Author:
Mora-Maltas Bernat,Lucas Ignacio,Granero Roser,Vintró-Alcaraz Cristina,Miranda-Olivos Romina,Baenas Isabel,Sánchez Isabel,Jiménez-del Toro Jessica,Sánchez-González Jéssica,Krug Isabel,Tapia Javier,Jiménez-Murcia Susana,Fernández-Aranda Fernando
Abstract
Abstract
Background
The severity criteria for eating disorders (EDs) proposed in the DSM-5 have been established without sufficient empirical support. Drive for thinness (DT) and duration of illness have been proposed as two alternative severity measures, however their empirical evidence is also limited. To date, no research has assessed the validity of current eating disorder (ED) severity criteria regarding cognitive flexibility factors. Cognitive flexibility is often impaired in EDs, becoming a possible severity symptom. The current study assessed for the first time (1) whether the severity indexes for EDs proposed in the DSM-5 were associated with deficits in cognitive flexibility and, (2) whether drive for thinness and illness duration, acted as an alternative, more meaningful severity indices for deficiencies in cognitive flexibility.
Methods
Participants were 161 patients diagnosed with an ED, who were categorized according to DSM-5 severity categories, DT and duration of illness. Discriminative capacity of each classification was assessed for cognitive flexibility measured by Wisconsin card sorting test (WCST).
Results
The findings for the DSM-5 classification comprised: (a) In the anorexia nervosa (AN) group, patients with moderate severity showed better scores in WCST than patients with mild and severe/extreme severity. Also, patients with moderate severity showed lower percentage of cognitive flexibility deficits than the other two severity categories; (b) For the binge spectrum disorders (BSD) group, the patients with mild severity showed a higher percentage of cognitive flexibility deficits than did the moderate and severe/extreme categories. When assessing the alternative severity index of DT, no differences were found in cognitive flexibility in any of the groups. Regarding illness duration, in the AN group the task performance of the patients with longer illness duration was worse than the performance of the short duration group and, in the BSD group, patients with longer duration also showed more deficits in cognitive flexibility than the patients with shorter duration of illness.
Conclusions
Our findings point out the limitations of the DSM-5 severity criteria to categorize cognitive flexibility in EDs and support illness duration as an alternative severity approach for EDs.
Funder
Ministerio de Ciencia e Innovación
Institució Catalana de Recerca i Estudis Avançats
Plan Nacional sobre Drogas
Centres de Recerca de Catalunya
Instituto de Salud Carlos III
Departament de Salut, Generalitat de Catalunya
European Regional Development Fund
H2020 Societal Challenges
Publisher
Springer Science and Business Media LLC
Subject
Behavioral Neuroscience,Psychiatry and Mental health,Nutrition and Dietetics
Cited by
2 articles.
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