A systematic review and meta-analysis of set-shifting ability in eating disorders.
BACKGROUND
The aim was to critically appraise and synthesize the literature relating to set-shifting ability in eating disorders. PsycINFO, Medline, and Web of Science databases were searched to December 2005. Hand searching of eating-disorder journals and relevant reference sections was also undertaken.


METHODS
The 15 selected studies contained both eating disorder and healthy control groups, and employed at least one of the following six neuropsychological measures of set-shifting ability; Trail Making Test (TMT), Wisconsin Card Sort Test (WCST), Brixton task, Haptic Illusion, CatBat task, or the set-shifting subset of the Cambridge Neuropsychological Test Automated Battery (CANTAB). The outcome variable was performance on the set-shifting aspect of the task. Pooled standardized mean differences (effect sizes) were calculated.


RESULTS
TMT, WCST, CatBat and Haptic tasks had sufficient sample sizes for meta-analysis. These four tasks yielded acceptable pooled standardized effect sizes (0.36; TMT -1.05; Haptic) with moderate variation within studies (as measured by confidence intervals). The Brixton task showed a small pooled mean difference, and displayed more variation between sample results. The effect size for CANTAB set shifting was 0.17.


CONCLUSIONS
Problems in set shifting as measured by a variety of neuropsychological tasks are present in people with eating disorders.
Roberts
Marion E
ME
Division of Psychological Medicine, Eating Disorders Research Unit, Department of Academic Psychiatry, King's College, Guy's Hospital, London, UK. marion.roberts@iop.kcl.ac.uk
Tchanturia
Kate
K
Stahl
Daniel
D
Southgate
Laura
L
Treasure
Janet
J
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D052018:Bulimia Nervosa / Q000523:psychology*; D005260:Female; D006801:Humans; D009483:Neuropsychological Tests; D011340:Problem Solving; D012307:Risk Factors; D012718:Set, Psychology