Neuropsychological investigation of decision-making in anorexia nervosa.
Anorexia nervosa (AN) could be considered a form of obsessive-compulsive disorder in which an impairment of the cognitive domain related to decision-making was found. We explored this function in AN patients, as well as possible differences between restricting type and binge/purge type, with the aim of examining the hypothesis that AN is part of the obsessive-compulsive spectrum. Decision-making was assessed in 59 inpatients with AN and 82 control subjects using the Gambling task, which simulates real-life decision-making by assessing the ability to balance immediate rewards against long-term negative consequences. We confirmed the supposed deficit of decision-making in AN. However, restricting and binge eating/purge subtypes showed different patterns of decision-making impairment. Poor performance on the Gambling task is not a mere consequence of starvation and does not appear to be related to illness severity. The decision-making deficiency that some AN patients show is linked to those individual features that contribute to the phenomenological expression of the disorder.
Department of Neuropsychiatric Sciences, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20, Via Stamira d'Ancona, 20127 Milan, Italy. cavedini.paolo@hsr.it
Paolo
P
Cavedini
Tommaso
T
Bassi
Alessandro
A
Ubbiali
Alessia
A
Casolari
Silvia
S
Giordani
Claudia
C
Zorzi
Laura
L
Bellodi
D000328:Adult; D000704:Analysis of Variance; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000523:psychology*; D015992:Body Mass Index; D002032:Bulimia / Q000453:epidemiology / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D003657:Decision Making; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005715:Gambling / Q000523:psychology; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index