Psychological Medicine

Review Article

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

MARION E. ROBERTSa1 c1, KATE TCHANTURIAa2, DANIEL STAHLa3, LAURA SOUTHGATEa1 and JANET TREASUREa1

a1 Division of Psychological Medicine, Eating Disorders Research Unit, Department of Academic Psychiatry, King's College, Guy's Hospital, London, UK

a2 Division of Psychological Medicine, Eating Disorders Research Unit, Institute of Psychiatry, King's College London, UK

a3 Department of Biostatics and Computing, Institute of Psychiatry, King's College London, UK

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.

(Online publication January 30 2007)

Correspondence

c1 *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)

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