title: Weak central coherence in weight-restored adolescent anorexia nervosa: Characteristics and remediation.
abstract: Weak central coherence (WCC) refers to a bias towards processing details (local processing) at the expense of paying attention to the bigger picture (global processing). Multiple studies reported WCC in adults with anorexia nervosa (AN). Evidence for WCC in adolescents with AN has been inconsistent. The current study characterizes WCC in weight-restored adolescents with AN (WR-AN) using a direct measure of WCC, and examines whether WCC can be remediated by increasing alertness level-a manipulation that was found useful in enhancing global processing in healthy individuals and clinical populations.
  
  
  
  40 adolescents (18 WR-AN and 22 healthy adolescents) performed a global/local processing task (Navon task). Auditory alerting cues that elevate alertness level were integrated into the task.
  
  
  
  Both groups processed global information faster than local information. However, compared with controls, adolescents with WR-AN were better at ignoring an irrelevant bigger picture while attending to details (smaller global interference) and had greater difficulty ignoring irrelevant details while attending to the bigger picture (larger local interference). These differences were attenuated when adolescents with WR-AN were under a state of high alertness. Additionally, the local interference effect was positively correlated with three independent self-report questionnaires assessing eating disorders symptomatology.
  
  
  
  This study suggests that abnormal interference by irrelevant global and local information is a central characteristic of WCC in adolescents with WR-AN that cannot be accounted for by enduring illness or malnourishment. Additionally, this study demonstrates that WCC can be temporarily remediated by encouraging a state of high alertness.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California.|Department of Psychology and the Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.|Eating Disorder Unit, Child and Adolescent Psychiatry, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: Noam
authors.identifier: 0000-0003-3449-5278
authors.initials: N
authors.lastname: Weinbach
authors.affiliation: Department of Psychology and the Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Amit
authors.initials: A
authors.lastname: Perry
authors.affiliation: Eating Disorder Unit, Child and Adolescent Psychiatry, Soroka Medical Center, Beer-Sheva, Israel.
authors.forename: Helene
authors.initials: H
authors.lastname: Sher
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California.
authors.forename: James D
authors.identifier: 0000-0002-5169-1484
authors.initials: JD
authors.lastname: Lock
authors.affiliation: Department of Psychology and the Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Avishai
authors.initials: A
authors.lastname: Henik
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000628:therapy*; D015982:Bias; D005260:Female; D006801:Humans; D008297:Male; D015430:Weight Gain / Q000502:physiology*
keywords: adolescents; alertness; anorexia nervosa; central coherence; global/local processing