title: Clinical investigation of set-shifting subtypes in anorexia nervosa.
abstract: While evidence continues to accumulate on the relevance of cognitive inflexibility in anorexia nervosa (AN), its clinical correlates remain unclear. We aimed at examining the relationship between set-shifting and clinical variables (i.e., eating psychopathology, depression, and personality) in AN. Ninety-four individuals affected by AN and 59 healthy controls (HC) were recruited. All participants were assessed using: Eating Disorders Inventory-2 (EDI-2), Temperament and Character Inventory (TCI), Beck Depression Inventory (BDI), and Wisconsin Card Sorting Test (WCST). The AN group scored worse than HCs on set-shifting. According to their neuropsychological performances, AN patients were split into two groups corresponding to poor (N=30) and intact (N=64) set-shifting subtypes. Interoceptive awareness, impulse regulation, and maturity fears on the EDI-2 and depression on the BDI differed across all groups (HC, intact, and poor set-shifting subtype). Self-directedness on the TCI differed significantly among all groups. Cooperativeness and reward dependence differed instead only between HC and AN poor set-shifting subtype. After controlling for depression, only interoceptive awareness remained significant with reward dependence showing a trend towards statistical significance. These findings suggest that multiple clinical variables may be correlated with set-shifting performances in AN. The factors contributing to impaired cognitive inflexibility could be more complex than heretofore generally considered.
authors.affiliation: Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy. Electronic address: giovanni.abbatedaga@unito.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Abbate-Daga
authors.affiliation: Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Buzzichelli
authors.affiliation: Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Marzola
authors.affiliation: Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Amianto
authors.affiliation: Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy.
authors.forename: Secondo
authors.initials: S
authors.lastname: Fassino
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D015992:Body Mass Index; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis; D003863:Depression; D003866:Depressive Disorder; D056344:Executive Function; D005260:Female; D006801:Humans; D065812:Interoception; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D010551:Personality; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012718:Set, Psychology
keywords: Anorexia nervosa; Cognitive flexibility; Eating disorders; Interoceptive awareness; Neuropsychology; Personality