Conflation between self-report and neurocognitive assessments of cognitive flexibility: a critical review of the Jingle Fallacy

Cognitive flexibility is a widely studied construct and is considered an important treatment target for several psychological disorders. The convergence of several independent fields of research has led to assumptions about the assessment of cognitive flexibility – assumptions that are not empirically supported and often conflate different notions of flexibility. This critical review discusses how the conflation of self-report and neurocognitive assessments has seemingly arisen from literature on eating disorders. We describe how seminal early observations of “inflexible” personality characteristics, communication competence research, and investigations of frontal lobe function after injury led to two methods of assessing “cognitive flexibility”. We discuss the impact that conflation of self-report and neurocognitive assessments has had on the field, and we provide recommendations for assessing cognitive flexibility in both research and clinical settings.Caitlin A. Howlett, Stephanie Miles, Carolyn Berryman, Andrea Phillipou and G. Lorimer Mosele

Exploring the impact of the COVID-19 pandemic and UK lockdown on individuals with experience of eating disorders

Background The coronavirus disease 2019 (COVID-19) pandemic may raise unique challenges for individuals with experience of eating disorders. Many factors have potential for detrimental impacts on psychological wellbeing and eating disorder recovery, including: Disruption to living situations, ‘social distancing’ restrictions, difficult access to healthcare, and societal changes to food behaviours and technology usage. To date, little is known on the impact of the pandemic on this population, particularly within the UK. Method A mixed-methods online survey was developed for the purpose of this study. Data was collected from 129 individuals currently experiencing, or in recovery from, an eating disorder during the early stages of the UK pandemic lockdown. Participants were aged between 16 and 65 years, with 121 participants identifying as female, 7 male and 1 participant preferring not to disclose their gender. Results Findings suggest that the pandemic is having a profound, negative impact upon individuals with experience of eating disorders. Eight key themes were generated: Disruption to living situation, increased social isolation and reduced access to usual support networks, changes to physical activity rates, reduced access to healthcare services, disruption to routine and perceived control, changes to relationship with food, increased exposure to triggering messages, and positive outcomes. The results suggest detrimental impacts on psychological wellbeing including decreased feelings of control, increased feelings of social isolation, increased rumination about disordered eating, and low feelings of social support. Conclusions Individuals with eating disorders are at significant risk of negative impacts of the pandemic. There is a vital need for interventions to support this population. Inequalities in healthcare provision were identified, emphasising a need for a more cohesive approach to remote treatment across UK healthcare services. Positive aspects of technology use were identified but the results suggest a need to address and/or limit the potential for negative impacts of public messages around food and exercise behaviours, and to co-design technologies with end-users to facilitate effective treatment

Photoaffinity labelling displacement assay using multiple recombinant protein domains

The development and optimisation of a photoaffinity labelling (PAL) displacement assay is presented, where a highly efficient PAL probe was used to report on the relative binding affinities of compounds to specific binding sites in multiple recombinant protein domains in tandem. The N- and C-terminal bromodomains of BRD4 were used as example target proteins. A test set of 264 compounds annotated with activity against the bromodomain and extra-terminal domain (BET) family in ChEMBL were used to benchmark the assay. The pIC50 values obtained from the assay correlated well with orthogonal TR‑FRET data, highlighting the potential of this highly accessible PAL biochemical screening platform

Intrapersonal, interpersonal, and physical space in anorexia nervosa: a virtual reality and repertory grid study.

This document is the Accepted Manuscript version of a published work that appeared in final form in Psychiatry Research after peer review and technical editing by the publisher. To access the final edited and published work see doi: https://doi.org.10.1016/j.psychres.2017.02.060.Anorexia nervosa (AN) is an eating disorder characterized by severe body image disturbances. Recent studies from spatial cognition showed a connection between the experience of body and of space. The objectives of this study were to explore the meanings that characterize AN experience and to deepen the examination of spatiality in relational terms, through the study of how the patient construes herself and her interpersonal world. More specifically this study aimed (1) to verify whether spatial variables and aspects of construing differentiate patients with AN and healthy controls (HCs) and are related to severity of anorexic symptomatology; (2) to explore correlations between impairments in spatial abilities and interpersonal construing. A sample of 12 AN patients and 12 HCs participated in the study. The Eating Disorder Inventory, a virtual reality-based procedure, traditional measures of spatial abilities, and repertory grids were administered. The AN group compared to HCs showed significant impairments in spatial abilities, more unidimensional construing, and more extreme construing of the present self and of the self as seen by others. All these dimensions correlated with the severity of symptomatology. Extreme ways of construing characterized individuals with AN and might represent the interpersonal aspect of impairment in spatial reference frames.Peer reviewedFinal Accepted Versio

Eating disorder symptomatology and body mass index are associated with readers’ expectations about character behavior: evidence from eye-tracking during reading

Objective: Many theories have been put forward suggesting key factors underlying the development and maintenance of eating disorders, such as: unhealthy food-related cognitive biases, negative body attitude, and perfectionism; however, underlying cognitive processes associated with eating disorder symptomatology remain unclear. We used eye-tracking during reading as a novel implicit measure of how these factors may relate to eating disorder symptomatology. Method: In two experiments, we monitored women’s eye movements while they read texts in which the characters’ emotional responses to food-, body image-, and perfectionism-related scenarios were described. Participants’ eating disorder symptomatology was then assessed. Results: Both studies suggest that moment-to-moment processing of characters’ emotional responses to perfectionism-, and to a lesser extent, body image-related information was associated with participants’ eating disorder symptomatology, thus supporting theories in which these factors are key to developing and maintaining eating disorders

A systematic review of resting-state functional-MRI studies in anorexia nervosa: Evidence for functional connectivity impairment in cognitive control and visuospatial and body-signal integration.

This paper systematically reviews the literature pertaining to the use of resting-state functional magnetic resonance imaging (rsfMRI) in anorexia nervosa (AN), classifying studies on the basis of different analysis approaches. We followed PRISMA guidelines. Fifteen papers were included, investigating a total of 294 participants with current or past AN and 285 controls. The studies used seed-based, whole-brain independent component analysis (ICA), network-of-interest ICA based and graph analysis approaches. The studies showed relatively consistent overlap in results, yet little overlap in their analytical approach and/or a-priori assumptions. Functional connectivity alterations were mainly found in the corticolimbic circuitry, involved in cognitive control and visual and homeostatic integration. Some overlapping findings were found in brain areas putatively important in AN, such as the insula. These results suggest altered functional connectivity in networks/areas linked to the main symptom domains of AN, such as impaired cognitive control and body image disturbances. These preliminary evidences suggest that more targeted treatments need to be developed that focus on these two symptom domains. Further studies with multi-approach analyses and longitudinal designs are needed to better understand the complexity of AN

N-Acetylcysteine (NAC) in Schizophrenia Resistant to Clozapine: A Double-Blind, Randomized, Placebo-Controlled Trial Targeting Negative Symptoms

Background and hypothesis Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia, yet a significant proportion of individuals on clozapine continue to experience disabling symptoms, despite being treated with an adequate dose. There is a need for adjunct treatments to augment clozapine, notably for negative and cognitive symptoms. One such potential agent is the glutathione precursor N-acetylcysteine (NAC). Study design A randomized double-blind, multi-center, placebo-controlled trial for clozapine patients with enduring psychotic symptoms (n = 84) was undertaken to investigate the efficacy of adjunctive NAC (2 g daily) for negative symptoms, cognition and quality of life (QoL). Efficacy was assessed at 8, 24, and 52 weeks. Study results NAC did not significantly improve negative symptoms (P = .62), overall cognition (P = .71) or quality of life (Manchester quality of life: P = .11; Assessment of quality of life: P = .57) at any time point over a 1-year period of treatment. There were no differences in reported side effects between the groups (P = .26). Conclusions NAC did not significantly improve schizophrenia symptoms, cognition, or quality of life in treatment-resistant patients taking clozapine. This trial was registered with "Australian and New Zealand Clinical Trials" on the 30 May, 2016 (Registration Number: ACTRN12615001273572).Erica Neill, Susan L. Rossell, Caitlin Yolland, Denny Meyer, Cherrie Galletly, Anthony Harris, Dan Siskind, Michael Berk, Kiymet Bozaoglu, Frances Dark, Olivia M. Dean, Paul S. Francis, Dennis Liu, Andrea Phillipou, Jerome Sarris, and David J. Castl

N-acetylcysteine (NAC) in schizophrenia resistant to clozapine: a double blind randomised placebo controlled trial targeting negative symptoms

BACKGROUND: Clozapine is an effective treatment for a proportion of people with schizophrenia (SZ) who are resistant to the beneficial effects of other antipsychotic drugs. However, anything from 40-60&nbsp;% of people on clozapine experience residual symptoms even on adequate doses of the medication, and thus could be considered \u27clozapine resistant\u27. Agents that could work alongside clozapine to improve efficacy whilst not increasing the adverse effect burden are both desired and necessary to improve the lives of individuals with clozapine-resistant SZ. N-Acetylcysteine (NAC) is one such possible agent. Previous research from our research group provided promising pilot data suggesting the efficacy of NAC in this patient population. The aim of the study reported here is to expand this work by conducting a large scale clinical trial of NAC in the treatment of clozapine-resistant SZ. METHODS: This study is an investigator initiated, multi-site, randomised, placebo-controlled trial. It aims to include 168 patients with clozapine-resistant SZ, divided into an intervention group (NAC) and a control group (placebo). Participants in the intervention group will receive 2&nbsp;g daily of NAC. The primary outcome measures will be the negative symptom scores of the Positive and Negative Syndrome Scale (PANSS). Secondary outcome measures will include: changes in quality of life (QoL) as measured by the Lancashire Quality of Life Profile (LQoLP) and cognitive functioning as measured by the total score on the MATRICS. Additionally we will examine peripheral and cortical glutathione (GSH) concentrations as process outcomes. DISCUSSION: This large scale clinical trial will investigate the efficacy of NAC as an adjunctive medication to clozapine. This trial, if successful, will establish a cheap, safe and easy-to-use agent (NAC) as a \u27go to\u27 adjunct in patients that are only partly responsive to clozapine.<br /