title: Restrictive anorexia nervosa and set-shifting in adolescents: a biobehavioral interface.
abstract: OBJECTIVE
  Set-shifting is a neurocognitive concept defined as the ability to switch tasks flexibly. Set-shifting scores are worse in adults with restrictive anorexia nervosa (AN-R) than in controls. Adolescence is a developmental period when young people must respond flexibly to new situations. The purpose of this study was to compare the set-shifting scores of 24 adolescent females with AN-R with 37 matched normal adolescent controls (ages, 14-20).
  
  
  METHODS
  Methods used for the study included sociodemographic, psychological, and biological data, and neurocognitive testing using the Behavior Rating of Executive Function - Self- and Parent-Reports, the Cambridge Neuropsychological Automated Battery, and the Wisconsin Card-Sorting Test. Statistical analyses included t-tests, multiple analysis of variance, and correlations.
  
  
  RESULTS
  Sociodemographic data and intelligence quotient of study and control subjects were similar. There were differences in body mass index and the Eating Disorder Inventory-3 evaluation. Significant differences in the composite score of set-shifting between the study and control groups were found using multiple analysis of variance.
  
  
  CONCLUSIONS
  Adolescent females with AN-R had significantly worse set-shifting scores than the control subjects. Future studies of adolescent AN-R subjects should include biological (functional magnetic resonance imaging) and neurocognitive measures to determine the mechanisms at the brain-behavioral interface so that treatment can be directed specifically to set-shifting deficits.
authors.affiliation: Division of Adolescent Medicine, Department of Pediatrics, Adolescent Eating Disorders Center, University of Rochester Medical Center, Rochester, New York 14642, USA. elizabeth_mcanarney@urmc.rochester.edu
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: McAnarney
authors.forename: Jennifer
authors.initials: J
authors.lastname: Zarcone
authors.forename: Pamela
authors.initials: P
authors.lastname: Singh
authors.forename: Jennifer
authors.initials: J
authors.lastname: Michels
authors.forename: Sarah
authors.initials: S
authors.lastname: Welsh
authors.forename: Theresa
authors.initials: T
authors.lastname: Litteer
authors.forename: Hongyue
authors.initials: H
authors.lastname: Wang
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Klein
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000856:Anorexia Nervosa / Q000523:psychology*; D003071:Cognition; D005260:Female; D006801:Humans; D012718:Set, Psychology; D011795:Surveys and Questionnaires; D055815:Young Adult