Can Cognitive Flexibility and Clinical Perfectionism Be Used to Identify People with Anorexia Nervosa?

Miles, Stephanie; Nedeljkovic, Maja; Phillipou, Andrea

doi:10.3390/jcm11071954

Cited by 4 publications

(4 citation statements)

References 49 publications

(73 reference statements)

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“…Furthermore, it was described several years ago how anorexia patients could present anxiety persistence, perfectionism, and obsessional behaviors, including symmetry, exactness, and order [12][13][14]. Nowadays, researchers point out how female anorexia patients self-report significantly lower cognitive flexibility and significantly higher clinical perfectionism [15]. In this study, participants self-reported in a questionnaire which evaluated different items, including cognitive, behavioral and affective components of setting aims and struggling to achieve them, as well as the consequences on their self-evaluation when these principles were accomplished or not accomplished [16].…”

Section: Psychological Profilementioning

confidence: 99%

The Impact of Anorexia Nervosa and the Basis for Non-Pharmacological Interventions

Clemente-Suárez,

Ramírez-Goerke,

Redondo-Flórez

et al. 2023

Nutrients

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Anorexia nervosa is a psychiatric disorder with an unknown etiology that is characterized by an individual’s preoccupation with their weight and body structure while denying the severity of their low body weight. Due to the fact that anorexia nervosa is multifaceted and may indicate the coexistence of genetic, social, hormonal, and psychiatric disorders, a description of non-pharmacological interventions can be used to ameliorate or reduce the symptoms of this condition. Consequently, the purpose of the present narrative review is to describe the profile’s context in the anorexic person as well as the support they would require from their family and environment. In addition, it is aimed at examining preventative and non-pharmacological interventions, such as nutritional interventions, physical activity interventions, psychological interventions, psychosocial interventions, and physical therapy interventions. To reach the narrative review aims, a critical review was conducted utilizing both primary sources, such as scientific publications, and secondary sources, such as bibliographic indexes, web pages, and databases. Nutritional interventions include nutritional education and an individualized treatment for each patient, physical activity interventions include allowing patients to perform controlled physical activity, psychological interventions include family therapy and evaluation of the existence of other psychological disorders, psychosocial interventions include management of the relationship between the patient and social media and physical therapy interventions include relaxation massages and exercises to relieve pain. All these non-pharmacological interventions need to be individualized based on each patient’s needs.

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Section: Psychological Profilementioning

confidence: 99%

The Impact of Anorexia Nervosa and the Basis for Non-Pharmacological Interventions

Clemente-Suárez,

Ramírez-Goerke,

Redondo-Flórez

et al. 2023

Nutrients

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show abstract

“…Of particular interest would be research on specific clinical populations or profiles, such as patients with eating disorders, who report lower levels of outcome improvement and satisfaction with hospital care. It may be suggested that, more than in other groups of patients, the subjective well-being of patients with eating disorders depends on factors other than symptom improvement, for example, interfering personality traits such as “perfectionism” [ 62 ]. Exploring this hypothesis could shed valuable light on how to adapt clinical care strategies and interventions accordingly for this subset of patients.…”

Section: Discussionmentioning

confidence: 99%

How subjective well-being, patient-reported clinical improvement (PROMs) and experience of care (PREMs) relate in an acute psychiatric care setting?

et al. 2023

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Background Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are increasingly acknowledged as critical tools for enhancing patient-centred, value-based care. However, research is lacking on the impact of using standardized patient-reported indicators in acute psychiatric care. The aim of this study was to explore whether subjective well-being indicators (generic PROMs) are relevant for evaluating the quality of hospital care, distinct from measures of symptom improvement (disease-specific PROMs) and from PREMs. Methods Two hundred and forty-eight inpatients admitted to a psychiatric university hospital were included in the study between January and June 2021. Subjective well-being was assessed using standardized generic PROMs on well-being, symptom improvement was assessed using standardized disease-specific PROMs, and experience of care using PREMs. PROMs were completed at admission and discharge, PREMs were completed at discharge. Clinicians rated their experience of providing treatment using adapted PREMs items. Results Change in subjective well-being (PROMs) at discharge was significantly (p < 0.001), but moderately (r 2 = 28.5%), correlated to improvement in symptom outcomes, and weakly correlated to experience of care (PREMs) (r 2 = 11.0%), the latter being weakly explained by symptom changes (r 2 = 6.9%). Patients and clinicians assessed the experience of care differently. Conclusions This study supports the case for routinely measuring patients’ subjective well-being to better capture the unmet needs of patients undergoing psychiatric hospital treatment, and the use of standardized patient-reported measures as key indicators of high quality of care across mental health services.

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“…Perfectionism is a personality trait that reflects the tendency to have very high personal standards, be overly critical of oneself when these standards are not achieved, have an extreme preoccupation with mistakes, doubt when considering personal achievements, and have an excessive focus on organization and precision [ 9 ]. Higher levels of perfectionism are consistently found in adolescents and adults with AN compared to healthy controls [ 10 , 11 , 12 ] and may be a risk factor for longer illness duration [ 13 ]. Perfectionism has also been associated with feeling the need for control over the self and body [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Cognitive and Interpersonal Factors in Adolescent Inpatients with Anorexia Nervosa: A Network Analysis

Godart

Fatséas

et al. 2023

Children

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The cognitive-interpersonal model of anorexia nervosa (AN) posits that cognitive and interpersonal traits contribute to the development and maintenance of AN. We investigated cognitive and interpersonal factors put forward by the model in a sample of 145 adolescent inpatients with AN using network analysis. Our main outcomes included core eating disorder symptoms, cognitive style, socio-affective factors, and mood symptoms. We estimated a cross-sectional network using graphical LASSO. Core and bridge symptoms were identified using strength centrality. Goldbricker was used to reduce topological overlap. The node with the highest strength centrality was Concern over Mistakes, followed by Eating Preoccupation, Social Fear, and Overvaluation of Weight and Shape. The nodes with the highest bridge strength were Concern over Mistakes, Doubt about Actions, Overvaluation of Weight and Shape, and Depression. Notably, both performance on a cognitive flexibility task and BMI were not connected to any other nodes and were subsequently removed from the final network. We provide partial support for the cognitive-interpersonal model while also supporting certain premises put forward by the transdiagnostic cognitive-behavioral model. The high centrality of Concern over Mistakes and Social Fear supports the theory that both cognitive and interpersonal difficulties contribute to AN, particularly in adolescence.

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Can Cognitive Flexibility and Clinical Perfectionism Be Used to Identify People with Anorexia Nervosa?

Cited by 4 publications

References 49 publications

The Impact of Anorexia Nervosa and the Basis for Non-Pharmacological Interventions

The Impact of Anorexia Nervosa and the Basis for Non-Pharmacological Interventions

How subjective well-being, patient-reported clinical improvement (PROMs) and experience of care (PREMs) relate in an acute psychiatric care setting?

Cognitive and Interpersonal Factors in Adolescent Inpatients with Anorexia Nervosa: A Network Analysis

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