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Neuropsychological variables and clinical status in anorexia nervosa: relationship between visuospatial memory and central coherence and eating disorder symptom severity

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Aim

To explore the relationship between visuospatial memory, weak central coherence, and eating disorder (ED) symptoms in anorexia nervosa (AN) inpatients.

Sample

31 female AN inpatients.

Methods

Rey complex figure test (RCFT) was used to assess both visuospatial memory and central coherence. RCFT consisted of copy and recall trials. ED symptoms were assessed by The Eating Disorder Examination-Questionnaire (EDE-Q) and The Clinical and Research Inventory for Eating Disorders (CR-EAT).

Results

We found a statistically significant negative correlation between recall accuracy and the total EDE-Q score. Furthermore, recall accuracy and recall central coherence significantly negatively correlate with several EDE-Q and CR-EAT scales.

Conclusions

These findings may contribute to a better understanding of cognitive impairments specifically in ED, and to refining interventions aiming at their improvement.

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References

  1. Duchesne M, Mattos P, Fontenelle LF et al (2004) Neuropsychology of eating disorders: a systematic review of literature. Rev Bras Psiquiatr 26(2):107–117

    Article  PubMed  Google Scholar 

  2. Alvarado-Sánchez N, Silva-Gutiérrez C, Salvador-Cruz J (2009) Visuoconstructive deficits and risk of developing eating disorders. Span J Psychol 12(2):677–685

    Article  PubMed  Google Scholar 

  3. Gillberg IC, Råstam M, Wentz E et al (2007) Cognitive and executive functions in anorexia nervosa ten years after onset of eating disorder. J Clin Exp Neuropsychol 29(2):170–178

    Article  PubMed  Google Scholar 

  4. Mathias JL, Kent PS (1998) Neuropsychological consequences of extreme weight loss and dietary restrictions in patients with anorexia nervosa. J Clin Exp Neuropsychol 20(4):548–564

    Article  PubMed  CAS  Google Scholar 

  5. Szmukler GI, Andrewes D, Kingston K et al (1992) Neuropsychological impairment in anorexia nervosa: before and after refeeding. J Clin Exp Neuropsychol 14(2):347–352

    Article  PubMed  CAS  Google Scholar 

  6. Treasure J (2013) Coherence and other autistic spectrum traits and eating disorders: building from mechanism to treatment. The Birgit Olsson lecture. Nord J Psychiatry 67(1):38–42

    Article  PubMed  Google Scholar 

  7. Lopez C, Tchanturia K, Stahl D et al (2008) An examination of the concept of central coherence in women with anorexia nervosa. Int J Eat Disord 41(2):143–152

    Article  PubMed  Google Scholar 

  8. Lopez C, Tchanturia K, Stahl D et al (2008) Central Coherence in eating disorders: a systematic review. Psychol Med 38(10):1393–1404

    Article  PubMed  CAS  Google Scholar 

  9. Tokley M, Kemps E (2007) Preoccupation with detail contributes to poor abstraction in women with anorexia nervosa. J Clin Exp Neuropsychol 29(7):734–741

    Article  PubMed  Google Scholar 

  10. Allen KL, Byrne SM, Hji H et al (2012) Neurocognitive functioning in adolescents with eating disorders: a population-based study. Cogn Neuropsychiatry

  11. Stedal K, Rose M, Frampton I et al (2012) The neuropsychological profile of children, adolescents, and young adults with anorexia nervosa. Arch Clin Neuropsychol 27(3):329–337

    Article  PubMed  Google Scholar 

  12. Van Autreve S, De Baene W, Baeken C et al (2013) Do restrictive and bingeing/purging subtypes of anorexia nervosa differ on central coherence and set shifting? Eur Eat Disord Rev 21(4):308–314

    Article  PubMed  Google Scholar 

  13. Shott ME, Filoteo JV, Bhatnagar KA et al (2012) Cognitive set-shifting in anorexia nervosa. Eur Eat Disord Rev 20(5):343–349

    Article  PubMed  Google Scholar 

  14. Tchanturia K, Davies H, Roberts M et al (2012) Poor cognitive flexibility in eating disorders: examining the evidence using the Wisconsin card sorting task. PLoS ONE 7(1):e28331. doi:10.1371/journal.pone.0028331

    Article  PubMed  CAS  Google Scholar 

  15. Tchanturia K, Harrison A, Davies H et al (2011) Cognitive flexibility and clinical severity in eating disorders. PLoS ONE 6(6):e20462. doi:10.1371/journal.pone.0020462

    Article  PubMed  CAS  Google Scholar 

  16. Roberts ME, Tchanturia K, Stahl D et al (2007) A systematic review and meta-analysis of set-shifting ability in eating disorders. Psychol Med 37(8):1075–1084

    Article  PubMed  Google Scholar 

  17. Steinglass JE, Walsh BT, Stern Y (2006) Set shifting deficits in anorexia nervosa. J Int Neuropsychol Soc 12(3):431–435

    Article  PubMed  Google Scholar 

  18. Holliday J, Tchanturia K, Landau S et al (2005) Is impaired set-shifting an endophenotype of anorexia nervosa? Am J Psychiatry 162(12):2269–2275

    Article  PubMed  Google Scholar 

  19. Cavedini P, Bassi T, Ubbiali A et al (2004) Neuropsychological investigation of decision-making in anorexia nervosa. Psychiatry Res 127(3):259–266

    Article  PubMed  Google Scholar 

  20. Thanturia K, Liao PC, Uher R et al (2007) An investigation of decision making in anorexia nervosa using the Iowa Gambling Task and skin conductance measurements. J Int Neuropsychol Soc 13(4):635–641

    Google Scholar 

  21. Zakzanis KK, Campbell Z, Polsinelli A (2010) Quantitative evidence for distinct cognitive impairment in anorexia nervosa and bulimia nervosa. J Neuropsychol 4(Pt 1):89–106

    Article  PubMed  Google Scholar 

  22. Frith U (1994) Autism: explaining the Enigma. Basil Blackwell, Oxford

    Google Scholar 

  23. Happé F, Frith U (2006) The weak coherence account: detail-focused cognitive style in autism spectrum disorder. J Autism Dev Disord 36:5–25

    Article  PubMed  Google Scholar 

  24. Happé FG, Booth RD (2008) The power of the positive: revisiting weak central coherence in autism spectrum disorder. Q J Exp Psychol (Colchester) 61(1):50–63

    Article  Google Scholar 

  25. Lindner SE, Fichter MM, Quadflieg N (2013) Central coherence in full recovery of anorexia nervosa. Eur Eat Disord Rev 21(2):115–120

    Article  PubMed  Google Scholar 

  26. Danner UN, Sanders N, Smeets PA et al (2012) Neuropsychological weaknesses in anorexia nervosa: set-shifting, central coherence, and decision making in currently ill and recovered women. Int J Eat Disord 45(5):685–694

    Article  PubMed  Google Scholar 

  27. Lopez C, Tchanturia K, Stahl D et al (2009) Weak central coherence in eating disorders: a step towards looking for an endophenotype of eating disorders. J Clin Exp Neuropsychol 31(1):117–125

    Article  PubMed  Google Scholar 

  28. Baldock E, Tchanturia K (2007) Translating laboratory research into practice: foundations, functions and future of cognitive remediation therapy for anorexia nervosa. Therapy 4(3):285–292

    Article  Google Scholar 

  29. Lopez C, Roberts MR, Tchanturia K et al (2008) Using neuropsychological feedback therapeutically in treatment for anorexia nervosa: two illustrative case reports. Eur Eat Disord Rev 16(6):480–488

    Article  Google Scholar 

  30. Tchanturia K, Davies H, Campbell IC (2007) Cognitive remediation therapy for patients with anorexia nervosa: preliminary findings. Ann Gen Psychiatry 5(6):14

    Article  Google Scholar 

  31. Pretorius N, Tchanturia K (2007) Anorexia nervosa: how people think and how we address it in cognitive remediation therapy. Therapy 4(4):423–431

    Article  Google Scholar 

  32. Tchanturia K, Whitney J, Treasure J (2006) Can cognitive exercise help treat anorexia nervosa? Eat Weight Disord 11(4):112–116

    Article  Google Scholar 

  33. Tchanturia K, Lloyd S, Lang K (2013) Cognitive remediation therapy for anorexia nervosa: current evidence and future research directions. In J Eat Disord 46:492–495

    Article  Google Scholar 

  34. Genders R, Tchanturia K (2010) Cognitive remediation therapy (CRT) for anorexia nervosa in group format: a pilot study. Eat Weight Disord 15(4):e234–e239

    PubMed  CAS  Google Scholar 

  35. Zuchova S, Erler T, Papezova H (2013) Group cognitive remediation therapy for adult anorexia nervosa inpatients: first experiences. Eat Weight Disord 18(3):269–273

    Article  PubMed  Google Scholar 

  36. Tchanturia K, Easter A (2011) Therapists’ experiences of cognitive remediation therapy for anorexia nervosa: implications for working with adolescents. Clin Child Psychol Psychiatry 16(2):233–246

    Article  PubMed  Google Scholar 

  37. Wood L, Al-Khairulla H, Lask B (2011) Group cognitive remediation for adolescents with anorexia nervosa. Clin Child Psychol Psychiatry 16(2):225–231

    Article  PubMed  Google Scholar 

  38. Lock J, Agras WS, Fitzpatrick KK et al (2013) Is outpatient cognitive remediation therapy feasible to use in randomized clinical trials for anorexia nervosa? Int J Eat Disord. 2013 (Epub ahead of print). doi:10.1002/eat.22134

  39. Pitt S, Lewis R, Morgan S et al (2010) Cognitive remediation therapy in an outpatient setting: a case series. Eat Weight Disord 15(4):28

    Google Scholar 

  40. Whitney J, Easter A, Tchanturia K (2008) Service users’ feedback on cognitive training in the treatment of anorexia nervosa: a qualitative study. Int J Eat Disord 41(6):542–550

    Article  PubMed  Google Scholar 

  41. Tchanturia K, Davies H, Lopez C et al (2008) Neuropsychological task performance before and after cognitive remediation therapy for anorexia nervosa: a pilot case series. Psychol Med 38(9):1371–1373

    Article  PubMed  Google Scholar 

  42. Thompson S (1993) Implications of neuropsychological test results of women in a new phase of anorexia nervosa. Eur Eat Dis Rev 1:152–165

    Article  Google Scholar 

  43. Southgate L, Tchanturia K, Treasure J (2008) Information processing bias in anorexia nervosa. Psychiatry Res 160(2):221–227

    Article  PubMed  Google Scholar 

  44. Sherman BJ, Savage CR, Eddy KT et al (2006) Strategic memory in adults with anorexia nervosa: are there similarities to obsessive compulsive disorders? Int J Eat Disord 39(6):468–476

    Article  PubMed  Google Scholar 

  45. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn, text rev, Washington, DC

  46. Osterrieth PA (1944) Le test de copie d’une figure complex: contribution a l’etude de la perception et de la memoire. Archives de Psychologie 30:286–356

    Google Scholar 

  47. Rey A (1941) L’examen psychologique dans les cas d’encephalopathie traumatique. Archives de Psychologie 28:215–285

    Google Scholar 

  48. Spreen O, Strauss E (1998) A compendium of neuropsychological tests, 2nd edn. Oxford University Press, New York

    Google Scholar 

  49. Liberman J, Stewart W (1994) Rater agreement for the Rey–Osterrieth complex figure test. J Clin Psychol 50(4):615–624

    Article  PubMed  CAS  Google Scholar 

  50. Lezak MD, Howieson DB, Loring DW (2004) Neuropsychological assessment, 4th edn. Oxford University Press, Oxford

    Google Scholar 

  51. Booth R (2006) Local-global processing and cognitive style in autism spectrum disorders and typical development. King’s College London, Institute of Psychiatry, London

    Google Scholar 

  52. Fairburn CG, Beglin SJ (1994) Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 16(4):363–370

    PubMed  CAS  Google Scholar 

  53. Moessner M, Fassnacht D, Bauer S (2013) Online assessment of eating disorders: the clinical and research inventory for eating disorders (CR-EAT) (Submitted)

  54. Landgraf S, Amado I, Purkhart R et al (2011) Visuo-spatial cognition in schizophrenia: confirmation of a preference of local information processing. Schizophr Res 127(1–3):163–170

    Article  PubMed  CAS  Google Scholar 

  55. Seidman LJ, Lanca M, Kremen WS et al (2003) Organizational and visual memory deficits in schizophrenia and bipolar psychoses using the Rey–Osterrieth complex figure: effects of duration of illness. J Clin Exp Neuropsychol 25(7):949–964

    Article  PubMed  Google Scholar 

  56. Silverstein SM, Osborn LM, Palumbo DR (1998) Rey–Osterrieth complex figure test performance in acute, chronic, and remitted schizophrenia patients. J Clin Psychol 54(7):985–994

    Article  PubMed  CAS  Google Scholar 

  57. Cha KR, Koo MS, Kim CH et al (2008) Nonverbal memory dysfunction in obsessive–compulsive disorder patients with checking compulsions. Depress Anxiety 25(11):E115–E120

    Article  PubMed  Google Scholar 

  58. Moritz S, Kloss M, Jacobsen D et al (2005) Extent, profile and specificity of visuospatial impairment in obsessive–compulsive disorder (OCD). J Clin Exp Neuropsychol 27(7):795–814

    Article  PubMed  Google Scholar 

  59. Moritz S, Wendt M (2006) Processing of local and global visual features in obsessive–compulsive disorder. I Int Neuropsychol Soc 12(4):566–569

    Google Scholar 

  60. Olley A, Malhi G, Sachdey P (2007) Memory and executive functioning in obsessive–compulsive disorder: a selective review. J Affect Disord 104(1–3):15–23

    Article  PubMed  Google Scholar 

  61. Lopez CA, Tchanturia K, Stahl D et al (2008) Central coherence in women with bulimia nervosa. Int J Eat Disord 41(4):340–347

    Article  PubMed  Google Scholar 

  62. Nakahachi T, Yamashita K, Iwase M et al (2008) Disturbed holistic processing in autism spectrum disorders verified by two cognitive tasks requiring perception of complex visual stimuli. Psychiatry Res 159(3):330–338

    Article  PubMed  Google Scholar 

  63. Rankins D, Bradshaw JL, Georgiou-Karistianis N (2005) Local-global processing in obsessive–compulsive disorder and comorbid Tourette’s syndrome. Brain Cogn 59(1):43–51

    Article  PubMed  CAS  Google Scholar 

  64. Johnson SC, Lowery N, Kohler C et al (2005) Global-local visual processing in schizophrenia: evidence for an early visual processing deficit. Biol Psychiatry 58(12):937–946

    Article  PubMed  Google Scholar 

  65. Witkin H, Oltman P, Raskin E et al (2002) Group embedded figures test manual. Mind Garden, Inc, Redwood City

    Google Scholar 

  66. Salbach-Andrae H, Klinkowski N, Lenz K et al (2008) Correspondance between self-reported and parent-reported psychopathology in adolescents with eating disorders. Psychopathology 41(5):307–312

    Article  PubMed  Google Scholar 

  67. Ruffolo JS, Javorsky DJ, Tremont G et al (2001) A comparison of administration procedures for the Rey Osterrieth complex figure: flowchart versus pen switching. Psychol Assess 13(3):299–305

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This work was supported by funding from the FP6 Marie Curie Research Training Network INTACT (Individually tailored stepped care for women with eating disorders; Reference Number: MRTN-CT-2006-035988) and from the grant IGA MZ (Internal Grant Agency of the Ministry of Health) NT 14094-3.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Ke Karlovu 11, 120 00, Prague 2, Czech Republic

    Svetlana Zuchova & Hana Papezova

  2. Institute of Information Theory and Automation, Academy of Sciences of the Czech Republic, Pod vodarenskou vezi 4, 182 21, Prague 8, Czech Republic

    Ales Antonin Kubena

  3. Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 1999/2, 182 21, Prague 8, Czech Republic

    Theodore Erler

Authors
  1. Svetlana Zuchova
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  2. Ales Antonin Kubena
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  3. Theodore Erler
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  4. Hana Papezova
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Correspondence to Svetlana Zuchova.

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Zuchova, S., Kubena, A.A., Erler, T. et al. Neuropsychological variables and clinical status in anorexia nervosa: relationship between visuospatial memory and central coherence and eating disorder symptom severity. Eat Weight Disord 18, 421–428 (2013). https://doi.org/10.1007/s40519-013-0062-7

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  • DOI: https://doi.org/10.1007/s40519-013-0062-7

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