Skip to main content
×
Home
    • Aa
    • Aa

Central coherence in eating disorders: a systematic review

  • C. Lopez (a1), K. Tchanturia (a1), D. Stahl (a2) and J. Treasure (a3)
Abstract
Background

This review systematically appraised the research evidence for local versus global information processing to test the hypothesis that people with eating disorders (ED) had weak central coherence.

Method

Searches on Medline, EMBASE, PsycINFO and ISI Web of Science databases were conducted in November 2006 and subsequently updated in September 2007. Each search was conducted in two steps: (1) neuropsychological tasks measuring central coherence and (2) words related to cognitive functioning in eating disorders. Data were summarized in a meta-analysis if the number of studies for a given test was >5.

Results

Data were extracted from 16 studies. Meta-analyses were conducted for four tasks obtaining moderate effect sizes. The majority of studies found global processing difficulties across the ED spectrum. The results are less clear regarding local processing.

Conclusions

People with ED have difficulties in global processing. It is less certain as to whether they have superior local processing. Currently, there is insufficient evidence to refute the weak central coherence hypothesis.

Copyright
Corresponding author
*Address for correspondence: C. Lopez, Eating Disorders Research Unit, 5th Floor, Academic Psychiatry Department, Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK. (Email: carolina.lopez@iop.kcl.ac.uk)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

S Baron-Cohen , J Hammer (1997). Parents of children with Asperger syndrome: what is the cognitive phenotype? Journal of Cognitive Neuroscience 9, 548554.

HI Basseches , SA Karp (1984). Field dependence in young anorectic and obese women. Psychotherapy and Psychosomatics 41, 3337.

J Bayless , J Kanz , D Moser , B McDowell , W Bowers , A Andersen , J Paulsen (2002). Neuropsychological characteristics of patients in a hospital-based eating disorder program. Annals of Clinical Psychiatry 14, 203207.

CB Begg , M Mazumdar (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics 50, 10881101.

W Bowers (1994). Neuropsychological impairment among anorexia nervosa and bulimia patients. Eating Disorders: The Journal of Treatment and Prevention 2, 4246.

SJ Bradley , MJ Taylor , JF Rovet , E Goldberg , J Hood , R Wachsmuth , MP Azcue , PB Pencharz (1997). Assessment of brain function in adolescent anorexia nervosa before and after weight gain. Journal of Clinical and Experimental Neuropsychology 19, 2033.

CM Bulik , J Hebebrand , A Keski-Rahkonen , KL Klump , T Reichborn-Kjennerud , SE Mazzeo , TD Wade (2007). Genetic epidemiology, endophenotypes, and eating disorder classification. International Journal of Eating Disorders 40, S52S60.

JR Dura , RA Bornstein (1989). Differences between IQ and school achievement in anorexia nervosa. Journal of Clinical Psychology 45, 433435.

M Egger , GD Smith , M Schneider , C Minder (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal 315, 629634.

BK Flexer , JJ Roberge (1980). IQ, field dependence–independence, and the development of formal operational thought. Journal of General Psychology 103, 191201.

C Fox (1981). Neuropsychological correlates of anorexia nervosa. International Journal of Psychiatry in Medicine 11, 285290.

S Galderisi , A Mucci , P Monteleone , D Sorrentino , G Piegari , M Maj (2003). Neurocognitive functioning in subjects with eating disorders: the influence of neuroactive steroids. Biological Psychiatry 53, 921927.

I Gillberg , C Gillberg , M Rastam , M Johansson (1996). The cognitive profile of anorexia nervosa: a comparative study including a community-based sample. Comprehensive Psychiatry 37, 2330.

I Gillberg , M Rastam , E Wentz , C Gillberg (2007). Cognitive and executive functions in anorexia nervosa ten years after onset of eating disorder. Journal of Clinical and Experimental Neuropsychology 29, 170178.

DP Gordon , KA Halmi , PM Ippolito (1984). A comparison of the neuropsychological evaluation of adolescents with anorexia nervosa and of adolescents with conduct disorders. Journal of Adolescence 7, 245266.

K Hamsher , K Halmi , A Benton (1981). Prediction of outcome in anorexia nervosa from neuropsychological status. Psychiatry Research 4, 7988.

F Happé (1997). Central coherence and theory of mind in autism: reading homographs in context. British Journal of Developmental Psychology 15, 112.

F Happé , R Booth (2008). The power of the positive: revisiting weak coherence in autism spectrum disorders. Quarterly Journal of Experimental Psychology 61, 5063.

F Happé , J Briskman , U Frith (2001). Exploring the cognitive phenotype of autism: weak ‘central coherence’ in parents and siblings of children with autism. I. Experimental tests. Journal of Child Psychology and Psychiatry 42, 299307.

F Happé , U Frith (2006). The weak coherence account: detail-focused cognitive style in autism spectrum disorders. Journal of Autism and Developmental Disorders 36, 525.

JPT Higgins , SG Thompson , JJ Deeks , DG Altman (2003). Measuring inconsistency in meta-analyses. British Medical Journal 327, 557560.

J Holliday , K Tchanturia , S Landau , DA Collier , J Treasure (2005). Is impaired set-shifting an endophenotype of anorexia nervosa? American Journal of Psychiatry 162, 22692275.

J Kagan , B Rosman , D Day , J Albert , W Philips (1964). Information processing and the child: significance of analytic and reflective attitudes. Psychological Monographs 78, No. 578.

WH Kaye , AM Bastiani , H Moss (1995). Cognitive style of patients with anorexia nervosa and bulimia nervosa. International Journal of Eating Disorders 18, 287290.

A Key , A O'Brien , I Gordon , D Christie , B Lask (2006). Assessment of neurobiology in adults with anorexia nervosa. European Eating Disorders Review 14, 308314.

SM Lena , AJ Fiocco , JK Leyenaar (2004). The role of cognitive deficits in the development of eating disorders. Neuropsychological Review 14, 99113.

C Lopez , K Tchanturia , D Stahl , J Treasure (2008 b). Central coherence in women with bulimia nervosa. International Journal of Eating Disorders 41, 340347.

J Mathias , P Kent (1998). Neuropsychological consequences of extreme weight loss and dietary restriction in patients with anorexia nervosa. Journal of Clinical and Experimental Neuropsychology 20, 548564.

BD McDowell , DJ Moser , K Ferneyhough , WA Bowers , AE Andersen , JS Paulsen (2003). Cognitive impairment in anorexia is not due to depressed mood. International Journal of Eating Disorders 33, 351355.

EF McLaughlin , SA Karp , DB Herzog (1985). Sense of ineffectiveness in woman with eating disorders: a clinical study of anorexia nervosa and bulimia. International Journal of Eating Disorders 4, 511523.

R Murphy , DO Nutzinger , T Paul , B Leplow (2002). Dissociated conditional-associative learning in anorexia nervosa. Journal of Clinical and Experimental Neuropsychology 24, 176186.

R Murphy , DO Nutzinger , T Paul , B Leplow (2004). Conditional-associative learning in eating disorders: a comparison with OCD. Journal of Clinical and Experimental Neuropsychology 26, 190199.

B Pendleton Jones , C Duncan , P Brouwers , A Mirsky (1991). Cognition in eating disorders. Journal of Clinical and Experimental Neuropsychology 13, 711728.

JD Ranseen , LL Humphries (1992). The intellectual functioning of eating disorder patients. Journal of the American Academy of Child and Adolescent Psychiatry 31, 844846.

RJ Riding , F Pearson (1994). The relationship between cognitive style and intelligence. Educational Psychology 14, 413425.

CR Savage , L Baer , N Keuthen , HD Brown , SL Rauch , MA Jenike (1999). Organizational strategies mediate nonverbal memory impairment in obsessive-compulsive disorder. Biological Psychiatry 45, 905916.

U Schmidt , J Treasure (2006). Anorexia nervosa: valued and visible. A cognitive-interpersonal maintenance model and its implications for research and practice. British Journal of Clinical Psychology 45, 343366.

A Shah , U Frith (1993). Why do autistic individuals show superior performance on the block design task? Journal of Child Psychology and Psychiatry 34, 13511364.

BJ Sherman , CR Savage , KT Eddy , MA Blais , T Deckersbach , SC Jackson , DL Franko , SL Rauch , DB Herzog (2006). Strategic memory in adults with anorexia nervosa: are there similarities to obsessive compulsive spectrum disorders? International Journal of Eating Disorders 39, 468476.

A Small , J Madero , L Teagno , M Ebert (1983). Intellect, perceptual characteristics, and weight gain in anorexia nervosa. Journal of Clinical Psychology 39, 780782.

A Small , L Teagno , J Madero , H Gross , M Ebert (1982). A comparison of anorexics and schizophrenics on psychodiagnostic measures. International Journal of Eating Disorders 1, 4956.

JA Sours (1969). The anorexia nervosa syndrome: phenomenologic and psychodynamic components. Clinical heterogeneity in four cases. Psychiatric Quarterly 43, 240256.

GI Szmukler , D Andrewes , K Kingston , L Chen , R Stargatt , R Stanley (1992). Neuropsychological impairment in anorexia nervosa: before and after refeeding. Journal of Clinical and Experimental Neuropsychology 14, 347352.

K Tchanturia , R Morris , M Anderluh , D Collier , V Nikolaou , J Treasure (2004). Set shifting in anorexia nervosa: an examination before and after weight gain, in full recovery and relationship to childhood and adult OCPD traits. Journal of Psychiatric Research 38, 545552.

S Thompson (1993). Implications of neuropsychological test results of women in a new phase of anorexia nervosa. European Eating Disorders Review 1, 152165.

M Tokley , E Kemps (2007). Preoccupation with detail contributes to poor abstraction in anorexia nervosa. Journal of Clinical and Experimental Neuropsychology 29, 734741.

SW Touyz , PJV Beumont , LC Johnstone (1986). Neuropsychological correlates of dieting disorders. International Journal of Eating Disorders 5, 10251034.

J Treasure , C Lopez , M Roberts (2007). Endophenotypes in eating disorders: moving toward etiologically based diagnosis and treatment focused on pathophysiology. Pediatric Health 1, 171181.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords: