Hostname: page-component-848d4c4894-jbqgn Total loading time: 0 Render date: 2024-06-17T03:35:54.516Z Has data issue: false hasContentIssue false

The inability to ignore: distractibility in women with restricting anorexia nervosa

Published online by Cambridge University Press:  29 February 2008

H. Dickson*
Affiliation:
Section of Eating Disorders, Psychological Medicine, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
S. Brooks
Affiliation:
Section of Eating Disorders, Psychological Medicine, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
R. Uher
Affiliation:
Section of Eating Disorders, Psychological Medicine, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
K. Tchanturia
Affiliation:
Section of Eating Disorders, Psychological Medicine, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
J. Treasure
Affiliation:
Section of Eating Disorders, Psychological Medicine, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
I. C. Campbell
Affiliation:
Section of Eating Disorders, Psychological Medicine, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
*
*Address for correspondence: H. Dickson, PO59, Eating Disorders Unit, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email: h.dickson@iop.kcl.ac.uk)

Abstract

Background

Attentional difficulties reported in individuals with anorexia nervosa (AN) may be due to preferential processing of disease-salient stimuli at a pre-attentive or at a conscious level or to a general problem in attention. Attentional difficulties may be associated with duration of illness.

Method

Female participants with AN (restricting subtype; n=24) and healthy comparison women (n=24) were randomly allocated to subliminal or supraliminal exposure to visual stimuli (food, neutral and aversive images) while performing the 1-back and 2-back working-memory tasks.

Results

Participants with AN made fewer errors than the healthy comparison group in the subliminal condition but significantly more errors in the supraliminal condition [condition×group interaction, F(1, 44)=6.82, p<0.01]: this was irrespective of stimulus type (food, neutral and aversive) and task (1-back or 2-back). The total number of errors made correlated positively with the duration of the AN for both the 1-back task (rs=0.46, p<0.05) and for the 2-back task (rs=0.53, p<0.01).

Conclusions

Decreased ability to concentrate in the presence of explicit distracters is a feature of AN and is associated with longer duration of illness. This phenomenon could be addressed in psychological interventions.

Type
Original Articles
Copyright
Copyright © 2008 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bayless, JD, Kanz, JE, Moser, DJ, McDowell, BD, Bowers, WA, Andersen, AE, Paulsen, JS (2002). Neuropsychological characteristics of patients in a hospital-based eating disorder programme. Annals of Clinical Psychiatry 14, 203207.CrossRefGoogle Scholar
Ben-Tovim, DI, Walker, MK (1991). Further evidence for the Stroop test as a quantitative measure of psychopathology in eating disorders. International Journal of Eating Disorders 10, 609613.3.0.CO;2-M>CrossRefGoogle Scholar
Ben-Tovim, DI, Walker, MK, Fok, D, Yap, E (1989). An adaption of the Stroop test for measuring shape and food concerns in eating disorders: a quantitative measure of psychopathology? International Journal of Eating Disorders 8, 681687.3.0.CO;2-#>CrossRefGoogle Scholar
Bryant-Waugh, R, Turner, H, East, P, Gamble, C (2007). Developing a parenting skills-and-support intervention for mothers with eating disorders and pre-school children. Part 1: qualitative investigation of issues to include. European Eating Disorders Review 15, 350356.CrossRefGoogle ScholarPubMed
Channon, S, Hemsley, D, Silva, P (1988). Selective processing of food words in anorexia nervosa. British Journal of Clinical Psychology 27, 259260.CrossRefGoogle ScholarPubMed
Cooper, MJ, Todd, G (1997). Selective processing of three types of stimuli in eating disorders. British Journal of Clinical Psychology 36, 279281.CrossRefGoogle ScholarPubMed
Delvenne, V, Lotstra, F, Goldman, S, Biver, F, De, M, Pelboom-Fondu, J, Schoutens, A, Bidaut, LM, Luxen, A, Mendelwicz, J (1995). Brain hypometabolism of glucose in anorexia nervosa: a PET scan study. Biological Psychiatry 37, 161169.CrossRefGoogle ScholarPubMed
Duchesne, M, Mattos, P, Fontenelle, LF, Veiga, H, Rizo, L, Appolinario, JC (2004). Neuropsychology of eating disorders: a systematic review of the literature [in Portuguese]. Revista Brasileira Psiquiatria 26, 107117.CrossRefGoogle ScholarPubMed
Eimer, M, Schlaghecken, F (2003). Response facilitation and inhibition in subliminal priming. Biological Psychology 64, 726.CrossRefGoogle ScholarPubMed
Esteves, F, Ohman, A (1993). Masking the face recognition of emotional facial expressions as a function of the parameters of backward masking. Scandinavian Journal of Psychology 34, 118.CrossRefGoogle ScholarPubMed
Fassino, S, Piero, A, Daga, GA, Leombruni, P, Mortara, P, Rovera, GG (2002). Attentional biases and frontal functioning in anorexia nervosa. International Journal of Eating Disorders 31, 247283.CrossRefGoogle ScholarPubMed
Ferro, AM, Brugnolo, A, De, LC, Dessi, B, Girtler, N, Morbelli, F, Rossi, DS, Falchero, M, Murialdo, G, Rossini, PM, Babiloni, C, Schizzi, R, Padolecchia, R, Rodriguez, G (2005). Stroop interference task and single-photon emission tomography in anorexia: a preliminary report. International Journal of Eating Disorders 38, 323329.CrossRefGoogle ScholarPubMed
First, MB, Gibbon, M, Spitzer, RL, Williams, J (2001). User's Guide for the Structured Clinical Interview for the Diagnosis for DSM-IV-R Axis I Disorders: Research Version. Biometrics Research: New York.Google Scholar
Fox, CF (1981). Neuropsychological correlates of anorexia nervosa. International Journal of Psychiatry in Medicine 11, 282290.Google ScholarPubMed
Green, MW, McKenna, KP (1993). Developmental onset of eating related colour-naming interference. International Journal of Eating Disorders 13, 391397.3.0.CO;2-U>CrossRefGoogle Scholar
Grice, DE, Halmi, KA, Fichter, MM, Strober, M, Woodside, DB, Treasure, JT, Kaplan, AS, Magistretti, PJ, Goldman, D, Bulik, CM, Kaye, WH, Berrenttini, WH (2002). Evidence for a susceptibility gene for anorexia nervosa on chromosome 1. American Journal of Human Genetics 70, 787792.CrossRefGoogle ScholarPubMed
Grunwald, M, Ettrich, C, Assman, B, Busse, F, Krause, W, Gertz, HJ (2001). Deficits in haptic perception and right parietal theta power changes in patients with anorexia nervosa before and after weight gain. International Journal of Eating Disorders 29, 417428.CrossRefGoogle ScholarPubMed
Hamsher, KD, Pieters, G, Eelen, P (1981). Prediction of outcome in anorexia nervosa from neuropsychological status. Psychiatry Research 4, 7988.CrossRefGoogle ScholarPubMed
Happe, F, Frith, U (2006). The Weak Coherence Account: detail-focused cognitive style in autism spectrum disorders. Journal of Autism and Developmental Disorders 36, 523.CrossRefGoogle ScholarPubMed
Herzog, DB, Field, AE, Martin, KB, West, JC, Robbins, WM, Staley, J, Colditz, GA (1996). Subtyping eating disorders: is it justified? Journal of the American Academy of Child and Adolescent Psychiatry 35, 928936.CrossRefGoogle ScholarPubMed
Johansson, L, Ghaderi, A, Andersson, A (2005). Stroop interference for food- and body-related words: a meta-analysis. Eating Behaviors 6, 271281.CrossRefGoogle ScholarPubMed
Katzman, DK, Christensen, B, Young, AR, Zipursky, RB (2001). Starving the brain: structural abnormalities and cognitive impairment in adolescents with anorexia nervosa. Seminars in Clinical Neuropsychiatry 6, 146152.CrossRefGoogle ScholarPubMed
Kaye, WH, Ebert, MH, Gwirstman, HE, Weiss, SR (1984). Differences in brain serotonergic metabolism between nonbulimic and bulimic patients with anorexia nervosa. American Journal of Psychiatry 141, 15981601.Google ScholarPubMed
Kerem, NC, Katzman, DK (2003). Brain structure and function in adolescents with anorexia nervosa. Adolescent Medicine 14, 109118.Google ScholarPubMed
Kingston, K, Szmuckler, G, Andrewes, D, Tress, B, Desmond, P (1996). Neuropsychological and structural brain changes in anorexia nervosa before and after refeeding. Psychological Medicine 26, 1528.CrossRefGoogle ScholarPubMed
Lang, PJ, Bradley, MM, Cuthbert, BN (1996). International Affective Picture System (IAPS). NIMH Center for the Study of Emotion and Affection: New York.Google Scholar
Lauer, CJ (2002). Neuropsychological findings in eating disorders. In Biological Psychiatry (ed. D'Haenen, H., den Booer, J. A. and Westenberg, H.), p. 1167. Wiley: Swansea, UK.CrossRefGoogle Scholar
Lauer, CJ, Gorzewski, B, Gerlinghoff, M, Backmund, H, Zihl, J (1999). Neuropsychological assessments before and after treatment in patients with anorexia nervosa and bulimia nervosa. Journal of Psychiatric Research 33, 129138.CrossRefGoogle ScholarPubMed
Long, CG, Hinton, C, Gillespie, NK (1994). Selective processing of food and body size words: application of the Stroop test with obese restrained eaters, anorexics and normals. International Journal of Eating Disorders 15, 279283.3.0.CO;2-2>CrossRefGoogle ScholarPubMed
Lopez, C, Tchanturia, K, Stahl, D, Booth, R, Holliday, J, Treasure, J (2007). An examination of the concept of central coherence in women with anorexia nervosa. International Journal of Eating Disorders. Published online: 15 October 2007. doi: 10.1002/eat.20478.Google Scholar
Murphy, ST, Zajonc, RB (1993). Affect, cognition and awareness: affective priming with optimal and suboptimal stimulus exposures. Journal of Personality and Social Psychology 64, 723739.CrossRefGoogle ScholarPubMed
Murphy, ST, Zajonc, RB, Monahan, JL (1995). Additivity of nonconscious affect: combined effects of priming and exposure. Journal of Personality and Social Psychology 69, 589602.CrossRefGoogle ScholarPubMed
Nelson, HE, Willison, JE (1991). The Revised National Adult Reading Test – Test Manual. NFER-Nelson: Windsor, UK.Google Scholar
Perpina, C, Hemsley, D, Treasure, J, De Silva, P (1993). Is the selective information processing of food and body words specific to patients with eating disorder? International Journal of Eating Disorders 14, 359366.3.0.CO;2-G>CrossRefGoogle Scholar
Pieters, G, Sabbe, B, Hulstijn, W, Probst, M, Vandereycken, W, Peuskens, J (2003). Fast psychomotor functioning in underweight anorexia nervosa patients. Journal of Psychiatric Research 37, 501508.CrossRefGoogle ScholarPubMed
Pratkanis, AR, Greenwald, AG (1988). Recent perspectives on unconscious processing: still no marketing applications. Psychology and Marketing 5, 337353.CrossRefGoogle Scholar
Ribases, M, Gratacos, M, Fernandez-Aranda, F, Bellodi, L, Boni, C, Anderluh, M, Cristina, CM, Cellini, E, Di, BD, Erzegovesi, S, Foulon, C, Gabrovsek, M, Gorwood, P, Hebebrand, J, Hinney, A, Holliday, J, Xu, X, Karwautz, A, Kipman, A, Komel, R, Nacmias, B, Remschmidt, H, Ricca, V, Sorbi, S, Tomori, M, Wagner, G, Treasure, J, Collier, DA, Estivill, X (2005). Association of BDNF with restricting anorexia nervosa and minimum body mass index: a family-based association study of eight European populations. European Journal of Human Genetics 13, 428434.CrossRefGoogle ScholarPubMed
Rieger, E, Schotte, DE, Touyz, SW, Beumont, PIV, Griffiths, R, Russell, J (1998). Attentional biases in eating disorders: a visual probe detection procedure. International Journal of Eating Disorders 23, 199205.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
Roberts, M, Tchanturia, K, Stahl, D, Southgate, L, Treasure, J (2007). A systematic review and meta-analysis of set shifting ability in eating disorders. Psychological Medicine 37, 10751084.CrossRefGoogle ScholarPubMed
Rovet, J, Bradley, S, Goldberg, E, Wachsmuth, R (1988). Lateralization in anorexia nervosa: a pilot study. Journal of Clinical and Experimental Neuropsychology 10, 24.Google Scholar
Sackville, T, Schotte, ED, Touyz, WS, Griffiths, R, Beumont, VJP (1998). Conscious and preconscious processing of food, body weight and shape, and emotion-related words in women with anorexia nervosa. International Journal of Eating Disorders 23, 7782.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
Shafran, R, Lee, M, Cooper, Z, Palmer, RL, Fairburn, CG (2007). Attentional bias in eating disorders. International Journal of Eating Disorders 40, 369380.CrossRefGoogle ScholarPubMed
Southgate, L, Tchanturia, K, Treasure, J (2005). Building a model of the aetiology of eating disorders by translating experimental neuroscience into clinical practice. Journal of Mental Health 14, 553566.CrossRefGoogle Scholar
Southgate, L, Tchanturia, K, Treasure, J (2007). Information processing bias in anorexia nervosa. Psychiatry Research. Published online: 2007. doi: 10.1016/j.psychres.2007.07.017.Google Scholar
Strober, M, Freeman, R, Morrell, W (1997). The long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse and outcome predictors over 10–15 years in a prospective study. International Journal of Eating Disorders 22, 339360.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
Tchanturia, K, Anderluh, MB, Morris, RG, Rabe-Hesketh, S, Collier, DA, Sanchez, P, Treasure, JL (2004). Cognitive flexibility in anorexia nervosa and bulimia nervosa. Journal of the International Neuropsychological Society 10, 513520.CrossRefGoogle ScholarPubMed
Tchanturia, K, Davies, H, Campbell, IC (2007). Cognitive remediation therapy for patients with anorexia nervosa: preliminary findings. Annals of General Psychiatry 6, 14.CrossRefGoogle ScholarPubMed
Tokley, M, Kemps, E (2007). Preoccupation with detail contributes to poor abstraction in anorexia nervosa. Journal of Clinical and Experimental Neuropsychology 29, 734741.CrossRefGoogle ScholarPubMed
Treasure, J, Schmidt, U (2005). The early phase of eating disorders. Journal of Mental Health 14, 535538.CrossRefGoogle Scholar
Treasure, J, Tchanturia, K, Schmidt, U (2005). Developing a model of the treatment for eating disorder: using neuroscience research to examine the how rather than the what of change. Counselling and Psychotherapy 5, 112.Google Scholar
Uher, R, Brammer, MJ, Murphy, T, Campbell, IC, Ng, VW, Williams, SC, Treasure, J (2003). Recovery and chronicity in anorexia nervosa: brain activity associated with differential outcomes. Biological Psychiatry 54, 934942.CrossRefGoogle ScholarPubMed
Uher, R, Murphy, T, Brammer, MJ, Dalgleish, T, Phillips, ML, Ng, VW, Andrew, CM, Williams, SC, Campbell, IC, Treasure, J (2004). Medial prefrontal cortex activity associated with symptom provocation in eating disorders. American Journal of Psychiatry 161, 12381246.CrossRefGoogle ScholarPubMed
Whalen, PJ, Rauch, SL, Etcoff, NL, Mclnerney, SC, Lee, MB, Jenike, MA (1998). Masked presentations of emotional facial expressions modulate amygdala without explicit knowledge. Journal of Neuroscience 18, 411418.CrossRefGoogle ScholarPubMed
Wilson, A, Wade, TD (2006). Executive functioning in anorexia nervosa: exploration of the role of obsessionality, depression and starvation. Journal of Psychiatric Research 40, 746754.CrossRefGoogle Scholar
Wykes, T, Reeder, C, Williams, C, Corner, J, Rice, C, Everitt, B (2003). Are the effects of cognitive remediation therapy (CRT) durable? Results from an exploratory trial in schizophrenia. Schizophrenia Research 61, 199207.CrossRefGoogle ScholarPubMed