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Anorexia nervosa is a complex and severe eating disorder characterized by an intense fear of weight gain, an unrelenting pursuit of thinness, and a distorted body image. It often leads to dangerously low body weight relative to an individual's age and height. This disorder is marked by significant physical and psychological consequences, making it one of the most life-threatening psychiatric illnesses.
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Base Rates of Low Delis Kaplan Executive Function System Scores in Individuals With Anorexia Nervosa.

Jiana Schnabel1,2, Kristin Stedal3, Mark Rose4

  • 1Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA.

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Summary

Cognitive flexibility (CF) deficits are common in anorexia nervosa (AN). Adults with AN showed the most low scores on the Delis Kaplan Executive Function System (D-KEFS), suggesting CF issues may persist or scar after AN illness.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Psychology

Background:

  • Cognitive flexibility (CF) is crucial for executive functions and may be impaired in anorexia nervosa (AN).
  • Existing research on CF in AN has yielded mixed results, particularly in adolescent populations.
  • Understanding the prevalence of low cognitive assessment scores is vital for accurate interpretation in AN research.

Purpose of the Study:

  • To investigate the prevalence of low scores on the Delis Kaplan Executive Function System (D-KEFS) in adolescents and adults with AN.
  • To compare these prevalence rates with adolescent healthy controls (HC).
  • To explore the relationship between low D-KEFS scores and clinical factors in adolescents with AN.

Main Methods:

  • Secondary analysis of D-KEFS data from 739 participants.
  • Inclusion of 552 adolescents with AN, 69 adults with AN, and 118 adolescent HC.
  • Analysis of age, sex, body mass index (BMI) z-score, and illness duration.

Main Results:

  • Low D-KEFS scores were prevalent across all participant groups.
  • Adults with AN had the highest proportion of individuals with abnormally low scores, followed by adolescents with AN and adolescent HC.
  • In adolescents with AN, a higher proportion of low scores correlated with lower BMI z-scores and longer illness duration.

Conclusions:

  • Findings reveal significant differences in cognitive flexibility assessment scores between adult and adolescent AN populations.
  • The results support the hypothesis that cognitive flexibility impairments are either a marker of persistent AN course or a lasting consequence of the illness.
  • These insights are crucial for understanding the neurobiological underpinnings and long-term effects of AN.