Enduring Changes in Decision Making in Patients with Full Remission from Anorexia Nervosa.

BACKGROUND Deficits in neuropsychological functioning have consistently been identified in patients with anorexia nervosa (AN). However, little is known on how decision making in AN patients evolves in response to treatment or whether impairments are reversible. METHOD AN patients (n = 42) completed the Iowa Gambling Task (IGT) upon admission to a 3-month day-hospital treatment programme and at a 1-year follow-up. Patient IGT performance was compared to age-matched controls (n = 46). RESULTS AN patients displayed poorer performance on the IGT at admission compared to controls (p < .001). Patients with full remission (n = 31; 73.9%) at the 1-year follow-up improved IGT performance (p = 0.007), and scores were similar compared to controls (p = 0.557). AN patients with partial/no remission at follow-up (n = 11; 26.1%) did not improve IGT scores (p = 0.867). CONCLUSIONS These findings uphold that enduring remission from AN can reverse decision-making impairments, and they might be most likely explained by clinical state rather than a trait vulnerability. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

[1]  C. Wierenga,et al.  Anxiety Impacts Cognitive Inhibition in Remitted Anorexia Nervosa. , 2016, European eating disorders review : the journal of the Eating Disorders Association.

[2]  J. Treasure,et al.  Is inefficient cognitive processing in anorexia nervosa a familial trait? A neuropsychological pilot study of mothers of offspring with a diagnosis of anorexia nervosa , 2016, The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry.

[3]  D. Ståhl,et al.  The set-shifting profiles of anorexia nervosa and autism spectrum disorder using the Wisconsin Card Sorting Test: a systematic review and meta-analysis , 2016, Psychological Medicine.

[4]  P. Santonastaso,et al.  Executive Functioning and Visuospatial Abilities in Bulimia Nervosa with or without a Previous History of Anorexia Nervosa. , 2016, European eating disorders review : the journal of the Eating Disorders Association.

[5]  I. Frampton,et al.  Literature Review of Cognitive Neuroscience and Anorexia Nervosa , 2016, Current Psychiatry Reports.

[6]  J. H. Decker,et al.  On Weight and Waiting: Delay Discounting in Anorexia Nervosa Pretreatment and Posttreatment , 2015, Biological Psychiatry.

[7]  P. Courtet,et al.  Impaired decision-making in symptomatic anorexia and bulimia nervosa patients: a meta-analysis , 2015, Psychological Medicine.

[8]  E. Marzola,et al.  Does depression matter in neuropsychological performances in anorexia nervosa? A descriptive review. , 2015, The International journal of eating disorders.

[9]  T. Wade,et al.  Trail making task performance in inpatients with anorexia nervosa and bulimia nervosa. , 2015, European eating disorders review : the journal of the Eating Disorders Association.

[10]  R. Murray,et al.  Eating disorder psychopathology, brain structure, neuropsychological correlates and risk mechanisms in very preterm young adults. , 2015, European eating disorders review : the journal of the Eating Disorders Association.

[11]  Joseph A. King,et al.  Temporal delay discounting in acutely ill and weight-recovered patients with anorexia nervosa , 2015, Psychological Medicine.

[12]  P. Courtet,et al.  A further assessment of decision-making in anorexia nervosa , 2015, European Psychiatry.

[13]  B. Fagerlund,et al.  Cognitive Profile of Children and Adolescents with Anorexia Nervosa , 2014, European eating disorders review : the journal of the Eating Disorders Association.

[14]  D. Tranel,et al.  Longitudinal examination of decision-making performance in anorexia nervosa: before and after weight restoration. , 2014, Journal of psychiatric research.

[15]  M. Fichter,et al.  Set-shifting and its relation to clinical and personality variables in full recovery of anorexia nervosa. , 2014, European eating disorders review : the journal of the Eating Disorders Association.

[16]  Jerome R Busemeyer,et al.  Differential impairments underlying decision making in anorexia nervosa and bulimia nervosa: a cognitive modeling analysis. , 2014, The International journal of eating disorders.

[17]  M. Cavallini,et al.  Executive functioning in anorexia nervosa patients and their unaffected relatives , 2013, Psychiatry Research.

[18]  J. Treasure,et al.  The cognitive-interpersonal maintenance model of anorexia nervosa revisited: a summary of the evidence for cognitive, socio-emotional and interpersonal predisposing and perpetuating factors , 2013, Journal of Eating Disorders.

[19]  M. Fichter,et al.  Decision-making and planning in full recovery of anorexia nervosa. , 2012, The International journal of eating disorders.

[20]  R. Baños,et al.  Executive Functions Profile in Extreme Eating/Weight Conditions: From Anorexia Nervosa to Obesity , 2012, PloS one.

[21]  H. Hoek,et al.  Neuropsychological weaknesses in anorexia nervosa: set-shifting, central coherence, and decision making in currently ill and recovered women. , 2012, The International journal of eating disorders.

[22]  R. Uher,et al.  Poor decision making in male patients with anorexia nervosa. , 2012, European eating disorders review : the journal of the Eating Disorders Association.

[23]  J. Treasure,et al.  Poor Cognitive Flexibility in Eating Disorders: Examining the Evidence using the Wisconsin Card Sorting Task , 2012, PloS one.

[24]  J. Treasure,et al.  Attentional Bias, Emotion Recognition, and Emotion Regulation in Anorexia: State or Trait? , 2010, Biological Psychiatry.

[25]  M. Cavallini,et al.  Executive Dysfunctions in Obsessive-Compulsive Patients and Unaffected Relatives: Searching for a New Intermediate Phenotype , 2010, Biological Psychiatry.

[26]  R. Uher,et al.  An investigation of decision making in anorexia nervosa using the Iowa Gambling Task and skin conductance measurements , 2007, Journal of the International Neuropsychological Society.

[27]  A. Gorini,et al.  Decision-making functioning as a predictor of treatment outcome in anorexia nervosa , 2006, Psychiatry Research.

[28]  Laura Bellodi,et al.  Decision-making heterogeneity in obsessive-compulsive disorder: ventromedial prefrontal cortex function predicts different treatment outcomes , 2002, Neuropsychologia.

[29]  A. Damasio,et al.  Deciding Advantageously Before Knowing the Advantageous Strategy , 1997, Science.

[30]  A. Damasio.  The somatic marker hypothesis and the possible functions of the prefrontal cortex. , 1996, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[31]  A. Damasio,et al.  Insensitivity to future consequences following damage to human prefrontal cortex , 1994, Cognition.

[32]  V. Glauche,et al.  Grey matter deficit in long-term recovered anorexia nervosa patients. , 2011, European eating disorders review : the journal of the Eating Disorders Association.