Cognitive Remediation in Anorexia Nervosa and Related Conditions: A Systematic Review

Abstract

Research evidence for cognitive remediation therapy's (CRT) effectiveness for anorexia nervosa (AN) has been gathering. This approach is also increasingly being implemented in other disorders including major depressive disorder, obsessive-compulsive disorder and autistic spectrum disorder that share commonalities with AN in neuropsychological profiles and clinical presentations. This systematic literature review identified and appraised the current evidence base to see whether evidence from related conditions could be integrated into the theoretical understanding of CRT for AN as well as future AN treatment developments and research. Overall, CRT studies in AN report promising findings, and CRT appears to be associated with improvements in set-shifting and in central coherence. Cognitive remediation approaches in other conditions also show promising evidence in associated improvements in areas of executive functioning and information processing; links are made between AN treatment and what future treatment developments could consider.

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

“…Furthermore, as normative body image and eating difficulties have per se important negative biopsychosocial consequences (e.g., [7]), the current study offers important directions for the development of preventive programmes focused on body image and eating behaviours directed at adolescent girls. In fact, this study seems to support the relevance of therapeutic approaches that target cognitive rigidity and promote flexibility [49,50]. In particular, the development of higher psychological flexibility may be beneficial to attenuate the impact of body and weight dimensions on eating difficulties, and to help adolescent girls to focus on and engage with valued life domains [51,33].…”

Emotions mediate the relationship between autistic traits and disordered eating: A new autistic-emotional model for eating pathology

“…Cognitive therapies that directly target deficits associated with autistic traits such as socio-emotional deficits and problems with attention switching, may be particularly effective in this population. Previous work has found that cognitive remediation therapy (CRT, Tchanturia et al, 2014) and emotion skills training (CREST, was helpful for ED patients, which could be extended to individuals at risk for both autistic traits and eating pathology. Finally, as difficulties regulating emotions are associated with the development of a range of psychopathologies including EDs and ASD (Globerson et al, 2015), interventions targeting emotion regulation may provide a transdiagnostic approach to resilience and mental health promotion programs, and the prevention of psychopathology more broadly.…”

Benefits of group cognitive remediation therapy in anorexia nervosa: case series

“…Cognitive training has been found to hold promises for personalized care of individuals in numerous mental illnesses, as well as been a target in the development of behavioural interventions [6]. A key clinical intervention targeting thinking styles, with growing empirical support, is cognitive remediation therapy (CRT; for review see [7]). CRT is an easy to deliver, manualised treatment, tailored to target problematic thinking styles (for details of the manual see http://www.katetchanturia.com-publications; for current research evidence see [8]).…”