Background: Research on the neuropsychological characteristics of eating disorders (EDs) has primarily focused on inhibitory control, set-shifting and central coherence, as well as attention bias and decision making. These neuropsychological aspects may be related to a more severe clinical status and also influence attitudes towards therapeutic change. The objective of this research was to analyse the relationship of psychopathological and clinical variables with neuropsychological characteristics of patients with EDs and to see the possible influence of these variables on patients’ attitude towards change. Methods: An observational analytical cross-sectional study was performed. The participants were 74 consecutive outpatients who received treatment at an ED unit. They were assessed during a 6-month period, using clinical (Psychiatric Status Rating Scale, modified) and neuropsychological tests (Letter Number Sequencing test; Stroop test; Symbol Digit Modalities Test; Rey-Osterrieth Complex Figure Test). They were asked to complete several self-report psychopathological questionnaires: Body Shape Questionnaire; Eating Disorders Inventory; Beck Depression Inventory; State-Trait Anxiety Inventory; Dissociative Experiences Scale; Attitudes Towards Change in Eating Disorders Scale (ACTA), but 23 participants (31.08%) did not return them. Descriptive statistics and multivariate analysis were performed to study the relationships between clinical and psychopathological neuropsychological variables.Results: Nineteen patients (25.68%) were diagnosed with restricting anorexia nervosa (AN), 19 (25.68%) with purging AN, 14 with bulimia nervosa (18.92%), 9 with binge eating disorder (12.16%) and 13 with ED not otherwise specified (17.57%). There were no significant differences among the groups regarding the scores on neuropsychological tests. Body max index (BMI) was related to the majority of the neuropsychological scores. Depression (BDI), severity of the illness status and BMI, were predictors of deficits in working memory (F=3.46; p <0.01, 33% of the variance). On the other hand, higher score on time of the copy [B=3.56; 95% CI (0.82-6.29), p<0.01] and lower score on memory time [B=-2.31; 95% CI [-4.58-(-0.05)]; p<0.05] predicted the score on the “Precontemplation” subscale of the ACTA (F=2.59; p<0.05; 16% of the variance). Higher score on the copy time [B=1.43; 95% CI (0.42-2.45); p<0.01] and lower score on the style index [B= -14.01; 95% CI (-24.98-(-3.04)); p<0.01] predicted the score on the “Contemplation” subscale of the ACTA (F=3.40; p<0.05; 22% of the variance). Conclusions: The main results suggest that neuropsychological dysfunctions in EDs are transdiagnostic dimensions and that BMI, the severity of the illness and depression predict some of these disturbances. Besides, they influence the attitudes towards change. The findings highlight the need of setting up a broad framework to increase the acknowledgment of the problem. This approach could enhance conventional therapy, providing additional cognitive remediation therapy to motivational interview aimed to improve the decisional balance. At present, there are no definitive conclusions about whether neuropsychological disturbances are underlying traits or consequences of the illness, thus comprehensive longitudinal studies are needed.
Background:Research on the neuropsychological characteristics of eating disorders (EDs) has primarily focused on inhibitory control, set-shifting and central coherence, as well as attention bias and decision making. These neuropsychological aspects may be related to a more severe clinical status and could influence attitudes towards therapeutic change.The objective of this research was to analyse the relationships of psychopathological and clinical variables with neuropsychological characteristics of patients with EDs and to explore the possible influence of these variables on patients’ attitude towards change.Methods:An observational analytical cross-sectional study was performed. The participants were 74 consecutive outpatients who received treatment at an ED unit. They were assessed during a 6-month period using clinical (Psychiatric Status Rating Scale, modified) and neuropsychological tests (Letter Number Sequencing test; Stroop test; Symbol Digit Modalities Test; Rey-Osterrieth Complex Figure Test). They were asked to complete several self-report psychopathological questionnaires—Body Shape Questionnaire; Eating Disorders Inventory; Beck Depression Inventory; State-Trait Anxiety Inventory; Dissociative Experiences Scale; Attitudes Towards Change in Eating Disorders Scale (ACTA)—but 23 participants (31.08%) did not return them. Descriptive statistics and multivariate analysis were performed to study the relationships between clinical, psychopathological and neuropsychological variables.Results:Nineteen patients (25.68%) were diagnosed with restricting anorexia nervosa (AN), 19 (25.68%) with purging AN, 14 with bulimia nervosa (18.92%), 9 with binge eating disorder (12.16%) and 13 with ED not otherwise specified (17.57%). There were no significant differences among the groups regarding scores on the neuropsychological tests. Body max index (BMI) was related to the majority of the neuropsychological scores. Depression (BDI), trait anxiety, severity of the illness and BMI were predictors (F=3.46; p<0.01, 28.5% of the variance) of working memory scores. On the other hand, higher scores on copy time [B=3.56; 95% CI (0.82-6.29); p<0.01, 10.2% of the variance] and lower scores on memory time [B=-2.31; 95% CI [-4.58-(-0.05)]; p<0.05, 7.4% of the variance] predicted scores on the Precontemplation subscale of the ACTA (F=2.59; p<0.05; 17.6% of the variance). Higher scores on copy time [B=1.43; 95% CI (0.42-2.45); p<0.01] and lower scores on the style index [B=-14.01; 95% CI (-24.98-(-3.04); p<0.01] predicted scores on the Contemplation subscale of the ACTA (F=3.40; p<0.05; 22% of the variance).Conclusions:The main results suggest that neuropsychological dysfunctions in EDs are transdiagnostic dimensions and that BMI, the severity of the illness and the presence of depression predict some of these disturbances. Moreover, they influence attitudes towards change. The findings highlight the need to set up a broad framework to increase acknowledgement of the problem. This approach could enhance conventional therapy by providing additional cognitive remediation therapy to motivational interviewing with the goal of improving the decisional balance. At present, there are no definitive conclusions about whether neuropsychological disturbances are underlying traits or consequences of the illness; thus, comprehensive longitudinal studies are needed.
Background:Recent models try to find in eating disorders (ED) a relationship between the neuropsychological dimensions, the psychopathological disturbances and the clinical manifestations. Carrying out an investigation on neuropsychological aspects that may be related with an ED’s characteristic cognitive pattern could contribute to their possible influence towards therapeutic change. The main objective of this paper is to analyse the possible relationship between psychopathological and clinical variables with the neuropsychological characteristics of patients diagnosed with an ED and their possible influence on the attitude towards change. Methods:An observational analytical transversal study was done. Patients were outpatients referred during a 6-month period who signed informed consent. Seventy-four subjects were included. Clinical (Psychiatric Status Rating Scale modified) and neuropsychological tests (Letter Number Sequencing; Stroop’s test; Symbol and Digit Modalities Test; Rey-Osterrieth complex figure test) were administrated and psychopathological self-report questionnaires (Body Shape Questionnaire; Eating Disorders Inventory; The Bulimic Investigatory Test, Edinburgh; Beck’s depression inventory; State-Trait Anxiety Inventory; Dissociative Experiences Scale; Attitudes Towards Change in Eating Disorders Scale) were given (but 23 participants, 31.08%, did not give them back).Results:Nineteen patients (25,68%) were diagnosed with restrictive anorexia nervosa (AN), 19 (25,68%) purgative AN, 14 bulimia nervosa (18,92%), 9 binge eating disorder (12,16%) and 13 ED not otherwise specified (17,57%). There are not any significant differences between the diagnoses with regards to the score of neuropsychological tests. BMI was related to the majority of the neuropsychological scores. “Precontemplation” was related to time of copy (B=3.56; IC 95% (0.82-6.29), p<0,01) and time of memory (B=-2.31; IC 95% (-4.58-(-0.05)); p<0.05). “Contemplation” was related to time of copy (B=1.43; IC 95% (0.42-2.45); p<0.01) and index of style (B= -14.01; IC 95% (-24.98-(-3.04)); p<0.01). “Decision” was related to working memory (SpanLN), quantitative score of copy, index of order and index of style.Conclusions:Neuropsychological alterations could be summarized as the working memory is lowered and the interference is increased, which is associated with a more controlling and less flexible attitude, and scores in inhibitory care are lower. ROCFT shows a visoperceptive deficit in some patients.
Objectives: The study aimed to examine whether dissociation and attitudes towards change were associated with the psychopathology in patients with eating disorders (EDs) at 1-year follow-up. Method: The study included 110 females with anorexia nervosa and bulimia nervosa (48 and 62 respectively). At the beginning of the study and 1 year later, they were assessed by means of the following questionnaires: Dissociative Experiences Scale, Attitudes Towards Change (ACTA), State
Background: The interest of research on the neuropsychological characteristics of eating disorders (EDs) has primarily focused on inhibitory control, set-shifting and central coherence, as well as attention bias and decision making. These neuropsychological aspects may also influence attitudes towards therapeutic change and be related to a more severe clinical status. The objective of this paper was to analyse the relationship of psychopathological and clinical variables with neuropsychological characteristics of patients with EDs and to determine possible influence of these variables on patients’ attitude towards change. Methods: An observational analytical cross-sectional study was performed. The participants were 74 consecutive outpatients who received treatment at an ED unit during a 6-month period. They were assessed using clinical (Psychiatric Status Rating Scale, modified) and neuropsychological tests (Letter Number Sequencing test; Stroop test; Symbol Digit Modalities Test; Rey-Osterrieth Complex Figure Test). They were asked to complete several self-report psychopathological questionnaires (Body Shape Questionnaire; Eating Disorders Inventory; Beck Depression Inventory; State-Trait Anxiety Inventory; Dissociative Experiences Scale; Attitudes Towards Change in Eating Disorders Scale), but 23 participants (31.08%) did not return them. Descriptive statistics and multivariate analysis were performed to study the relationships between clinical and psychopathological neuropsychological variables.Results: Nineteen patients (25.68%) were diagnosed with restricting anorexia nervosa (AN), 19 (25.68%) with purging AN, 14 with bulimia nervosa (18.92%), 9 with binge eating disorder (12.16%) and 13 with ED not otherwise specified (17.57%). There were no significant differences among the groups in the scores on neuropsychological tests. BMI was related to the majority of the neuropsychological scores. “Precontemplation” was related to copy time (B=3.56; 95% CI (0.82-6.29), p<0.01) and memory time (B=-2.31; 95% CI (-4.58-(-0.05)); p<0.05). “Contemplation” was related to copy time (B=1.43; 95% CI (0.42-2.45); p<0.01) and style (B= -14.01; 95% CI (-24.98-(3.04)); p<0.01). “Decision” was related to working memory (SpanLN), the quantitative copy score, order and style.Conclusions: In EDs, neuropsychological dysfunction could be associated with decreased motivation to change. Hence, a comprehensive therapeutic framework should be established with the aim of providing neurocognitive training in addition to conventional therapy. This approach could enhance acknowledgment of the problem and improve the decisional balance.
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