Performance variability as a new theoretical mechanism regarding eating disorders and cognitive processing

Abstract

Bulimic (n = 23) and control subjects (n = 28) were compared on four neuropsychological tests and several clinical variables. Between-group differences were observed on neuropsychological measures that reflected marked impulsivity and problem-solving deficits in the bulimics. Additional between-group comparisons, based on the variability of performance on the neuropsychological tests, revealed that bulimics were more variable than controls on approximately 50% of the tests given Performance variability on the remaining two tests was equal across the bulimic and control groups. This represents the first known application of this performance variability analysis in subjects with bulimia nervosa. It is proposed that there may be considerable variability in performance among bulimics and that by examining performance from this "sub-group" perspective may lead to a more analytic understanding of this eating disorder.

Neuropsychology of Bulimia Nervosa: New Findings

“…This indicates that the group with BN was deficient in its ability to establish an appropriate strategy to solve problems. These results are consistent with those of Ferraro et al (1997) who found differences between the group with BN and the control group in executive planning. It is likely that patients who participated in this investigation possess a bad strategy or choose a bad strategy or do not take the time to select a strategy, which could indicate a planning problem.…”

Neuropsychological study of underweight and “weight‐recovered” anorexia nervosa compared with bulimia nervosa and normal controls

“…Although other studies have found impaired attention tasks in underweight AN, 4,6,[8][9][10]51 ''weightrecovered'' AN, 8 and BN, 8,10,28 only two of these studies have had a control group. 8,51 Apart from one study utilizing CDR tests of attention, 51 the remainder of these studies utilized different attention tasks, thereby limiting direct comparison.…”

“…22,26,27 Studies comparing bulimia nervosa (BN) to NC 1 have revealed impaired recall, abstraction, 28 attention, 8,28,10 visuospatial functioning, 8,28 and problem solving. 28 In non-eating disordered participants, dieting has been associated with impaired attention, 29,30 word recall, reaction times, vigilance task performance, [31][32][33] and working memory. 34,35 Postulated mechanisms of impairments related to dieting include preoccupying cognitions about food and body shape affecting the efficiency of cognitive processing.…”

Genetic epidemiology, endophenotypes, and eating disorder classification

“…Set shifting involves the ability to move back and forth between tasks, operations or sets, and impaired ability in this area is postulated to contribute to rigid and obsessional behavior. It is moderately heritable, 88,89 deficits are present in women with AN [90][91][92] and BN, 93 and are observed in both women with AN and women with high levels of obsessionality who have no eating disorder history compared to controls. 94 Importantly, these set-shifting deficits persist after recovery from AN.…”