Impaired set-shifting ability in patients with bulimia nervosa: A systematic review and meta-analysis

Document Type : Review Article

Authors

1 Department of Psychology, Islamic Azad University, Zahedan branch, Zahedan, Iran

2 Department of Psychology, Faculty of Psychology and Educational Sciences, Sistan and Baluchestan University, Zahedan, Iran

3 Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Ferdowsi University, Mashhad, Iran

Abstract

Introduction: Previous research has shown that there is a link between bulimia nervosa (BN) diagnosis and set-shifting disability although with some conflicting results, yet no meta-analyses have examined the BN pathology with set-shifting. The aim of the present research is to critically appraise and synthesize the literature relating to set-shifting ability in Bulimia Nervosa.
Materials and Methods: Four databases (PubMed, PsycINFO, Scopus, and Google Scholar) were searched for eligible studies. The 8 selected studies contained (with 24 effect sizes) both bulimia nervosa disorder and healthy control groups, and employed at least one of the following six neuropsychological measures of set-shifting ability; Trail Making Test (TMT), Wisconsin Card Sorting Test (WCST), Brixton task (BT), Haptic Illusion Task (HIT), CatBat task (CBT), Picture Set Test (PTS); Verbal Fluency Task (VFT); Intra-Extra Dimensional Set Shifting Test (ID/ED Shift Task); and Affective Shifting Task (AST) used for meta-analyses. The outcome variable was performance on the set-shifting aspect of the task. Effect sizes (Hedges’s g) were pooled using fixed-effects models.
 Results: Twenty-one studies were examined with a total of 514 BN patients and 939 healthy control groups. There was a small effect of BN diagnosis on set-shifting (Hedges’s g = 0.24).
 Conclusion: Based on the findings, problems in set-shifting as measured by a variety of neuropsychological tasks are present in people with bulimia nervosa.

Keywords

References

  1. Mehler PS, Rylander M. Bulimia Nervosa–medical complications. J Eat Disord 2015; 3(1): 1-5.
  2. American Psychiatric Association, American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, VA; American Psychiatric Association; 2013.
  3. Kessler RC, Merikangas KR, Wang PS. The prevalence and correlates of workplace depression in the national comorbidity survey replication. J Occup Environ Med 2008; 50(4): 381-90.
  4. National Eating Disorders Statistics and research on eating disorders. [cited 2013]. Available from: https://www.nationaleatingdisorders.org/statistics-research-eating-disorders.
  5. Rezaei M, Aflakseir A, Ghayour M. Prevalence of eating disorders and obesity in female student of Shiraz University. Iran J Nurs Res 2015; 10(3): 36-42.
  6. Safarzade S, Mahmoody Khorandi Z. [Survey on eating disorders (mental anorexia, bulimia) among 13-18-year-old adolescents of Gonabad city in 2014]. Journal of Rafsanjan University of Medical Sciences 2015; 14(5): 393-404. (Persian)
  7. Donnelly B, Touyz S, Hay P, Burton A, Russell J, Caterson I. Neuroimaging in bulimia nervosa and binge eating disorder: A systematic review. J Eat Disord 2018; 6(1): 1-24.
  8. Brown C, Mehler PS. Medical complications of anorexia nervosa and their treatments: an update on some critical aspects. Eat Weight Disord 2015; 20(4): 419-25.
  9. Seitz J, Kahraman- Lanzerath B, Legenbauer T, Sarrar L, Herpertz S, Salbach- Andrae H, et al. The role of impulsivity, inattention and comorbid ADHD in patients with bulimia nervosa. PLoS One 2013; 8(5): 1-8.
  10. Hirst RB, Beard CL, Colby KA, Quittner Z, Mills BM, Lavender JM. Anorexia nervosa and bulimia nervosa: A meta-analysis of executive functioning. Neurosci Biobehav Rev 2017; 83:678–90.
  11. Wu M, Brockmeyer T, Hartmann M, Skunde M, Herzog W, Friederich HC. Set-shifting ability across the spectrum of eating disorders and in overweight and obesity: A systematic review and meta-analysis. Psychol Med 2014; 44(16): 3365-85.
  12. Roberts ME, Tchanturia K, Treasure JL. Exploring the neurocognitive signature of poor set-shifting in anorexia and bulimia nervosa. J Psychiatr Res 2010; 44(14): 964-70.
  13. Darcy AM, Fitzpatrick KK, Colborn D, Manasse S, Datta N, Aspen V, et al. Set-shifting among adolescents with bulimic spectrum eating disorders. Psychosom Med 2012; 74(8): 869-72.
  14. Keegan E, Tchanturia K, Wade TD. Central coherence and set‐shifting between nonunderweight eating disorders and anorexia nervosa: A systematic review and meta‐ Int J Eat Disord 2021; 54(3): 229-43.
  15. Grant JE, Chamberlain SR. Neurocognitive findings in young adults with binge eating disorder. Int J Psychiatry Clin Pract 2020; 24(1): 71-6.
  16. Roberts ME, Tchanturia K, Stahl D, Southgate L, Treasure J. A systematic review and meta-analysis of set-shifting ability in eating disorders. Psychol Med 2007; 37(8): 1075-84.
  17. Van den Eynde F, Guillaume S, Broadbent H, Stahl D, Campbell IC, Schmidt U, et al. Neurocognition in bulimic eating disorders: A systematic review. Acta Psychiatr Scand 2011; 124(2): 120-40.
  18. Kim YR, Kim JE, Kim MH. Impaired set-shifting ability in patients with eating disorders, which is not moderated by their catechol-o-methyltransferase val158met genotype. Psychiatry Investig 2010; 7(4): 298-301.
  19. Pignatti R, Bernasconi V. Personality, clinical features, and test instructions can affect executive functions in Eating Disorders. Eat Behav 2013; 14(2): 233-6.
  20. Dann KM, Hay P, Touyz S. Are poor set-shifting and central coherence associated with everyday function in anorexia nervosa? A systematic review. J Eat Disord 2021; 9(1): 1-7.
  21. Tchanturia K, Morris RG, Surguladze S, Treasure J. An examination of perceptual and cognitive set shifting tasks in acute anorexia nervosa and following recovery. Eat Weight Disord 2002; 7(4): 312-5.
  22. Galderisi S, Bucci P, Mucci A, Bellodi L, Cassano GB, Santonastaso P, et al. Neurocognitive functioning in bulimia nervosa: The role of neuroendocrine, personality and clinical aspects. Psychol Med 2011; 41(4): 839-48.
  23. Galimberti E, Martoni RM, Cavallini MC, Erzegovesi S, Bellodi L. Motor inhibition and cognitive flexibility in eating disorder subtypes. Prog Neuropsychopharmacol Biol Psychiatry 2012; 36(2): 307-12.
  24. Moher D, Liberati A, Tetzlaff J, Altman D, Altman D, Antes G, et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med 2009; 6(7): e1000097.
  25. Borenstein M, Hedges L, Higgins J, Rothstein H. Comprehensive Meta-Analysis (CMA) software. Version 3.0. [cited 2014]. Available from: https://www.meta-analysis.com/downloads/Meta-Analysis% 20 Manual% 20V3. pdf
  26. Tchanturia K, Davies H, Roberts M, Harrison A, Nakazato M, Schmidt U, et al. Poor cognitive flexibility in eating disorders: Examining the evidence using the Wisconsin card sorting task. PLoS ONE 2012; 7: 1-5.
  27. Vall E, Wade TD. Trail making task performance in inpatients with anorexia nervosa and bulimia nervosa. Eur Eat Disord Rev 2015; 23(4): 304-11.
  28. Brand M, Franke-Sievert C, Jacoby GE, Markowitsch HJ, Tuschen-Caffier B. Neuropsychological correlates of decision making in patients with bulimia nervosa. Neuropsychology 2007; 21(6): 742-50.
  29. Camacho Ruiz EJ, Escoto Ponce de León MC, Mancilla Díaz JM, Franco Paredes K, de Jesús Díaz Resendiz F. Neuropsychology of bulimia nervosa: New findings, relevant topics in eating disorders, Ignacio Jauregui-Lobera, IntechOpen, DOI: 10.5772/32866. [cited 2012]. Available from: https://www.intechopen.com/chapters/29054
  30. Degortes D, Tenconi E, Santonastaso P, Favaro A. Executive functioning and visuospatial abilities in bulimia nervosa with or without a previous history of anorexia nervosa. Eur Eat Disord Rev 2016; 24(2): 139-46.
  31. Camacho Ruiz EJ, Escoto Ponce de León MC, Mancilla Díaz JM. Neuropsychological evaluation in patients with eating disorders. Salud Ment 2008; 31(6): 441-6.
  32. Mobbs O, Van der Linden M, D’Acremont M, Perroud A. Cognitive deficits and biases for food and body in bulimia: Investigation using an affective shifting task. Eat Behav 2008; 9(4): 455-61.
  33. Tchanturia K, Anderluh MB, Morris RG, Rabe-Hesketh S, Collier DA, Sanchez P, et al. Cognitive flexibility in anorexia nervosa and bulimia nervosa. J Int Neuropsychol Soc 2004; 10(4): 513-20.
  34. Murphy R, Nutzinger DO, Paul T, Leplow B. Dissociated conditional-associative learning in anorexia nervosa. J Clin Exp Neuropsychol 2020; 24(2): 176-86.
  35. Wang L, Kong QM, Li K, Li XN, Zeng YW, Chen C, et al. Altered intrinsic functional brain architecture in female patients with bulimia nervosa. J Psychiatry Neurosci 2017; 42(6): 414-23.
  36. Brockmeyer T, Ingenerf K, Walther S, Wild B, Hartmann M, Herzog W, et al. Training cognitive flexibility in patients with anorexia nervosa: A pilot randomized controlled trial of cognitive remediation therapy. Int J Eat Disord 2014; 47(1): 24-31.
  37. Lounes N, Khan G, Tchanturia K. Assessment of cognitive flexibility in anorexia nervosa – self-report or experimental measure? A brief report. J Int Neuropsychol Soc 2011; 17: 925-28.
  38. Tchanturia K, Davies H, Lopez C, Schmidt U, Treasure J, Wykes T. Research letter. Neuropsychological task performance before and after cognitive remediation in anorexia nervosa: a pilot case-series. Psychol Med 2008; 38: 1371-73.
  39. Fuglset TS. Is set-shifting and central coherence in anorexia nervosa influenced by body mass index, anxiety or depression? A systematic review. BMC psychiatry 2021; 21(1): 1-4.
  40. Steegers C, Dieleman G, Moskalenko V, Santos S, Hillegers M, White T, et al. The longitudinal relationship between set‐shifting at 4 years of age and eating disorder related features at 9 years of age in the general pediatric population. Int J Eat Disord 2021; 54(12): 2180-91.

 

Journal of Fundamentals of Mental Health
Volume 24, Issue 1
January and February 2022
Pages 3-10

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