Cognitive flexibility and attention to detail in adolescents and adults with severe forms of anorexia nervosa

Sylvie Berthoz, Anne‐Solène Maria, Damien Ringuenet, Léna Bourdier, Isabelle Nicolas, Corinne Blanchet, Christine Foulon, Guillaume Lavoisy, Nathalie Godart, Caroline Barry
Euro Eating Disorders Rev. 2022-02-28; 30(3): 289-297
DOI: 10.1002/erv.2883

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Berthoz S(1)(2), Maria AS(3), Ringuenet D(4), Bourdier L(5), Nicolas I(2),
Blanchet C(6)(7), Foulon C(8), Lavoisy G(8), Godart N(6)(9)(10), Barry C(6).

Author information:
(1)Université Bordeaux, CNRS, EPHE, INCIA, UMR 5287, Bordeaux, France.
(2)Department of Psychiatry for Adolescents and Young Adults, Institut
Mutualiste Montsouris, Paris, France.
(3)Private Practice, Stimulus Consulting Ltd, Cascavelle, Mauritius.
(4)APHP, Hôpital Paul Brousse, Département de Psychiatrie, Unité Troubles du
Comportement Alimentaires, Villejuif, France.
(5)Addictology Department, University Hospital of Bordeaux, Bordeaux, France.
(6)Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif,
France.
(7)APHP, Hôpital Cochin, Maison des Adolescents-Maison de Solenn, Paris, France.
(8)Clinique Villa Montsouris, Paris, France.
(9)UFR Simone Veil, UVSQ, Univ. Paris-Saclay, Montigny-le-Bretonneux, France.
(10)Fondation Santé des Etudiants de France, Paris, France.

OBJECTIVE: To determine if adolescents and adults diagnosed with anorexia
nervosa differ in their levels of cognitive flexibility and attention to detail
independently of potential confounds.
METHOD: Sixty-two adolescents and 54 adults were assessed while receiving
inpatient treatment and completed the following self-reports: Eating Disorders
Examination Questionnaire, Maudsley Obsessive Compulsive Inventory and Hospital
Anxiety and Depression scale. Performance-based evaluations included the
Wisconsin Card Sorting Test Computerised Version, the Comprehensive Trail Making
Test, the Brixton Spatial Anticipation Test, the Rey Complex Figure and the
Group Embedded Figures Test.
RESULTS: Comparisons of the adolescents and adults with anorexia nervosa
revealed no significant differences for any of the neuropsychological test
scores even after adjusting for potential confounding factors. Neither cognitive
flexibility nor attention to detail were associated with level of eating
disorder symptomatology, depression, anxiety or obsessive-compulsive
symptomatology. Unlike age, illness duration was found weakly associated with
perseverative errors Wisconsin Card Sorting Test and with the central coherence
index of the Rey Complex Figure recall condition.
CONCLUSIONS: Set-shifting and central coherence performance were independent of
age, clinical symptoms severity and emotional status. Additional studies on the
relationship between the duration of anorexia nervosa and neuropsychological
difficulties are needed.

© 2022 Eating Disorders Association and John Wiley & Sons Ltd.

Auteurs Bordeaux Neurocampus