Difficulties in retrieving specific details of autobiographical memories and imagining positive future events in individuals with acute but not remitted anorexia nervosa

Abstract

Introduction The factors that contribute to the maintenance of anorexia nervosa (AN) are not fully understood, although it is generally accepted that depression is a core feature and contributes to poor prognosis. Individuals with depression tend to have difficulties in producing specific details of autobiographical memories and future episodes. Our aim was to investigate autobiographical memory and episodic future thinking (EFT) in individuals with AN (n = 46), people recovered from AN (recAN; n = 40), and non-affected controls (n = 35). Method Using a remotely administered computerised version of the autobiographical memory test and episodic future thinking task, we measured six aspects of memory retrieval and EFT generation: specificity, detailedness, difficulty in remembering/imagining, positivity, vividness and realism. Memory and EFT cue valence was manipulated; cues were either positive, neutral, or disorder-related/negative. As the production of EFTs is theoretically linked to the ability to retrieve autobiographical memories, the relationship between autobiographical memory specificity and EFT specificity was explored. To investigate whether autobiographical memory and EFT performance were independent of performance on other forms of cognition, working memory, verbal fluency and cognitive flexibility were measured. Results People with AN had difficulties retrieving specific details of autobiographical memories and rated autobiographical memories as less positive overall, and less vivid when primed by positive cues. People with a lifetime diagnosis (currently ill or recovered) reported greater difficulty in retrieving memories. The AN group generated less positive EFTs, particularly to positive and neutral cues. Comorbid depressive symptoms had some contribution to the observed findings. Lastly, in all groups autobiographical memory specificity predicted EFT specificity. Discussion Problems with retrieving specific details of autobiographical memories and simulating positive EFTs may be a state feature of AN. Treatments targeted at alleviating depressive symptoms, as well those targeted towards facilitating memory retrieval or reconsolidation, and the construction of positive EFTs, may contribute to hope for recovery and strengthen the sense of self beyond the disorder.

“Your mind doesn’t have room for anything else”: a qualitative study of perceptions of cognitive functioning during and after recovery from anorexia nervosa

“…Respondents described difficulty in retrieving details of autobiographical memories, albeit had a better ability for remembering notable (usually negative) events. This aligns with findings of autobiographical memory overgeneralisation in AN [ 39 , 40 ], as well as the prior neuropsychological study [ 26 ], which found that people with AN showed an overgeneralisation when retrieving autobiographical memories, and reported positive memories as less vivid than neutral and negative memories. It is possible this represents a bias in recall in AN, whereby positive memories are less salient in one’s perception of the past.…”

“…However, it is interesting that despite this relatively short period of recovery, many respondents reported an inability to remember their period of illness. Moreover, all respondents had previously taken part in a neuropsychological study investigating autobiographical memory and episodic future thinking [ 26 ], where they were fully debriefed. Therefore, all respondents had some prior knowledge of the overall research objectives, which may have biased their responses.…”

“…Twenty-one female participants (AN = 11, rec-AN = 10) who previously took part in an online neuropsychological study of autobiographical memory and future thinking [ 26 ] were recruited in this follow-up study. Inclusion criteria for all participants included the following: age ≥ 18 years, fluency in the English language, access to a computer and stable internet connection.…”

“…Following recruitment of the AN and rec-AN samples for the prior study [ 26 ], all participants who consented to being contacted for future studies were emailed details of this follow-up interview study. Those who replied were provided with an information sheet and consent form for the study.…”

‘Physically it was fine, I'd eat what normal people do. But it's never like this in my head’: A qualitative diary study of daily experiences of life in recovery from an eating disorder

“…Qualitative diary methods could support improving understanding of this, capturing participants' insights as they occur, and allowing experiences to be recorded and tracked across time, enabling patterns to be uncovered (Craig et al, 2017). Keeler et al (2022) found that those with past or present AN had difficulty retrieving memories, which suggests that capturing experiences as they happen may provide more detailed insights into behavioural, thought, and emotion patterns than those recalled later in interviews.…”