Contribution of executive functions to eating behaviours in obesity and eating disorders.

BACKGROUND: Patients with eating disorders (ED) or obesity show difficulties in tasks assessing decision-making, set-shifting abilities and central coherence. AIMS: The aim of this study was to explore executive functions in eating and weight-related problems, ranging from restricting types of ED to obesity. METHOD: Two hundred and eighty-eight female participants (75 with obesity; 149 with ED: 76 with restrictive eating, 73 with bingeing-purging symptoms; and 64 healthy controls) were administered the Wisconsin Card Sorting Test, the Iowa Gambling Task, and the Group Embedded Figures Test to assess set-shifting, decision-making and central coherence, respectively. RESULTS: Participants with either obesity or ED performed poorly on tests measuring executive functioning compared with healthy controls, even after controlling for age and intelligence. Both participants with obesity and participants with ED showed a preference for global information processing. CONCLUSIONS: The findings suggest that treatments for obesity and ED would benefit from addressing difficulties in cognitive functioning, in addition to the more evident clinical symptoms related to eating, body weight and shape.

Funciones ejecutivas y regulación emocional en obesidad y trastornos alimentarios.

INTRODUCTION: Introduction: eating disorders (ED) such as anorexia nervosa (AN) or bulimia nervosa (BN), as well as obesity (OB), are related to emotional and neuropsychological impairments on measures of cognitive flexibility, central coherence or decision making. However, little is known about the association among emotional regulation, neuropsychological variables and affect. Objectives: to analyze whether neuropsychological and affect variables can predict emotional regulation in ED and in OB. Methods: thirty females with restricting ED (restricting AN) were assessed, 18 with purging ED (purging AN and BN), 33 with OB and 39 healthy controls matched for intelligence. The Wisconsin Card Sorting Test (WCST) assessed cognitive flexibility, the Group Embedded Figures Test (GEFT) assessed central coherence, the Iowa Gambling Task (IGT) assessed decision making, the Positive and Negative Affect Schedule assessed positive (PANAS-PA) and negative (PANAS-NA) affect, and the Difficulties in Emotion Regulation Scale (DERS) assessed emotional regulation. Results: relative to the healthy control group, ED and OB groups performed worse on IGT (p = 0.002) and GEFT (p = 0.003), had lower scores on PANAS-PA (p = 0.001) and higher scores on DERS (p < 0.001). ED groups had higher scores on PANAS-NA tan both OB and healthy controls (p = 0.001). PANAS-PA, PANAS-NA and IGT accounted for 51.4% of the variance of the DERS (p < 0.001). Conclusions: our study shows a significant association between decision making, affect and emotional regulation in the continuum from AN to OB, and also highlights the importance of including programs focused on decision making and affect in cognitive interventions for ED and OB.

INTRODUCCIÓN: Introducción: los trastornos de la conducta alimentaria (TCA) como la anorexia nerviosa (AN) o la bulimia nerviosa (BN), así como la obesidad (OB), se relacionan con alteraciones neuropsicológicas en flexibilidad cognitiva, coherencia central, toma de decisiones y alteraciones emocionales. Sin embargo, se desconoce la asociación entre regulación emocional, variables neuropsicológicas y variables de afecto. Objetivos: analizar si variables neuropsicológicas y afectivas pueden predecir la regulación emocional en los TCA y en la OB. Métodos: se evaluó a 30 mujeres con TCA restrictivo (AN restrictiva), 18 con TCA purgativo (AN purgativa y BN), 33 OB y 39 controles sanas emparejadas por nivel intelectual. El Wisconsin Card Sorting Test (WCST) evaluó la flexibilidad cognitiva; el Group Embedded Figures Test (GEFT), la coherencia central; el Iowa Gambling Task (IGT), la toma de decisiones; el Positive and Negative Affect Schedule, el afecto positivo (PANAS-PA) y negativo (PANAS-NA); y la Difficulties in Emotion Regulation Scale (DERS), la regulación emocional. Resultados: respecto al grupo control, los grupos TCA y OB rindieron peor en IGT (p = 0,002) y GEFT (p = 0,003) y presentaron menores puntuaciones en PANAS-PA (p = 0,001) y mayores en DERS (p < 0,001). Los grupos TCA puntuaron más alto en PANAS-NA que los grupos OB y control (p = 0,001). El 51,4% de la varianza del DERS fue explicado por PANAS-PA, PANAS-NA e IGT (p < 0,001). Conclusiones: nuestro estudio muestra una asociación entre toma de decisiones y afecto con regulación emocional en el continuo de AN a OB e indica la importancia de incluir programas de toma de decisiones y afecto en las intervenciones cognitivas para TCA y para OB.

Executive functions and emotion regulation in obesity and eating disorders / Funciones ejecutivas y regulación emocional en obesidad y trastornos alimentarios

Introduction: eating disorders (ED) such as anorexia nervosa (AN) or bulimia nervosa (BN), as well as obesity (OB), are related to emotional and neuropsychological impairments on measures of cognitive flexibility, central coherence or decision making. However, little is known about the association among emotional regulation, neuropsychological variables and affect. Objectives: to analyze whether neuropsychological and affect variables can predict emotional regulation in ED and in OB. Methods: thirty females with restricting ED (restricting AN) were assessed, 18 with purging ED (purging AN and BN), 33 with OB and 39 healthy controls matched for intelligence. The Wisconsin Card Sorting Test (WCST) assessed cognitive flexibility, the Group Embedded Figures Test (GEFT) assessed central coherence, the Iowa Gambling Task (IGT) assessed decision making, the Positive and Negative Affect Schedule assessed positive (PANAS-PA) and negative (PANAS-NA) affect, and the Diffi culties in Emotion Regulation Scale (DERS) assessed emotional regulation. Results: relative to the healthy control group, ED and OB groups performed worse on IGT (p = 0.002) and GEFT (p = 0.003), had lower scores on PANAS-PA (p = 0.001) and higher scores on DERS (p < 0.001). ED groups had higher scores on PANAS-NA tan both OB and healthy controls (p = 0.001). PANAS-PA, PANAS-NA and IGT accounted for 51.4% of the variance of the DERS (p < 0.001). Conclusions: our study shows a significant association between decision making, affect and emotional regulation in the continuum from AN to OB, and also highlights the importance of including programs focused on decision making and affect in cognitive interventions for ED and OB

Introducción: los trastornos de la conducta alimentaria (TCA) como la anorexia nerviosa (AN) o la bulimia nerviosa (BN), así como la obesidad (OB), se relacionan con alteraciones neuropsicológicas en flexibilidad cognitiva, coherencia central, toma de decisiones y alteraciones emocionales. Sin embargo, se desconoce la asociación entre regulación emocional, variables neuropsicológicas y variables de afecto. Objetivos: analizar si variables neuropsicológicas y afectivas pueden predecir la regulación emocional en los TCA y en la OB. Métodos: se evaluó a 30 mujeres con TCA restrictivo (AN restrictiva), 18 con TCA purgativo (AN purgativa y BN), 33 OB y 39 controles sanas emparejadas por nivel intelectual. El Wisconsin Card Sorting Test (WCST) evaluó la flexibilidad cognitiva; el Group Embedded Figures Test (GEFT), la coherencia central; el Iowa Gambling Task (IGT), la toma de decisiones; el Positive and Negative Affect Schedule, el afecto positivo (PANAS-PA) y negativo (PANAS-NA); y la Difficulties in Emotion Regulation Scale (DERS), la regulación emocional. Resultados: respecto al grupo control, los grupos TCA y OB rindieron peor en IGT (p = 0,002) y GEFT (p = 0,003) y presentaron menores puntuaciones en PANAS-PA (p = 0,001) y mayores en DERS (p < 0,001). Los grupos TCA puntuaron más alto en PANAS-NA que los grupos OB y control (p = 0,001). El 51,4% de la varianza del DERS fue explicado por PANAS-PA, PANAS-NA e IGT (p < 0,001). Conclusiones: nuestro estudio muestra una asociación entre toma de decisiones y afecto con regulación emocional en el continuo de AN a OB e indica la importancia de incluir programas de toma de decisiones y afecto en las intervenciones cognitivas para TCA y para OB