Perfectionism and cognitive rigidity in anorexia nervosa: Is there an association?

Buzzichelli, Sara; Marzola, Enrica; Amianto, Federico; Fassino, Secondo; Abbate-Daga, Giovanni

doi:10.1002/erv.2591

Cited by 43 publications

(26 citation statements)

References 32 publications

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“…Evidence in the literature regarding reaction time performance in the ED population is mixed. Similar to the present study, Buzzichelli et al (2018) found that adults with ED presented slower reaction times. However, other authors (Bentz, Jepsen, Kjaersdam Telleus, et al, 2017;Giannunzio et al, 2018;Terhoeven et al, 2017) emphasized the link between illness stage and processing speed: they concluded that patients in the acute phase present more severe impairments than recovered patients, noting that processing speed deficits frequently reverse after treatment.…”

Section: Discussionsupporting

confidence: 91%

“…Research focused on women has shown consistent difficulties in executive functions, in particular in cognitive flexibility, central coherence, decision-making and inhibitory control (Bentz, Jepsen, Kjaersdam Telleus, et al, 2017;Buzzichelli et al, 2018;Giannunzio et al, 2018;Hamatani et al, 2018;Harper et al, 2017;Hirst et al, 2017;Kanakam, Krug, Collier, & Treasure, 2017;Overas, Kapstad, Brunborg, Landro, & Ro, 2017;Smith, Mason, Johnson, Lavender, & Wonderlich, 2018;Steward et al, 2016;Weinbach, Perry, Sher, Lock, & Henik, 2017;Zegarra-Valdivia & Chino-Vilca, 2018), and in social functions, mainly in theory of mind and affect recognition Bora & Kose, 2016;Brockmeyer et al, 2016;Dapelo et al, 2017;Fujiwara, Kube, Rochman, Macrae-Korobkov, & Peynenburg, 2017;Postorino et al, 2017;Zegarra-Valdivia & Chino-Vilca, 2018). In contrast, language (Overas et al, 2017;Spitoni et al, 2018) and orientation (Spitoni et al, 2018) frequently appear to be preserved.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, language (Overas et al, 2017;Spitoni et al, 2018) and orientation (Spitoni et al, 2018) frequently appear to be preserved. Meanwhile, results for measures of attention (Bentz, Jepsen, Kjaersdam Telleus, et al, 2017;Buzzichelli et al, 2018;Giannunzio et al, 2018;Spitoni et al, 2018;Terhoeven et al, 2017), processing speed (Bentz, Jepsen, Kjaersdam Telleus, et al, 2017;Buzzichelli et al, 2018;Giannunzio et al, 2018;Terhoeven et al, 2017), memory (Bentz, Jepsen, Kjaersdam Telleus, et al, 2017;Hamatani et al, 2018;Overas et al, 2017;Terhoeven et al, 2017) and verbal fluency (Spitoni et al, 2018;Zegarra-Most of the existing studies included small samples, and examined cognitive performance mostly in adolescents and young adults. The present research aimed to extend the evidence base, by including a larger sample, with older female participants, who were recruited by UK Biobank.…”

Section: Introductionmentioning

confidence: 99%

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Cross-sectional study of cognitive function in women with a history of eating disorders in the UK Biobank cohort

M¹,

Cullen²

2020

Preprint

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Objective: The present study aimed to compare the cognitive functions of women who reported a history of eating disorders (ED) with women who did not report any such history. Within the group of women who reported a history of ED, it aimed to compare the cognitive functions of those who met anorexia nervosa body mass index (BMI) criteria at the time of assessment with those who did not meet such criteria. Method: The sample in this observational cross-sectional study belonged to the UK Biobank cohort, and consisted of 260,601 women in middle to older age, of whom 347 had a lifetime history of ED. Participants underwent sociodemographic, medical and psychological evaluation, and were assessed with four computerized cognitive tasks. Multiple regression analyses were conducted to take account of covariates. Results: Slower reaction time was found in those with an ED history: differences of small effect size were found across different levels of model adjustment (d=-.096 [95% CI -.201, .009] to -.150 [95% CI -.249, -.052]). Reasoning, visuospatial memory and prospective memory were not significantly different between those with and without a history of ED. A consistent pattern of results was not found when comparing the sub-sample of participants with ED split according to current BMI criteria. Discussion: The findings suggest that an ED history may correlate with slower processing speed in middle to older age, but this may be partly accounted for by clinical covariates. Further research in population-representative cohorts is required.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cross-sectional study of cognitive function in women with a history of eating disorders in the UK Biobank cohort

M¹,

Cullen²

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…These neuropsychological factors-set-shifting and weak central coherence-would likely make it more di cult for patients to develop new cognitive and behavioural skills and could in uence their outcomes (54). Relationships among these neurocognitive domains, eating psychopathology and other relevant issues such as perfectionism, comorbid psychopathology, and motivation need to be further elucidated considering that several authors have also related perfectionism with neuropsychological de cits (31).…”

Section: Introductionmentioning

confidence: 99%

Relationship between neuropsychology, clinical traits, psychopathology and attitudes towards change in eating disorders

Mata-Saenz

Rodríguez-Cano

Muñoz-Martínez

et al. 2020

Preprint

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Background:Research on the neuropsychological characteristics of eating disorders (EDs) has primarily focused on inhibitory control, set-shifting and central coherence, as well as attention bias and decision making. These neuropsychological aspects may be related to a more severe clinical status and could influence attitudes towards therapeutic change.The objective of this research was to analyse the relationships of psychopathological and clinical variables with neuropsychological characteristics of patients with EDs and to explore the possible influence of these variables on patients’ attitude towards change.Methods:An observational analytical cross-sectional study was performed. The participants were 74 consecutive outpatients who received treatment at an ED unit. They were assessed during a 6-month period using clinical (Psychiatric Status Rating Scale, modified) and neuropsychological tests (Letter Number Sequencing test; Stroop test; Symbol Digit Modalities Test; Rey-Osterrieth Complex Figure Test). They were asked to complete several self-report psychopathological questionnaires—Body Shape Questionnaire; Eating Disorders Inventory; Beck Depression Inventory; State-Trait Anxiety Inventory; Dissociative Experiences Scale; Attitudes Towards Change in Eating Disorders Scale (ACTA)—but 23 participants (31.08%) did not return them. Descriptive statistics and multivariate analysis were performed to study the relationships between clinical, psychopathological and neuropsychological variables.Results:Nineteen patients (25.68%) were diagnosed with restricting anorexia nervosa (AN), 19 (25.68%) with purging AN, 14 with bulimia nervosa (18.92%), 9 with binge eating disorder (12.16%) and 13 with ED not otherwise specified (17.57%). There were no significant differences among the groups regarding scores on the neuropsychological tests. Body max index (BMI) was related to the majority of the neuropsychological scores. Depression (BDI), trait anxiety, severity of the illness and BMI were predictors (F=3.46; p<0.01, 28.5% of the variance) of working memory scores. On the other hand, higher scores on copy time [B=3.56; 95% CI (0.82-6.29); p<0.01, 10.2% of the variance] and lower scores on memory time [B=-2.31; 95% CI [-4.58-(-0.05)]; p<0.05, 7.4% of the variance] predicted scores on the Precontemplation subscale of the ACTA (F=2.59; p<0.05; 17.6% of the variance). Higher scores on copy time [B=1.43; 95% CI (0.42-2.45); p<0.01] and lower scores on the style index [B=-14.01; 95% CI (-24.98-(-3.04); p<0.01] predicted scores on the Contemplation subscale of the ACTA (F=3.40; p<0.05; 22% of the variance).Conclusions:The main results suggest that neuropsychological dysfunctions in EDs are transdiagnostic dimensions and that BMI, the severity of the illness and the presence of depression predict some of these disturbances. Moreover, they influence attitudes towards change. The findings highlight the need to set up a broad framework to increase acknowledgement of the problem. This approach could enhance conventional therapy by providing additional cognitive remediation therapy to motivational interviewing with the goal of improving the decisional balance. At present, there are no definitive conclusions about whether neuropsychological disturbances are underlying traits or consequences of the illness; thus, comprehensive longitudinal studies are needed.

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“…These neuropsychological factors, set-shifting and weak central coherence, would likely make more di cult for patients to develop new cognitive and behavioural skills and could in uence their outcomes (54). Relationships between these neurocognitive domains, eating psychopathology and other relevant issues, as perfectionism, comorbid psychopathology, or motivation, need to be further elucidated, seeing as several authors have also related perfectionism with neuropsychological de cits (31).…”

Section: Introductionmentioning

confidence: 99%

Relationship between neuropsychology, clinical traits, psychopathology and attitudes towards change in eating disorders

Mata-Saenz

Rodríguez-Cano

Muñoz-Martínez

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Research on the neuropsychological characteristics of eating disorders (EDs) has primarily focused on inhibitory control, set-shifting and central coherence, as well as attention bias and decision making. These neuropsychological aspects may be related to a more severe clinical status and also influence attitudes towards therapeutic change. The objective of this research was to analyse the relationship of psychopathological and clinical variables with neuropsychological characteristics of patients with EDs and to see the possible influence of these variables on patients’ attitude towards change. Methods: An observational analytical cross-sectional study was performed. The participants were 74 consecutive outpatients who received treatment at an ED unit. They were assessed during a 6-month period, using clinical (Psychiatric Status Rating Scale, modified) and neuropsychological tests (Letter Number Sequencing test; Stroop test; Symbol Digit Modalities Test; Rey-Osterrieth Complex Figure Test). They were asked to complete several self-report psychopathological questionnaires: Body Shape Questionnaire; Eating Disorders Inventory; Beck Depression Inventory; State-Trait Anxiety Inventory; Dissociative Experiences Scale; Attitudes Towards Change in Eating Disorders Scale (ACTA), but 23 participants (31.08%) did not return them. Descriptive statistics and multivariate analysis were performed to study the relationships between clinical and psychopathological neuropsychological variables.Results: Nineteen patients (25.68%) were diagnosed with restricting anorexia nervosa (AN), 19 (25.68%) with purging AN, 14 with bulimia nervosa (18.92%), 9 with binge eating disorder (12.16%) and 13 with ED not otherwise specified (17.57%). There were no significant differences among the groups regarding the scores on neuropsychological tests. Body max index (BMI) was related to the majority of the neuropsychological scores. Depression (BDI), severity of the illness status and BMI, were predictors of deficits in working memory (F=3.46; p <0.01, 33% of the variance). On the other hand, higher score on time of the copy [B=3.56; 95% CI (0.82-6.29), p<0.01] and lower score on memory time [B=-2.31; 95% CI [-4.58-(-0.05)]; p<0.05] predicted the score on the “Precontemplation” subscale of the ACTA (F=2.59; p<0.05; 16% of the variance). Higher score on the copy time [B=1.43; 95% CI (0.42-2.45); p<0.01] and lower score on the style index [B= -14.01; 95% CI (-24.98-(-3.04)); p<0.01] predicted the score on the “Contemplation” subscale of the ACTA (F=3.40; p<0.05; 22% of the variance). Conclusions: The main results suggest that neuropsychological dysfunctions in EDs are transdiagnostic dimensions and that BMI, the severity of the illness and depression predict some of these disturbances. Besides, they influence the attitudes towards change. The findings highlight the need of setting up a broad framework to increase the acknowledgment of the problem. This approach could enhance conventional therapy, providing additional cognitive remediation therapy to motivational interview aimed to improve the decisional balance. At present, there are no definitive conclusions about whether neuropsychological disturbances are underlying traits or consequences of the illness, thus comprehensive longitudinal studies are needed.

show abstract

Perfectionism and cognitive rigidity in anorexia nervosa: Is there an association?

Cited by 43 publications

References 32 publications

Cross-sectional study of cognitive function in women with a history of eating disorders in the UK Biobank cohort

Cross-sectional study of cognitive function in women with a history of eating disorders in the UK Biobank cohort

Relationship between neuropsychology, clinical traits, psychopathology and attitudes towards change in eating disorders

Relationship between neuropsychology, clinical traits, psychopathology and attitudes towards change in eating disorders

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