Task‐switching inefficiencies in currently ill, but not remitted anorexia nervosa

Abstract

Objective Models of anorexia nervosa (AN) posit that set‐shifting deficits may contribute to behavioral inflexibility and extreme dietary restriction. Findings from neurocognitive studies of set‐shifting in AN have been somewhat mixed, perhaps due to the use of tasks that cannot distinguish shifting from other processes (i.e., learning). To more precisely characterize cognitive flexibility and selectively assess this process independent of rule learning and feedback sensitivity, we examined task‐switching ability in AN. Method Women ill with AN, subthreshold AN or atypical AN (IAN; n = 40), women remitted from AN (RAN; n = 24), and age‐matched healthy control women (n = 42) completed a computerized cued color‐shape task‐switching paradigm. Groups were compared on mix costs (reflecting global cognitive control) and switch costs (reflecting transient cognitive control). Results Although mix costs were equivalent across groups, switch costs were more pronounced in the IAN group, as indicated by a group‐by‐trial type interaction for reaction times on stay and switch trials. Discussion Findings indicate that IAN, but not RAN, have difficulty flexibly switching between cognitive task sets, and suggest that prior findings of set‐shifting deficits in AN may reflect difficulty with cognitive flexibility independent of learning deficits. As such, task‐switching may represent a promising adjunctive treatment target.

Difficulties in retrieving specific details of autobiographical memories and imagining positive future events in individuals with acute but not remitted anorexia nervosa

“…Moreover, there are other indices of cognitive flexibility that may have been impaired in our group of individuals with, or remitted from, AN (e.g. task switching; [ 4 , 5 ]), which are distinct from the index of cognitive flexibility traditionally measured by the WCST (i.e. perseverance).…”

Central coherence and set‐shifting between nonunderweight eating disorders and anorexia nervosa: A systematic review and meta‐analysis

“…First, participants were primarily white females meaning we cannot determine whether our findings generalize to a more diverse sample of people with eating disorders. Second, while it was also a strength that we used just the RCFT and WCST to reduce heterogeneity, future meta‐analyses should investigate whether the same pattern of results is observed if studies using other traditional neuropsychological measures and new paradigms (e.g., Berner et al, 2019) tapping central coherence and set‐shifting are examined.…”

Assessing cognitive flexibility in anorexia nervosa using eye tracking: A registered report

“…To aid comparison with recent studies in AN (Berner et al, 2019 ; King et al, 2019 ), adult female participants 18 years or older will be recruited. All participants will complete an initial screening process which will include administration of a standardized Eating Disorder Assessment for DSM‐5 (EDA‐5; Sysko et al, 2015 ) to determine study eligibility.…”

“…Recent cognitive flexibility research using a cued task‐switching paradigm which requires participants to perform one of two tasks in response to a bivalent stimulus, has demonstrated that both currently ill and weight‐restored individuals with a history of AN perform as accurately as a healthy control group, but with slower reaction times (Berner et al, 2019 ; King et al, 2019 ). A bias towards accuracy over speed was noted in the task‐switching results for weight‐restored participants who were more accurate than the control group, and the authors suggested that this high level of self‐control may be related to trait perfectionism (King et al, 2019 ).…”