Base Rates of Low Delis Kaplan Executive Function System Scores in Individuals With Anorexia Nervosa

Inefficiencies in cognitive flexibility (CF) are a potential vulnerability trait for anorexia nervosa (AN). Yet, much of the research on CF in AN has been conducted in adult samples, with mixed results from research on adolescents. Knowledge of the prevalence of low scores on assessments can help avoid erroneous interpretations of test scores. The current study examined the prevalence of low scores on the Delis Kaplan Executive Function System (D-KEFS) in adolescents and adults with AN and adolescent healthy controls.

We conducted a secondary analysis of D-KEFS data from 739 participants (552 adolescents with AN [aged 15.39 ± 1.91, 92% female], 69 adults with AN [aged 26.5 ± 6.1, 98.6% female], and 118 adolescent healthy controls [HC] [aged 15.09 ± 2.14, 98.3% female]).

Low scores on the D-KEFS were common across all groups. Adults with AN exhibited the highest proportion of individuals with abnormally low scores, followed by adolescents with AN and adolescent HC. Adolescents with a higher proportion of low scores had a lower BMI z-score and longer length of illness.

Results highlight differences between adults and adolescents and lend support to the hypothesis that inefficiencies in flexibility are either a marker of persistent course or a scar of AN illness.