Table 2.
Main studies on the neuropsychology of bulimia nervosa and binge-eating disorder
| Authors | Journal | Sample | Mean age and sex | Tests | Follow-up | Results |
|---|---|---|---|---|---|---|
| Kaye et al54 | Int J Eat Disord | 9 AN, 7 BN | 22 AN, 19 BN Females |
MFFT | AN patients took a greater amount of time to respond after the sample stimulus item was presented. In contrast, the BN patients responded more quickly after the sample item was presented. AN were less impulsive than BN patients. | |
| Black et al61 | Int J Eat Disord | 16 BN, 29 C (RE and non-RE) | 23.8 BN (10 retested), 21.25 C Females |
Stroop | 2 weeks | The data failed to show any specificity in the Stroop effect. Nor did the test provide a useful measure of treatment response. |
| Cooper et al86 | Br J Clin Psychol | 12 AN, 12 BN, 18 C | Age NR Females |
Color naming Stroop |
Both patient groups showed attentional bias for eating and weight related words. Only AN patients showed attentional bias for body shape-related words. | |
| Ferraro et al55 | J Clin Psychol | 23 BN, 28 C | 18–41, NR | SDMT, FR, WCST, Eckman faces | Measures reflected marked impulsivity and problem-solving deficits in BN. | |
| Lovell et al62 | Br J Clin Psychol | 31 AN, 24 BN, 23 R-AN, 11 R-BN, 33 C | 25.48 AN, 26.92 BN, 29.30 R-AN, 34.36 R-BN, 24.72 C Females |
Color naming Stroop test | Women currently suffering from bulimia, and those who had recovered from anorexia were found to be more distracted by shape concerns than women who had never suffered eating disorders and women who had recovered from bulimia. | |
| Jones-Chesters et al63 | Int J Eat Disord | 32 BN, 16 C | 25.25 BN, 26.55 C Females |
“Emotional” Stroop task | Retesting after 6–8 days | In a mixed condition (mixture of word types in each block), patients took longer to color-name food/eating and weight/shape words than control words. With blocked presentation (with words from just one set in each block) this effect was magnified; and patients with bulimia nervosa also showed increased naming-latency for “emotion” words. |
| Rieger et al16 | Int J Eat Disord | 16 AN, 17 BN, 32 C | 20.9 AN, 23.9 BN, 20.3 C Females |
VPDT | ED patients detected target probes more slowly than C when they appeared in the same location as stimulus words connoting a thin physique. The contrary (faster detection) occurs with words connoting a large physique. | |
| Lauer et al18 | J Psychiatr Res | 12 AN, 14 BN | 19.7 AN, 21.9 BN Females |
LCT (d2), TMT, DTD, FPR, MVMT, RSPM, DLPST | 7 months | Initial testing, AN and BN showed similar impaired performance on attention and problem solving abilities. Their mnemonic functions were preserved. Both improved after treatment. |
| Steiger et al67 | Int J Eat Disord | 51 BN | 27.35 Females |
DAPP-BQ | Recording 8–22 days | Urge to binge was higher (on average) prior to eating binges than at comparable times on binge free days, and thus seemed to signal the potential for binge eating. |
| Carter et al64 | Int J Eat Disord | 98 BN | 17–45 Females |
Color naming Stroop test | 6 weeks | Patients processed information more quickly following treatment and that, overall, patients processed food/body words more slowly than control words, but processed color words even more slowly. |
| Esplen et al66 | Int J Eat Disord | 50 BN | 26.6 48 females |
SRS, A/E MS, BPI-IRS | A lower level of soothing receptivity (indicating a decreased capacity for self-soothing) was correlated with a decreased capacity for evocative memory. A lower level of soothing receptivity and decreased capacity for evocative memory were associated with a greater experience of aloneness. | |
| Murphy et al32 | J Clin Exp Neuropsychol | 16 AN, 16 BN, 16 C | 22.3 AN, 22 BN, 25.3 C Females |
MWT-B, WIP, BSRT, COWA, AHQ, Rey, SDMT, TMT, CAL | In the conditional-associative learning task, AN patients displayed an impaired performance with neutral material but not with individually threatening material. Such a deficit was not evident in BN or in C. | |
| Tchanturia et al36,78 | J Int Neuropsychol Soc | 34 AN, 19 BN, 35 C | 26.7 AN, 26.5 BN, 24.8 C NR |
NART-R, TMT, BT, PST, VFT, CBT, HIT | Anorectic patients show impairments on simple alternation and perceptual shift and bulimic patients show difficulties in mental flexibility and perceptual shift. | |
| Brand et al68 | Neuropsychology | 15 BN, 15 C | 21.86 BN, 21.64 Females |
GDT and NTB | On the GDT, patients with BN chose the disadvantageous alternatives more frequently than did C subjects. Performance on the GDT was related to executive functioning but not to other neuropsychological functions, personality, or disease-specific variables in the BN group. | |
| Mobbs et al57 | Eat Behav | 18 BN, 18 C | 25.11 BN, 24.28 C Females |
Go/no go affective shifting task | BN patients reacted faster than C in the task. BN patients showed poorer discrimination ability than C and inhibition problems (especially with targets related to food). | |
| Southgate et al38 | Psyciatr Res | 20 AN, 14 BN, 26 C | 26.80 AN, 25.71 BN, 27.27 C Females |
MFFT | AN patients scored significantly higher on the efficiency dimension score than the control group. | |
| Liao et al69 | J Clin Exp Neuropsychol | 29 AN, 26 BN, 51 C | 28.5 AN, 27.8 BN, 29.4 C Females |
IGT | BN patients performed poorly. | |
| Davis et al77 | Appetite | 65 obese patients with BED, 73 obese patients without BED, 71 C | 34.3 BED, 35.2 non-BED, 31.8 C Females |
IGT, DDT | BED and obese patients performed worse than C, but did not differ from each other. | |
| Guillaume et al45 | Neuropsychology | 49 AN, 38 BN, 83 C | 23.3 AN, 23 BN, 28 C Females |
NART, IGT | No significant differences in IGT performance were observed between patients and healthy controls, or between restrictive and purging types of anorexia nervosa. | |
| Kemps et al56 | J Clin Exp Neuropsychol | 13 BN, 13 C | 22.17 BN, 20.76 C Females |
Stroop, HSCT, MFFT, BIS-11 | BN patients displayed significant impairments on all inhibition measures and posited significantly higher impulsivity scores than the controls. | |
| Legenbauer et al65 | J Clin Psychol | 25 BN, 27 C | 23.88 BN, 24.74 C Females |
Recall and recognition rates of body related, food related and neutral TV commercials | Poorer recognition and recall of body related stimuli was found for BN in comparison to C, suggesting a memory bias. | |
| Brogan et al49 | J Int Neuropsychol Soc | 22 AN, 17 B, 18 Ob, 20 C | 29.09 AN, 29.94 BN, 52.11 Ob, 27.75 C Females |
IGT | The three clinical groups were significantly impaired on the IGT compared with the C group on both overall task performance and task learning; however, the three clinical groups were not significantly different from each other. | |
| Mobbs et al76 | Appetite | 16 obese patients with BED, 16, obese patients without BED, 16 C | 45.1, 39.3 and 40.2 respectively 34 females |
Mental flexibility task | Obese patients made more errors and more omissions than controls in both food and body sections of the task. Obese patients with BED made significantly more errors and omissions than those without BED. | |
| Cardi et al59 | World J Biol Psychiatry | 29 AN, 17 BN, 13 R-AN, 9 R-BN, 50 C | 27.3 ED, 29.5 ED-R, 25.3 C Females |
Dot probe task with faces (rejection or acceptance) | Patients with a lifetime diagnosis of ED showed an attentional bias to reject faces and a difficulty disengaging attention from these stimuli. | |
| Van den Eynde et al58 | J Clin Exp Neuropsychol | 40 BN, 30 EDNOS- BN, 65 C | 28.3 BN, 27.5 EDNOS-BN, 24 C | LCT (d2), Stroop and go/no go task, GDT | People with BN and EDNOS-BN performed as well as C on all tasks. Attention task performance was poorer in the EDNOS-BN than in the BN group. |
Abbreviations: A/E MS, aloneness/evocative memory scale; AHQ, Annett handedness questionnaire; AN, anorexia nervosa; BED, ; BIS-11, Barratt impulsiveness scale version 11; BN, bulimia nervosa; BPI-IRS, BPI, basic personality inventory; BSRT, Buschke’s selective reminding test; BT, Brixton test; C, control; CAL, conditional associative learning; CBT, cat bat task; COWA, controlled oral association test; DDT, delay discounting task; ED, eating disorders; ED-R, eating disorders recovered; EDNOS, eating disorders not otherwise specified; DAPP-BQ, dimensional assessment of personality pathology basic questionnaire; DLPST, daily living problem solving test; DTD, dual task design; FPR, free paragraph recall; FR, free recall; GDT, game of dice task; HIT, haptic illusion task; HSCT, Haylings sentence completion test; IGT, Iowa gambling task; LCT (d2), letter cancellation task (d2); MFFT, matching familiar figures test; MVMT, Munich verbal memory test; MWT-B, verbal intelligence; NART, National adult reading test; NART-R, National adult reading test (revised); NTB, neuropsychological test battery; PST, picture set test; RSPM, Raven standard progressive matrices test; SDMT, symbol digits modalities test; SRS, soothing receptivity scale; TMT, trail making test; VFT, verbal fluency task; VPDT, visual probe detection task; WCST, Wisconsin card sorting test; WIP, reduced version of the Wechsler adult intelligence scale.