Decision-Making, Impulsiveness and Temperamental Traits in Eating Disorders

To explore decision-making, impulsiveness and temperamental traits in patients suffering from eating disorders (EDs), as compared with healthy controls (HC).

Fifty-one patients affected by ED (fourteen with anorexia restricting subtype, AN-R; fourteen with bulimia, BN; thirteen with anorexia bingeing/purging subtype, AN-BP; ten with binge-eating disorder, BED) and twenty-eight HC. The patients, recruited at the Section of Psychiatry of the University of Pisa (Italy, were evaluated with a battery of neuropsychological questionnaires, including the IOWA Gambling Task (IGT), the Barratt Impulsiveness Scale (BIS-11), the Temperament and Character Inventory (TCI), the Frontal Assessment Battery (FAB) and the Hamilton Depression Rating Scale (HAM-D).

The results indicated that AN-R, AN-BP and BN patients showed poorer IGT performances than HC (p < .05), while BED performances were similar to those of HC. IGT scores suggested the existence of similarities in decision-making performances of AN-BP and BN patients, as they performed differently from HC starting from block 3 (F(16.2)=1.7). In addition, differences between AN-BP/BN and AN-R patients were detected, given that they performed differently starting from block 4. As far as BIS-11 is concerned, AN-BP and BN patients reached the highest BIS total scores, when compared with the other groups. Further, they shared similar temperamental and impulsiveness profiles, as demonstrated by their BIS-11 'motor impulsiveness' scores, and by their TCI 'novelty seeking', 'reward dependence' and 'persistence' dimensions. The post-hoc analyses revealed that both AN groups (namely, AN-R and AN-BP) scored significantly lower than HC on the FAB. No patients fulfilled the criteria for the diagnosis of a current major depression.

Decision-making deficits are common in EDs. In AN-R these seem related to cognitive styles, while in AN-BP and BN patients with temperament features and impulsiveness traits.