Restrictive Anorexia Nervosa and Set-Shifting in Adolescents: A Biobehavioral Interface

Purpose: Set-shifting is a neurocognitive concept defined as the ability to switch tasks flexibly. Set-shifting scores are worse in adults with restrictive anorexia nervosa (AN-R) than in controls. Adolescence is a developmental period when young people must respond flexibly to new situations. The purpose of this study was to compare the set-shifting scores of 24 adolescent females with AN-R with 37 matched normal adolescent controls (ages, 14-20). Methods: Methods used for the study included sociodemographic, psychological, and biological data, and neurocognitive testing using the Behavior Rating of Executive Function - Self-and Parent-Reports, the Cambridge Neuropsychological Automated Battery, and the Wisconsin Card-Sorting Test. Statistical analyses included t-tests, multiple analysis of variance, and correlations. Results: Sociodemographic data and intelligence quotient of study and control subjects were similar. There were differences inbody mass index and the Eating Disorder Inventory-3evaluation. Significant differences in the composite score of set-shifting between the study and control groups were found using multiple analysis of variance. Conclusion: Adolescent females with AN-R had significantly worse set-shifting scores than the control subjects. Future studies of adolescent AN-R subjects should include biological (functional magnetic resonance imaging) and neurocognitive measures to determine the mechanisms at the brain-behavioral interface so that treatment can be directed specifically to set-shifting deficits. (C) 2011 Society for Adolescent Health and Medicine. All rights reserved.