Exploring neuropsychological and socio‐emotional task performance in anorexia nervosa: A cluster analytic approach

Abstract

The aim of this study was to characterise heterogeneity in neuropsychological and socio-emotional task performance in young women with anorexia nervosa (AN) using hierarchical cluster analysis. Further, we aimed to test whether cognitive profiles were associated with differences in clinical variables (body mass index, illness duration and age at diagnosis), psychopathology (eating disorder, autistic symptoms, anxiety and depression) and functional impairment. Method:Set-shifting, central coherence and theory of mind abilities were measured in 118 women with acute or remitted AN. A hierarchical cluster analysis using Ward's method with a Euclidean distance measure was performed with the neuropsychological and socio-emotional variables.Differences between clusters were assessed using ANOVAs.Results: Four clusters emerged, with significant differences in neuropsychological and socio-emotional task performance. There were no significant differences between clusters in clinical variables, psychopathology or functional impairment, however, these analyses lacked power due to small cluster sizes. Conclusions:Our results demonstrate significant heterogeneity in cognitive profiles in AN, supporting a more personalised approach to treatment. Studies in larger samples are required to establish whether these variables map onto clinically significant differences in aetiology, clinical presentation, comorbidity patterns and/or treatment responses.

In-Session-Reflective-Functioning in Anorexia Nervosa: An Analysis of Psychotherapeutic Sessions of the ANTOP Study

“…Future studies should investigate more systematically if the stage of starvation has an impact on the capacity to mentalize in patients with AN. Large sample studies are needed to identify clinically relevant subgroups of patients, as previous studies pointed to considerable heterogeneity in related constructs like ToM in patients with AN ( 25 ). Additionally, prospective studies are warranted that examine the relationship between therapeutic interventions and in-session RF as well as RF as a possible moderator and mediator of the psychotherapeutic process.…”

“…ToM is defined as the ability to represent the mental states of others and use them to understand and predict behavior. Findings so far point to difficulties in ToM as assessed in standardized tasks in patients with AN, but also to significant interpersonal variability ( 25 – 27 ). It is not yet clear to what extent difficulties are state-dependent (e.g., related to the degree of malnutrition, illness duration, and comorbidity) or constitute predisposing traits.…”