Neurocognitive functioning in adolescents with eating disorders: A population-based study

Abstract

Introduction

Neurocognitive deficits have been identified in eating disorders, including anorexia nervosa and bulimia nervosa. However, current data do not allow for firm conclusions regarding the nature or extent of these deficits. The current study aimed to evaluate neurocognitive functioning in a population-based sample of adolescents with and without eating disorders.

Methods

Participants (N=669) were drawn from the Western Australian Pregnancy Cohort (Raine) Study. Cognitive testing was conducted using the computerised CogState assessment battery. Eating disorder symptoms were assessed using questions adapted from the Child Eating Disorder Examination and Eating Disorder Examination–Questionnaire. Adolescents who met full or partial criteria for a DSM-IV eating disorder (n=58) were compared to adolescents with no significant eating pathology (n=592).

Results

The eating disorder sample showed impaired performance on measures of executive functioning, including global processing and set shifting, but performed better than control participants on measures of visual attention and vigilance.

Conclusions

This is the first study to evaluate neurocognitive functioning in a population-based sample of adolescents with eating disorders. Support is provided for weak central coherence and set-shifting difficulties early in the course of eating disorders. Research is needed to determine if these deficits precede and predict eating disorder onset.

Keywords:

• Central coherence
• Eating disorders
• Neurocognitive functioning
• Raine Study
• Set shifting

We are extremely grateful to all the families who took part in this study; to the whole Raine Study team (which includes data collectors, cohort managers, data managers, clerical staff, research scientists, and volunteers); to the National Health and Medical Research Council of Australia (NHMRC) for their long-term contribution to funding the study; and to the Telethon Institute for Child Health Research for their long-term support of the study. We are especially grateful to the TICHR Developmental Neuroscience Group, including Michael Smith, and to CogState personnel who facilitated cognitive data collection and analysis (data originally collected for a complementary study). KLA is supported by an early career fellowship from the NHMRC. The Western Australian Pregnancy Cohort (Raine) Study is funded by the NHMRC, the Raine Medical Research Foundation, the University of Western Australia (and particularly the Faculty of Medicine, Dentistry and Health Sciences), Curtin University, the Telethon Institute for Child Health Research, and the Women and Infants Research Foundation. Specific funding for CogState assessment was provided by NHMRC Grant 458623 and additional funding for the 17-year Raine Study follow-up was provided by NHMRC Grant 353514.