Cognitive flexibility and DSM-5 severity criteria for eating disorders: assessing drive for thinness and duration of illness as alternative severity variables

Journal of Eating Disorders

Research

Javier Tapia¹  Jessica Jiménez-del Toro²  Bernat Mora-Maltas²  Jéssica Sánchez-González²  Romina Miranda-Olivos³  Ignacio Lucas³  Isabel Sánchez³  Isabel Baenas³  Cristina Vintró-Alcaraz³  Fernando Fernández-Aranda⁴  Susana Jiménez-Murcia⁴  Isabel Krug⁵  Roser Granero⁶ 

[1] Clinical Psychology Unit, University Hospital Bellvitge and CIBERobn, Feixa Llarga s/n 08907 L’Hospitalet del Llobregat, Barcelona, Spain;Gerencia Territorial Metropolitana Sud. Hospital Universitari de Bellvitge, Barcelona, Spain;Clinical Psychology Unit, University Hospital Bellvitge and CIBERobn, Feixa Llarga s/n 08907 L’Hospitalet del Llobregat, Barcelona, Spain;Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain;Clinical Psychology Unit, University Hospital Bellvitge and CIBERobn, Feixa Llarga s/n 08907 L’Hospitalet del Llobregat, Barcelona, Spain;Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain;CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain;Clinical Psychology Unit, University Hospital Bellvitge and CIBERobn, Feixa Llarga s/n 08907 L’Hospitalet del Llobregat, Barcelona, Spain;Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain;CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain;Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain;Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia;Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain;CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain;Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain;

关键词: Eating disorders;    Neuropsychology;    DSM-5-TR;    Illness duration;    Severity ratings;   

DOI  :  10.1186/s40337-023-00875-z

 received in 2023-04-27, accepted in 2023-08-22,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe severity criteria for eating disorders (EDs) proposed in the DSM-5 have been established without sufficient empirical support. Drive for thinness (DT) and duration of illness have been proposed as two alternative severity measures, however their empirical evidence is also limited. To date, no research has assessed the validity of current eating disorder (ED) severity criteria regarding cognitive flexibility factors. Cognitive flexibility is often impaired in EDs, becoming a possible severity symptom. The current study assessed for the first time (1) whether the severity indexes for EDs proposed in the DSM-5 were associated with deficits in cognitive flexibility and, (2) whether drive for thinness and illness duration, acted as an alternative, more meaningful severity indices for deficiencies in cognitive flexibility.MethodsParticipants were 161 patients diagnosed with an ED, who were categorized according to DSM-5 severity categories, DT and duration of illness. Discriminative capacity of each classification was assessed for cognitive flexibility measured by Wisconsin card sorting test (WCST).ResultsThe findings for the DSM-5 classification comprised: (a) In the anorexia nervosa (AN) group, patients with moderate severity showed better scores in WCST than patients with mild and severe/extreme severity. Also, patients with moderate severity showed lower percentage of cognitive flexibility deficits than the other two severity categories; (b) For the binge spectrum disorders (BSD) group, the patients with mild severity showed a higher percentage of cognitive flexibility deficits than did the moderate and severe/extreme categories. When assessing the alternative severity index of DT, no differences were found in cognitive flexibility in any of the groups. Regarding illness duration, in the AN group the task performance of the patients with longer illness duration was worse than the performance of the short duration group and, in the BSD group, patients with longer duration also showed more deficits in cognitive flexibility than the patients with shorter duration of illness.ConclusionsOur findings point out the limitations of the DSM-5 severity criteria to categorize cognitive flexibility in EDs and support illness duration as an alternative severity approach for EDs.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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