Cognitive Flexibility and Clinical Severity in Eating Disorders

Tchanturia, Kate; Harrison, Amy; Davies, Helen; Roberts, Marion; Oldershaw, Anna; Nakazato, Michiko; Ståhl, Daniel; Morris, Robin G.; Schmidt, Ulrike; Treasure, Janet

doi:10.1371/journal.pone.0020462

Cited by 198 publications

(182 citation statements)

References 18 publications

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“…Further studies are needed to longitudinally explore the development of eating psychopathology, its risk factors, and inflexible adherence to eating rules. Given the large body of evidence derived from neuropsychological studies on inflexible thinking style in disordered eating patients [23,24,22], the findings from the current study should also be corroborated through experimental designs using neuropsychological tasks, which overcome the limitation of using selfreport measures. Besides, more work is needed to confirm this study's findings on patients with eating disorders.…”

Section: It Is Increasingly Recognized That Adolescence Is a Criticalmentioning

confidence: 83%

“…This may occur when the individual blindly follows rigid eating rules, without meeting internal and external cues, and consequently engages in disordered eating behaviours with possible damaging consequences [11]. A large number of studies using neuropsychological tasks have been gathering support that eating disorders patients, especially with restrictive eating patterns, present an inflexible cognitive style [22][23][24]. This pattern of poor flexibility of thinking has been identified as a vulnerability trait, as being associated with the maintenance of the disorder, and with poorer treatment outcomes [25].…”

Section: Introductionmentioning

confidence: 99%

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Normative body dissatisfaction and eating psychopathology in teenage girls: the impact of inflexible eating rules

et al. 2015

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Purpose: Adolescence has been considered a critical time for the development of body image-related difficulties and disordered eating behaviours, especially in females. Although adherence to eating rules has been linked to disordered eating, literature has not yet explored how the inflexible subscription to those rules impacts on eating psychopathology. Therefore, the aim of the current study was to explore whether inflexible eating impacts on the relationships between weight and body image-related variables, and disordered eating.Methods: Participated in this study 497 female adolescents from the community, aged between 14 and 18 years old, who completed self-report measures.Results: Results revealed that the majority of the participants were dissatisfied with their weight and body shape. Moreover, 6.64% of the participants demonstrated severe eating psychopathology. A path analysis revealed that BMI, body dissatisfaction and social comparisons based on physical appearance impact on disordered eating behaviours, through the mechanism of inflexible adherence to eating rules. This model explained 52% of eating psychopathology's variance. Conclusions:Findings highlight the relevance of body image-related difficulties in adolescence and additionally they emphasise the importance of promoting more flexible attitudes towards eating in prevention and intervention programs with female adolescents.

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Section: It Is Increasingly Recognized That Adolescence Is a Criticalmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Normative body dissatisfaction and eating psychopathology in teenage girls: the impact of inflexible eating rules

et al. 2015

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“…Our findings-even in light of these limitations-may have implications for the therapy and management of women with eating disorders. Executive function deficits have been cited as relevant to treatment resistance in this population, 40 and to the extent that such deficits are related to anxiety symptoms, the latter may be particularly targeted when treating women with eating disorders.…”

Section: Discussionmentioning

confidence: 99%

Executive function in eating disorders: The role of state anxiety

Billingsley-Marshall¹,

Basso²,

Lund³

et al. 2013

Intl J Eating Disorders

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Objective: We examined the influence of depression and anxiety on executive function in individuals with a DSM-IV diagnosis of anorexia nervosa-restricting type, anorexia nervosa-binge-eating/ purging type, bulimia nervosa, or eating disorder not otherwise specified. Method:We assessed 106 women after their inpatient treatment in an eating disorders program. All participants were nutritionally stable at the time of testing.Results: Thirty percent of the total sample showed impaired performance on one or more tests of executive function. No differences in executive function were observed among diagnostic groups. Anxiety scores accounted for significant variance in performance for all groups.Discussion: Executive function deficits were found in a minority of our sample, with significant variance in performance accounted for by self-reported anxiety. State anxiety appears to contribute to diminished executive function in women with eating disorders. V V C 2013 by Wiley Periodicals, Inc.

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“…For [76,77]. However, it is important to bear in mind that similar cognitive biases have been found in otherwise healthy individuals experiencing starvation [78], therefore it is possible that the similarities between ASD and AN are a temporary result of the eating disorder, rather than a shared underlying cause. Case studies suggest that some women with AN may in fact have an undiagnosed ASD, with self-reported ASD symptoms, based on descriptions of behaviour from before the development of their eating disorder, reaching levels sufficient for an ASD diagnosis [79].…”

Section: Anorexia Nervosamentioning

confidence: 96%

Protective Effect or Missed Diagnosis? Females with Autism Spectrum Disorder

Hull

Mandy

2017

Future Neurol.

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Autism Spectrum Disorder (ASD) has historically been diagnosed more frequently in males than females. One explanation for this is the 'female protective effect': that there is something inherent in being female that makes girls and women less susceptible to ASD.Another possibility is that ASD is under-diagnosed in girls and women, due to the existence of a 'female autism phenotype', which is not well captured by current, male-biased diagnostic criteria. To evaluate the 'female protective effect' and 'female autism phenotype' hypotheses, this narrative review describes recent developments exploring the genetic underpinning and behavioural expression of ASD in females. We then look at ways to better identify females with ASD who may be missed under the current diagnostic criteria. KeywordsAutism, Autism Spectrum Disorders, Gender Differences, Sex Differences, Genetics, Diagnosis, Person-Environment Fit IntroductionAutism Spectrum Disorder (ASD) is a group of neurodevelopmental conditions characterised by deficits in social communication and reciprocity, and by restricted and repetitive interests and behaviours 1 . ASD is the current term used to integrate the previously separate diagnostic categories of autistic disorder, Asperger's disorder, childhood disintegrative disorder and pervasive developmental disorder -not otherwise specified (aka 'atypical autism' [2]). ASD is a lifelong condition that is present from birth. Although adult diagnosis is possible, symptoms must be reported as present from early developmental stages in order for the 1 In line with preferences from a majority of the autism community [1], we use identity-first language (e.g. 'autistic person') to refer to individuals with an ASD throughout this paper, while recognising that others might prefer person-first language (e.g. 'person with autism'). Gender differences in diagnosisASD affects approximately one to two per cent of the population [3,4], and is much more likely to be diagnosed in males than in females. Gender ratios in diagnosis vary depending on the country, cohort, and characteristics of those included, but average ratios are reported at around four males for every one female [3][4][5]. However, when looking at those individuals with intellectual disability, the male-to-female ratio narrows significantly to around two-toone [6]. In addition, population-based studies, which screen all participants in order to identify cases regardless of whether they have already been diagnosed by local services, suggest that the male-to-female ratio is closer to 3:1 [7,8]. This is in contrast to the average of around 4-5:1 generally reported in studies based on clinically-diagnosed cases [9]. The fact that a lower proportion of females are found in clinical samples than in community-based, epidemiological samples suggests that there is a bias against autistic girls and women coming to clinical attention. This bias may have existed from the very first conceptions of ASD; only 3 of 11 children in Kanner's original cases were female, and no gi...

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Cognitive Flexibility and Clinical Severity in Eating Disorders

Cited by 198 publications

References 18 publications

Normative body dissatisfaction and eating psychopathology in teenage girls: the impact of inflexible eating rules

Normative body dissatisfaction and eating psychopathology in teenage girls: the impact of inflexible eating rules

Executive function in eating disorders: The role of state anxiety

Protective Effect or Missed Diagnosis? Females with Autism Spectrum Disorder

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