Do Children and Adolescents with Anorexia Nervosa Display an Inefficient Cognitive Processing Style?

Abstract

ObjectiveThis study aimed to examine neuropsychological processing in children and adolescents with Anorexia Nervosa (AN). The relationship of clinical and demographic variables to neuropsychological functioning within the AN group was also explored.MethodThe performance of 41 children and adolescents with a diagnosis of AN were compared to 43 healthy control (HC) participants on a number of neuropsychological measures.ResultsThere were no differences in IQ between AN and HC groups. However, children and adolescents with AN displayed significantly more perseverative errors on the Wisconsin Card Sorting Test, and lower Style and Central Coherence scores on the Rey Osterrieth Complex Figure Test relative to HCs.ConclusionInefficient cognitive processing in the AN group was independent of clinical and demographic variables, suggesting it might represent an underlying trait for AN. The implications of these findings are discussed.

The set-shifting profiles of anorexia nervosa and autism spectrum disorder using the Wisconsin Card Sorting Test: a systematic review and meta-analysis

“…The addition of Lang et al's (2015a) empirical study to the child literature indicates a small non-significant effect of AN on set-shifting, in line with a previous systematic review (Lang et al 2014). This non-significant difference between AN and HC groups may be driven by a lack of statistical power with a limited number of studies conducted with small numbers of participants.…”

“…This non-significant difference between AN and HC groups may be driven by a lack of statistical power with a limited number of studies conducted with small numbers of participants. The Lang et al (2015a) study was designed to specifically replicate the methods used within adult studies and to address previous methodological shortcomings in the child literature and therefore adds strength to the current literature, despite the result remaining nonsignificant. The analysis presented here shows that young people with AN may have difficulties with setshifting, but further studies are needed to determine whether these difficulties are significant.…”

“…While some traits associated with ASD, such as emotional theory of mind, have been found to reduce in recovered AN groups (Oldershaw et al 2010), other traits including difficulties with set-shifting, or flexible thinking, appear to persist after weight gain (Tchanturia et al 2004;Gillberg et al 2010;Danner et al 2012;Lindner et al 2014). Recent reports suggest that set-shifting inefficiencies are present in children with AN who have had a relatively short duration of illness (Lang et al 2015a) and relatives with AN (Holliday et al 2005;Roberts et al 2010;Lang et al 2015b). Conversely, fasting in healthy controls (HCs) has been found to reduce set-shifting test performance, suggesting that starvation may exacerbate underlying difficulties in this domain (Bolton et al 2014;Pender et al 2014).…”

Young people’s experience of individual cognitive remediation therapy (CRT) in an inpatient eating disorder service: a qualitative study

“…The final sample consisted of seventy participants; the mean age was 14.8 (SD 1.6, range [11][12][13][14][15][16][17]. The Weight for Height (WfH) percentage was measured at the beginning of the CRT course (Mean 78.1; SD 7.8, range 63.9-110.1).…”

Is overestimation of body size associated with neuropsychological weaknesses in anorexia nervosa?

“…Danner et al, 2012;Lounes, Khan, & Tchanturia, 2011;Roberts, Tchanturia, & Treasure, 2010;Tchanturia et al, 2012). However, the emerging trend has been that the cognitive difficulties apparent in adults with AN, in particular set-shifting difficulties, are less pronounced in children and adolescents (Allen et al, 2013;Lang, Stahl, Espie, Treasure & Tchanturia, 2014;Lang et al, 2015). The research on cognitive abilities in adolescents with AN is still limited.…”