Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-16T23:02:56.665Z Has data issue: false hasContentIssue false
  • English
  • Français

A systematic review and meta-analysis of set-shifting ability in eating disorders

Published online by Cambridge University Press:  30 January 2007

MARION E. ROBERTS ,
KATE TCHANTURIA ,
DANIEL STAHL ,
LAURA SOUTHGATE  and
JANET TREASURE
MARION E. ROBERTS*
Affiliation:
Division of Psychological Medicine, Eating Disorders Research Unit, Department of Academic Psychiatry, King's College, Guy's Hospital, London, UK
KATE TCHANTURIA
Affiliation:
Division of Psychological Medicine, Eating Disorders Research Unit, Institute of Psychiatry, King's College London, UK
DANIEL STAHL
Affiliation:
Department of Biostatics and Computing, Institute of Psychiatry, King's College London, UK
LAURA SOUTHGATE
Affiliation:
Division of Psychological Medicine, Eating Disorders Research Unit, Department of Academic Psychiatry, King's College, Guy's Hospital, London, UK
JANET TREASURE
Affiliation:
Division of Psychological Medicine, Eating Disorders Research Unit, Department of Academic Psychiatry, King's College, Guy's Hospital, London, UK
*
*Address for correspondence: Marion E. Roberts, Division of Psychological Medicine, Eating Disorders Research Unit, Department of Academic Psychiatry, King's College, 5th Floor Thomas Guy House, Guy's Hospital, London SE1 9RT, UK. (Email: marion.roberts@iop.kcl.ac.uk)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The aim was to critically appraise and synthesize the literature relating to set-shifting ability in eating disorders. PsycINFO, Medline, and Web of Science databases were searched to December 2005. Hand searching of eating-disorder journals and relevant reference sections was also undertaken.

Method

The 15 selected studies contained both eating disorder and healthy control groups, and employed at least one of the following six neuropsychological measures of set-shifting ability; Trail Making Test (TMT), Wisconsin Card Sort Test (WCST), Brixton task, Haptic Illusion, CatBat task, or the set-shifting subset of the Cambridge Neuropsychological Test Automated Battery (CANTAB). The outcome variable was performance on the set-shifting aspect of the task. Pooled standardized mean differences (effect sizes) were calculated.

Results

TMT, WCST, CatBat and Haptic tasks had sufficient sample sizes for meta-analysis. These four tasks yielded acceptable pooled standardized effect sizes (0·36; TMT −1·05; Haptic) with moderate variation within studies (as measured by confidence intervals). The Brixton task showed a small pooled mean difference, and displayed more variation between sample results. The effect size for CANTAB set shifting was 0·17.

Conclusion

Problems in set shifting as measured by a variety of neuropsychological tasks are present in people with eating disorders.

Type
Review Article
Information
Psychological Medicine , Volume 37 , Issue 8 , August 2007 , pp. 1075 - 1084
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bayless, J. D., Kanz, J. E., Moser, D. J., McDowell, B. D., Bowers, W. A., Andersen, A. & Paulson, J. S. (2002). Neuropsychological characteristics of patients in a hospital-based eating disorder program. Annals of Clinical Psychiatry 14, 203–207.CrossRefGoogle Scholar
Begg, C. B. & Mazumdar, M. (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics 50, 1088–1101.CrossRefGoogle Scholar
Bradburn, M. J., Deeks, J. J. & Altman, D. G. (1998). sbe24: metan – an alternative meta-analysis command. Stata Technical Bulletin 44, 1–15.Google Scholar
Burgess, P. W. & Shallice, T. (1997). The Hayling and Brixton Tests. Thames Valley Test Company Ltd: Bury St Edmunds, UK.Google Scholar
Chamberlain, S. R., Fineberg, N. A., Blackwell, A. D., Robbins, T. W. & Sahakain, B. J. (2006). Motor Inhibition and cognitive flexibility in obsessive-compulsive disorder and trichotillomania. American Journal of Psychiatry 163, 1282–1284.CrossRefGoogle ScholarPubMed
Clark, L., Sarna, A. & Goodwin, G. M. (2005). Impairment of executive function but not memory in first-degree relatives of patients with bipolar I disorder and in euthymic patients with unipolar depression. American Journal of Psychiatry 162, 1980–1982.CrossRefGoogle Scholar
Cooper, H. & Hedges, L. (1994). The Handbook of Research Synthesis. The Russell Sage Foundation: New York.Google Scholar
Davies, H. & Tchanturia, K. (2005). Cognitive remediation therapy as an intervention for acute anorexia nervosa: a case report. European Eating Disorders Review 13, 311–316.CrossRefGoogle Scholar
Downes, J. J., Roberts, A. C., Sahakian, B. J., Evenden, J. L., Morris, R. G. & Robbins, T. W. (1989). Impaired extra-dimensional shift performance in medicated and unmedicated Parkinson's disease: evidence for a specific attentional dysfunction. Neuropsychologia 27, 1329–1343.CrossRefGoogle ScholarPubMed
Egger, M., Smith, G. D., Schneider, M. & Minder, C. (1997). Bias in meta analysis detected by a simple, graphical test. British Medical Journal 315, 629–634.CrossRefGoogle ScholarPubMed
Eliava, N. (1964). A Problem of Set in Cognitive Psychology. Academic Press: Tbilisi, Georgia.Google Scholar
Everitt, B. S. (2003). Modern Medical Statistics. Arnold Publishers: London.Google Scholar
Fassino, S., Piero, A., Daga, G. A., Leombruni, P., Mortara, P. & Rovers, G. G. (2002). Attentional biases and frontal functioning in anorexia nervosa. International Journal of Eating Disorders 31, 274–283.CrossRefGoogle ScholarPubMed
Ferraro, F. R., Wonderlich, S. & Jocic, Z. (1997). Performance variability as a newtheoretical mechanism regarding eating disorders and cognitive processing. International Journal of Eating Disorders 53, 117–121.Google ScholarPubMed
Fowler, L., Blackwell, A., Jaffa, A., Palmer, R., Robbins, T. W., Sahakian, B. J. & Dowson, J. H. (2005). Profile of neurocognitive impairments associated with female in-patients with anorexia nervosa. Psychological Medicine 36, 517–527.CrossRefGoogle ScholarPubMed
Fox, C. F. (1981). Neuropsychological correlates of anorexia nervosa. International Journal of Psychiatry in Medicine 11, 285–290.CrossRefGoogle ScholarPubMed
Frieling, H., Roschke, B., Kornhuber, J., Wilhelm, J., Romer, K. D., Gruss, B., Donsch, D., Hillemacher, T., de Zwaan, M., Jacoby, G. E. & Bleich, S. (2005). Cognitive impairment and its association with homocysteine plasma levels in females with eating disorders – findings from the HEaD study. Journal of Neural Transmission 112, 1591–1598.CrossRefGoogle ScholarPubMed
Grunwald, M., Ettrich, C., Assmann, B., Dahne, A., Krause, W., Busse, F. & Gertz, H.-J. (2001 a). Deficits in haptic perception and right parietal theta power changes in patients with anorexia nervosa before and after weight gain. International Journal of Eating Disorders 29, 417–428.CrossRefGoogle ScholarPubMed
Grunwald, M., Ettrich, C., Krause, W., Assmann, B., Dahne, A., Weiss, T. & Gertz, H.-J. (2001 b). Haptic perception in anorexia nervosa before and after weight gain. Journal of Clinical and Experimental Neuropsychology 23, 520–529.CrossRefGoogle ScholarPubMed
Henry, J. D. (2006). A meta-analytic review of Wisconsin card sorting test and verbal fluency performance in obsessive-compulsive disorder. Cognitive Neuropsychiatry 11, 156–176.CrossRefGoogle ScholarPubMed
Higgins, J. P. T., Thompson, S. G., Deeks, J. J. & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal 327, 557–560.CrossRefGoogle ScholarPubMed
Holliday, J., Tchanturia, K., Landau, S., Collier, D. & Treasure, J. (2005). Is impaired set shifting an endophenotype of anorexia nervosa? American Journal of Psychiatry 162, 2269–2275.CrossRefGoogle ScholarPubMed
Jones, B. P., Duncan, C. C., Brouwers, P. & Mirsky, A. F. (1991). Cognition in eating disorders. Journal of Clinical and Experimental Neuropsychology 13, 711–728.CrossRefGoogle ScholarPubMed
Kemps, E., Tiggemann, M., Wade, T., Ben-Tovim, D. & Breyer, R. (2006). Selective working memory deficits in anorexia nervosa. European Eating Disorders Review 14, 97–103.CrossRefGoogle Scholar
Kingston, J., Szmukler, G., Andrews, D., Tress, B. & Desmond, P. (1996). Neuropsychological and structural brain changes in anorexia nervosa before and after refeeding. Psychological Medicine 26, 15–28.CrossRefGoogle ScholarPubMed
Kitabayashi, Y., Ueda, H., Kashima, A., Okamoto, A., Kooguchi, Y., Narumoto, J., Wada, Y., Yamashita, T. & Fukui, K. (2004). Change of cognitive function following body weight recovery in anorexia nervosa. Seishin Igaku 46, 243–248.Google Scholar
Koba, T., Shrie, S. & Nabeta, Y. (2002). Impaired performance of Wisconsin Card Sorting Test in patients with eating disorders: a preliminary study. Seishin Igaku 44, 681–683.Google Scholar
Kravariti, E., Morris, R. G., Rabe-Hesketh, D., Murray, R. M. & Frangou, S. (2003). The Maudsley early onset schizophrenia study: cognitive function in adolescents with recent onset schizophrenia. Schizophrenia Research 61, 137–148.CrossRefGoogle ScholarPubMed
Lauer, C. J., Gorzewski, B., Gerlinghoff, M., Backmund, H. & Zihl, J. (2002). Neuropsychological assessments before and after treatment in patients with anorexia nervosa and bulimia nervosa. Journal of Psychiatric Research 33, 129–138.CrossRefGoogle Scholar
Mathias, J. L. & Kent, P. S. (1998). Neuropsychological consequences of extreme weight loss and dietary restriction in patients with anorexia nervosa. Journal of Clinical and Experimental Neuropsychology 20, 548–564.CrossRefGoogle ScholarPubMed
Miyake, A., Freidman, N. P., Emerson, M. J., Wizki, A. H., Howerter, A. & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex ‘frontal lobe’ tasks: a latent variable analysis. Cognitive Psychology 41, 49–100.CrossRefGoogle ScholarPubMed
Murphy, R., Nutzinger, D. O., Paul, T. & Leplow, B. (2002). Dissociated conditional-associative learning in anorexia nervosa. Journal of Clinical and Experimental Neuropsychology 24, 176–186.CrossRefGoogle ScholarPubMed
Ohrmann, P., Kersting, A., Suslow, T., Lalee-Mentzel, J., Donges, U. S., Feibich, M., Arolt, V., Heindel, W. & Pfleidrer, B. (2004). Proton magnetic resonance spectroscopy in anorexia nervosa: Correlations with cognition. Neuroreport 15, 549–553.CrossRefGoogle ScholarPubMed
Reitan, R. M. (1958). Validity of the trail making test as indicator of organic brain damage. Perceptual and Motor Skills 8, 271–276.CrossRefGoogle Scholar
Robinson, L. J., Thompson, J. M., Gallagher, P., Goswami, U., Young, A. H., Ferrier, I. N. & Moore, P. B. (2006). A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder. Journal of Affective Disorders 93, 105–115.CrossRefGoogle ScholarPubMed
Rosenberg, M. S., Adams, D. C. & Gurevitch, J. (2000). MetaWin: Statistical Software for Meta-analysis. Version 2.0. Sinauer: Sunderland, MA.Google Scholar
Snitz, B. E., Macdonald, A. W. III & Carter, C. S. (2006). Cognitive deficits inunaffected first-degree relatives of schizophrenia patients: a meta-analytic review of putative endophenotypes. Schizophrenia Bulletin 32, 179–194.CrossRefGoogle Scholar
Southgate, L. (2005). Response inhibition in anorexia nervosa and bulimia nervosa: an exploration of neuropsychological functions and their association with personality traits and behaviours. Ph.D. thesis. Kings College London, Institute of Psychiatry.Google Scholar
Southgate, L., Tchanturia, K. & Treasure, J. (2005). Building a model of the aetiology of eating disorders by translating experimental neuroscience into clinical practice. Journal of Mental Health 14, 553–566.CrossRefGoogle Scholar
Steichen, T. (1998). sbe19: tests for publication bias in meta-analysis. Stata Technical Bulletin 41, 9–15.Google Scholar
Steinglass, J. & Walsh, B. T. (2006). Habit learning and anorexia nervosa: a cognitive neuroscience hypothesis. International Journal of Eating Disorders 39, 267–275.CrossRefGoogle ScholarPubMed
Steinglass, J. E., Walsh, B. T. & Stern, Y. (2006). Set shifting deficit in anorexia nervosa. Journal of the International Neuropsychological Society 12, 431–435.CrossRefGoogle ScholarPubMed
Tchanturia, K., Brecelj, Anderlug M., Morris, R. G., Rabe-Hesketh, S., Collier, D., Sanchez, P. & Treasure, J. L. (2004 a). Cognitive Flexibility in anorexia nervosa and bulimia nervosa. Journal of the International Neuropsychological Society 10, 513–520.CrossRefGoogle ScholarPubMed
Tchanturia, K., Campbell, I., Morris, R. & Treasure, J. (2005). Neuropsychological studies in anorexia nervosa. International Journal of Eating Disorders 37 (Suppl.), S72–S76.CrossRefGoogle ScholarPubMed
Tchanturia, K., Morris, R. G., Brecelj, Anderluh M., Collier, D. A., Nikolaou, V. & Treasure, J. (2004 b). Set shifting in anorexia nervosa: an examination before and after weight gain, in full recovery, and relationship to childhood and adult OCPD traits. Journal of Psychiatric Research 38, 545–552.CrossRefGoogle ScholarPubMed
Tchanturia, K., Morris, R., Surguladze, S. & Treasure, J. (2002). An examination of perceptual and cognitive set shifting tasks in acute anorexia nervosa and following recovery. Eating and Weight Disorders 7, 312–316.CrossRefGoogle ScholarPubMed
Tchanturia, K., Serpell, L., Troop, N. & Treasure, J. (2001). Perceptual illusions in eating disorders: rigid and fluctuating styles. Journal of Behaviour Therapy and Experimental Psychiatry 32, 107–115.CrossRefGoogle ScholarPubMed
Tchanturia, K., Whitney, J. & Treasure, J. (in press). Can cognitive exercises help treat anorexia nervosa? A Case Report. Weight and Eating Disorders 11.Google Scholar
Thompson, S. B. N. (1993). Implications of neuropsychological test results of women in a new phase of anorexia nervosa. European Eating Disorders Review 1, 152–165.CrossRefGoogle Scholar
Touyz, S. W., Beumont, P. J. V. & Johnstone, L. C. (1986). Neuropsychological correlates of dieting disorders. International Journal of Eating Disorders 5, 1025–1034.3.0.CO;2-T>CrossRefGoogle Scholar
Uznadze, D. N. (1966). The Psychology of Set. Consultants' Bureau: New York.Google Scholar
Witt, E. D., Ryan, C. & George, Hsu L. K. (1985). Learning deficits in adolescents with anorexia nervosa. Journal of Nervous and Mental Disease 173, 182–184.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Roberts Supplementary Material

Appendix.pdf

Download Roberts Supplementary Material(PDF)
PDF 38.1 KB