Set-Shifting Among Adolescents With Bulimic Spectrum Eating Disorders

Objective Set-shifting difficulties are observed among adults with bulimia nervosa (BN). This study aimed to assess whether adolescents with BN and BN spectrum eating disorders exhibit set-shifting problems relative to healthy controls. Methods Neurocognitive data from 23 adolescents with BN were compared with those from 31 adolescents with BN-type eating disorder not otherwise specified and 22 healthy controls on various measures of set-shifting (Trail Making Task [shift task], Color-Word Interference, Wisconsin Card Sorting Test, and Brixton Spatial Anticipation Task). Results No significant differences in set-shifting tasks were found among groups (p >.35), and effect sizes were small (Cohen f < 0.17). Conclusions Cognitive inflexibility may develop over time because of the eating disorder, although it is possible that there is a subset of individuals in whom early neurocognitive difficulty may result in a longer illness trajectory. Future research should investigate the existence of neurocognitive taxons in larger samples and use longitudinal designs to fully explore biomarkers and illness effects. Trial Registration clinicaltrials.gov NCT00879151. Abbreviations BN = bulimia nervosa EDNOS-BN = BN-type eating disorder not otherwise specified HC = healthy control EDE = Eating Disorder Examination EDE-Q = EDE Questionnaire MBW = median body weight IQ = intelligence quotient WCST = Wisconsin Card Sorting Test