Article

A systematic review and metaanalysis of set-shifting ability in eating disorders.Psychol. Med., 37:1075-1084

Division of Psychological Medicine, Eating Disorders Research Unit, Department of Academic Psychiatry, King's College, Guy's Hospital, London, UK.
Psychological Medicine (Impact Factor: 5.43). 09/2007; 37(8):1075-84. DOI: 10.1017/S0033291707009877
Source: PubMed

ABSTRACT The aim was to critically appraise and synthesize the literature relating to set-shifting ability in eating disorders. PsycINFO, Medline, and Web of Science databases were searched to December 2005. Hand searching of eating-disorder journals and relevant reference sections was also undertaken.
The 15 selected studies contained both eating 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 Sort Test (WCST), Brixton task, Haptic Illusion, CatBat task, or the set-shifting subset of the Cambridge Neuropsychological Test Automated Battery (CANTAB). The outcome variable was performance on the set-shifting aspect of the task. Pooled standardized mean differences (effect sizes) were calculated.
TMT, WCST, CatBat and Haptic tasks had sufficient sample sizes for meta-analysis. These four tasks yielded acceptable pooled standardized effect sizes (0.36; TMT -1.05; Haptic) with moderate variation within studies (as measured by confidence intervals). The Brixton task showed a small pooled mean difference, and displayed more variation between sample results. The effect size for CANTAB set shifting was 0.17.
Problems in set shifting as measured by a variety of neuropsychological tasks are present in people with eating disorders.

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    • "In the related disorder OCD, most studies show evidence of deficits in set-shifting ((Kuelz et al., 2004; Penades et al., 2005; Rampacher et al., 2010) and see review (Kuelz et al., 2004)). Multiple studies in anorexia nervosa, a related disorder involving body image disturbance, also have found impairments in set-shifting (for review see (Roberts et al., 2007)). "
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    Journal of Psychiatric Research 10/2014; 57. DOI:10.1016/j.jpsychires.2014.06.003 · 4.09 Impact Factor
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    • "However, candidate biomarkers might be identified by examining the brain circuitry underlying the cognitive inefficiencies reported in AN (Tchanturia et al., 2012a; Fonville et al., 2013). AN is associated with a specific neuropsychological profile, including impaired set shifting (e.g., inflexibility and perseveration) and weak central coherence (exaggerated focus on detail to the neglect of the whole) (Tchanturia et al., 2012b, 2001, 2002, 2004; Holliday et al., 2006; Lock et al., 2011; Roberts et al., 2007; Benson et al., 2010; Harrison et al., 2010). This cognitive style appears to be heritable, persists after recovery, and is seen in relatives without AN (Fossella et al., 2003; Treasure, 2007; Wade and Bulik, 2007; Grice et al., 2002). "
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    Journal of Psychiatric Research 10/2014; 57(1). DOI:10.1016/j.jpsychires.2014.06.013 · 4.09 Impact Factor
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    • "More experience with cognitive tasks, corresponding to greater task efficiency, can reduce activation [77], whereas inefficient performance can lead to increased activation in clinical populations [78]. In addition to replicating findings of altered MFG brain response in AN, ill adolescent AN revealed decreased BOLD response to hard trials in the right dorsal ACC and left PCC that may reflect impaired representation of task difficulty consistent with the cognitive inflexibility and set-shifting impairment common in AN [23], [30]. For instance, the dorsal ACC has been generally implicated in motor control and response selection, particularly when presented options conflict on several dimensions [50]–[52], [79]–[81], and more specifically it is implicated in response inhibition [53]. "
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    PLoS ONE 03/2014; 9(3):e92017. DOI:10.1371/journal.pone.0092017 · 3.23 Impact Factor
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