Decision‐making and planning in full recovery of anorexia nervosa

Lindner, S.; Fichter, Manfred M.; Quadflieg, Norbert

doi:10.1002/eat.22025

Cited by 38 publications

(36 citation statements)

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“…However, the findings are discrepant with a number of studies that report recall and copy data from the Rey figure as a measure of central coherence [32]. Contrary to other findings, this study did not however, find any differences between recovered AN and the HC group [33]. The difference in effect size between currently ill ANs and recovered can be observed in Fig 2, with recovered ANs demonstrating a more global processing style than the AN group.…”

Section: Discussioncontrasting

confidence: 99%

Central Coherence in Eating Disorders: A Synthesis of Studies Using the Rey Osterrieth Complex Figure Test

et al. 2016

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BackgroundLarge variability in tests and differences in scoring systems used to study central coherence in eating disorders may lead to different interpretations, inconsistent findings and between study discrepancies. This study aimed to address inconsistencies by collating data from several studies from the same research group that used the Rey Osterrieth Complex Figure Test (Rey Figure) in order to produce norms to provide benchmark data for future studies.MethodData was collated from 984 participants in total. Anorexia Nervosa, Bulimia Nervosa, recovered Anorexia Nervosa, unaffected family members and healthy controls were compared using the Rey Figure.ResultsPoor global processing was observed across all current eating disorder sub-groups and in unaffected relatives. There was no difference in performance between recovered AN and HC groups.ConclusionsThis is the largest dataset reported in the literature and supports previous studies implicating poor global processing across eating disorders using the Rey Figure. It provides robust normative data useful for future studies.

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Section: Discussioncontrasting

confidence: 99%

Central Coherence in Eating Disorders: A Synthesis of Studies Using the Rey Osterrieth Complex Figure Test

et al. 2016

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“…In addition, although brain volume in the AN patients increased, we did not have brain volume data on the healthy comparison group to evaluate whether these changes represented fully normalized volume in weight-restored AN patients. Other studies have found individuals recovered from AN to have similar or better IGT performance than comparison participants (Lindner et al, 2012; Tchanturia et al, 2007). Thus, it is possible that decision-making deficits observed in the current study would improve with longer duration of follow-up.…”

Section: Discussionmentioning

confidence: 89%

“…Thus, poor decision-making in patients actively ill with AN may reflect a consequence of illness rather than a premorbid underlying impairment in decision-making that contributes to vulnerability. Researchers have evaluated decision-making in weight-restored patients with AN in order to disentangle state versus trait impairments; however, mixed findings have emerged from such studies (Bosanac et al, 2007; Danner et al, 2012; Lindner et al, 2012; Tchanturia et al, 2007). Studies have found poorer (Danner et al, 2012), similar (Bosanac et al, 2007; Tchanturia et al, 2007), and even superior performance (Lindner et al, 2012) in individuals recovered from AN compared to healthy comparison participants.…”

Section: Introductionmentioning

confidence: 99%

“…Researchers have evaluated decision-making in weight-restored patients with AN in order to disentangle state versus trait impairments; however, mixed findings have emerged from such studies (Bosanac et al, 2007; Danner et al, 2012; Lindner et al, 2012; Tchanturia et al, 2007). Studies have found poorer (Danner et al, 2012), similar (Bosanac et al, 2007; Tchanturia et al, 2007), and even superior performance (Lindner et al, 2012) in individuals recovered from AN compared to healthy comparison participants. Importantly, all studies were cross-sectional, thus it is unclear whether decision-making performance in individuals with AN actually improves with increased weight, given that differences may or may not have been present during the acute phase of illness.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal examination of decision-making performance in anorexia nervosa: Before and after weight restoration

Bodell

Keel

Brumm

et al. 2014

Journal of Psychiatric Research

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Background This study aimed to extend previous work on decision-making deficits in anorexia nervosa (AN) by using a longitudinal design to examine decision-making before and after weight restoration. Methods Participants were 22 women with AN and 20 healthy comparison participants who completed the Iowa Gambling Task (IGT). Decision-making was assessed both before and after weight restoration in a subset of 14 AN patients. Self-report and interview assessments were used to measure psychological correlates of decision-making performance including depression, anxiety, and eating disorder symptoms, and magnetic resonance imaging (MRI) scans were conducted to explore associations between brain volume in the orbitofrontal cortex (OFC) and decision-making in individuals with AN. Results Currently ill AN patients performed worse on the IGT compared to the control group. Although decision-making performance did not improve significantly with weight restoration in the full AN sample, AN patients who were poor performers at baseline did improve task performance with weight-restoration. When actively ill, lower body mass index (BMI) and decreased left medial OFC volume were significantly associated with worse IGT performance, and these associations were no longer significant after weight restoration. Conclusions Findings suggest that decision-making deficits in AN in the acute phase of illness are associated with low weight and decreased left medial OFC volume, but increases in brain volume and BMI may not have been sufficient to improve decision-making in all patients. Findings contribute to a model for understanding how some patients may sustain self-starvation, and future work should examine whether decision-making deficits predict relapse.

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“…Such decision-making deficits are often assessed using gambling tasks that require participants to learn from their mistakes and forgo immediate gratification in order to avoid longer-term negative consequences (Southgate et al, 2005). Although evidence is mixed (Guillaume et al, 2010; Lindner, Fichter, & Quadflieg, 2012), participants with EDs often display poorer outcomes compared to healthy controls, suggestive of deficits in global decision making and executive functioning (Boeka & Lokken, 2006; Danner et al, 2012). Further, preliminary evidence suggests that individuals with EDs may process food and illness-related cues (e.g., body image) differently, and fMRI studies reveal abnormal brain activation in cortical and subcortical regions of the brain associated with affective processing and planning of behavior (García-García et al, 2013; Southgate et al, 2005).…”

mentioning

confidence: 99%

Implicit affective associations predict snack choice for those with low, but not high levels of eating disorder symptomatology

2014

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OBJECTIVE The central purpose of the current study was to examine whether eating disorder symptomatology moderates the extent to which implicitly and explicitly measured affective associations with fruits, or the feelings and emotions individuals associate with them, predict food choice. METHOD Participants (N=107) completed both implicit and explicit measures of affective associations with fruits, a self-report of eating disorder symptomatology, and their cognitive beliefs about fruits. In a subsequent snack selection task, they selected either a granola bar or fruit as a measure of their food choice behavior. RESULTS Logistic regression analyses revealed that eating disorder symptomatology moderated the relation of implicit affective associations on behavior, OR=0.27, p=.024, 95% CI (0.085, 0.84). A test of the simple effects indicated that implicit affective associations predicted snack choice at or below mean symptomatology levels [OR=2.073, p=.02, 95% CI (1.12, 3.84)], but not at high levels [OR=0.56, p=.28, 95% CI (0.18, 1.74)]. The effects of explicit measures on eating behavior were not moderated by eating disorder symptomatology (ps>.05). CONCLUSION These findings advance our understanding of both the relation of implicit affective associations on behavior, as well as the ways in which eating disorder symptomatology may impact the decision-making process, thereby perpetuating disorder-related eating behavior. These findings have implications for both health decision-making theory and practice, as well as for the study and treatment of eating disorders.

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Decision‐making and planning in full recovery of anorexia nervosa

Abstract: This study does not support results from other studies showing that rec AN participants perform better in decision-making. Results from this study show that planning is impaired even after full recovery from AN.

Cited by 38 publications

References 59 publications

Central Coherence in Eating Disorders: A Synthesis of Studies Using the Rey Osterrieth Complex Figure Test

Central Coherence in Eating Disorders: A Synthesis of Studies Using the Rey Osterrieth Complex Figure Test

Longitudinal examination of decision-making performance in anorexia nervosa: Before and after weight restoration

Implicit affective associations predict snack choice for those with low, but not high levels of eating disorder symptomatology

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