The role of set shifting and central coherence in differentiating bingeing/purging and restrictive eating disorder subtypes

Abstract

Objective : Eating disorders (ED) have been associated with dysfunctions in set shifting and central coherence. This association has been repeatedly confirmed with regard to anorexia nervosa (AN), while the evidence for bulimia nervosa (BN) remains inconclusive. A small amount of neuropsychological studies focuses on the distinction between AN and BN, whereas research about differences between restrictive ED and bingeing/purging ED is lacking. From personality research there is however growing evidence for the usefulness of this latter distinction. The aim of this study is to further investigate these dysfunctions across ED subtypes, with special attention to the differences between restrictive ED patients and bingeing/purging ED patients. We hypothesize that the first group will exhibit lower levels of set shifting ability and that central coherence will not discriminate both groups. In addition, we sought to examine the relationship with personality characteristics and clinical features. Methods : This ongoing study contains 41 inpatients (17 with AN restrictive type, 9 with AN bingeing/purging type and 15 with BN) and 19 healthy controls, until now. All participants individually complete a neuropsychological test battery including three measures of set shifting ability (a designed task-switching paradigm, the Wisconsin Card Sorting Test and the Trail Making Test), and two measures of central coherence (Picture Completion and Block Design). Personality-related characteristics are examined with the Temperament and Character Inventory; clinical characteristics are assessed using self report questionnaires, including the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Frost Multidimensional Perfectionism Scale. A General Linear Model repeated measures ANOVA is employed to test our major hypothesis. Results & Conclusions : Results will be presented and conclusions and implications for clinical practice and further research will be discussed