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Free AccessOriginal Article

Cognitive Flexibility in Juvenile Anorexia Nervosain Relation to Comorbid Symptoms of Depression, Obsessive Compulsive Symptoms and Duration of Illness

Published Online:December 12, 2016https://doi.org/10.1024/1422-4917/a000493

Abstract

Abstract.Objective: Whereas the evidence in adolescents is inconsistent, anorexia nervosa (AN) in adults is characterized by weak cognitive flexibility. This study investigates cognitive flexibility in adolescents with AN and its potential associations with symptoms of depression, obsessive compulsive disorder (OCD), and duration of illness. Methods: 69 patients and 63 age-matched healthy controls (HC) from 9 till 19 years of age were assessed using the Trail-Making Test (TMT) and self-report questionnaires. Results: In hierarchical regression analyses, set-shifting ability did not differ between AN and HC, whereas AN patients reported significantly higher rates of depression symptoms and OCD symptoms. Age significantly predicted set-shifting in the total sample. Only among AN patients aged 14 years and older did set-shifting decline with increasing age. Discussion: The presence of AN with depression or OCD symptoms or the duration of illness do not influence cognitive flexibility in children and adolescents. Early interventions may be helpful to prevent a decline in cognitive flexibility in adolescent AN with increasing age.


Kognitive Flexibilität bei Jugendlichen mit Anorexia Nervosa in Verbindung mit Depressivität, Zwanghaftigkeit und Erkrankungsdauer

Zusammenfassung.Fragestellung: Während sich bei Erwachsenen mit Anorexia Nervosa (AN) Einschränkungen der kognitiven Flexibilität zeigen, sind die Befunde bei Jugendlichen uneinheitlich. Ziel dieser Studie war eine Untersuchung der kognitiven Flexibilität bei Jugendlichen mit AN und der möglichen Zusammenhänge mit Symptomen von Depression und Zwanghaftigkeit sowie der Dauer der Erkrankung. Methodik: Insgesamt wurden 69 Patientinnen mit AN und 63 gesunde Kontrollprobandinnen im Alter von 9 bis 19 Jahren mittels des Trail-Making-Tests (TMT) und Selbstbeurteilungsfragebögen untersucht. Ergebnisse: In hierarchischen Regressionsanalysen ergaben sich keine Unterschiede in der kognitiven Flexibilität zwischen Patientinnen und Kontrollprobandinnen, wobei Erstere deutlich höhere Ausprägungen der Depressivität und Zwanghaftigkeit angaben. Das Alter war in der Gesamtgruppe ein signifikanter Prädiktor der kognitiven Flexibilität; bei Patientinnen ab 14 Jahren zeigte sich hingegen bei steigendem Alter eine sinkende kognitive Flexibilität. Schlussfolgerungen: Das Vorliegen einer AN mit Symptomen von Depressivität oder Zwanghaftigkeit sowie die Dauer der Erkrankung zeigen keinen Einfluss auf die kognitive Flexibilität. Um bei jugendlichen Patientinnen mit AN einer negativen Entwicklung der kognitiven Flexibilität vorzubeugen, sind möglicherweise frühe Interventionen hilfreich.

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