Social emotional functioning and cognitive styles in eating disorders.

Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, London, UK.
British Journal of Clinical Psychology (Impact Factor: 1.9). 09/2012; 51(3):261-79. DOI: 10.1111/j.2044-8260.2011.02026.x
Source: PubMed

ABSTRACT Contemporary models of eating disorders (EDs) argue that both cognitive style (weak coherence and poor set shifting) and social emotional difficulties are involved in the maintenance of EDs. This study aimed to explore the factor structure of cognitive and social emotional functioning and to investigate whether a particular cognitive or social emotional profile was associated with a more severe and chronic form of illness.
A cross-sectional design was used to investigate cognitive and social emotional functioning in people with EDs compared to healthy controls (HCs) and those recovered from an ED.
Two hundred twenty-five participants were assessed (100 with an ED, 35 recovered from an ED, and 90 HCs) using a battery of set shifting, coherence, and social emotional measures.
There were no significant correlations between the cognitive or social emotional variables. A principal components analysis (PCA) identified three components: a fragmented perseverative cognitive style, for which the ED group scored highly, a global flexible cognitive style, for which HCs scored highly, and a social emotional difficulties profile, for which those with EDs scored highly. Individuals in recovery from an ED did not differ from the acute group, suggesting this cognitive and social emotional profile may be a trait associated with EDs. ED participants scoring highest for the fragmented perseverative cognitive style and social emotional difficulties had a more severe and chronic form of illness.
The findings provide empirical support for Schmidt and Treasure's (2006) maintenance model of EDs and suggest both cognition and emotional functioning should be considered in treatment.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Self-evaluation closely dependent upon body shape and weight is one of the defining criteria for bulimia nervosa (BN). We studied 53 adult women, 17 with BN, 18 with a recent history of anorexia nervosa (AN), and 18 healthy comparison women, using three different fMRI tasks that required thinking about self-knowledge and social interactions: the Social Identity task, the Physical Identity task, and the Social Attribution task. Previously, we identified regions of interest (ROI) in the same tasks using whole-brain voxel-wise comparisons of the healthy comparison women and women with a recent history of AN. Here, we report on the neural activations in those ROIs in subjects with BN. In the Social Attribution task, we examined activity in the right temporoparietal junction (RTPJ), an area frequently associated with mentalization. In the Social Identity task, we examined activity in the precuneus (PreC) and dorsal anterior cingulate (dACC). In the Physical Identity task, we examined activity in a ventral region of the dACC. Interestingly, in all tested regions, the average activation in subjects with bulimia was more than the average activation levels seen in the subjects with a history of anorexia but less than that seen in healthy subjects. In three regions, the RTPJ, the PreC, and the dACC, group responses in the subjects with bulimia were significantly different from healthy subjects but not subjects with anorexia. The neural activations of people with BN performing fMRI tasks engaging social processing are more similar to people with AN than healthy people. This suggests biological measures of social processes may be helpful in characterizing individuals with eating disorders.
    Frontiers in Psychiatry 01/2013; 4:103.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background The behavioural literature in anorexia nervosa (AN) has suggested impairments in psychosocial functioning and studies using facial expression processing tasks (FEPT) have reported poorer recognition and slower identification of emotions. Methods Functional magnetic resonance imaging (fMRI) was used alongside a FEPT, depicting neutral, mildly happy and happy faces, to examine the neural correlates of implicit emotion processing in AN. Participants were instructed to specify the gender of the faces. Levels of depression, anxiety, obsessive–compulsive symptoms and eating disorder behaviour were obtained and principal component analysis (PCA) was performed to acquire uncorrelated variables. Results fMRI analysis revealed a greater blood-oxygenation level dependent (BOLD) response in AN in the right fusiform gyrus to all facial expressions. This response showed a linear increase with the happiness of the facial expression and was found to be stronger in those not taking medication. PCA analysis revealed a single component indicating a greater level of general clinical symptoms. Conclusion Neuroimaging findings would suggest that alterations in implicit emotion processing in AN occur during early perceptual processing of social signals and illustrate greater engagement on the FEPT. The lack of separate components using PCA suggests that the questionnaires used might not be suited as predictive measures.
    NeuroImage: Clinical. 01/2013; 4.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study is a preliminary investigation of the reliability and validity of the Behaviour Rating Inventory of Executive Function – Adult Version (BRIEF-A) in a clinical sample of patients with eating disorders (ED). Participants were 252 adult females who were referred to a center for the treatment of EDs, as well as 31 individuals who completed the informant version of the BRIEF-A. Patients completed the BRIEF-A and other psychological measures on one occasion during their initial clinic visit, and informants nominated by patients completed the informant version at home. Reliability analyses revealed high internal consistency (Cronbach’s alpha) of the two indices (Metacognition Index and Behavioural Regulation Index), and for the Global Executive Composite (GEC) of the BRIEF-A (α = .96). Convergent validity was shown by a high positive relationship between the self-report and informant-report versions of the BRIEF-A, and between the GEC and the Anxiety and Depression scales. Construct validity was assessed by an exploratory and confirmatory factor analysis. The BRIEF-A may be a reliable and valid tool for measuring executive functioning (EF) in an ED population, and may serve as an initial screening tool of EF for clinicians and researchers.
    Eating Behaviors 04/2014; · 1.58 Impact Factor


Available from
May 29, 2014