological tests [2,3,4,5,6,8]. Weak central coherence refers to superior detail processing and weak global integration, which is present in individuals with current AN and BN [12,13].…”

Processing of novel stimuli as cognitive remediation therapy in patients with eating disorder / Procesamiento de estímulos novedosos como terapia de remediación cognitiva en pacientes con trastorno alimentario

“…Además, a estos pacientes se les dificultan aquellas actividades que exigen realizar simultáneamente varias tareas, lo que reduce su capacidad para involucrarse en experiencias nuevas o usar el tiempo en forma más productiva. Inflexibilidad que afecta no solo su desempeño interpersonal y cognitivo (Abbate-Daga et al, 2011;Lezak, 2012), sino también su respuesta al tratamiento (Crane, Roberts y Treasure, 2007), constituyendo un factor agravante del trastorno .…”

“…Estos estilos de pensamiento, que con frecuencia coinciden con rasgos de personalidad relacionados con el trastorno obsesivo-compulsivo , están presentes no sólo en fases agudas, sino aún después de haber mejorado sus condiciones clínicas (Abbate-Daga et al, 2011;Aloi et al, 2015;Darcy, Fitzpatrick y Lock, 2016;Roberts et al, 2010;Stedal, Frampton, Landro y Lask, 2012). llamada "Con la cabeza en las nubes" (CCN).…”

Psychiatric Problems Emerging in Teens: The Situation for the Design of Future Interventions

“…Depressive disorders and other psychiatric disorders in parents can influence adaptation issues or the adolescents' psychopathology [31]. The specific lack in parenting skills is linked to disorders of somatization [32], eating disorders [33][34][35][36] and borderline personality [37,38]. On the other hand it has been ascertained that conflicts and intra-family stress predispose to disorders such as substance abuse in adolescents [39].…”