Poor Decision Making in Male Patients with Anorexia Nervosa

Tchanturia, Kate; Liao, Pei-Chi; Forcano, Laura; Fernández‐Aranda, Fernando; Uher, Rudolf; Treasure, Janet; Schmidt, Ulrike; Penelo, Eva; Granero, Roser; Jiménez‐Murcia, Susana; Sánchez, Isabel; Campbell, Iain C.

doi:10.1002/erv.1154

Cited by 46 publications

(39 citation statements)

References 18 publications

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“…Group differences were more marked on the cognitive flexibility and decision making domains, although the inhibition response task also showed marginally statistical differences. Therefore, cognitive results are in agreement with several previous neuropsychological studies showing that EWC deficits extend to several executive processes [32], [33], [36], [37], [39]–[41], [44], [55], [56], almost certainly relying on the functioning of different fronto striatal systems, including the dorsolateral prefrontal cortex and the orbitofrontal cortex [21], [57]–[59].…”

Section: Discussionsupporting

confidence: 91%

“…Both, AN and OB subjects go for choices that result in elevated immediate gains despite important future losses, showing a similar level of impairment between them. Therefore, according to previous general conducted studies [32], [39], [40], [42]–[44], [55], [56], the extreme eating/weight behaviors of these subjects might partially be an expression of their incapacity to successfully regulate reward and punishment, which might be translated into deficit in planning every day functioning. From a clinical perspective, it might be postulated that there are reasonable similarities between their test performance and their day to day pathological eating behaviors.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, differences between individuals in these areas would be making them more or less vulnerable to EWC. However, and in spite of the importance of straight comparison of the executive profiles in EWC subjects, research has explored each group separately and usually using single cognitive tasks [32], [34], [39]–[41], [43], [44]. As far as we know, only one study has compared cognitive performance in AN and obese subjects, that also included bulimia nervosa (BN) patients [42].…”

Section: Introductionmentioning

confidence: 99%

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Executive Functions Profile in Extreme Eating/Weight Conditions: From Anorexia Nervosa to Obesity

et al. 2012

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BackgroundExtreme weight conditions (EWC) groups along a continuum may share some biological risk factors and intermediate neurocognitive phenotypes. A core cognitive trait in EWC appears to be executive dysfunction, with a focus on decision making, response inhibition and cognitive flexibility. Differences between individuals in these areas are likely to contribute to the differences in vulnerability to EWC. The aim of the study was to investigate whether there is a common pattern of executive dysfunction in EWC while comparing anorexia nervosa patients (AN), obese subjects (OB) and healthy eating/weight controls (HC).MethodsThirty five AN patients, fifty two OB and one hundred thirty seven HC were compared using the Wisconsin Card Sorting Test (WCST); Stroop Color and Word Test (SCWT); and Iowa Gambling Task (IGT). All participants were female, aged between 18 and 60 years.ResultsThere was a significant difference in IGT score (F(1.79); p<.001), with AN and OB groups showing the poorest performance compared to HC. On the WCST, AN and OB made significantly more errors than controls (F(25.73); p<.001), and had significantly fewer correct responses (F(2.71); p<.001). Post hoc analysis revealed that the two clinical groups were not significantly different from each other. Finally, OB showed a significant reduced performance in the inhibition response measured with the Stroop test (F(5.11); p<.001) compared with both AN and HC.ConclusionsThese findings suggest that EWC subjects (namely AN and OB) have similar dysfunctional executive profile that may play a role in the development and maintenance of such disorders.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Executive Functions Profile in Extreme Eating/Weight Conditions: From Anorexia Nervosa to Obesity

et al. 2012

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“…Eating disorders share neuropsychiatric co-morbidity and certain susceptibility genes with mood disorder, impulsiveness and substance abuse [155,156] with greater suicide prevalence among anorexia nervosa patients [157]. Tchanturia et al [158] have found impaired decision-making in both male and female patients presenting eating disorder. Concurrently, it was shown that internalizing problems (cf.…”

Section: Introductionmentioning

confidence: 99%

Neurogenetics and Epigenetics in Impulsive Behaviour: Impact on Reward Circuitry

Archer

Oscar‐Berman²,

Blum³

et al. 2012

J Genet Syndr Gene Ther

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Adverse, unfavourable life conditions, particularly during early life stages and infancy, can lead to epigenetic regulation of genes involved in stress-response, behavioral disinhibition, and cognitive-emotional systems. Over time, the ultimate final outcome can be expressed through behaviors bedeviled by problems with impulse control, such as eating disorders, alcoholism, and indiscriminate social behavior. While many reward gene polymorphisms are involved in impulsive behaviors, a polymorphism by itself may not translate to the development of a particular behavioral disorder unless it is impacted by epigenetic effects. Brain-derived neurotrophic factor (BDNF) affects the development and integrity of the noradrenergic, dopaminergic, serotonergic, glutamatergic, and cholinergic neurotransmitter systems, and plasma levels of the neurotrophin are associated with both cognitive and aggressive impulsiveness. Epigenetic mechanisms associated with a multitude of environmental factors, including premature birth, low birth weight, prenatal tobacco exposure, non-intact family, young maternal age at birth of the target child, paternal history of antisocial behavior, and maternal depression, alter the developmental trajectories for several neuropsychiatric disorders. These mechanisms affect brain development and integrity at several levels that determine structure and function in resolving the final behavioral expressions.

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“…Patients with AN have been shown to possess poor decisionmaking abilities (Tchanturia et al 2012) and are inclined to logically and rationally defend their food choices. Cognitive distortions are often difficult to correct, and in P.'s case there was limited success with CBT.…”

Section: Paul Mehta and Coffeymentioning

confidence: 99%

Anorexia Nervosa in a 14-Year-Old Second-Generation Hispanic Adolescent Boy

Paul

Mehta²

2013

Journal of Child and Adolescent Psychopharmacology

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Poor Decision Making in Male Patients with Anorexia Nervosa

Abstract: Impaired decision making is present in male and female patients with AN. These data suggest that male patients with AN are very similar to female patients in decision making, and as a result, treatment approaches that seek to improve this ability should be similar in both genders.

Cited by 46 publications

References 18 publications

Executive Functions Profile in Extreme Eating/Weight Conditions: From Anorexia Nervosa to Obesity

Executive Functions Profile in Extreme Eating/Weight Conditions: From Anorexia Nervosa to Obesity

Neurogenetics and Epigenetics in Impulsive Behaviour: Impact on Reward Circuitry

Anorexia Nervosa in a 14-Year-Old Second-Generation Hispanic Adolescent Boy

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