Browsing by Author "Ketvel, Laila"

Abstract Objective. Cognitive flexibility is defined as the ability to properly adjust one’s behaviour to changing environmental demands. Research shows that in many psychiatric illnesses this ability is impaired compared to healthy controls. It is also known that the psychopathology of eating disorders includes rigid ways of functioning that resemble obsessive-compulsive behaviours. Furthermore, eating disorders have proved difficult to treat with traditional psychotherapy, which is thought to reflect the incapability to change one’s behaviour according to feedback. It has been proposed that eating disorder patients have poor cognitive flexibility, and this manifests in the symptoms and makes these mental illnesses difficult to treat. The purpose of this review is to examine the incidence of problems in cognitive flexibility tasks in eating disorder patients. Other research questions include the neural correlates of these problems, the direction of the causal relationship between cognitive rigidity and eating disorders, and the effectiveness of cognitive remediation therapy in eating disorder treatment. Methods. A search using the term ”eating disorders” in connection with the words ”cognitive flexibility”, ”set shifting”, ”neuropsychology”, ”neural correlates”, ”executive function” and ”cognitive remediation” was made using electronic databases. The databases used were Google Scholar, PubMed, Helka, Cochrane Library and PsychInfo. Results and conclusions. A considerable amount of evidence showed that eating disorder patients have difficulties in cognitive flexibility compared to healthy controls. This has been proposed as an explanation for the poor outcomes of eating disorder treatments. The neural functions of eating disorder patients also differed from those of healthy controls while performing cognitive flexibility tasks, which is thought to reflect the problem in cognitive processing and explain the lower than average scores. There are different theories regarding the direction of the causation between cognitive rigidity and the development of eating disorder pathology: some researchers think that problems in cognitive flexibility cause eating disorders, while others argue that the malnutrition associated with eating disorders precedes the cognitive deficit. Both theories had empirical support, and it seems that the process might be two-directional. There have been efforts to include cognitive remediation in the treatment of eating disorders in order to ameliorate both the cognitive deficit and the eating disorder symptoms. Research on the topic is still quite limited, but the initial results about combining traditional therapy with cognitive treatment seemed promising.