Hostname: page-component-7c8c6479df-8mjnm Total loading time: 0 Render date: 2024-03-28T17:56:31.170Z Has data issue: false hasContentIssue false

Set shifting deficit in anorexia nervosa

Published online by Cambridge University Press:  17 May 2006

JOANNA E. STEINGLASS
Affiliation:
Department of Psychiatry, College of Physicians & Surgeons of Columbia University, and The New York State Psychiatric Institute, New York, New York
B. TIMOTHY WALSH
Affiliation:
Department of Psychiatry, College of Physicians & Surgeons of Columbia University, and The New York State Psychiatric Institute, New York, New York
YAAKOV STERN
Affiliation:
Department of Psychiatry, College of Physicians & Surgeons of Columbia University, and The New York State Psychiatric Institute, New York, New York Department of Neurology, College of Physicians & Surgeons of Columbia University, New York, New York

Abstract

Anorexia nervosa (AN) is a severe mental illness characterized in part by rigid thinking and ritualized behaviors involving eating and weight. Cognitive rigidity may play a role in the perpetuation of symptoms, and may provide information as to important brain-based abnormalities. Neuropsychological studies of patients with AN have shown cognitive dysfunction, but few have focused on cognitive flexibility. This study assessed set shifting in patients with AN, as a measure of cognitive flexibility. In this study, 15 patients with AN were compared with 11 healthy controls using a neuropsychological battery including the Wisconsin Card Sort Test (WCST). While patients with AN did not differ from controls on 5 measures of neuropsychological function, they made significantly more perseverative errors on the WCST, indicating a problem in set shifting. This finding suggests that patients with AN have a specific neurocognitive abnormality that may play a role in the development and persistence of this disorder. (JINS, 2006, 12, 431–435.)

Type
BRIEF COMMUNICATION
Copyright
© 2006 The International Neuropsychological Society

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

Berg, E.A. (1948). A simple objective technique for measuring flexibility in thinking. Journal of General Psychology, 39, 1522.Google Scholar
Delvenne, V., Goldman, S., De Maertelaer, V., & Lotstra, F. (1999). Brain glucose metabolism in eating disorders assessed by positron emission tomography. International Journal of Eating Disorders, 25, 2937.Google Scholar
Fairburn, C.G. & Cooper, P.J. (1993). The Eating Disorder Examination. In C.G. Fairburn & G.T. Wilson (Eds.), Binge eating: Nature, assessment, and treatment (pp. 317360). New York: Guilford Press.
Fassino, S., Piero, A., Daga, G.A., Leombruni, P., Mortara, P., & Rovera, G.G. (2002). Attentional biases and frontal functioning in anorexia nervosa. International Journal of Eating Disorders, 31, 274283.Google Scholar
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (1995). Structured Clinical Interview for DSM-IV Axis I Disorders, Patient Edition (SCID-P), version 2. New York: New York State Psychiatric Institute, Biometrics Research.
Frank, G.K., Bailer, U.F., Henry, S.E., Drevets, W., Meltzer, C.C., Price, J.C., Mathis, C.A., Wagner, A., Hoge, J., Ziolko, S., Barbarich-Marsteller, N., Weissfeld, L., & Kaye, W.H. (2005). Increased dopamine d2/d3 receptor binding after recovery from anorexia nervosa measured by positron emission tomography and [(11)c]raclopride. Biological Psychiatry, 58, 908912.Google Scholar
Grant, M.M., Thase, M.E., & Sweeney, J.A. (2001). Cognitive disturbance in outpatient depressed younger adults: Evidence of modest impairment. Biological Psychiatry, 50, 3543.Google Scholar
Graybiel, A.M. & Rauch, S.L. (2000). Toward a neurobiology of obsessive-compulsive disorder. Neuron, 28, 343347.Google Scholar
Green, M.W., Elliman, N.A., Wakeling, A., & Rogers, P.J. (1996). Cognitive functioning, weight change and therapy in anorexia nervosa. Journal of Psychiatric Research, 30, 401410.Google Scholar
Husain, M.M., Black, K.J., Doraiswamy, P.M., Shah, S.A., Rockwell, W.J.K., Ellinwood, E.H., Jr., & Krishnan, K.R.R. (1992). Subcortical brain anatomy in anorexia and bulimia. Biological Psychiatry, 31, 735738.Google Scholar
Kingston, K., Szmukler, G., Andrewes, D., Tress, B., & Desmond, P. (1996). Neuropsychological and structural brain changes in anorexia nervosa before and after refeeding. Psychological Medicine, 26, 1528.Google Scholar
Lezak, M.D., Howieson, D.B., & Loring, D.W. (2004). Neuropsychological assessment, fourth edition. New York: Oxford University Press.
Merriam, E.P., Thase, M.E., Haase, G.L., Keshavan, M.S., & Sweeney, J.A. (1999). Prefrontal cortical dysfunction in depression determined by Wisconsin Card Sort Test performance. American Journal of Psychiatry, 156, 780782.Google Scholar
Monchi, O., Petrides, M., Petre, V., Worsley, K., & Dagher, A. (2001). Wisconsin Card Sorting revisited: Distinct neural circuits participating in different stages of the task identified by event-related functional magnetic resonance imaging. The Journal of Neuroscience, 21, 77337741.Google Scholar
Pike, K.M., Walsh, B.T., Vitousek, K., Wilson, G.T., & Bauer, J. (2003). Cognitive behavior therapy in the posthospitalization treatment of anorexia nervosa. American Journal of Psychiatry, 160, 20462049.Google Scholar
Sachs, G., Anderer, P., Margreiter, N., Semlitsch, H., Saletu, B., & Katschnig, H. (2004). P300 event-related potentials and cognitive function in social phobia. Psychiatric Research: Neuroimaging, 131, 249261.Google Scholar
Shafritz, K.M., Kartheiser, P., & Belger, A. (2005). Dissociation of neural systems mediating shifts in behavioral response and cognitive set. Neuroimage, 25, 600606.Google Scholar
Steinglass, J.E. & Walsh, B.T., (in press). Habit learning and anorexia nervosa: A cognitive neuroscience hypothesis. International Journal of Eating Disorders.
Strober, M. (1980). Personality and symptomatological features in young, nonchronic anorexia nervosa patients. Journal of Psychosomatic Research, 24, 353359.Google Scholar
Tchanturia, K., Anderluh, M.B., Morris, R.G., Rabe-Hesketh, S., Collier, D.A., Sanchez, P., & Treasure, J.L. (2004). Cognitive flexibility in anorexia nervosa and bulimia nervosa. Journal of the International Neuropsychological Society, 10, 513520.Google Scholar
Tchanturia, K., Morris, R.G., 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, 312316.Google Scholar
Tchanturia, K., Serpell, L., Troop, N., & Treasure, J. (2001). Perceptual illusions in eating disorders: Rigid and fluctuating styles. Journal of Behavior Therapy and Experimental Psychology, 32, 107115.Google Scholar