Browsing by Subject "kognitiivinen joustavuus"

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.

The aim of this paper is to provide an overview of the effects of stress on cognitive flexibility, based on selected recent research. Cognitive flexibility can be defined as the ability to flexibly take different points of view and avoid fixation on unsuitable solution attempts, and as such it is a very important part of human executive functioning. Such a descriptive definition is not sufficiently detailed to be used in research, and thus researchers have used a very wide palette of different operationalizations to measure cognitive flexibility, varying from very simple task switching paradigms to rather open-ended word association tasks. This variation in the choice of methods can be a significant source of variation in the results. Stress is believed to favor a shift from top-down cognitive control to bottom-up processing, favoring automatic and reflexive responses over deliberate and flexible judgment. Generally, the evidence points towards impaired cognitive flexibility under stress, but there is considerable variation in the results. There is also some evidence that the effect of stress varies by gender, so that stress has a bigger impact on cognitive flexibility on men than on women, and in certain task even an opposite effect. Stress creates a rapid physiological response through sympathetic nervous system activation, but also a slower hormonal response. Majority of the research on the mediating mechanisms focuses on the slow hormonal pathway, and the correlation between cortisol response and impairment of cognitive flexibility is strong. On the other hand, with certain tasks the impairment of cognitive flexibility can be observed before the onset of the hormonal response. The impact of stress can be attenuated by blocking the physiological mechanisms with pharmacological means, but also by psychological interventions by reducing the perceived uncontrollability of the situation, and by promoting solution focused approach. The connection between stress and cognitive flexibility is not a widely studied research subject. This is apparent in the variability of the operationalizations being used, and correspondingly also in the variability of the research results. This makes it difficult to combine the results and form an unambiguous overall view, as the research does not share a uniform foundation. The differences in operationalizations, possible gender effects, and the temporal variation of physiological responses all contribute to the challenges. Thus, these are important factors to be considered in future studies. Creative decision making under stress would be an interesting research topic, which could have also major practical implications.