Neuropsychological Profiles in Patients With Restrictive or Binge/Purge Subtype Eating Disorders: A Continuum Approach

OBJECTIVE: Eating disorders (EDs) are associated with neuropsychological inefficiencies across diagnoses. A transdiagnostic approach may help clarify how neuropsychological factors contribute to ED psychopathology. This study aimed to investigate the neuropsychological profiles in patients with restrictive or binge/purge subtype of EDs.

METHODS: Sixty-nine patients with restrictive or binge/purge subtype of EDs participated. Neuropsychological functioning was assessed using a comprehensive battery of tests. Neuropsychological outcomes were compared between the two groups, and with normative scores. Multiple linear regression was used to investigate potential predictors of neuropsychological inefficiencies.

RESULTS: The subgroups displayed similar performance on most cognitive measures. Compared to normative scores inefficiencies related to central coherence, impulsivity, and self-reported executive functioning difficulties were observed in both groups. In addition, the restrictive subgroup demonstrated better set-shifting abilities, while the binge/purge subgroup excelled on a planning task. A significant association was found between depressive symptoms and self-reported executive function difficulties, but not with performance-based measures.

CONCLUSION: The findings suggest similar cognitive inefficiencies across ED subtypes. However, each group demonstrated some distinct cognitive strengths compared to normative scores. Findings underscore discrepancies between performance-based and self-reported executive functioning assessment, raising questions about ecological validity, and the distinctiveness of cognitive measures in this population.

TRAIL REGISTRATION: The current study utilises baseline data from a randomised controlled trail (ClinicalTrials.gov Id: NCT03808467).