Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-19T09:50:00.008Z Has data issue: false hasContentIssue false

The neuropsychological profile of children at high risk of developing an eating disorder

Published online by Cambridge University Press:  01 October 2012

R. Kothari*
Affiliation:
Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, UK
F. Solmi
Affiliation:
Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, UK
J. Treasure
Affiliation:
Institute of Psychiatry, King's College London, UK
N. Micali
Affiliation:
Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, UK
*
*Address for correspondence: Miss R. Kothari, Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK. (Email: [email protected])

Abstract

Background

There is a large body of evidence indicating that eating disorders (EDs) are characterized by particular neuropsychological profiles. We aimed to further explore whether impairments in neuropsychological functioning previously found in ED groups are present prior to onset, or are secondary to the disorder.

Method

This is the first study to explore neuropsychological functioning in children born to a mother with a lifetime ED, who are therefore at high risk of developing an ED, in a large cohort sample. We investigated intelligence and attention at age 8 years (n = 6201) and working memory (WM) and inhibition at age 10 years (6192) in children who are at high risk of developing an ED, compared to children who are not.

Results

The children of women with lifetime anorexia nervosa (AN) showed high full-scale and performance IQ, increased WM capacity, better visuo-spatial functioning, and decreased attentional control. The children of women with lifetime bulimia nervosa (BN) showed comparatively poor visuo-spatial functioning.

Conclusions

Our findings suggest that high intelligence, increased WM capacity and impaired attentional control might be intermediate phenotypes on the pathway between genetic vulnerability and the development of an ED.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Altman, SE, Shankman, SA (2009). What is the association between obsessive-compulsive disorder and eating disorders? Clinical Psychology Review 29, 638646.CrossRefGoogle ScholarPubMed
Bellodi, L, Cavallini, MC, Bertelli, S, Chiapparino, D, Riboldi, C, Smeraldi, E (2001). Morbidity risk for obsessive-compulsive spectrum disorders in first-degree relatives of patients with eating disorders. American Journal of Psychiatry 158, 563569.CrossRefGoogle ScholarPubMed
Ben-Dor, DH, Laufer, N, Apter, A, Frisch, A, Weizman, A (2002). Heritability, genetics and association findings in anorexia nervosa. Israel Journal of Psychiatry and Related Sciences 39, 262270.Google ScholarPubMed
Byrne, M, Hodges, A, Grant, E, Owens, DC, Johnstone, EC (1999). Neuropsychological assessment of young people at high genetic risk for developing schizophrenia compared with controls: preliminary findings of the Edinburgh High Risk Study (EHRS). Psychological Medicine 29, 11611173.CrossRefGoogle ScholarPubMed
Case, R, Kurland, DM, Goldberg, J (1982). Operational efficiency and the growth of short-term memory span. Journal of Experimental Child Psychology 33, 386404.CrossRefGoogle Scholar
Chamberlain, SR, Fineberg, NA, Blackwell, AD, Robbins, TW, Sahakian, BJ (2006). Motor inhibition and cognitive flexibility in obsessive-compulsive disorder and trichotillomania. American Journal of Psychiatry 163, 12821284.CrossRefGoogle ScholarPubMed
Chamberlain, SR, Fineberg, NA, Menzies, LA, Blackwell, AD, Bullmore, ET, Robbins, TW, Sahakian, BJ (2007). Impaired cognitive flexibility and motor inhibition in unaffected first-degree relatives of patients with obsessive-compulsive disorder. American Journal of Psychiatry 164, 335338.CrossRefGoogle ScholarPubMed
Claes, L, Robinson, MD, Muehlenkamp, JJ, Vandereycken, W, Bijttebier, P (2010). Differentiating bingeing/purging and restrictive eating disorder subtypes: the roles of temperament, effortful control, and cognitive control. Personality and Individual Differences 48, 166170.CrossRefGoogle Scholar
Cosway, R, Byrne, M, Clafferty, R, Hodges, A, Grant, E, Abukmeil, SS, Lawrie, SM, Miller, P, Johnstone, EC (2000). Neuropsychological change in young people at high risk for schizophrenia: results from the first two neuropsychological assessments of the Edinburgh High Risk Study. Psychological Medicine 30, 11111121.CrossRefGoogle ScholarPubMed
Dobson, KS, Dozois, DJA (2004). Attentional biases in eating disorders: a meta-analytic review of Stroop performance. Clinical Psychology Review 23, 10011022.CrossRefGoogle ScholarPubMed
Field, AE, Camargo, CA, Taylor, CB, Berkey, CS, Roberts, SB, Colditz, GA (2001). Peer, parent, and media influences on the development of weight concerns and frequent dieting among preadolescent and adolescent girls and boys. Pediatrics 107, 5460.CrossRefGoogle ScholarPubMed
Field, AE, Javaras, KM, Aneja, P, Kitos, N, Camargo, CA, Taylor, CB, Laird, NM (2008). Family, peer, and media predictors of becoming eating disordered. Archives of Pediatrics and Adolescent Medicine 162, 574579.CrossRefGoogle ScholarPubMed
Galderisi, S, Bucci, P, Mucci, A, Bellodi, L, Cassano, GB, Santonastaso, P, Erzegovesi, S, Favaro, A, Mauri, M, Monteleone, P, Maj, M (2011). Neurocognitive functioning in bulimia nervosa: the role of neuroendocrine, personality and clinical aspects. Psychological Medicine 41, 839848.CrossRefGoogle ScholarPubMed
Galimberti, E, Martoni, RM, Cavallini, MC, Erzegovesi, S, Bellodi, L (2012). Motor inhibition and cognitive flexibility in eating disorder subtypes. Progress in Neuro-Psychopharmacology and Biological Psychiatry 36, 307312.CrossRefGoogle ScholarPubMed
Gillberg, I, Rastam, M, Wentz, E, Gillberg, C (2007). Cognitive and executive functions in anorexia nervosa ten years after onset of eating disorder. Journal of Clinical and Experimental Neuropsychology 29, 170178.CrossRefGoogle ScholarPubMed
Golding, J (2004). The Avon Longitudinal Study of Parents and Children (ALSPAC) – study design and collaborative opportunities. European Journal of Endocrinology 151, U119U123.CrossRefGoogle ScholarPubMed
Green, MW, Rogers, PJ (1998). Impairments in working memory associated with spontaneous dieting behaviour. Psychological Medicine 28, 10631070.CrossRefGoogle ScholarPubMed
Handley, SJ, Capon, A, Beveridge, M, Dennis, I, Evans, JSBT (2004). Working memory, inhibitory control and the development of children's reasoning. Thinking and Reasoning 10, 175195.CrossRefGoogle Scholar
Holland, AJ, Sicotte, N, Treasure, J (1988). Anorexia nervosa: evidence for a genetic basis. Journal of Psychosomatic Research 32, 561571.CrossRefGoogle ScholarPubMed
Holliday, J, Tchanturia, K, Landau, S, Collier, D, Treasure, J (2005). Is impaired set-shifting an endophenotype of anorexia nervosa? American Journal of Psychiatry 162, 22692275.CrossRefGoogle ScholarPubMed
Jones, BP, Duncan, CC, Brouwers, P, Mirsky, AF (1991). Cognition in eating disorders. Journal of Clinical and Experimental Neuropsychology 13, 711728.CrossRefGoogle ScholarPubMed
Keefe, RS (1995). The contribution of neuropsychology to psychiatry. American Journal of Psychiatry 152, 615.Google ScholarPubMed
Kemps, E, Tiggemann, M, Wade, T, Ben-Tovim, D, Breyer, R (2006). Selective working memory deficits in anorexia nervosa. European Eating Disorders Review 14, 97103.CrossRefGoogle Scholar
Kemps, E, Wilsdon, A (2009). Preliminary evidence for a role for impulsivity in cognitive disinhibition in bulimia nervosa. Journal of Clinical and Experimental Neuropsychology 32, 515521.CrossRefGoogle Scholar
Keski-Rahkonen, A, Sihvola, E, Raevuori, A, Kaukoranta, J, BuliK, CM, Hoek, HW, Rissanen, A, Kaprio, J (2006). Reliability of self-reported eating disorders: optimizing population screening. International Journal of Eating Disorders 39, 754762.CrossRefGoogle ScholarPubMed
Lask, B, Gordon, I, Christie, D, Frampton, I, Chowdhury, U, Watkins, B (2005). Functional neuroimaging in early-onset anorexia nervosa. International Journal of Eating Disorders 37, S49S51.CrossRefGoogle ScholarPubMed
Lee, SW, Stewart, SM, Striegel-Moore, RH, Lee, S, Ho, S-Y, Lee, PWH, Katzman, MA, Lam, T-H (2007). Validation of the eating disorder diagnostic scale for use with Hong Kong adolescents. International Journal of Eating Disorders 40, 569574.CrossRefGoogle ScholarPubMed
Lena, SM, Fiocco, AJ, Leyenaar, JK (2004). The role of cognitive deficits in the development of eating disorders. Neuropsychology Review 14, 99113.CrossRefGoogle ScholarPubMed
Lilenfeld, LR, Kaye, WH, Greeno, CG, Merikangas, KR, Plotnicov, K, Pollice, C, Rao, R, Strober, M, Bulik, CM, Nagy, L (1998). A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity. Archives of General Psychiatry 55, 603610.CrossRefGoogle ScholarPubMed
Logan, GD (1994). On the ability to inhibit thought and action: a users' guide to the stop signal paradigm. In Inhibitory Processes in Attention, Memory, and Language (ed. Dagenbach, D. and Carr, T. H.), pp. 189240. Academic Press: London.Google Scholar
Lopez, C, Stahl, D, Tchanturia, K (2010). Estimated intelligence quotient in anorexia nervosa: a systematic review and meta-analysis of the literature. Annals of General Psychiatry 9, 40.CrossRefGoogle ScholarPubMed
Lopez, C, Tchanturia, K, Stahl, D, Booth, R, Holliday, J, Treasure, J (2008 a). An examination of the concept of central coherence in women with anorexia nervosa. International Journal of Eating Disorders 41, 143152.CrossRefGoogle ScholarPubMed
Lopez, C, Tchanturia, K, Stahl, D, Treasure, J (2008 b). Central coherence in eating disorders: a systematic review. Psychological Medicine 38, 13931404.CrossRefGoogle ScholarPubMed
Manly, T, Anderson, V, Nimmo-Smith, I, Turner, A, Watson, P, Robertson, IH (2001). The differential assessment of children's attention: the Test of Everyday Attention for Children (TEA-Ch), normative sample and ADHD performance. Journal of Child Psychology and Psychiatry, and Allied Disciplines 42, 10651081.CrossRefGoogle ScholarPubMed
Micali, N, Simonoff, E, Treasure, J (2007 a). Risk of major adverse perinatal outcomes in women with eating disorders. British Journal of Psychiatry 190, 255259.CrossRefGoogle ScholarPubMed
Micali, N, Treasure, J, Simonoff, E (2007 b). Eating disorders symptoms in pregnancy: a longitudinal study of women with recent and past eating disorders and obesity. Journal of Psychosomatic Research 63, 297303.CrossRefGoogle ScholarPubMed
Ohrmann, P, Kersting, A, Suslow, T, Lalee-Mentzel, J, Donges, US, Fiebich, M, Arolt, V, Heindel, W, Pfleiderer, B (2004). Proton magnetic resonance spectroscopy in anorexia nervosa: correlations with cognition. NeuroReport 15, 549553.CrossRefGoogle ScholarPubMed
Patel, P, Wheatcroft, R, Park, RJ, Stein, A (2002). The children of mothers with eating disorders. Clinical Child and Family Psychology Review 5, 119.CrossRefGoogle ScholarPubMed
Pieters, G, Sabbe, B, Hulstijn, W, Probst, M, Vandereycken, W, Peuskens, J (2003). Fast psychomotor functioning in underweight anorexia nervosa patients. Journal of Psychiatric Research 37, 501508.CrossRefGoogle ScholarPubMed
Ranseen, JD, Humphries, LL (1992). The intellectual functioning of eating disorder patients. Journal of the American Academy of Child and Adolescent Psychiatry 31, 844846.CrossRefGoogle ScholarPubMed
Rasetti, R, Weinberger, DR (2011). Intermediate phenotypes in psychiatric disorders. Current Opinion in Genetics and Development 21, 340348.CrossRefGoogle ScholarPubMed
Roberts, ME, Tchanturia, K, Treasure, JL (2011). Exploring the neurocognitive signature of poor set-shifting in anorexia and bulimia nervosa. Journal of Psychiatric Research 44, 964970.CrossRefGoogle Scholar
Rosval, L, Steiger, H, Bruce, K, Israel, M, Richardson, J, Aubut, M (2006). Impulsivity in women with eating disorders: problem of response inhibition, planning, or attention? International Journal of Eating Disorders 39, 590593.CrossRefGoogle ScholarPubMed
Southgate, L (2005). Response inhibition in anorexia nervosa and bulimia nervosa: an exploration of neuropsychological functions and their association with personality traits and behaviours. PhD thesis, Institute of Psychiatry, King's College London.Google Scholar
Strober, M, Freeman, R, Lampert, C, Diamond, J, Kaye, W (2000). Controlled family study of anorexia nervosa and bulimia nervosa: evidence of shared liability and transmission of partial syndromes. American Journal of Psychiatry 157, 393401.CrossRefGoogle ScholarPubMed
Strober, M, Lampert, C, Morrell, W, Burroughs, J, Jacobs, C (1990). A controlled family study of anorexia nervosa: evidence of familial aggregation and lack of shared transmission with affective disorders. International Journal of Eating Disorders 9, 239253.3.0.CO;2-7>CrossRefGoogle Scholar
Tchanturia, K (2012). Poor cognitive flexibility in eating disorders: examining the evidence using the Wisconsin Card Sorting Task. PLoS ONE 7, e28331.CrossRefGoogle ScholarPubMed
Tchanturia, K, Harrison, A, Davies, H, Roberts, M, Oldershaw, A, Nakazato, M, Stahl, D, Morris, R, Schmidt, U, Treasure, J (2011). Cognitive flexibility and clinical severity in eating disorders. PLoS ONE 6, e20462.CrossRefGoogle ScholarPubMed
Thompson, JK, Spana, RE (1991). Visuospatial ability, accuracy of size estimation, and bulimic disturbance in noneating-disordered college sample: a neuropsychological analysis. Perceptual and Motor Skills 73, 335338.CrossRefGoogle Scholar
van Soelen, ILC (2011). Heritability of verbal and performance intelligence in a pediatric longitudinal sample. Twin Research and Human Genetics 14, 119128.CrossRefGoogle Scholar
Wechsler, D, Golombok, S, Rust, J (1992). WISC-III UK: Wechsler Intelligence Scale for Children – Third Edition UK Manual.Google Scholar
Williams, BR, Ponesse, JS, Schachar, RJ, Logan, GD, Tannock, R (1999). Development of inhibitory control across the life span. Developmental Psychology 35, 205213.CrossRefGoogle ScholarPubMed
Zakzanis, KK, Campbell, Z, Polsinelli, A (2010). Quantitative evidence for distinct cognitive impairment in anorexia nervosa and bulimia nervosa. Journal of Neuropsychology 4, 89106.CrossRefGoogle ScholarPubMed
Supplementary material: File

Kothari et al. supplementary material

Supplementary tables

Download Kothari et al. supplementary material(File)
File 36.4 KB