Could training executive function improve treatment outcomes for eating disorders?

Juarascio, Adrienne S.; Manasse, Stephanie M.; Espel, Hallie M.; Kerrigan, Stephanie G.; Forman, Evan M.

doi:10.1016/j.appet.2015.03.013

Cited by 78 publications

(33 citation statements)

References 104 publications

(151 reference statements)

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“…Future research and replication with larger samples is needed; however, findings suggest that individuals with poorer food-specific response inhibition may benefit from interventions that target the ability to withhold a prepotent response towards food. For example, recent research has suggested that training inhibitory control is a promising venue for treating eating disorders (44), and researchers have begun to develop paradigms for training food-specific inhibitory control (e.g., (45)).…”

Section: Discussionmentioning

confidence: 99%

Does impulsivity predict outcome in treatment for binge eating disorder? A multimodal investigation

et al. 2016

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Multiple dimensions of impulsivity (e.g., affect-driven impulsivity, impulsive inhibition – both general and food-specific, and impulsive decision-making) are associated with binge eating pathology cross-sectionally, yet the literature on whether impulsivity predicts treatment outcome is limited. The present pilot study explored impulsivity-related predictors of 20-week outcome in a small open trial (n=17) of a novel treatment for binge eating disorder. Overall, dimensions of impulsivity related to emotions (i.e., negative urgency) and food cues emerged as predictors of treatment outcomes (i.e., binge eating frequency and global eating pathology as measured by the Eating Disorders Examination), while more general measures of impulsivity were statistically unrelated to global eating pathology or binge frequency. Specifically, those with higher levels of negative urgency at baseline experienced slower and less pronounced benefit from treatment, and those with higher food-specific impulsivity had more severe global eating pathology at baseline that was consistent at post-treatment and follow-up. These preliminary findings suggest that patients high in negative urgency and with poor response inhibition to food cues may benefit from augmentation of existing treatments to achieve optimal outcomes. Future research will benefit from replication with a larger sample, parsing out the role of different dimensions of impulsivity in treatment outcome for eating disorders, and identifying how treatment can be improved to accommodate higher levels of baseline impulsivity.

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Section: Discussionmentioning

confidence: 99%

Does impulsivity predict outcome in treatment for binge eating disorder? A multimodal investigation

et al. 2016

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“…Altogether, an understanding of the neurocognitive differences across eating and weight disorders can be leveraged to form the basis of treatments specifically targeted to a particular disorder. Further development of treatments targeting these underlying mechanisms, which can improve neurocognitive functioning for individuals with eating and weight disorders is needed (36–38). With low remission and high recidivism rates in current treatment modalities (3–7), it is important to investigate adjunctive or alternative treatments that target these underlying mechanisms.…”

Section: Treatments Targeting Neurocognitive or Executive Function Inmentioning

confidence: 99%

“…As noted by others, CRT is often conducted in inpatient populations, with small samples and limited statistical power, with severely limits the generalizability of the results (36, 43). Despite these limitations, CRT has many potential benefits, including increased motivation and treatment adherence (50).…”

Section: Treatments Targeting Neurocognitive or Executive Function Inmentioning

confidence: 99%

Neurocognitive Treatments for Eating Disorders and Obesity

Eichen

Matheson

Appleton-Knapp

et al. 2017

Curr Psychiatry Rep

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Purpose of Review Recent research has highlighted executive function and neurocognitive deficits among individuals with eating and weight disorders, identifying a potential target for treatment. Treatments targeting executive function for eating and weight disorders are emerging. This review aims to summarize the recent literature evaluating neurocognitive/executive function-oriented treatments for eating and weight disorders and highlights additional work needed in this area. Recent Findings Cognitive remediation therapy (CRT) for anorexia nervosa has been the most extensively studied neurocognitive treatment for eating disorders. Results demonstrate that CRT improves executive function and may aid in the reduction of eating disorder symptomatology. Computer training programs targeting modifying attention and increasing inhibition are targeting reduction of binge eating and weight loss with modest success. Summary Neurocognitive treatments are emerging and show initial promise for eating and weight disorders. Further research is necessary to determine whether these treatments can be used as stand-alone treatments or whether they need to be used as an adjunct to or in conjunction with other evidence-based treatments to improve outcomes.

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“…Finally, given the increasing evidence for EF-eating behavior associations, EF has been proposed as a method to combat obesity specifically through reducing impulsive overeating behavior pathways. 92,93 Studies in adults and older children that have enhanced EF skills in the context of obesity treatment 94 or trained inhibitory responses specifically in relation to tempting foods 93,95,96 have shown promise in this area. Therefore, computer-mediated EF-training interventions that also take food reward sensitivity into account, particularly if they are delivered in a context that could address risk factors in the child’s broader social context, could also be a helpful new tool for preventing childhood obesity.…”

Section: Intervention Implicationsmentioning

confidence: 99%

Neurocognitive Processes and Pediatric Obesity Interventions

Miller

2016

Pediatric Clinics of North America

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Summary Childhood obesity is a significant problem in the United States, yet current childhood obesity prevention programming approaches have limited efficacy. Self-regulation is a set of processes (e.g., cognitive control, emotion coping) that organize behavior in order to achieve a goal. As such, self-regulation may shape health behaviors and over time, long-term health outcomes. Obesity-prevention approaches that incorporate a focus on the cognitive and behavioral mechanisms that underlie self-regulation early in the lifespan may therefore lead to better outcomes. Executive functioning (EF) is a central aspect of self-regulation; skills include attention, working memory, and inhibitory control. Deficits in these areas are associated with higher weight status in children. The current paper reviews the development of EF from childhood to adolescence, identifies social-contextual influences on EF development, presents how different aspects of EF relate to behaviors known to be associated with increased risk for childhood obesity, and considers how EF-weight associations may change across development. Implications for intervention, including the need to consider the direction of association and possibility of bidirectional associations, the multiple potential pathways between EF and weight status, and a brief review of EF-enhancement intervention approaches are discussed.

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Could training executive function improve treatment outcomes for eating disorders?

Cited by 78 publications

References 104 publications

Does impulsivity predict outcome in treatment for binge eating disorder? A multimodal investigation

Does impulsivity predict outcome in treatment for binge eating disorder? A multimodal investigation

Neurocognitive Treatments for Eating Disorders and Obesity

Neurocognitive Processes and Pediatric Obesity Interventions

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