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.
Cavedini
Paolo
P
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
Bassi
Tommaso
T
Ubbiali
Alessandro
A
Casolari
Alessia
A
Giordani
Silvia
S
Zorzi
Claudia
C
Bellodi
Laura
L
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