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

Abstract

Background:Recent models try to find in eating disorders (ED) a relationship between the neuropsychological dimensions, the psychopathological disturbances and the clinical manifestations. Carrying out an investigation on neuropsychological aspects that may be related with an ED’s characteristic cognitive pattern could contribute to their possible influence towards therapeutic change. The main objective of this paper is to analyse the possible relationship between psychopathological and clinical variables with the neuropsychological characteristics of patients diagnosed with an ED and their possible influence on the attitude towards change. Methods:An observational analytical transversal study was done. Patients were outpatients referred during a 6-month period who signed informed consent. Seventy-four subjects were included. Clinical (Psychiatric Status Rating Scale modified) and neuropsychological tests (Letter Number Sequencing; Stroop’s test; Symbol and Digit Modalities Test; Rey-Osterrieth complex figure test) were administrated and psychopathological self-report questionnaires (Body Shape Questionnaire; Eating Disorders Inventory; The Bulimic Investigatory Test, Edinburgh; Beck’s depression inventory; State-Trait Anxiety Inventory; Dissociative Experiences Scale; Attitudes Towards Change in Eating Disorders Scale) were given (but 23 participants, 31.08%, did not give them back).Results:Nineteen patients (25,68%) were diagnosed with restrictive anorexia nervosa (AN), 19 (25,68%) purgative AN, 14 bulimia nervosa (18,92%), 9 binge eating disorder (12,16%) and 13 ED not otherwise specified (17,57%). There are not any significant differences between the diagnoses with regards to the score of neuropsychological tests. BMI was related to the majority of the neuropsychological scores. “Precontemplation” was related to time of copy (B=3.56; IC 95% (0.82-6.29), p<0,01) and time of memory (B=-2.31; IC 95% (-4.58-(-0.05)); p<0.05). “Contemplation” was related to time of copy (B=1.43; IC 95% (0.42-2.45); p<0.01) and index of style (B= -14.01; IC 95% (-24.98-(-3.04)); p<0.01). “Decision” was related to working memory (SpanLN), quantitative score of copy, index of order and index of style.Conclusions:Neuropsychological alterations could be summarized as the working memory is lowered and the interference is increased, which is associated with a more controlling and less flexible attitude, and scores in inhibitory care are lower. ROCFT shows a visoperceptive deficit in some patients.