Enduring Changes in Decision Making in Patients with Full Remission from Anorexia Nervosa

Steward, Trevor; Mestre‐Bach, Gemma; Agüera, Zaida; Granero, Roser; Martín-Romera, Virginia; Sánchez, Isabel; Riesco, Nadine; Tolosa-Sola, Iris; Fernández-Formoso, José Antonio; Fernández‐García, José Carlos; Tinahones, Francisco J.; Casanueva, Felipe F.; Baños, Rosa; Botella, Cristina; Crujeiras, Ana B.; Torre, Rafael de la; Fernández-Real, José Manuel; Frühbeck, Gema; Ortega, Francisco; Rodríguez, Amaia; Jiménez‐Murcia, Susana; Menchón, José M.; Fernández‐Aranda, Fernando

doi:10.1002/erv.2472

Cited by 28 publications

(44 citation statements)

References 35 publications

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“…Indeed, they indicate that the difference between remitted/recovered AN patients and healthy controls in BMI was larger and with higher variance (as indicated by a larger confidence interval) in studies that used minimal remission criteria (k = 5, Hedges' g = −0. Krawczyk, 2011;Nikendei et al, 2011;Phillips, Jimerson, Pillai, & Wolfe, 2016;Schebendach et al, 2011;Shott, Pryor, Yang, & Frank, 2016;Steward et al, 2016;Tchanturia et al, 2012) or were found to not improve in ED symptoms (Haynos, Roberto, Martinez, Attia, & Fruzzetti, 2014). Sustained weight-restored AN patients did not differ significantly from acutely ill AN patients in body shape dissatisfaction (Harper, Brodrick, Van Enkevort, & McAdams, 2017).…”

Section: Results Of Meta-analysis On Residual Ed Symptomsmentioning

confidence: 95%

“…Among ED patients in recovery, results indicated that two cognitive functioning aspects may be deficient: executive functions and emotion regulation processes. In terms of executive functions, AN patients in remission underperformed compared to healthy controls in tasks involving visual perception, decision making, memory, social cognition network, and in set shifting (Holliday, Tchanturia, Landau, Collier, & Treasure, 2005;Buehren et al, 2011;McAdams & Krawczyk, 2011: Danner et al, 2012Heled, Hoofien, Bachner-Melman, Bachar, & Ebstein, 2014;Lindner et al, 2014;Talbot et al, 2015;Steward et al, 2016) or showed no significant change after recovery (Bodell et al, 2014;Nikendei et al, 2011). Moreover, specifically in decision making, partially remitted AN patients were impaired compared to healthy controls (Steward et al, 2016).…”

Section: Cognitive Functioningmentioning

confidence: 90%

“…In terms of executive functions, AN patients in remission underperformed compared to healthy controls in tasks involving visual perception, decision making, memory, social cognition network, and in set shifting (Holliday, Tchanturia, Landau, Collier, & Treasure, 2005;Buehren et al, 2011;McAdams & Krawczyk, 2011: Danner et al, 2012Heled, Hoofien, Bachner-Melman, Bachar, & Ebstein, 2014;Lindner et al, 2014;Talbot et al, 2015;Steward et al, 2016) or showed no significant change after recovery (Bodell et al, 2014;Nikendei et al, 2011). In terms of executive functions, AN patients in remission underperformed compared to healthy controls in tasks involving visual perception, decision making, memory, social cognition network, and in set shifting (Holliday, Tchanturia, Landau, Collier, & Treasure, 2005;Buehren et al, 2011;McAdams & Krawczyk, 2011: Danner et al, 2012Heled, Hoofien, Bachner-Melman, Bachar, & Ebstein, 2014;Lindner et al, 2014;Talbot et al, 2015;Steward et al, 2016) or showed no significant change after recovery (Bodell et al, 2014;Nikendei et al, 2011).…”

Section: Cognitive Functioningmentioning

confidence: 95%

“…In terms of executive functions, AN patients in remission underperformed compared to healthy controls in tasks involving visual perception, decision making, memory, social cognition network, and in set shifting (Holliday, Tchanturia, Landau, Collier, & Treasure, 2005;Buehren et al, 2011;McAdams & Krawczyk, 2011: Danner et al, 2012Heled, Hoofien, Bachner-Melman, Bachar, & Ebstein, 2014;Lindner et al, 2014;Talbot et al, 2015;Steward et al, 2016) or showed no significant change after recovery (Bodell et al, 2014;Nikendei et al, 2011). However, recovered or fully remitted AN patients showed improvements in global integration skills (Harrison, Tchanturia, & Treasure, 2011), in gambling-based decision making (Steward et al, 2016), and had verbal memory skills associated with social functioning that did not significantly differ from healthy controls (Bentz et al, 2017). However, recovered or fully remitted AN patients showed improvements in global integration skills (Harrison, Tchanturia, & Treasure, 2011), in gambling-based decision making (Steward et al, 2016), and had verbal memory skills associated with social functioning that did not significantly differ from healthy controls (Bentz et al, 2017).…”

Section: Cognitive Functioningmentioning

confidence: 99%

“…The majority of remitted and recovered AN and BN patients exhibited an improved BMI, which however was significantly lower compared to that of healthy controls (see also Krawczyk, 2011;Nikendei et al, 2011;Phillips, Jimerson, Pillai, & Wolfe, 2016;Schebendach et al, 2011;Shott, Pryor, Yang, & Frank, 2016;Steward et al, 2016;Tchanturia et al, 2012) or were found to not improve in ED symptoms (Haynos, Roberto, Martinez, Attia, & Fruzzetti, 2014). The majority of remitted and recovered AN and BN patients exhibited an improved BMI, which however was significantly lower compared to that of healthy controls (see also Krawczyk, 2011;Nikendei et al, 2011;Phillips, Jimerson, Pillai, & Wolfe, 2016;Schebendach et al, 2011;Shott, Pryor, Yang, & Frank, 2016;Steward et al, 2016;Tchanturia et al, 2012) or were found to not improve in ED symptoms (Haynos, Roberto, Martinez, Attia, & Fruzzetti, 2014).…”

Section: Residual Ed Symptomsmentioning

confidence: 99%

See 4 more Smart Citations

Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

Tomba

Tecuta

Crocetti

et al. 2019

Intl J Eating Disorders

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Objective: In psychiatry, the presence of residual symptoms after treatment is linked to the definitions of remission and recovery. To identify the presence of residual eating disorder (ED) symptoms and associated non-ED clinical features in remitted and recovered EDs, the current systematic review with meta-analysis was performed.Method: A systematic review was conducted on residual ED symptoms and non-ED clinical features including comorbid psychopathology, neurophysiological functioning, cognitive functioning, and quality of life in ED patients considered remitted or recovered. To examine residual ED symptoms, meta-analyses were performed while considering age, study quality, remission, and recovery criteria strictness as moderators.Sensitivity, publication bias, and heterogeneity analyses were also conducted. Results: The 64 studies selected for the systematic review underscored the presence of residual ED symptoms in anorexia nervosa (AN) and bulimia nervosa (BN), and impairments and deficits in the additional features examined. From the 64 studies, 31 were selected regarding residual ED symptoms in AN for meta-analysis. Large effect sizes indicated that remitted/recovered AN patients reported significantly lower body mass index (Hedges' g = −0.62[−0.77, −0.46]) and significantly greater symptomatology in terms of ED examination-questionnaire (Hedges'g = 0.86 [0.48,1.23]) and ED inventory (Hedges' g = 0.94[0.64,1.24]) than healthy controls, independently of remission and recovery criteria strictness, age, and study quality. Discussion: The presence of residual ED symptoms in AN is quantitatively supported, whereas the presence of residual ED symptoms in BN should be further investigated. Data on binge-eating disorder are missing. Future research should use consistent, multicomponent, and standardized comparable indicators of recovery. ResumenObjetivo: En psiquiatría, la presencia de síntomas residuales después de tratamiento está ligado a las definiciones de remisión y recuperación. Para identificar la presencia de síntomas residuales del trastorno de la conducta alimentaria (TCA) y características clínicas no de TCA asociadas en pacientes remitidos y recuperados de TCAs, se realizó la presente revisión sistemática con meta-análisis.

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Section: Results Of Meta-analysis On Residual Ed Symptomsmentioning

confidence: 95%

Section: Cognitive Functioningmentioning

confidence: 90%

Section: Cognitive Functioningmentioning

confidence: 95%

“…In terms of executive functions, AN patients in remission underperformed compared to healthy controls in tasks involving visual perception, decision making, memory, social cognition network, and in set shifting (Holliday, Tchanturia, Landau, Collier, & Treasure, 2005;Buehren et al, 2011;McAdams & Krawczyk, 2011: Danner et al, 2012Heled, Hoofien, Bachner-Melman, Bachar, & Ebstein, 2014;Lindner et al, 2014;Talbot et al, 2015;Steward et al, 2016) or showed no significant change after recovery (Bodell et al, 2014;Nikendei et al, 2011). However, recovered or fully remitted AN patients showed improvements in global integration skills (Harrison, Tchanturia, & Treasure, 2011), in gambling-based decision making (Steward et al, 2016), and had verbal memory skills associated with social functioning that did not significantly differ from healthy controls (Bentz et al, 2017). However, recovered or fully remitted AN patients showed improvements in global integration skills (Harrison, Tchanturia, & Treasure, 2011), in gambling-based decision making (Steward et al, 2016), and had verbal memory skills associated with social functioning that did not significantly differ from healthy controls (Bentz et al, 2017).…”

Section: Cognitive Functioningmentioning

confidence: 99%

Section: Residual Ed Symptomsmentioning

confidence: 99%

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Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

Tomba

Tecuta

Crocetti

et al. 2019

Intl J Eating Disorders

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In pursuit of biomarkers for predicting susceptibility to activity‐based anorexia in adolescent female rats

Milton

Patton

O’Keeffe

et al. 2022

Intl J Eating Disorders

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Objective Identifying risk factors that contribute to the development of anorexia nervosa (AN) is critical for the implementation of early intervention strategies. Anxiety, obsessive–compulsive behavior, and immune dysfunction may be involved in the development of AN; however, their direct influence on susceptibility to the condition remains unclear. Here, we used the activity‐based anorexia (ABA) model to examine whether activity, anxiety‐like behavior, compulsive behavior, and circulating immune markers predict the subsequent development of pathological weight loss. Method Female Sprague–Dawley rats (n = 44) underwent behavioral testing before exposure to ABA conditions after which they were separated into susceptible and resistant subpopulations. Blood was sampled before behavioral testing and after recovery from ABA to screen for proinflammatory cytokines. Results Rats that were vulnerable to pathological weight loss differed significantly from resistant rats on all key ABA parameters. While the primary measures of anxiety‐like or compulsive behavior were not shown to predict vulnerability to ABA, increased locomotion and anxiety‐like behavior were both associated with the extent of weight loss in susceptible but not resistant animals. Moreover, the change in expression of proinflammatory markers IL‐4 and IL‐6 evoked by ABA was associated with discrete vulnerability factors. Intriguingly, behavior related to risk assessment was shown to predict vulnerability to ABA. Discussion We did not find undisputable behavioral or immune predictors of susceptibility to pathological weight loss in the ABA rat model. Future research should examine the role of cognition in the development of ABA, dysfunction of which may represent an endophenotype linking anorectic, anxiety‐like and compulsive behavior. Public Significance Anorexia nervosa (AN) has among the highest mortality rates of all psychiatric disorders and treatment options remain limited in their efficacy. Understanding what types of risk factors contribute to the development of AN is essential for implementing early intervention strategies. This study describes how some of the most common psychological features of AN could be used to predict susceptibility to pathological weight loss in a well‐established animal model.

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Short‐Term Treatment Outcomes and Dropout Risk in Men and Women with Eating Disorders

Agüera

Sánchez

Granero

et al. 2017

Euro Eating Disorders Rev

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This study compared treatment outcomes between men and women with eating disorders (EDs) and analysed clinical predictors of treatment outcome. Our sample consisted of 131 male and 131 female ED patients who underwent cognitive behavioural therapy treatment. ED severity, personality and psychopathology were assessed using standard instruments. We found that the risk of dropout was higher for men with bulimia nervosa (BN) than for women with BN and that men with BN and other specified feeding and EDs were more likely to obtain full remission in comparison with their female counterparts. Predictive models of treatment outcome indicated that higher scores in novelty seeking were a shared factor associated with higher risk of dropout and not obtaining full remission for both men and women with ED. However, only in men, younger age and lower scores in reward dependence predicted higher dropout. Contrastingly, higher persistence scores were predictors of full remission. This study reinforces the effectiveness of using outpatient cognitive behavioural therapy as treatment as usual for men with ED. Nonetheless, placing greater emphasis on strategies targeting gender-specific issues could enhance outcomes. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

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Enduring Changes in Decision Making in Patients with Full Remission from Anorexia Nervosa

Cited by 28 publications

References 35 publications

Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

In pursuit of biomarkers for predicting susceptibility to activity‐based anorexia in adolescent female rats

Short‐Term Treatment Outcomes and Dropout Risk in Men and Women with Eating Disorders

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