The profile of “hot” and “cool” executive functions in young women with anorexia and bulimia nervosa

Gałuszka, Kinga M.; Daniluk, Beata M. · 2023 · Crossref

DOI: 10.5114/nan.2023.129071

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Summary

This study investigates the profile of executive functions (EF) in young women diagnosed with anorexia nervosa (AN) and bulimia nervosa (BN), addressing inconsistent findings in previous literature regarding cognitive deficits in eating disorders. Motivated by the role of emotion in the psychopathology of these conditions, the authors utilized Zelazo’s distinction between “hot” EF (triggered by emotional or motivational tension) and “cool” EF (triggered in emotionally neutral contexts). The research aimed to determine if women with AN and BN exhibit cognitive rigidity, impaired planning, or decision-making difficulties compared to healthy controls, and whether deficits differ between hot and cool EF domains. The study included 34 women aged 18–31: a clinical group of 15 women with AN (n=8) or BN (n=7) and a control group of 19 healthy women. Participants were matched for age and education. EF was assessed using three neuropsychological tasks: the Tower of London (ToL) for planning, the Color Trails Test (CTT) for set-shifting and cognitive flexibility, and an experimental version of the Iowa Gambling Task (IGT) for decision-making under risk. General mental health was evaluated using the GHQ-28 questionnaire. Statistical analyses included t-tests, Mann-Whitney U tests, and ipsatization of results to identify specific deficits relative to the control group’s standard deviations. Results indicated a non-harmonic EF profile in the clinical group. While most between-group comparisons were not statistically significant, women with eating disorders performed significantly worse on the CTT interference index, indicating deficits in set-shifting ability (Cohen’s d = 0.77). Ipsatization revealed that the clinical group frequently exhibited difficulties in planning (measured by ToL moves) and set-shifting, whereas performance on tasks measuring processing speed (e.g., CTT completion times) was comparable to the healthy group. There were no significant differences between the AN and BN subgroups, nor between hot and cool EF domains within the clinical group. Additionally, no significant correlations were found between EF indicators and psychopathology scores. The findings suggest that women with AN and BN do not exhibit a uniform deficit across all executive functions but rather a specific impairment in cognitive flexibility and planning. The lack of distinction between hot and cool EF suggests that emotional context does not differentially impact executive performance in this sample. Understanding this specific cognitive profile may aid in developing targeted treatments that address the rigid thinking and inefficient planning characteristic of eating disorders, potentially improving therapeutic outcomes.

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• executive function