Insight in eating disorders: clinical and cognitive correlates

Psychiatry Research, 2013

The primary goal of the present study was to explore the neuropsychological basis of insight into illness in anorexia nervosa by evaluating its differential and joint links with cognitive vs. metacognitive performance. Participants in the study were 25 women with anorexia nervosa (AN) and 25 healthy comparisons (HC). All participants completed a computerized version of the Wisconsin Card Sorting Task (WCST) and the Computerized Body-Size Discrimination task (CBSD). In addition to the standard administration of the tasks, subjects were also asked to rate their level of confidence in the correctness of each sort and to choose whether they wanted each sort to be ''counted'' toward their overall performance score on the test. Insight into illness in the AN group was assessed with the Scale of Unawareness of Mental Disorder (SUMD). Prediction of poor insight was significantly improved when adding the new, free-choice metacognitive measures to the conventional measures in both tasks, but not the other way around. These preliminary results suggest that metacognition might be an important mediator between basic cognitive deficits and poor insight and that it might be even more relevant to poor insight than cognitive deficits per se.

Journal of Education, Humanities and Social Sciences

Eating disorder has created severe health problems for people different in gender, age and culture. The cognitive process varies depending on different types of the eating disorder. The current study of the cognitive process, including impulsivity (including motor response and decision domain), behavioral flexibility (including set shifting and goal-directed behavior), and attention bias are reviewed for eating disorders including Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED). Then, the difference in decision-making is specifically discussed between AN, BN, and BED, indicating that decision impairment may reflect the trait of different types of the eating disorder. Besides, the decision-making process may reflect the different behavior of eating disorders. The article aims to categorize further subtypes of eating disorders and the conceptualization of AN-R (Restrictive type of Anorexia Nervosa), AN-B (Binging type of Anorexia Nervosa), BN, and BED. The...

Orvosi hetilap, 2009

The continuum model of the eating disorders proposes that eating disorders can be described on a continuous spectrum from restrictive anorexia to stable obesity. Previous studies suggested that emotional disturbances (depression, anxiety and alexithymia), cognitive impairments and distortion of body image are frequently associated with anorexia nervosa. However, obesity is mostly regarded as a weight management problem. We investigated common deficits in cognition, emotion and body image underlying the pathology of the two extreme sides of eating spectrum (restriction and excessive eating). Neuropsychological tasks assessed cognitive deficits; questionnaires were used to evaluate mood and explicit attitudes and Affective Priming paradigm to assess implicit attitudes. Neuropsychological tasks showed common deficit in attention capacity. Obese patients, both children and adult showed impaired shifting capacity and mental rigidity associated with frontal lobe based executive functions....

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity

Background The Reading the Mind in the Eyes Test (RMET) is listed in the National Institute of Mental Health’s Research Domain Criteria as a tool apt to measure the understanding of others’ mental states. People diagnosed with anorexia nervosa (AN) showed poorer performances on the RMET than healthy controls. Less data are available concerning other eating disorders. Methods Systematic review of four major databases from inception to July 15, 2021 following the PRISMA guidelines. Meta-analysis of cross-sectional observational studies comparing the scores of the RMET between patients with eating disorders and age- and-gender matched control groups. Results Out of 21 studies, we retrieved 29 independent samples of patients diagnosed with an eating disorder. Patients with active AN (n = 580) showed worse performances on the RMET than controls (n = 1019). Year of publication accounted for 61% of the (substantial: I2 = 81%) heterogeneity in the meta-analysis. Earlier studies were more li...

European Eating Disorders Review, 2013

Objective: This study aimed to assess cognitive and affective theory of mind (ToM) in patients with eating disorders and to explore its relationship with the clinical and psychopathological profile. Method: Theory of mind was assessed in 65 women, consisting of 22 with anorexia nervosa (AN), 19 with bulimia nervosa (BN), and 24 healthy controls (HC), using the Reading the Mind in the Eyes Test and the Faux Pas Test. These tasks evaluate affective and cognitive ToM, respectively. We also examined the correlations between performance on ToM tasks and the clinical psychopathological profile, which was extensively evaluated through self-report instruments and clinical interviews. Results: Patients with AN had poorer performance than BN patients and HCs had in the affective ToM task, particularly in recognizing negative emotions and emotions in male eyes. Moreover, this deficit showed no correlation with the psychopathological profile. Performance in the BN group was equivalent to that of HCs in both tasks. Conclusions: In this study, patients with AN showed an impairment in affective ToM, independent of their clinical status. Consistent with other studies, our findings demonstrate a specific difficulty in social cognition in patients with AN. This may be a trait marker in this population and should be considered in treatment. Furthermore, patients with AN and BN have different difficulty profiles in this domain of social cognition.

Current Topics in Behavioral Neurosciences, 2010

Clinical Psychology Review, 2005

Important developments have taken place in cognitive theory of eating disorders (EDs) (and also in other disorders) since the review paper published by M.J. Cooper in 1997. The relevant empirical database has also expanded. Nevertheless, cognitive therapy for anorexia nervosa and bulimia nervosa, although helpful to many patients, leaves much to be desired. The current paper reviews the relevant empirical evidence collected, and the theoretical revisions that have been made to cognitive models of eating disorders, since 1997. The status and limitations of these developments are considered, including whether or not they meet the criteria for bgoodQ theory. New theoretical developments relevant to cognitive explanations of eating disorders (second generation theories) are then presented, and the preliminary evidence that supports these is briefly reviewed. The lack of integration between cognitive theories of EDs and risk (vulnerability) factor research is noted, and a potential model that unites the two is noted. The implications of the review for future research and the development of cognitive theory in eating disorders are then discussed. These include the need for study of cognitive constructs not yet fully integrated (or indeed not yet applied clinically) into current theories and the need for cognitive theories of eating disorders to continue to evolve (as they have indeed done since 1997) in order to fully integrate such constructs. Treatment studies incorporating these new developments also urgently need to be undertaken. D

Psychiatry Research, 2008

The aim of this study was to investigate preferential information processing style in Eating Disorders (ED). We compared the performance of participants with EDs against healthy controls in a task that measures cognitive style (reflection-impulsivity) and cognitive efficiency (inefficient-efficient). Sixty non-medicated female participants (healthy controls n = 26, anorexia nervosa n = 20, bulimia nervosa n = 14) took part in the Matching Familiar , a difficult visual search paradigm with high response uncertainty. Participants with anorexia scored significantly higher on the efficiency dimension score than the control group. No significant differences were found across groups on the dimension 'reflection-impulsivity'. Participants with anorexia are more efficient (quicker response latencies in conjunction with fewer errors) in this visual search task that requires an analytic approach. This supports the hypothesis that individuals with anorexia have a positive bias toward local detail processing, indicative of weak central coherence.

The International journal of eating disorders, 2015

In the treatment research literature on other psychological disorders, there is a move towards session-by-session symptom measurement. The necessary measures need to be brief, focused on core features since the last session, and readily available to clinicians. There is no measure in the eating disorders that meets those criteria. This research reports the development and validation of such a self-report questionnaire. The authors generated and refined a brief set of attitudinal and behavioral items. The resulting questionnaire (the ED-15) and an existing measure (Eating Disorders Examination-Questionnaire; EDE-Q) were completed by a large nonclinical adult sample (N = 531), a group of self-reported eating disorder sufferers (N = 63), and a group of women (N = 33) diagnosed with bulimia nervosa or atypical bulimia nervosa and undertaking cognitive-behavioral therapy. Factor analysis identified two scales (Weight and Shape Concerns; Eating Concerns), with strong internal consisten...

Frontiers in Psychology, 2017